Question of the Week

February 23, 2009


With the recent economic downturn, people across the country are looking for ways to cut expenses. For some, this means eating out less and cooking more meals at home. In some cases, this is easier said than done.

Some neighborhoods don't have a local grocery store, and others are seeing their grocery stores close as businesses also cut back.

"Cub Foods today announced plans to close the Nakoma Cub store .... The store will be closed by mid March of 2009. In light of a difficult economic environment, Cub Foods has evaluated its stores and identified opportunities to strengthen its overall business. While the decision to close a store is always difficult--given the impact on associates and customers--it is guided by what is best for the company’s ongoing success and future growth."

The lack of a local grocery store has been shown to have a negative impact on a neighborhood. For those who have cars and/ or live near to other grocery stores, the lack of a store within walking distance is less of an issue. For those without access to cars or in rural communities, there can be a negative impact on the health and economy of those who live without easy access to a local full-service grocery store.

"On April 29, 2008 the California Center for Public Health Advocacy (CCPHA), the UCLA Center for Health Policy Research, and PolicyLink released Designed for Disease: The Link Between Local Food Environments and Obesity and Diabetes. The report demonstrates that people who live near an abundance of fast-food restaurants and convenience stores compared to grocery stores and produce vendors, have a significantly higher prevalence of obesity and diabetes regardless of individual or community income."

The availability of fast-food restaurants and convenience stores may appeal to some consumers, but the bottom line has a negative overall impact. In such establishments, the inexpensive choices are often the least nutritious, and the nutritious choices (if available) are often far more expensive than similar items would be if purchased at a larger grocery store.

Unfortunately, those who are least likely to have access to transportation and least likely to have extra money to spend are often the ones who find themselves without easy access to a grocery store.

"Households located in poor neighborhoods pay more for the same items than people living in wealthy ones, according to a new study in the Journal of Consumer Research. Author Debabrata Talukdar (Columbia University) examines the impact of what has been dubbed the 'ghetto tax' on low-income individuals. His study found that the critical factor in how much a household spends on groceries is whether it has access to a car. 'Arguably, as the bigger, more cost-efficient stores move out, the poor increasingly are likely to find themselves choosing between traveling farther to purchase nutritious, competitively priced groceries or paying inflated prices for low-quality, processed foods at corner stores,' Talukdar writes. According to the findings, those without access to cars ... pay higher prices for groceries than households with access to a car (whether wealthy or poor). Lacking mobility means consumers buy from the nearest neighborhood store rather than larger regional or national grocery chains, which have lower prices."

In addition to the initial negative financial impact, there are the immediate and long-term health problems that such eating habits can create (and compound). If consumers do not have access to transportation or extra money for healthier foods, they often don't have readily available access to quality, affordable health care.

"Poor neighborhoods in urban areas such as Louisville, KY, Detroit, MI, and Philadelphia, PA have a shortage of full-service supermarkets. There are an abundance of convenience stores, but these stores do not sell fresh fruits and vegetables, nor meats. The health departments have gotten involved in this disparity because of the correlation between health problems and the lack of quality food choices available. Without having healthy choices available, these people frequent the convenience store for potato chips, pop and ice cream. These foods do not provide people with the necessary nutrients, not to mention the high fat and sugar content that these foods contain. Sometimes going to a supermarket can mean an hour-long bus ride in which the person can only buy what he/she can carry with them."

For teens, there is more to consider than just whether or not they live in areas that have a predominance of fast-food restaurants.

"We found that students with fast-food restaurants near (within one half mile of) their schools (1) consumed fewer servings of fruits and vegetables, (2) consumed more servings of soda, and (3) were more likely to be overweight (odds ratio [OR] = 1.06; 95% confidence interval [CI] = 1.02, 1.10) or obese (OR = 1.07; 95% CI = 1.02, 1.12) than were youths whose schools were not near fast-food restaurants, after we controlled for student- and school-level characteristics. The result was unique to eating at fast-food restaurants (compared with other nearby establishments) and was not observed for another risky behavior (smoking)."

As communities become aware of these negative trends, some community leaders are attempting legislate change.

"A NEW weapon in the battle against obesity was rolled out last month when the Los Angeles City Council decided to stop new fast food restaurants from opening in some of the city's poorest neighborhoods. Even in a country where a third of the schoolchildren are overweight or obese, the yearlong moratorium raises questions about when eating one style of food stops being a personal choice and becomes a public health concern. ... The councilwoman behind the moratorium, Jan Perry, says its intent is not to crush food choices, but to encourage variety and give residents more nutritious options. Making healthy decisions about food is difficult when people have small incomes, the grocery store is five miles away and a $1 cheeseburger is right around the corner, she and supporters of the ban say."

Questions of the Week:
How does the lack of grocery stores in certain neighborhoods affect those who don't live there? What unexpected costs (both monetary and to health) might be encountered by those who are getting the majority of their food from fast-food restaurants and convenience stores? How can those who live in affected neighborhoods make healthful choices that they can afford in the short and long term? How might such legislation as they are trying in the Los Angeles area help improve what food options are available to those in poorer neighborhoods? Besides legislation, what can be done by governments and by individuals to ensure access to healthy food options for all?

Please email me with any ideas or suggestions.
Note: Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.

I look forward to reading what you have to say.

[email protected]
Health Community Coordinator
Access Excellence @ the National Health Museum

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