Further Evolution of the Food Desert Concept

As we have seen, right from the start there was resistance to recognizing the existence of food deserts. Amongst the misconceptions and unwarranted assumptions, further evolution of the food desert concept has followed a jagged trajectory, lurching along from seeming victory to crushing disappointment. Although most cities are less than enthusiastic about spending a bundle to improve or extend their public transit systems, some were willing to consider the idea that it might help the food desert problem.

While there is no doubt that many people have benefited from whatever improvements have been made, better bus management, sadly, has not proven to be the capital-A answer to food deserts. Since taking the people to the food is not a total solution, it was easy to conclude that “food must be brought back closer to residents of low-income neighborhoods” which is, to a certain extent, doable. But is it sensible?

A 1999 study in Alameda County, CA, found that…

[…] higher rates per 1000 population of common commercial stores (including grocery stores, supermarkets, laundries/dry cleaners and pharmacies) predicted higher mortality (those who lived in neighbourhoods with many stores/services had a 32% increased risk of dying in the following 11 years, compared with people who lived in neighbourhoods with few stores). This suggests that proximity to some or many resources need not necessarily be health promoting.

In the same year, in Scotland, the Greater Glasgow Health Board’s assessment of spatial variations in the price and availability of food “found that food stores were more numerous in the more deprived localities and postcode districts in the study site” and “did not find any evidence for the existence of food deserts.”

A few years later, another Glasgow-based study focused on the opening of a supermarket in a disadvantaged neighborhood. It has…

[…] found the main beneficiaries to have been people from outside the area who switched to that supermarket, rather than locals who continued to shop in smaller local shops and/or did not perceive the supermarket to be designed for them.

The punchline was, “actual provision may not overcome symbolic barriers to use.” In other words, just building another store is not necessarily a solution. We saw how Sally Macintyre, the author of one study that dealt with deprivation amplification, threw a wet blanket over the whole food desert idea.

Things kept happening that blew theories and assumptions right out of the water. For instance, the realization dawned that state-of-the-art Geographic Information System mapping can’t really supply a complete picture:

We use GIS methods to examine the congruence and coverage of different definitions for Portland, Oregon. Each identifies somewhat different neighborhoods as food deserts, with none accounting for the majority of socioeconomically vulnerable populations living with low food access.

Why does any of this matter? First, because a lot of human suffering could be avoided by eating more sanely, and that leads to a bunch of questions. If people’s terrible dietary transgressions do not stem from living in food deserts, then what is their excuse anyway?

Given that the large majority of health disasters are avoidable, how do we persuade people to actively avoid them? A work titled “Redefining the Food Desert” makes an eloquent case:

The health care burden of obesity becomes a tax burden if the patients are also socioeconomically disadvantaged and rely on Medicare or Medicaid rather than private health insurance. In an environment of increasing pressure on health care expenditures, identification and remediation of food deserts should be a priority.

Your responses and feedback are welcome!

Source: “Do poorer people have poorer access to local resources and facilities?…,” ScienceDirect.com, September 2008
Source: “The location of food stores in urban areas: a case study in Glasgow,” EmeraldInsight.com, 1999
Source: “Congruence and Coverage: Alternative Approaches to Identifying Urban Food Deserts and Food Hinterlands,” SagePub.com, 12/12/11
Source: “Redefining the Food Desert: Combining Computer-Based GIS with Direct Observation To Measure Food Access,” ResearchGate.net, Dec 2014
Photo credit: Stu Spivack on Visualhunt/CC BY-SA

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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