Pat Hartman | Childhood Obesity News

Where Do Meaningful Metrics Come From?

Pat Hartman February 25, 2019 No Comments

While spontaneity is admirable, agreement upon standards also has its very large and important place. Experts are trying to resolve important issues, like whether food deserts exist, and if they do, what should be done about them. When these consultants make decisions and recommendations, the people have to follow rules they perhaps don’t care for, and watch their tax money pay for unconventional and seemingly frivolous projects.

In the metaphysical realm, the law of unintended consequences is strict and cranky. Because this is so, when legislation is enacted on any level, there is (or should be) strong incentive to get it right. Part of that is getting the right information, and another part is knowing what to do with it.

GIS and other tools

In many fields of human endeavor, fusion produces impressive results. The geographic information system (GIS) is a melding of data and geography. We like having a mental picture to relate to, and GIS mapping will generate one or many, depending on requirements. The technology can display details about demographic, political, and economic factors in an easily comprehensible form.

GIS techniques can make maps where color intensity tells the tale, or convey information in two dimensions that look like three, or even create three-dimensional artifacts. It might make a picture that looks like a mountain range, where the highest peak represents the forest with the most elves — or the state of the Union with the most obese children under the age of 5.

GIS provides researchers with a framework in which to compile and manipulate data, with room for analysis of patterns, situations, and relationships, and for communication about them. It handles layers of information and lends the viewer a key to visual interpretation. As one source puts it,

GIS technology applies geographic science with tools for understanding and collaboration. It helps people reach a common goal: to gain actionable intelligence from all types of data.

Some matters are more geography-driven than others. The food desert dilemma is unquestionably crucially aligned with geography. Planners want to know the proven utility of encouraging more farmers markets, virtual grocery stores, and Corner Store programs. Will these actions ameliorate the health effects of bad food? We learn that “Information derived from GIS mapping is the predominant means of determining food availability.” So it is pretty important.

“Redefining the Food Desert” dissects the example of Bridgeport, CT, where food access was measured by enlisting both computer-based GIS mapping and on-the-ground direct observations of retail inventories. It doesn’t seem like they talked very much with area residents. The report even mentions this omission:

While the GIS output indicates generalized food accessibility issues, supplementation by survey data reduces the geographic extent of the food desert problem.

In this context, “supplementation by survey data” means asking the people who live there about the reality of their daily transactions. In some quarters, it is suspected that, in the quest to identify food deserts and more importantly, to do something about them, crucial aspects may be missed. Maybe people are not listened to enough, or questioned appropriately. “Does your local mom-and-pop grocer carry veggies?” is a different question from “Are they fresh and do you ever buy them?”

One acknowledged drawback of GIS mapping is its “inability to determine what products are actually available to residents in neighborhoods not served by a major grocery store,” which seems like a pretty serious methodological flaw. The glaring lesson here is that even the most elegantly executed map doesn’t mean zip if, at ground level, it measures the wrong things or depends on skewed data to get answers. Whatever its shortcomings, GIS mapping itself is not to blame, because the results depend on the information that is fed into it by humans, who are far from perfect.

P.S.

This is a good opportunity to recall that in Dr. Pretlow’s book, Overweight: What Kids Say, the Introduction credits the “anonymous, amazingly outspoken, bulletin board and chat room messages” written by “thousands of different overweight kids” and received by the Weigh2Rock website. The book was inspired by the idea of listening to the people who are actually affected by the phenomenon it describes.

Your responses and feedback are welcome!

Source: “What is GIS?,” esri.com
Source: “Redefining the Food Desert: Combining Computer-Based GIS with Direct Observation To Measure Food Access,” ResearchGate.net, Dec 2014
Photo credit: TheVRChris on Visualhunt.com/CC BY-SA

The Importance of Meaningful Metrics

Pat Hartman February 22, 2019 No Comments

When activists get together to design better ways to make healthful food accessible to more people, they look at several factors. The local density of convenience stores is one. Often combined with gas stations, they are designed for travelers concerned more with speed and urgency than with nutrition.

Such establishments carry many products that can be eaten, but that should perhaps not be eaten. In recent years, they have begun to stock apples and bananas, and even plastic containers of vegetable and fruit salad. These suppliers are not to be depended on for the ingredients to make nutritious family meals.

