Moving Beyond Food Deserts in Healthy Food Policy

Moving Beyond Food Deserts in Healthy Food Policy

By Sally Mancini, MPH and Kristen Cooksey Stowers, MPP, PhD
Published on: April 2023

Introduction

Advocates and policymakers have used the term “food desert” to shape public health and food policy in the US for decades. But in recent years, critics have identified limitations to the term—including its failure to acknowledge the root causes of limited food access and the vibrancy of the communities experiencing it. This resource explores the history of the term, discusses its shortcomings, and suggests how those working on healthy food access issues might move beyond the term by adopting an approach that focuses on a community’s assets rather than its deficits.

History of the Term “Food Desert”

The term “food desert” is reported to have been created by a Scottish public housing resident in the early 1990s.1 Use of the term quickly grew in popularity in the United Kingdom, and in the 2000s, was commonly used by US public health and food policy advocates.2 “Food desert” first appeared in federal legislation in the 2008 Farm Bill, also known as the Food, Conservation, and Energy Act of 2008,3 when Congress directed the US Department of Agriculture (USDA) to study and produce a report on food deserts.4

Although there is no definition of the term in US federal law, the USDA Economic Research Service, US Treasury Department, and US Department of Health and Human Services developed a definition after the 2008 Farm Bill used census tract5 data to qualify areas as food deserts.6 According to this definition, food deserts are low-income census tracts with a substantial number or share of residents with low levels of access to large retail outlets selling healthy and affordable foods.7

The United Kingdom’s House of Commons proposed the Food Poverty (Eradication) Bill in 2001. The bill required the secretary of state to publish and implement a strategy for abolishing food poverty and to set targets for implementing that strategy. When presenting the bill, Member of Parliament Alan Simpson stated: “Whatever collection of ideas we pursue, we will have to consider incentives for dealing with places in almost all our cities and communities that have become food deserts where one cannot find fresh food outlets that are accessible to the food poor.”

Alan Simpson. House of Commons official report (Hansard). 2001. Dec 12:part 5:column 840. Food Poverty (Eradication) Bill (parliament.uk)

Specifically, a census tract qualifies as a food desert if it meets these low-income and low-access thresholds:

  • Low income: a poverty rate of 20 percent or greater, or a median family income at or below 80 percent of the statewide or metropolitan area median family income.
  • Low access: at least 500 persons or at least 33 percent of the population lives more than one mile from a supermarket or large grocery store (or 10 miles, in the case of rural census tracts).8

According to these definitions and data from the 2000 Census of Population and Housing, an estimated 13.5 million people in the United States had low access to a supermarket or large grocery store, with 82 percent of those living in urban areas.9 Additionally, a Congressionally mandated 2009 USDA Economic Research Service Food Desert Report found that urban “areas with limited food access are characterized by higher levels of racial segregation and greater income inequality.”10 The report also found that small towns and rural areas that have limited food access also tend to have limited transportation infrastructure.11

In 2013, USDA phased out the term12 and began referring to food deserts as “low-income and low-access areas.” Through the Food Access Research Atlas, USDA continues to track and report data on access to large retail outlets selling healthy and affordable food.

The Term “Food Desert” in US Policy

Federal, state, and local governments have used the term “food desert” for over a decade and it remains common in policy language related to healthy food access. Many of these policies can be traced back to the Healthy Food Financing Initiative (HFFI), which was created as part of Michelle Obama’s Let’s Move campaign in 2010.13

HFFI policies at the local, state, and federal levels have provided critical funding for healthy food projects. They have been used to provide loans, tax credits, grants, and technical assistance to promote and finance the development and growth of businesses that can provide access to healthy food. While these businesses have primarily been grocery stores, these financing initiatives have also supported farmers markets, food hubs, and grocery co-ops in areas defined as food deserts. Between 2019 and 2020, the federal HFFI awarded $4.4 million in targeted grants to 30 projects designed to improve access to fresh, healthy food through food retail.14 Additionally, more than 35 states have pursued HFF initiatives in food deserts.15 At the local level, the Healthy Food Policy Project’s policy database contains at least 12 local policies that use the term “food desert.” These policies and programs seek to improve access to healthy foods while creating and preserving quality jobs and revitalizing communities through loans and grants to historically underserved and marginalized areas.16

