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By Matthew Rees

Food and Health Fact #143: The "food desert" fiction

Follow me on Twitter: @foodhealthfactsFind all previously published Food and Health Facts hereThis week marks the continuation of an experiment: occasionally publishing only once a week and featuring longer commentary pieces, many of which build on short items previously published in Food and Health Facts.

It’s an article of faith about high obesity rates in urban areas: the residents live in “food deserts” where there’s a limited supply of healthy food options. As Michelle Obama said while First Lady, “We can give people all the information and advice in the world about healthy eating and exercise, but if parents can't buy the food they need to prepare those meals because their only options for groceries are the gas station or the local minimart, then all that is just talk.” And a leading Democratic senator, Mark Warner, has introduced legislation to help eliminate food deserts.

Alas, the evidence doesn’t support what seems to be true. And attempts to remedy what’s not a problem only slows progress in treating the obesity epidemic.

About 40 percent of women, and 37 percent of men, living in urban areas exceeding 250,000 people are obese (according to this study). While those numbers are alarming, they are below the national obesity rate (42.4 percent).

Several different factors contribute to obesity, but inadequate access to supermarkets isn’t one of them. In fact, the “food desert” thesis has been refuted by multiple studies, including one published by the U.S. Department of Agriculture during the Obama Administration.

After a Washington Post food-policy columnist investigated the issue in 2018, she wrote that, “I have seldom found a body of evidence with results so relentlessly one-sided.” (Read the Post piece for a roundup of the studies or see this New York Times piece.)

The studies have shown that low-income neighborhoods have as many – or more – grocery stores as wealthier neighborhoods. The problem facing these neighborhoods is one that plagues the entire country: too much access to unhealthy food, which is why “food deserts” is slowly being replaced by a more accurate term: “food swamps.”

The authors of a study published in 2019 examined the food desert issue through the lens of supply and demand. (Yes, the study’s authors – professors at the University of Chicago, Northwestern, Stanford, the University Pennsylvania, Georgetown, and New York University – are mostly economists.) They found that “about 90 percent of the nutrition-income relationship is due to demand-side factors related to preferences, while only about ten percent is explained by the supply side.”

That’s a technical way of saying that the stores in low-income neighborhoods aren’t selling healthy food because people aren’t buying it. Or, in even simpler terms, “low-income households purchase less healthful foods” than higher-income households.

This is not a new challenge. More than 30 years ago, a Wall Street Journal reporter, Alix M. Freedman, wrote a compelling series of articles on the eating habits of the poor. In one of them, she observed that,

Food marketers in many cases don't even try to sell products for the health-conscious in low-income neighborhoods. Storekeepers may have found that such items don't move, or they don't care to take a chance on them, or they simply prefer to emphasize products that they know many customers want. Some inner-city food shops see drug addicts and alcoholics as their most dependable customers, and cater to them. . . . it's tough to make a living trying to sell people what they don't want to buy. 

But it’s not just the poor who are making unhealthy food choices. Obesity rates remain high across all incomes. A CDC study notes that high-income men have a higher obesity rate (32.6 percent) than low-income men (31.5 percent), though it’s the reverse among women, with a much bigger gap in obesity rates – 45.2 percent among low-income women and 29.7 percent higher-income women.

A more fundamental shortcoming of the “food desert” thesis is the assumption that easier access to grocery stores translates to better health. As noted above, low-income households are buying small quantities of healthy food. But the related issue is that most of what grocery stores sell is highly processed food. The average American supermarket carried more than 31,000 items in 2020, according to the Food Marketing Institute, and most of those items are not of the carrot and kale variety. The food offerings are also supplemented by the sale of lots and lots of sugar-sweetened beverages.

Facilitating access to foods that qualify as CRAP (Calorie Rich and Processed) is decidedly not the answer to preventing and reversing obesity. Let’s also remember that more than half of the American budget for food goes toward spending at restaurants – where the offerings are overwhelmingly of poor dietary quality.

One of the many obstacles to preventing and reversing obesity is disagreement about both its root causes and the appropriate remedies. But progress is linked to focusing on actual threats – not perceived ones. It’s encouraging that the Biden Administration doesn’t appear to have bought into the food desert fiction. Going forward, here’s hoping other well-meaning health advocates steer clear of it as well.