Imagine you are hungry and want to buy

Imagine you are hungry and want to buy a snack. What factors will ultimately lead you to buy an apple vs. a Pop-Tart?

What is a Food Desert? “Area in the US with limited access to affordable and nutritious food composed primarily of predominantly lower income neighborhoods and communities. ”-2008 Farm Bill

Food Deserts

What is a Food Desert? • Could simply be defined as an area with a lack of retail food, but that ignores the reasons that we study them… • Interested in health effects and different groups’ accessibility to healthy food • Rural vs. urban food deserts • • Population size Number of any store vs. type of store Transportation Pricing

What is a Food Desert? • In the news… • Eliminating Food Deserts is a goal of Michelle Obama’s Let’s Move campaign which is working to reduce childhood obesity • 6. 5 million children live in food deserts • Eliminate food deserts in America by 2017 • Hundreds of millions of dollars a year used to bring grocery stores and healthy foods to underserved areas • Relationship with health and chronic disease

What Causes Food Deserts? • Access? • • >23. 5 million people live in low-income neighborhoods more than a mile from a supermarket or large grocery store • Of these, about half are low income households Three key features: 1. Distance to store 2. Time of travel 3. Car ownership 93% of those who live in low-income areas with limited access traveled to grocery stores in a vehicle they or another household member drove • Traveled about 20 minutes as compared to the 15 minutes that is the national average Transportation is a larger problem in relation to rural areas

What Causes Food Deserts? • Prices? • Supermarkets and large grocery stores have lower prices than smaller stores • Vegetables and other healthy foods are not necessarily more expensive, but current trends have many healthy foods costing more. . . • How much does a bag of apples vs. box of poptarts cost? • Apples: $2. 99 per 1 lb. bag Poptarts: $1. 99 individual pack

What Causes Food Deserts? • Culture? • If we were able to rid of pricing inequalities and access issues, would food deserts still exist? • Problem of socioeconomic status • Urban areas of limited food access have greater income inequality and racial segregation than is to be expected • Interaction of environment and individual • Consumer behavior, preferences, and demands • Previous exposure • Knowledge/education • Quality of food options available • Bruised fruit

What Causes Food Deserts? • Spatial Reasons? • Space in the store to stock healthy foods • • Studies have found that low-income supermarkets have reduced space Space in the town for more grocery stores • Costs? • Higher costs for developing stores in underserved areas • Rent, utilities, transportation, limited parking, limited public transportation routes, safety • Quality and quantity of fresh food that can be afforded • Relates back to consumer preferences • Perishability

Do Food Deserts Exist? • Depends on how we classify the food retail stores that people have access to in an area. . . • Store type • Supermarkets, grocery stores, convenience stores, specialty stores, etc. • Size • Quarterly or annual profits • Food offerings • Canned, fresh, frozen foods • Healthy food vs. "Junk food"

Do Food Deserts Exist? • Is limited access to healthful foods the same as inadequate access? • According to two recent studies, neighborhoods in areas defined as food deserts not only have more fast food and convenience stores, but also more grocery stores, supermarkets, and full-service restaurants • Food swamp vs. food desert?

Our Definition • • The term food desert is more multilayered and complex than initially assigned when the term first appeared A food desert is not just an area in which healthy food is not readily available, but an area in which the culture and retail prices are not conducive to the sale of healthy food.

What Can We Do? • In order to intervene and establish change, we must identify and acknowledge the primary causes of food deserts. . . only then is prevention possible

Health Consequences of Food Insecurity

Physical Costs • Adult Obesity • Metabolic Effects • Digestion of HFCS • Dyslipidemia • Malnutrition

Monetary Costs • Future Chronic Conditions • Future Medical Bills • Societal Impacts

Effects on Youth • Food and Nutrition Assistance • Programs Children are a vulnerable population

CHILDHOOD FOOD INSECURITY HAS BEEN LINKED TO…

Iron-Deficiency Anemia • Iron is key in the production of red blood cells and • • hemoglobin, which deliver oxygen to cells Highly processed, inexpensive foods contain very little iron IDA means there are lower levels of RBCs and hemoglobin present A growing child needs more iron in their diet to sustain proper growth Less oxygen reaches the body's tissues and cells, impairing growth and function

Brain Development in Children 0 -3 Generation of neurons, synaptogenesis, axonal and dendritic growth, and synaptic pruning can all be interrupted and permanently damaged as a result of food insecurity

Lower Physical Function in Children Ages 3 -8 • A child can't develop muscle properly if they lack the necessary proteins to build that muscle • Lack of ability to excel can lead to other social consequences such as being picked on by one's peers

Chronic Health Conditions

Hungry children are 31 percent more likely to be hospitalized, at a cost of $12, 000 per pediatric hospitalization.

Lower Math and Reading Gains in Grades K-3

Long Term Effects • Most haven't been identified yet • Research on this issue hasn't been around for very long • Hard to track low-income children into their adult lifetimes

The process of applying for Food Assistance

In 2006 -2007 4 out of 5 families that demonstrated sufficient need received government assistance

How Do We Get Fresh Healthy Food Cheaper? • U. S. Agricultural Subsidies = Corn and Soybean Subsidies • Corn Subsidies leads to HFCS (High Fructose Corn Syrup) as an appealing, cheaper alternative to sugar. • Corn Subsidies lead to cheap corn being used for feed. • Corn Subsidies drive the highly processed food market as well.