State examples of funding for healthy food financing initiatives (HFFI)

Alabama:17 In 2017 the state of Alabama invested $300,000 of seed funding in its Healthy Food Financing Initiative (ALHFFI) to fund healthy food retail projects across the state. Under this program, which is being administered by the Alabama Department of Economic and Community Affairs (ADECA), eligible projects can include establishing new grocery stores, expansion or renovation of existing grocery stores, installation of cold or freezer equipment in existing stores, mobile grocery vans and delivery, food banks, farmers markets, and other venues that help bring healthy foods to families in low-income areas underserved by healthy grocery retail. The state legislature allocated an additional $200,000 in 2018 to be used to expand the program and fund new projects across Alabama.

Minnesota:18 The American Heart Association and Blue Cross Blue Shield together worked with a coalition of local stakeholders on state advocacy for healthy food financing, which resulted in the development of the Minnesota Good Food Access Fund (GFAF). Minnesota’s state legislature allocated $250,000 for the GFAF in 2016, which included funding for the establishment of a Fund Advisory Committee, as well as funds to support permanent healthy and affordable food retail facilities in areas of the state that had low access to healthy food. This program has grown, with the state expecting to award up to $320,750 in fiscal year 2023, in the form of grants between $2,500 and $50,000.

Shifts in “Food Desert” Terminology

Among those working on healthy food access policy, there has been a shift over the last ten years in how systemic and structural inequities are defined and addressed through law and policy. Consequently, advocates recognize the limitation of the term “food desert” and use it less frequently. The term implies that the problem of limited food access is simply part of the built environment, which suggests that more grocery stores and retail venues are the solution. As a result, the term fails to acknowledge the deliberate policy decisions that created the scarcity of grocery stores in low-income neighborhoods in the first place (such as supermarket redlining, resident segregation, and other historical phenomena).19

Learn More:

Food Apartheid: What Does Food Access Mean in America?
Interview with Detroit food activist Malik Yakini for the T. Colin Campbell Center for Nutrition Studies.

Food Apartheid: The Root of the Problem with America’s Groceries
Interview with Food Activist Karen Washington in the Guardian.

Further, the term does not recognize root causes (namely, structural racism), historical context, or racial inequities that account for the fact that more people of color live in food desert neighborhoods. Moreover, the term emphasizes distance to food as the leading determinant of food access rather than other dimensions of food access (such as affordability, cultural acceptability, convenient store hours, accessibility, and availability).20 Finally, the term fails to acknowledge the abundance of high-fat, high-sugar, high-salt, processed foods prevalent in the small store formats common in urban, low-income neighborhoods—a phenomenon more commonly captured by research on food swamps.21,22 Continued use of the term has contributed to policy solutions focused primarily on the development of grocery stores, rather than other policy options that address nonspatial barriers such as income, employment, education, and mobility.

Asset-based community development, also known as ABCD, acknowledges and embraces particularly the strong neighborhood rooted traditions of community organizing, community economic development and neighborhood planning.”

John P. Kretzmann and John L. McKnight, Introduction to “Building Communities from the Inside Out: A Path Toward Finding and Mobilizing a Community’s Assets,” Institute for Policy Research (1993).

Because the term “food desert” is rooted in deficit and lack of awareness, it does not use an asset-based or resiliency framework23 to reflect the vibrancy of communities lacking access to healthy food. This failure then leads to reduced opportunities to include communities in developing solutions. Research has demonstrated that supermarket interventions in low-income and low-access areas that focus on community assets through community engagement and cooperative management models are highly sustainable.24

Case Study: Baltimore, Maryland

In 2018, the city of Baltimore, Maryland, replaced the term “food desert” with Healthy Food Priority Areas. This change was driven by the recognition that there are structural elements shaping Baltimore’s food system that are better captured using the new term. People in these areas face additional barriers, travel further to reach healthy food outlets, and may not have the economic means to afford healthy food options.