The presence in a neighborhood of numerous fast foot outlets is not a reassuring sign, either. They are legendary purveyors of items that are energy-dense (a slightly nicer way to say high-calorie) and laced with questionable additives. Planners like to think that if people had a full-service grocery store nearby they would quit McDonald’s.

That dream is crushed by such comments as this one, received by Dr. Pretlow’s Weigh2Rock website, in response to a poll concerning Michelle Obama’s Let’sMove! program. A 14-year-old girl, describing herself as 5’4″ tall and 230 pounds heavy, contributed:

There are actually a lot of activities in my school, like intramural sports and i was in them, didn’t help a smidge. And there ARE healthy affordable foods where i live, it doesn’t mean that we buy them. I don’t think she has thought about the fact that there are multiple mcdonalds in every town. For years people have had programs and activities to help obese people and it hasn’t really helped. There are many holes in this plan.

As the preceding quotation asserts, although healthful, and even affordable food can be had, people do not necessarily want it. This is not to say they are incapable of change. But a general rule of therapy is, you have to meet people where they are at. Just because a produce department exists customers do not automatically flock to it. They bypass the veggie bins and proceed with alacrity to the ice cream freezer. When science and logic conflict with human nature, human nature usually wins.

When experts are plotting how to put enough of everything everywhere, basic questions need to be asked. How do we know what is enough, in each particular area of human habitation? Residents of different areas live under diverse conditions and hold very disparate values in terms of what they perceive to be the necessities of life.

And yet, it is important to measure the variables in useful ways. As the authors of one study phrased it,

Properly situating these assets in neighborhoods in need requires localized data on both the location of food outlets and the populations served. Previous literature on food deserts has generally used an ad hoc definition of what constitutes “access”.

Current ad hoc definitions likely lead to misidentification and inappropriate use of resources. Proper documentation of food access is a precondition for the design of appropriate measures to ameliorate the situation.

“Ad hoc” means made up on the spot, or what some call quick-and-dirty. The ability to think on our feet is one of the best traits we humans have going for us. People need to try new methods. When culture gets stuck in any kind of rut, it’s usually an indicator of trouble ahead.

Science, in particular, likes colleagues to work together by agreeing on basic items like measurement standards. Scientists want to be able to compare results between one study and the next, and it’s not as simple as choosing between liters and quarts. When their decisions will translate into public policy, those decisions matter.

Your responses and feedback are welcome!

Source: “Redefining the Food Desert: Combining Computer-Based GIS with Direct Observation To Measure Food Access,” ResearchGate.net, Dec 2014
Photo credit: Susan Fitzgerald (Spin Spin) on Visualhunt/CC BY-ND

Another Food Desert Solution With Problems

Pat Hartman February 21, 2019 No Comments

In the course of figuring out what’s going on with food deserts, several answers have been proposed at various times and diverse places — all of which seem to have some flaw. Sometimes they indicate an incomplete grasp of the problem, which can result from not asking the right questions or listening to the right people.

When the amount of available food is limited or perceived to be limited; or when the available food is nutritionally inadequate or even unsafe; or if people don’t have the opportunity to acquire a sufficient and dependable quantity of decent food, a food desert can be said to exist. Certain parameters are built in.

It doesn’t matter how much food might be available if people can’t afford to buy it. If they don’t have a way to bring the food from where it is to their homes, both availability and affordability are moot. A food desert condition might exist in several different ways.

In an urban center, there might be a sufficiency of pizza, while a pound of grass-fed beef is as rare as a unicorn. There could be several places in a single block to obtain gourmet cupcakes, with nary a carrot nor a grapefruit in sight. For a market to offer a bunch of grapes priced at more than someone’s entire monthly food stamp allotment is entirely within the realm of possibility.

In a complicated environment like the downtown area of a large city, there are a lot of moving parts, and a lot of ways to get the wrong impression. Superficial assessments won’t do.

Wheels

But the city has buses and/or subways, right? People can get themselves to a store one way or another? Well, some can. As we established in a former post, there are plenty of exceptions.

Once the discussion turns to public transport, the question immediately arises: How do customers get to the bus stop, and how do they bring their heavy and awkward burdens back home? Is it worthwhile to call a cab? What if the taxicab company went out of business, and you don’t have a fancy phone with an app on it to call Uber or Lyft?