How Do We Get Fresh, Healthy Food Cheaper?

How Do We Get Fresh Healthy Food Cheaper? • Government should stop subsidizing corn and soybeans and. . . • Encourage farmers to grow fresh produce through subsidies.

How Do We Get Healthy Food Cheaper in Convenience Stores? • Highly processed foods appeal to convenience stores while fresh produce does not. • Convenience store owners perceive a lack of demand. • Government subsidies for fresh produce would make carrying fresh produce more appealing, both to the convenience store owners and their customers. • Frozen Vegetables as an interim fix?

How Do We Get Healthy Food Cheaper in Convenience Stores?

Convenience Stores: A Regressive Tax on the Poor • Products at convenience and corner stores cost more and are of lower quality than at supermarkets and grocery stores. • Spatial and access issues force the poor to disproportionately shop at these stores that simply cost more and have little to fresh food. • Convenience store diet leads to health problems.

Convenience Stores: A Regressive Tax on the Poor

Getting Grocery Stores into Lowincome Areas • Grocery stores have to believe that there is a profit to be made. • Government can incentivize grocery stores to enter these areas. • SNAP (Supplemental Nutrition Assistance Program) restrictions on use at convenience stores and on items containing HFCS and transfat ( partially-hydrogenated oils made from soybeans).

Changing a Food Culture o o o Recipe cards at grocery stores and supermarkets. Reinforcement of healthy eating in the home. Food education in school.

Changing a Food Culture

Food Insecurity & Forsyth County • “ Feedingamerica. org: Map the Meal Gap” – 17. 5% of people in Forsyth County are food insecure – 24. 1% of kids in Forsyth County are food insecure • According to the Department of Agriculture, food insecurity is the lack of access to enough food for an active, healthy life for all household members and limited or uncertain availability of nutritionally adequate foods.

Food Hardship & Forsyth County According to the Gallup-Heathways Survey Winston-Salem is the 3 rd Hungriest MSA in the US for children. • Close to 20% of individuals in Winston Salem suffer from food hardship. • According to the Food Research Action Center, food hardship is a time in the past 12 months when a family could not afford to buy needed food.

Observations • Food deserts are centralized in East Winston. Salem • Observations included: –Only convenience and corner stores – No fresh produce available

CKWFU • • The Campus Kitchen at Wake Forest is a Food Recycling program that uses cooked but never served food from the campus dining hall to make healthy and nutritious meals for the needy of our community. We also partner with The Fresh Market to redistribute produce that is bruised or otherwise in excess to low-income neighborhoods in our community.

Initiatives For The Future • Philadelphia's Healthy Corner Store Initiative o • Worked with stores to stock and promote more healthy food options. Fresh Moves Chicago

Works Cited http: //grist. org/food/rahm-emanuel-to-chicago-eat-your-fingveggies/? utm_campaign=weekly&utm_medium=email&utm_source=newsletter http: //www. ers. usda. gov/data-products/food-access-research-atlas/go-to-the-atlas. aspx#. UXC 3 Bq. KG 1 X 8 http: //feedingamerica. org/hunger-in-america/hunger-studies/map-the-meal-gap. asp http: //foodtrust-prod. punkave. net/uploads/media_items/hcsi-y 2 report-final. original. pdf Treuhaft, Sarah and Karpyn, Allison. The Grocery Gap. "Farm Policy" CQ Press. 2012. Raja, Samina, Changxing Ma, and Pavan Yadav. "Beyond Food Deserts. " Journal of Public Education and Research. 2008. Fields, Scott. "Fat of the Land: Do Agricultural Stubsidies Foster Poor Health. " Environmental Health Perspectives. 2004. Bornstein, David. "Time to Revisit Food Deserts. " New York Times. 2012 http: //www. fns. usda. gov/snap Blue, Jessica. "High Fructose Corn Syrup & Digestion. " LIVESTRONG. COM. Livestrong Foundation, 10 June 2011. Web. 13 Apr. 2013. Chilton, Mariana, Michelle Chyatte, and Jennifer Breaux. "The Negative Effects of Poverty and Food Insecurity on Child Development. " Indian Journal of Medical Research 126. 4 (2007): 262 -72. Pro. Quest. Web. 13 Apr. 2013. "Iron-Deficiency Anemia. " Kids. Health. Nemours, n. d. Web. 13 Apr. 2013. Schaffer, Catherine. "Effects of Malnutrition on the Body. " LIVESTRONG. COM. Livestrong Foundation, 13 July 2011. Web. 13 Apr. 2013. http: //shop. mywebgrocer. com/shop. aspx? strid=7066104 http: //www. nytimes. com/2012/04/18/health/research/pairing-of-food-deserts-and-obesity-challenged-in-studies. html? _r=1& http: //www. ers. usda. gov/media/242654/ap 036_reportsummary_1_. pdf http: //www. policylink. org/atf/cf/%7 B 97 C 6 D 565 -BB 43 -406 D-A 6 D 5 -ECA 3 BBF 35 AF 0%7 D/FINALGrocery. Gap. pdf http: //oahu-ces. hawaii. edu/NEW/Food. Desert/USDAreport. html