Baltimore’s Department of Planning and the Johns Hopkins Center for a Livable Future collaborated to provide the research, analysis, and mapping of Healthy Food Priority Areas, using the Healthy Food Availability Index, that in turn informed the work of the Food Policy and Planning Division. The work of the Food Policy and Planning Division was led by the Food Policy Director and staffed by a Food Access Planner, a Food Resilience Planner, and a Food Systems Planner. The Food Policy and Planning Division oversees the Baltimore Food Policy Initiative (BFPI), which has three pillars: interagency collaboration, the Food Policy Action Coalition, and Resident Food Equity Advisors.

Together, these efforts seek to build an equitable and resilient urban food system by addressing health, economic, and environmental disparities in areas that have high food insecurity. In addition, BFPI renamed and expanded its Food Desert Retail Strategy. Now called the Healthy Food Environment Strategy, it addresses a broad range of food access policies, such as healthier small grocery, corner, and convenience stores; implementing supply chain solutions; and emphasizing resident engagement in all stages of the policy development process, including prioritization of food policies.

Rethinking Policy Language

Healthy food advocates have an opportunity to evaluate and propose alternative policy language that does not have the same limitations associated with the term “food desert.” Food policy councils and others working on food access policy can play a leading role in educating policymakers about these issues and advocate for new terminology that encourages community-driven solutions to address systemic issues and move families out of poverty.

Using an asset-based approach to food policy change identifies and builds upon the strength of a community.25 It allows community members to define themselves and the way in which they experience access, or lack of access, to healthy food. Depending on the community, local food policy councils, civic associations, or faith-based organizations may be well poised to lead efforts to replace the term “food desert” with more appropriate, asset-based terms and frameworks that identify the cause of current and historical inequities.

Acknowledgments

Kristen Cooksey-Stowers, PhD, Assistant Professor, Department of Allied Health, University of Connecticut; Anne Palmer, Food Communities and Public Health Program Director at Johns Hopkins Center for a Livable Future and senior research associate at the Johns Hopkins Bloomberg School of Public Health; and Lihlani Nelson, Deputy Director and Senior Researcher at the Center for Agriculture and Food Systems, Vermont Law and Graduate School reviewed and provided thoughtful feedback on this resource.

About HFPP
The Healthy Food Policy Project (HFPP) identifies and elevates local laws that seek to promote access to healthy food while also contributing to strong local economies, an improved environment, and health equity, with a focus on socially disadvantaged and marginalized groups. The HFPP is a collaboration of the Center for Agriculture and Food Systems (CAFS) at Vermont Law and Graduate School, the Public Health Law Center (PHLC), and the Rudd Center for Food Policy and Health at the University of Connecticut. This project is funded by the National Agricultural Library, Agricultural Research Service, US Department of Agriculture.

About CAFS
The Center for Agriculture and Food Systems (CAFS) trains law and policy students to develop real-world solutions for a more sustainable and just food system. With local, regional, national, and international partners, CAFS addresses food system challenges related to food justice, food security, farmland access, farmworker rights, animal welfare, worker protections, the environment, and public health, among others. CAFS works closely with its partners to provide legal services that respond to their needs and develop resources that empower the communities they serve. Through CAFS’ Food and Agriculture Clinic and Research Assistant program, Vermont Law and Graduate School students work directly on projects alongside partners nationwide, engaging in innovative work that spans the food system. Visit www.vermontlaw.edu/cafs to learn more.

