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The Public Health Effects of Food Deserts: Workshop Summary
research, presenters confirmed that food deserts do exist in the United States, particularly in lower-income, inner-city and rural areas with few supermarkets and numerous smaller stores that stock very limited healthy food items such as fruits and vegetables. Mapping shows that these are also frequently areas with high rates of obesity and chronic, diet-related diseases. However, presenters emphasized that food retail is only one component of the total food environment that affects how people eat and, more fundamentally, their health. Another caveat is that the supply of healthy food will not suddenly induce people to buy and eat such food over less-healthy options, especially when relative prices of the healthier foods are high.
To better understand the public health implications of food deserts, speakers reviewed the evidence on the link between different foods and health outcomes. The research showed that the increased consumption of fruits and vegetables, whole grains, and healthy fats slows weight gain but does not reduce weight unless they are substituted for other more energy-dense foods, and it does have benefits in terms of cardiovascular disease (CVD) risk and some cancers. Consumption of sweetened beverages has doubled since 1965, and this has had a harmful effect on weight, CVD, and some cancers. Perhaps not coincidentally, the relative price of these beverages has decreased over time. The evidence linking diet to health outcomes discussed at the workshop points to the reality of the complex relationships between interventions and health outcomes, therefore there is no magic bullet for improving health and those limitations need to be kept in mind.
Research-based experiments and policy interventions to mitigate food deserts have included working with supermarket chains to determine new store sites in underserved areas, providing incentives to small-store owners to improve offerings, and encouraging the growth of farmers’ markets that can improve access to fresh produce and possibly also accommodate payment with government nutrition assistance programs from the Supplemental Nutrition Assistance Program and the Special Supplemental Nutrition Program for Women, Infants, and Children.
A number of specific research needs were identified throughout the course of the workshop. These include the need for longitudinal research to track the same population over time as changes in their food environment occur, a focus on multiple outcome measures given the complexity of the food environment, and the role of price in food choice. Solving the food desert problem might not alone improve health or necessarily change what individuals eat. However, understanding where food deserts exist in the United States can provide guidance on where changes can be made to improve the availability of affordable healthy food options.