Nutritious food sustains us and helps us thrive. Food brings us together in community and is an important part of our culture and shared experience. For these reasons, food is fundamental to our well-being and, in many places throughout the world, food is recognized as a human right.
However, stark inequities persist that affect access to healthy, nutritious, culturally relevant food resulting in severe public health consequences in the form of hunger, food insecurity, and unhealthy food environments. There are also significant consequences to the concentration of ownership, wealth, and power in the food and agriculture sector, with large-scale, commercial businesses crowding out small, independent farmers, disrupting local and regional food systems, and diverting power and resources away from communities. Many food and agricultural workers are not compensated and afforded workplace protections in a manner that reflects the importance of their work. Without them, few of us would eat. The COVID-19 pandemic worsened these inequities and emphasized how structural racism and white supremacy have created and sustained an unjust food system. These inequities and systemic injustices impact communities’ ability to grow, raise, find, obtain, transport, prepare, and eat food.1
Over the past several decades, there has been a shift in how different levels of government define, measure, and address food system problems and solutions, which has resulted in a shift in what terms policy makers use. For example, the federal government, including the United States Department of Agriculture (USDA), began using the term “food desert” in 2008 to describe communities with low incomes (i.e., with a poverty rate of 20 percent or more or a median family income equal to or less than 80 percent of the statewide or metropolitan area median family income) with low access to grocery stores. In this context, low access means that 500 or more persons, or at least 33 percent of the population, live more than one mile from a supermarket or large grocery store (10 miles, in the case of rural census tracts).2 However, as we will further discuss later in this resource, the term has more recently been identified as problematic, with some researchers, policymakers, and advocates shifting away from its use.
Food justice, food sovereignty, and food apartheid have emerged as approaches or frameworks to understand and address the various multi-level social, political, and commercial drivers of inequity within the food system—such as why communities with low incomes and predominantly Black and Brown neighborhoods have high concentrations of fast food restaurants, convenience stores, and marketing for sugary drinks and other unhealthy foods, or in the case of American Indian communities and reservations, why there is such limited access to grocery stores or healthy foods in general.
These frameworks reflect long-standing work in communities to advance equity and can be used to inform policy. In the next section, we talk about these frameworks and how they relate to each other.
For more information and perspectives on the social determinants of health and how they impact health equity, check these out:
Structural Racism in the U.S. is the normalization and legitimization of an array of dynamics – historical, cultural, institutional and interpersonal – that routinely advantage whites while producing cumulative and chronic adverse outcomes for people of color. It is a system of hierarchy and inequity, primarily characterized by white supremacy – the preferential treatment, privilege and power for white people at the expense of Black, Latino, Asian, Pacific Islander, Native American, Arab and other racially oppressed people.
-Keith Lawrence & Terry Keleher: Chronic Disparity: Strong and Pervasive Evidence of Racial Inequalities (2004)
A political, economic, and cultural system in which whites overwhelmingly control power and material resources, conscious and unconscious ideas of white superiority and entitlement are widespread, and relations of white dominance and non-white subordination are daily reenacted across a broad array of institutions and social settings.
-Ansley, F.L. (1997) ‘White Supremacy (And What We Should Do about It)’, in R. Delgado and J. Stefancic (eds) Critical White Studies: Looking Behind the Mirror, pp. 592–55. Philadelphia, PA: Temple University Press. (Cited in David Gillborn: Rethinking White Supremacy: Who Counts in ‘WhiteWorld’ (2006))
This is equity: just and fair inclusion into a society in which all can participate, prosper, and reach their full potential. Unlocking the promise of the nation by unleashing the promise in us all.
-PolicyLink: The Equity Manifesto (2018)
Health equity means that everyone has a fair and just opportunity to be as healthy as possible. This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care.
-Robert Wood Johnson Foundation: What Is Health Equity? (2017)
Health equity is defined as the absence of unfair and avoidable or remediable differences in health among population groups defined socially, economically, demographically or geographically.
-World Health Organization: Social Determinants of Health (2017)
Next: Advancing Equity
1See the Health Food Policy Project definition of “access” in the context of access to healthy food: “Food is accessibility when it is affordable and community members can readily grow or raise it, find it, obtain it, transport it, prepare it, and eat it.” https://healthyfoodpolicyproject.org/about/key-definitions.
2Ver Ploeg, M., Nulph, D., & Williams, R. (2011, December 1). Mapping food deserts in the United States. Retrieved June 14, 2022, from https://www.ers.usda.gov/amber-waves/2011/december/data-feature-mapping-food-deserts-in-the-us/#:~:text=Low%2Dincome%20census%20tracts%20with,are%20defined%20as%20food%20deserts.