The experts concerned with such matters discuss a concept called the price-distance relationship. As “Redefining the Food Desert” article published in the Agriculture and Human Values journal explains:

As the distance to a food outlet rises, the total cost in terms of transportation and lost time rises also. The neighborhood bodega or fast-food outlet is likely to offer high-priced, low-nutrition foods, but the overall “price” is the same or lower than that offered by a distant supermarket that involves public transportation and a significant commitment of time…

Consequently, although nearby food retailers may be expensive and offer poor choices, residents may make the rational choice to secure food locally rather than devote scarce time and resources to the task of traveling to a supermarket outside their neighborhood.

Or, like the Spanish-speaking mothers of a Portland neighborhood, they might decide that saving close to 30 percent on food was worth the hassle of traveling. The economically disadvantaged expend a lot of energy weighing pros and cons. An hour on public transportation, or an extra $10 added to the grocery bill? People with adequate incomes tend to think that poor people’s time is not important, but it is to the individuals concerned, especially if they spend a lot of it in the freezing cold or the blazing sun waiting for buses.

That’s why gathering information on a human-to-human basis is crucial. Researchers can crunch elaborate streams of data and generate clever maps, but no amount of two-dimensional intellectualizing can depict the true situation on the ground. The report said, with dry understatement, that its analysis spotlighted “some challenges to the established means of identifying food deserts”:

More importantly, it is argued that the most straight-forward means by which city governments address food access issues — through the expanded availability of public transportation — may do little to solve the problem, as the opportunity cost to urban consumers of obtaining far away food remains too high.

What is the upshot of all this? The realization that, as “Redefining the Food Desert” states, “the monetary underpinnings of the food desert problem are not necessarily solvable through public transportation.” The conclusion drawn by the intellects behind this report was that “food must be brought back closer to residents of low-income neighborhoods if there is any expectation of a general improvement in diet and health.”

And that’s what the whole project is about — giving people the means and opportunity to buy, prepare, and eat fresh, wholesome food that will do their bodies more good than harm.

Your responses and feedback are welcome!

Source: “Redefining the Food Desert: Combining Computer-Based GIS with Direct Observation To Measure Food Access,” ResearchGate.net, December 2014
Photo credit: Judy Dean on Visualhunt/CC BY

The drawbacks

However, growing and preserving food are both labor-intensive and equipment-intensive endeavors. Even small-scale agriculture requires space, either at home or at some kind of collective site. You need a safe storage area for tools and supplies, and a neighborhood without miscreants who vandalize gardens as a hobby. Discouragement can set in when the would-be kitchen gardener realizes exactly how many variables need to be accounted for.

Decisions must be made about how to handle insect pests and marauding animals. Depending on where you live, there might even be deer. Cats will use the garden plot for a toilet, and spread toxoplasmosis. Drought conditions might force the local water authority to limit use. In some places, it is illegal to harvest rainwater. In some places, people have gotten in trouble for growing veggies in their own yards. Zoning ordinances and housing association rules can be stifling.

Indoor growing has its own set of difficulties. Even the most rudimentary hydroponic system requires the purchase of containers and lights, and you kind of actually need your own basement, and the ability to pay the electric bill. Even so, people who grow tomatoes in their basements have been raided, on suspicion of growing something else. In the past few years, rooftop gardens have come into vogue.

As for old-fashioned food preservation, like with Mason jars, that project also requires a lot of equipment, preparation space, and storage space. In addition, food poisoning is very hazardous, and if a litigious person claims that the Community Center taught them wrong, things could get messy. Yes, we have electric dehydrators now, but they are expensive.

One researcher found that “food access is frequently the result of perception, not fact, with residents in poor neighborhoods unaware of the proximity (less than one kilometer) of food retailers.” It sounds unlikely, but the writer of this post once had neighbors who were unaware of living six blocks from the Pacific Ocean, beach and all.

It goes back to the concept of deprivation amplification, the cost of being poor. Sometimes, the daily struggle to survive in the moment is so exhausting, a person is literally incapable of curiosity or initiative.

Your responses and feedback are welcome!

