Rodger Marion

You may have heard of food desert and wondered just what does that mean?  The term food desert was coined by the U.S. Department of Agriculture and refers to urban neighborhoods and rural towns without ready access to fresh, healthy and affordable food.  Instead of supermarkets and grocery stores, these communities may have no food access or are served only by fast food restaurants and convenience stores that offer few healthy, affordable food options.  In terms of distance, if you live in an urban community and have to travel at least one mile to get to a grocery store you are in a food desert.  For rural towns, where the population is more sparely distributed, it means needing to travel at least 10 miles for groceries.  If you have a car and can drive, that doesn’t sound like a great distance.  However, if you require a bus, taxi or special transportation to get to the grocery store, 10 miles can be a huge barrier.  In terms of health, the lack of access contributes to a poor diet and can lead to higher levels of obesity and other diet-related diseases, such as diabetes and heart disease. 

The elderly are at increased risk of malnutrition due to many reasons including poor dentition, decrease in taste buds and appetite, difficulty cooking and preparing health food.  Health conditions common among the elderly, such as dementia, arthritis, and diabetes combined with financial constraints and fixed income, all contribute to increased risk of malnutrition.  But what about the impact of poor access to good, healthy food on health?  Just how widespread is the issue of food deserts and what is being done about it?

According to the USDA Economic Research Service and its High Priority Performance Goals approximately 23.5 million people live in food deserts. More than half of those people (13.5 million) are low-income.  It is extremely difficult to come up with a fair and accurate estimate of the number of elderly, 65+ years of age, who live in food deserts.  Estimates among elderly living in food deserts have ranged anywhere from 10% in urban communities to 25% in rural areas.   According to Eric de Place (2009), residents with lack of access to grocery stores end up over-spending, or buying food with limited nutritional value, or both. Fresh fruits and vegetables—so important for a healthy diet—are in short supply, if they exist at all.   Finding local or organically grown food is even more remote.  So food deserts can result in poor health, tight budgets for those who can least afford it, or long cumbersome bus trips to other neighborhoods. He acknowledges that the problem is most severe for the elderly, single parents, and the disabled.  It’s not just an urban land use issue: it’s a problem with profound social justice implications.

Many agree that solutions to food deserts are few and mostly inadequate.  Legislation has been proposed, such as developing a revolving fund to offer loans to small grocers that can operate in food deserts.  But somehow throwing money at the problem never seems to work well, especially in politics.  Others suggest community involvement, such as volunteering at your local food bank, offer a ride to your elderly neighbor who is having difficulty accessing grocery stores.  Large food conglomerates, such as Wal-Mart, have a double-edged sword.  While many blame large food chains for putting smaller, local grocery stores out of business due to feasibility of competing with offering lower prices.  Yet many bus lines have large stores, including Wal-Mart, on their stop routes.  Another ‘solution’ may be to for private taxi companies to offer a lower, standard rate for elderly traveling to the grocery store.  De Place warns that assuming vulnerable low-income populations can just buy laptops, get high-speed Wi-Fi, order healthy groceries on-line and have them delivered, is obviously not a solution. Even if the tools of the Internet Age were widely available and affordable—and they’re not yet — they wouldn’t be of much use to the elderly, immigrants with limited English, or folks who don’t have a credit card or bank account.   Some grocery stores offer delivery service.  But then affordability for the service becomes a barrier.  Local community farmers markets are becoming more popular.  But if you’ve ever been to one, the majority of visitors are young and full of resources, such as money, energy and bright eyes.

Is it possible that more health providers, especially social workers and community health workers, can become more involved in identifying at risk elderly, who may be having issues accessing good, healthy food?

So, as I consume my huge Thanksgiving dinner and try not to feel guilty, I can hope that maybe increased awareness, empathy and community involvement can work in tandem to possibly increase access to food among older populations in our communities.  Anyone have any other ideas?

References

1. Eric de Place (@Eric_deP), March 5, 2009. Deliver Us from Food Deserts. Economy & Jobs, Food & Sustainable Living, Land Use & Transportation
2. Associated Press, 2012. Residents do Without in America’s Food Deserts. http://www.nbcnews.com/id/5353901/ns/health-fitness/t/residents-do-without-americas-food-deserts/
3. Morton, L.W. and Blanchard, T.C. Staved for Access: Life in Rural America’s Food Deserts.  Rural Realities, Vol. 1 (4), 2007.

Our Guest Blogger this week is Tony DiNuzzo, Ph.D., Director, East Texas Geriatric Education Center/Consortium, UTMB.

Join us for a real-time discussion about questions raised by this essay on Tuesday from 12:00 p.m. to 12:45 p.m. See Discussion and SL tabs above for details. Link to the virtual meeting room: http://tinyurl.com/cjfx9ag.