Food Deserts: Are They a Public Health Problem?

BY AYA HAMLISH

East Tacoma residents are among the nearly 39.5 million Americans who live in low-income communities that do not have a supermarket (1). These communities are known as “food deserts”. The City of Tacoma has several programs that make healthy foods available to families in East Tacoma, but do these programs address the root causes of food deserts? Do they have an impact on the serious public health issues in these communities? While bringing healthy food to residents in low-income communities is important, that may not be enough. Limited transportation options, the time, effort, and knowledge required to prepare healthy meals, and the easy availability of inexpensive, fast foods are all problems that remain, even when healthy food is available. Healthy food, alone, is not enough.

A food desert is defined as a low-income, urban neighborhood with limited access to a variety of nutritious and affordable food. Communities designated as food deserts have higher rates of poor nutrition and long-term health problems, such as heart disease, stroke, Type 2 diabetes, high blood pressure, and cancer (2). The Tacoma-Pierce County Health Department found that 28% of adults in East Tacoma meet the criteria for obesity (3). The health of people in those communities makes the elimination of food deserts an urgent public health problem.

When Jean-Pierre Dubé investigated the “food desert hypothesis” he looked at the relationship between 1) the availability of healthy food, 2) the presence of large supermarkets, and 3) the price of the food (4). Dubé found that when a full-service supermarket was introduced into a food desert, there was no change in the healthfulness of the food purchased (4). He suggests that having a grocery store does not solve all the problems of a food desert. Other factors, including transportation, convenience, and cost, have an impact on peoples’ food choices.

People in low-income communities often rely on public transportation to get to jobs, schools, healthcare, and food. When public transportation is limited, it adds multiple barriers to eating healthy food. The PierceTransit System that serves East Tacoma is known for being unpredictable, with frequent delays and indirect routes that require transfers and additional waiting time (5). This means that people must set aside more time for grocery shopping and have to deal with waiting and transfers while carrying all of their groceries, including perishables. Dependable transportation is one of the key factors needed to address food deserts.

Convenience and cost are also major factors in food deserts. Food deserts often have a lot of options for fast food or processed food that is quick, easy, lower cost compared to healthy foods, and appealing because it is high in fats, salt, and sugars (6). While Dubé claims that people prefer these options, this is not what residents in East Tacoma have said (4). They make it clear that they are “hungry for healthy cooking options” but may not have the time, resources, and knowledge to prepare a healthy meal (7). East Ta- coma is a haven for fast-food joints and Quick-E-Marts (8). After a long day at work, who wouldn’t choose the easier and less expensive option to pick up fast food instead of the planning, shopping, and cooking (not to mention clean up) needed to prepare and serve a well-balanced, nutritious meal.

There are several programs in Tacoma working to address food deserts. Farmers markets, food pantries, and educational programs bring important healthy options, however, they do not get at the root causes of the food desert problem. The Eastside Farmers Market offers an abundant selection of fresh fruits and vegetables (9). The market makes healthy food accessible by accepting all types of payment, including EBT/SNAP, P-EBT, SNAP Market Match, WIC, and Senior Nutrition Vouchers (9). While the market is open from 3pm - 7pm, which makes it easier for people to shop after work, the market is only available one day per week, and for only three months out of the year (every Tuesday during June - Aug). During the rest of the year, East Tacoma residents do not have a nearby source of fresh produce.

Eloise’s Cooking Pot (ECP) Food Bank provides a drop-in site for anyone in need of food, and home delivery for the elderly or people who are disabled (10). The site is open six hours a day, five days a week, including Saturdays, which makes food more accessible than the limited times of the farmers’ market. However, there are eligibility requirements to access the food bank’s services and requires that people disclose their household income, which may discourage some from seeking help. ECP brings an important resource to the community, but still does not solve the root causes.

The Metro Parks Mobile Teaching Kitchen was created in order to deal with the transportation barriers that individuals/families face, and to teach families how to cook healthy meals on a budget (11). The truck travels to community gardens, neighborhoods, and community centers around Tacoma. The teach- ing kitchen gives people the knowledge to prepare healthy meals, but they still need to get to a grocery store, shop, and prepare the food. Imagine how much more impact the Teaching Kitchen would have if they worked with food pantries to teach classes around the food that is immediately available to residents. The services provided to residents in East Tacoma certainly help to meet the needs of families who are hungry, but because each works in isolation they do not change the underlying environment that leaves communities without reliable access to shop, prepare, and eat healthy foods. Our efforts will be more successful if we look at the root causes – transportation issues, time, convenience, and cost – and then coordinate efforts to address these issues. Equally important, we need to recognize that choosing healthy foods requires much greater effort in low-income communities compared to middle-income and high-income communities where healthy food – and the resources to buy and prepare it – are readily available. Individual programs address only one aspect of the problem and won’t lead to healthier people until we coordinate our efforts to make a real impact.