Source: “Visioning For Healthful Food Access In Portland,” PDX.edy, June 2009
Source: “Redefining the Food Desert: Combining Computer-Based GIS with Direct Observation To Measure Food Access,” ResearchGate.net, Dec 2014
Photo credit: State Library and Archives of Florida on Visualhunt/No known copyright restrictions

Stress and Obesity — a Broad and Deep Study

Pat Hartman February 19, 2019 1 Comment

Longitudinal studies are good, and large samples are good. In this case, the subjects were 1,000 children observed over a span of 21 years. These are two reasons why this particular study is called important by such authorities as Tom Barabowski, Ph.D., Editor-in-Chief of the publication Childhood Obesity, who says it “identified four BMI trajectories through childhood, and the family, home, and neighborhood factors, even from infancy, that differentiated those groups.”

BMI stands for Body Mass Index and represents the person’s weight in kilograms, divided by the square of his or her height in meters. Americans eschew the international standard and use feet, inches, and pounds, but BMI is the measurement convention most commonly used to compare conditions in different countries and between different groups.

The Centers for Disease Control and Prevention webpage says, “BMI can be used to screen for weight categories that may lead to health problems but it is not diagnostic of the body fatness or health of an individual.” To some minds, the BMI measurement should only apply to people between the ages of 18 and 65, but it is commonly used in schools and in research applications.

The object of this six-author study was to investigate “the relation between adult weight status and parameters of BMI growth and home and family predictors of BMI growth.” It reconfirmed what other research has shown, that obesity is a kind of self-perpetuating state, because big kids tend to get bigger, and to get bigger faster.

This is why so much effort is devoted to catching a child’s tendency toward obesity early and acting upon it decisively. You can tell by age 5 who is pretty sure to be an overweight, obese, or extremely obese adult, unless something is done about it. The report says,

As a whole, findings highlight the intricate connections among early BMI, subsequent BMI increase, and acceleration of BMI increase, with all factors forecasting obesity in young adulthood.

One predictive factor is the absence of a father. Because “fathers are uniquely instrumental in involving children in boisterous, stimulating physical play,” they are seen as laying the foundation for motor development and physical activity. However, the lack of a father in the home might be offset by the presence of other children in the environment whose example and participation will stimulate active play.

According to the study, at the beginning,

Infants were recruited from community clinics serving low-to-middle income families (1991–1996). Eligible infants were healthy, singleton, born at term, and weighed ≥3.0 kg at birth. Participants were of mixed European, Spanish, American Indian descent. Children were studied in infancy (6-18 months), at ages 5, 10, and 21 years, and up to three times in adolescence (M ages 14.6, 16.2, and 17.3 years).

The study had a couple of weaknesses, like not including premature and low-birthweight babies, who certainly exist in real life. Some self-reporting was involved, such as in the area of the mothers’ pre-pregnancy weights and heights. Also, Chilean society has its differences from American society, so that has to be taken into account. On the other hand,

The study had several strengths, such as the large sample studied over 20 years, the inclusion of important controls to adjust for pertinent confounders, the repeated assessments of objectively measured BMI, and ratings of several home and parenting characteristics measured at children’s infancy and middle childhood.

The researchers concluded that keeping an eye on BMI increase, and especially on its rate of progress, even before age 5, is paramount. Accelerated weight gain is a red flag that forecasts later obesity struggles. Parents must be urged to limit child confinement and promote physical activity.

Small children need sufficient opportunity for movement and for stimulating experiences. Societal influences play into this, according to the report:

Aspects of children’s built environment, such as living in substandard housing and lack of access to safe, appealing play space, also pose risks for obesity.

Other factors that spell danger are unsupportive home and family conditions, especially those that create stress, like the crucial factors of father absence and maternal depression. Low parental warmth and acceptance were associated with the faster acceleration of BMI increase.

Your responses and feedback are welcome!

Source: “Home and Family Environment Related to Development of Obesity: A 21-Year Longitudinal Study,” LiebertPub.com, 01/24/19
Source: “Healthy Weight,” CDC.gov
Photo credit: ionelpop on Visualhunt/CC BY-SA

Food Desert Solutions With Problems

Pat Hartman February 18, 2019 No Comments

Agriculture Secretary Sonny Perdue, second from left (in a blue shirt), does not live in a food desert.