Endnotes

1. Steven Cummins, “Food Deserts”—Evidence and Assumption in Health Policy Making, 325(7361) British Med. J. 436 (2002).

2. Id.

3. H.R. 2419, 110 Cong. § 7527 (2008).

4. Cong. Rsch. Serv., IF11841, Defining Low-Income, Low-Access Food Areas (Food Deserts) (2021).

5. A census tract is a small, relatively permanent subdivision of a county that usually contains between 1,000 and 8,000 people but generally averages around 4,000. Census Tracts, U.S. Census Bureau, (last visited Apr. 5, 2023).

6. Michele Ver Ploeg et al., Mapping Food Deserts in the United States, USDA (Dec. 1, 2011)

7. Econ. Rsch. Serv., No. 140, Characteristics and Influential Factors of Food Deserts (2012)

8. Cong. Rsch. Serv.,supra note 4; Supermarkets and large grocery stores—defined as food stores with at least $2 million in annual sales and containing all the major food departments—are often used as proxies for sources of healthy and affordable food. Economic Research Service, Documentation, USDA,(last visited Apr. 14, 2023).

9. Ver Ploeg et al., supra note 7.

10. Access to Affordable and Nutritious Food: Measuring and Understanding Food Deserts and Their Consequences, USDA (June 2009)

11. USDA, supra note 11; Michele Ver Ploeg, USDA ERS – Access to Affordable and Nutritious Food-Measuring and Understanding Food Deserts and Their Consequences: Report to Congress, USDA (June 2009)

12. Hemi Kim, Food Deserts: What Are They? Their Causes, Effects and Possible Solutions, Sentient Media (July 8, 2022)

13. Let’s Move Blog, Opening Near You! New Food Markets and The Healthy Food Financing Initiative, Obama White House (Oct. 15, 2010)

14. Eligibility, America’s Healthy Food Fin. Initiative (last visited Apr. 5, 2023)

15. View Policy Efforts by State, Healthy Food Access, (last visited Apr. 5, 2023).

16. Id.

17. Policy Counts: 2018 Legislative Reports, Voices for Alabama’s Children, (last visited Apr. 5, 2023); Alabama, Healthy Food Access, (last visited Apr. 5, 2023).

18. Minnesota, Healthy Food Access, (last visited Apr. 5, 2023); Good Food Access Program Equipment and Physical Improvement Grant, Minn. Dept. of Agric., (last visited Apr. 5, 2023). For additional state examples, see the Appendix of the report published by the Minnesota Grocery Access Task Force. Miriam Manon & Eugene Kim, Stimulating Grocery Development in Minnesota, Minn. Grocery Access Task Force, (last visited Apr. 5, 2023).

19. Leah Joyner et al., Farms and Gardens Everywhere but Not a Bite to Eat? A Critical Geographic Approach to Food Apartheid in Salt Lake City, 11(2) J. Agric., Food Syss., & Cmty. Dev., 67 (2022).

20. Caitlin E. Caspi et al., The Local Food Environment and Diet: A Systematic Review, 18(5) Health Place 1172 (2012)

21.

22. Kristen Cooksey-Stowers et al., Food Swamps Predict Obesity Rates Better Than Food Deserts in the United States, 14(11) Int’l J. Env’t Rsch. & Publ. Health 1366 (2017); Kristen Cooksey-Stowers et al., Racial Differences in Perceived Food Swamp and Food Desert Exposure and Disparities in Self-Reported Dietary Habits, 17(19) Int’l J. Env’t Rsch. & Publ. Health 7143 (2020).

23. Viola Cassetti et al., A Systematic Scoping Review of Asset-Based Approaches to Promote Health in Communities: Development of a Framework, 27(3) Global Health Promotion 15 (2019).

24. Catherine Brinkley,“If You Build It With Them, They Will Come”: What Makes a Supermarket Intervention Successful in a Food Desert?, 19(3) J. Publ. Affairs 1863 (2019).

25. “Asset-based community development, also known as ABCD, acknowledges and embraces particularly the strong neighborhood rooted traditions of community organizing, community economic development and neighborhood planning.” John P. Kretzmann & John L. McKnight, Introduction in Building Communities from the Inside Out: A Path Toward Finding and Mobilizing a Community’s Assets (1993).

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