In order to grasp the dimensions of the food desert situation — or, as some would have it, the lack of a food desert situation — we examined the report issued some time back by the Bureau of Planning and Sustainability (BPS) in Portland, Oregon, because it so thoroughly enumerated and examined many of the basic questions. One thing became very clear. There are problems that have solutions, and there are solutions that have problems.

According to the report, 45 percent of the Portlanders who were surveyed were less than happy with the number of grocery stores in their neighborhoods. For 43 percent, transportation was a problem, at least some of the time. Almost half of the respondents did not generally have access to a car.

That’s a lot of people forced to encounter weather, exertion, time loss, and possible personal danger, just to get decent-quality food. The report said,

Several strategies could theoretically improve food access in these areas — bringing in low-priced grocery stores, improving transit access to low-cost stores in other areas, etc…. Strategies aimed at increasing affordability of existing options and improving purchasing power of low-income households are likely to be better long-term solutions in these cases.

It does not bode well that the 109-page document’s first Suggested Strategy is, “Regulate the food supply to keep harmful substances out of people’s diets.” Americans take their freedoms seriously, especially the freedom to self-destruct with a harmful diet. Some ideas specifically mentioned children:

Demand schools to improve the quality of cafeteria food and serve only healthy food to children… Create more community gardens in parks, so people can grow their own food and so children can learn how to grow plants.

During the years when former First Lady Michelle Obama was the national cheerleader for health, some good things happened in America. The present administration in Washington has been working hard to reverse all her efforts.

Sonny Perdue, Secretary of Agriculture, who thinks obesity is a joke, will be remembered mainly for telling a Virginia elementary school class, “I wouldn’t be as big as I am today without chocolate milk.” In the photo on this page, where he stands second from left, Mr. Perdue’s size can be seen. Since little kids aren’t tuned in to sarcasm or irony, we can only assume that he actually recommends aspiring to look like a beachball.

Two months ago, Julia Jacobs wrote for The New York Times,

This week, the United States Department of Agriculture announced its final plans to lower nutrition standards for grains, flavored milks and sodium in school cafeterias… Under the new rules, only half of the grain products on the cafeteria’s weekly menu must be whole grain-rich… As for the milk, the Trump administration is allowing schools to serve low-fat flavored milks, rather than just the nonfat version… Schools will still have to reduce sodium in lunches, but they will not be required to do so as aggressively.

One of the suggestions for Portland was to create a community forum where people could swap strategies about food resources. Faith communities and other groups sometimes organize van-pool excursions to full-service grocery stores or megamarts, and probably face bureaucratic obstacles like increased liability insurance. Volunteer services are unreliable, because stuff happens and people don’t show up — and what are you going to do, fire them?

An idea that should not be too arduous anywhere is the creation of numerous farmers’ market locations throughout a city, with a year-round location downtown. Activists are urged to encourage small grocers, convenience store owners, and farmers’ market vendors to accept WIC coupons and SNAP payments, which requires collaboration with government bureaus. Some innovative food access practices sound easy (at least to anyone who doesn’t have to do the paperwork.)

Citizens working for change are also advised to encourage these same retail food points to add extra service in the form of free (or cheap) delivery. The thing about a free service is the somewhere along the line, somebody pays for it. If free delivery is baked into the cost of doing business, all the customers pay.

If the only person who pays is the one who actually uses the service, that person is now penalized for being disabled, or for being a caregiver who can’t get out of the house, or a parent with sick child, or for not having a car, or for just plain being impoverished. Not surprisingly, this recalls a recently-discussed subject of deprivation amplification, also known as “It costs a lot to be poor.”

Your responses and feedback are welcome!

Source: “Visioning For Healthful Food Access In Portland,” PDX.edy, June 2009
Source: “Trump Administration Rolls Back Obama-Era Rules for School Lunches,” NYTimes.com, 12/08/18
Photo credit: Forest Service, USDA on Visualhunt/CC BY

Food Deserts vs. Realistic Scenarios

Pat Hartman February 15, 2019 1 Comment

We saw how Portland’s Bureau of Planning and Sustainability found some unexpected answers to its queries about neighborhood stores. Many city dwellers are perfectly okay with traveling out of their immediate area to shop for food. They have their reasons, two of which are lower cost, and the preservation of purely residential neighborhoods.

Despite the satisfaction experienced by some subgroups of citizens, the researchers found that in other parts of town, the people’s relationship to the food supply was less than satisfactory. According to the report:

In Portland, these neighborhoods are generally characterized by inconsistent food access — for example, the grocery store has prices too high for low-income residents, and more affordable smaller stores have few items low-income residents want or need. These areas may be less accessible — be less walkable, have more residents without cars, or have less available transit.

While some people are happy to buy their groceries from a distant megamart, what complicates matters is that the same giant corporation underpays its employees to the point where they can’t afford rent, and wind up living in a hammock in somebody’s backyard. The people who work at the megamart are on food stamps, so all the taxpayers share in subsidizing their employer’s greed. Giving that employer a tax break and a bunch of other freebies to open another megamart hardly seems like the perfect answer.

What to do?

And yet, “Encourage additional food points to locate in underserved areas of the City” is one of the suggested remedies. In some places, encouraging more stores to open is considered the right answer. Another recommendation is to “Provide incentives to small grocers and convenience store owners to stock fresh produce and other healthful food options at affordable prices, including grants for energy-efficient lighting and refrigerators.”

Here is a question: Isn’t the profit motive enough of an incentive? If customers want fresh produce, why are the owners of small groceries and convenience stores not stocking it already, out of sheer self-interest? A basic rule of business is that you plow back some of the profits into improvements.

Some taxpayers ask, “Why should we buy this guy a new refrigerator just because there are poor people in the neighborhood who suffer health consequences from not eating right?” The taxpayers, too, need encouragement. As do the people who don’t even know how to eat right.

One of the report’s accomplishments was to identify the numerous types of Direct Market Solutions, aka food retailers. They are:

Full-Service Grocery Store
Independent Grocers (including Specialty Store, Ethnic Market)
Convenience Stores
Farmers Markets
Cooperative Grocery Stores
Community-Supported Agriculture
Fruits and Vegetable Stands
Community Gardens
Emergency Food

Wheels within wheels

The food desert topic turns out to be incredibly complex and full of surprises. Transportation, for instance, is fraught with connections to other issues like racism, economic inequity, and corporate greed. A previous post finished up with words from one of the people who put together “Foodability — Visioning For Healthful Food Access In Portland.”

It was indeed a visionary document, with some blind spots. The quotation was, “Walking with groceries is not a realistic scenario.” This seems obvious on the face of it, but the implication has a long tail. Grocery shopping by bus cannot help but include some walking at both ends of the trip. So, in practical terms, this means that grocery shopping via public mass transit is not a realistic scenario. And yet it is the precise circumstance with which many thousands of Americans are stuck.

Your responses and feedback are welcome!

Source: “Visioning For Healthful Food Access In Portland,” PDX.edu, June 2009
Photo credit: MTAPhotos on Visualhunt/CC BY

Transit, a Big Food Desert Factor

Pat Hartman February 14, 2019 No Comments

The previous post looked at some of the components of the food desert problem. People who live in nice neighborhoods like the residential quality and do not mind driving to distant grocery stores. Even people in less prosperous neighborhoods prefer stores that are farther, yet more economical, and are fine with driving to them, as long as they have cars. The pain is really felt among people who do not have cars, and some cities take this seriously.

In Portland, Oregon, for instance, the Bureau of Planning and Sustainability (BPS)issued a lengthy study, identifying five variables (conveniently all starting with the same letter): affordability, accessibility, availability, awareness, and appropriateness. They also formulated five city-wide recommendations and 10 neighborhood-level recommendations — actually nine, because “Require a food access impact assessment before reducing transit service” is listed twice.

Bus rides

A safe and reliable travel method is important. Amazingly, some cities still have functional public transportation, and buses are a prime example. Do planners remember that even the best bus system is far from a great solution? Any grocery procurement mission that involves a bus also necessarily involves ambulation. Nobody gets a bus ride from door to door. A shopper might come home with a full backpack and multiple bags in both hands. Carrying grocery bags is difficult for the old and infirm, and even for the young and healthy: It occupies the hands and leaves a person vulnerable to mugging.

Another shopper might rely on a wheeled cart, but even so, 10 pounds of potatoes, a gallon of white vinegar, and a six-pack of bathroom tissue pretty much fill up the available space. Maybe the answer is to buy a smaller bottle of vinegar, five pounds of potatoes, a single bathroom roll, and save room for other purchases.

That suggestion leads directly back to the subject of deprivation amplification, the idea that misfortune breeds further misfortune. Any conscientious shopper knows that buying things in larger quantities usually saves money — and requires a capacious car trunk.

Walk a mile in their shoes

Grocery shopping without a vehicle presents other challenges. Unable to carry as much in one trip, a person has to make more frequent trips, which eats up time that could be more productively used. For a parent with two or three kids to wrangle, car-free grocery shopping can be an ordeal. How do you even carry the groceries while pushing a stroller or holding children’s hands?

Or, say, there’s no stroller, and the shopper has a personal wheeled cart. It needs to be pushed or pulled, maneuvered up and down curbs, and it does not function well in snow and ice. Any cart sturdy enough to be really useful is going to cost some bucks. And what if it’s hot outside? It doesn’t take long in the sun for food items that are supposed to stay cold to warm up. There’s the wait at the bus stop, and then the ride, and the walk home — plenty of time for the eggs to start cooking.

Another problem arises when the bus shopper does not bring a personal utility cart, but leaves the store with only bags. Getting off the bus near home, the customer will need to carry full bags some distance. That can’t be helped. But why — and this reasoning admittedly makes sense — lug the bags from the store to the bus stop? Lots of people just take off with the store’s grocery cart, and abandon it at the corner, leaving it to roll out into the street or whatever. Each year a certain number of grocery carts are ruined or lost, and their replacement cost is shared by all the business’ customers.

Even one of Portland’s fabulously optimistic planners was quoted as saying,

Walking with groceries is not a realistic scenario.

Your responses and feedback are welcome!

Source: “Visioning For Healthful Food Access In Portland,” PDX.edy, June 2009
Photo credit: Nieve44/Luz on Visualhunt/CC BY

Food Desert Distance Issues

Pat Hartman February 13, 2019 No Comments

Many cities have made all-encompassing plans to address their food desert dilemmas. A massive one was conceived some years back by the Bureau of Planning and Sustainability (BPS) in Portland, Oregon. The document began by saying, “This project considers food access largely as an issue of socioeconomic equity, and its strategies and recommendations reflect this.”

At the same time, it makes some admissions up front that seem to negate its very reason for being:

Overall, Portland is well served by the private market and does not suffer the sort of “food deserts” that impact other cities. Most parts of the City are accessible, with a number of food points offering a fairly affordable range of food.

In Portland, areas with poor and very poor food access are largely located in neighborhoods with high median household income. Residents in these neighborhoods are unlikely to perceive their food access as poor because they rely on auto travel to do their food shopping and are comfortable doing so.

That last sentence is key to understanding one of the basic problems involved in assessing the extent, or even the existence, of food deserts. In order to compare between places, or between conditions in the same place at different times, a unit of measurement has to be agreed upon. Several metrics are used. One is the distance between home and the nearest decently equipped food store.

It is immediately possible to see why this alone is not a good criterion. How can people be said to have very poor food access — just because there is no market nearby — when they have cars? For many, it might even be much more convenient to have a grocery store located near their workplace, so they can shop on the way home and avoid making a special trip.

Here’s another thing. Generally, neighborhoods with high median household incomes are not particularly eager to have grocery stores within a certain distance, because they tend to be very picky about maintaining their residential identity. Nobody wants a mega-mart in their neighborhood. They don’t want the traffic, or the transient strangers bunking overnight in the parking lot. The lack of nearby retail stores is not a bug, it’s intentional.

Across town

If that’s the situation in a prosperous neighborhood, how about a low-income area, like a housing complex? The BPS organizers invited Spanish-speaking mothers of young children to be interviewed about the importance of the presence of a retail food outlet nearby. Their neighborhood did in fact contain two full-service grocery stores and a number of small ethnically-oriented markets.

Was that satisfactory? As it turns out, the answer was no. According to the report:

They were willing to travel a distance of 5 to 8 miles in order to shop stores perceived as more affordable. They typically shopped for groceries every two weeks by car. One woman said, and others agreed, that they would pay $200 at the nearby full-service grocery stores for the same amount of food they could buy for $150 at a more affordable grocery store. This reflects a 33 percent difference in price in favor of the lower priced store.

When analysts actually compared the price structures of the neighborhood groceries to the more distant store, they found the difference to be 29 percent. So the women’s estimate was pretty darn close, and the savings definitely worth spending a bit of extra gas money and time to procure.

Still, one of the Portland recommendations was to provide subsidies to entice “food points” both large and small to locate in underserved areas of the city. But when municipal governments offer incentives to businesses, that generally means tax breaks and other financial favors that wind up being paid for by all the taxpayers. Why not just take that same money and buy everybody a car?

Your responses and feedback are welcome!

Source: “Visioning For Healthful Food Access In Portland,” PDX.edy, June 2009
Photo credit: dbking on Visualhunt/CC BY

Evolution of the Food Desert Concept

Pat Hartman February 12, 2019 No Comments

After the turn of the century, scholars began to notice that people in disadvantaged neighborhoods seemed to lack access to nutritious fresh foods. This absence was linked to poorer health in general, and specifically to increasing obesity, and was considered important to track. However, when it came time to study and document the problem in an orderly fashion, researchers were hindered by their frequent tendency to start out with varying definitions of “food desert,” which made it difficult to compare different areas or measure success.

The Food, Conservation, and Energy Act of 2008 came into being in June of that year, and a lot of it had to do with food deserts. It told the Department of Agriculture how to utilize its resources:

These activities include researching the prevalence and causes of food deserts; effects of food deserts on populations; recommendations for reducing and eliminating food deserts; community development initiatives; incentives for food stores to establish in food deserts; and partnerships to address food deserts.

Some professionals felt that a step had been skipped. While the politically-minded forged ahead, figuring out how to fix the food desert problem, some in the field were saying, “Wait a minute, how much proof do we have that there really is such a thing?”

The federal government prepared the USDA Food Atlas by setting up some definitions. City people living more than a mile from a supermarket; country people living more than 10 miles from a grocery store; and people anywhere with no food store in the area plus no access to a vehicle, are plotted separately. The maps are interactive in that the viewer can call up different categories of information.

Not long after the 2008 Act was passed, a report was released of a meta study that looked at 31 studies that measured food access by nine different criteria, and that focused on racial/ethnic and income disparities. Ten articles concerned access to supermarkets; 11 were about racial/ethnic disparities in food deserts; 11 described income/socioeconomic status in food deserts; and 14 were about the differences between chain and non-chain stores.

One of these areas, where additional research is needed, explores the impact of residing in a food desert. Specifically, there is debate about whether living in a food desert is associated with unhealthy eating and food buying practices. It is unknown to what extent additional factors, including personal preferences, are better indicators for healthy eating than the actual presence or absence of a supermarket.

The research team noted what was surely a deficiency in food desert investigation:

While many studies focus on the presence or absence of supermarkets, few examine the dynamic interaction between other food venues (restaurants, corner stores, gas stations, etc.) as places, where residents purchase food… This is important because these venues, in addition to local grocery stores, comprise the food environment and offer food items for residents.

The team came to some rather troubling conclusions. Even when the overall economic burden was eased by the opening of a new supermarket with periodic sales on many products, the residents did not use the savings to buy greater amounts of fresh food. Fresh produce is the main item on the reformers’ wish list, because of the belief that its consumption leads to improved health, so this finding naturally led to puzzlement and disappointment among the activists striving to bring about change.

Changes that would appear on the surface to improve the food desert situation, sometimes led to unintended consequences:

For instance, with the opening of a larger store, residents had a larger variety of foods, including prepared foods to choose from and reported feeling “tempted” to overspend small food budgets by purchasing large quantities of needed items or purchasing “luxury” items.

The long and short of it is that ready availability of nutritious food is no guarantee that people will lay down their money for it. After dissecting 31 previous studies, this team wrote what might be considered as an almost humorous understatement:

Research is needed to better understand additional factors involved in food buying practices among the residents of food deserts.

Your responses and feedback are welcome!

Source: “Disparities and Access to Healthy Food in the United States: A Review,” MafiaDoc.com, 04/17/10
Source: “Does Your City Have a Food Desert? Check with This Interactive Map,” OneGreenPlanet.org, 2018
Source: “Disparities and access to healthy food in the United States: A review of food deserts literature,” RootCauseCoalition.org, September 2010
Image by U.S. Dept of Agriculture

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