Mitigating America's food desert dilemma

Source: Smart Cities Dive | Katie Pyzyk | May 7, 2019

Food deserts are pervasive across the United States and have proven challenging to eradicate. However the past decade has ushered in a fresh wave of city innovation in the space, with data-driven, strategic and comprehensive plans replacing one-off efforts to bring food to underserved areas. 

The U.S. Department of Agriculture (USDA) estimates that 19 million people in the U.S., or 6.2% of the population, are more than 1 mile from the nearest supermarket or grocery store in an urban area, and more than 10 miles from a grocery store in a rural area. The Department defines urban food deserts as such communities meeting federal low-income and low-access thresholds, and the primary food options available in these areas often consist of fast food or processed snacks from convenience stores. The food desert phenomenon also disproportionately affects communities of color.

The Department also factors in vehicle accessibility when identifying food deserts. (USDA notes a tract is identified as having low vehicle availability if more than 100 households report having no vehicle available and are more than 0.5 miles from the nearest supermarket.) For example, food access is a concern in Baltimore, where nearly one-third of residents do not have a car; about 23% of the city’s residents are considered to live in a food desert.

Some advocates dislike using the term "food desert" because it indicates the dearth of a resource, whereas citizens in some designated food deserts have access to food, but those options don't hold significant nutritional value. Plus, a desert is a naturally occurring phenomenon, whereas food deserts are created by humans, often through disinvestment or inadequate resource allocation. Thus, some advocates prefer alternative language such as "food equity," or "healthy food priority areas," as Baltimore relabeled these zones last year.

Modern, data-driven strategies

The responsibility for alleviating food deserts largely rests at the local level. Previously, the most common food desert mitigation practice was to facilitate a new grocery store coming to an area; these brick-and-mortar stores are frequently referred to as "food retail."

But cities are finding that approach to be inadequate for a variety of reasons, including the challenge of retaining stores once they arrive. Grocery stores — which generally are considered capital intensive and only marginally profitable — struggle to sustain business in low-income neighborhoods because they only make half the sales they would in affluent neighborhoods. Retail owners also voice concerns about theft and crime, and underlying institutional racism also plays a part, advocates say.

The grocery industry’s own disruption and evolution are factors as well. City leaders report an overall food retail decline in their communities over the past decade. In Birmingham, AL, at least three major grocery locations have closed in the last year. Grocery stores "have opened fewer locations. In fact, I learned Walmart was only opening 10 stores nationally, and in its heyday it opened 300," Josh Carpenter, Birmingham’s director of economic development, told Smart Cities Dive. "It has made it more challenging for us to get grocery stores in proximity to our residents."

"We're taking an all hands on deck approach to this...The problem has gotten so difficult. It is the number one conversation in our community."

"Like a lot of industries, the grocery distribution industry is changing so we decided we wanted to take a little bit of a broader look at what might be able to do," Kirk Wendland, executive director of Jacksonville’s office of economic development, told Smart Cities Dive.

Jacksonville — where 23% of residents are deemed to live in a food desert — hired a consultant to examine healthy food access and provide recommendations to improve it in the Northwest portion of the city, where 38% of its food deserts are located. The consultant analyzed neighborhood-level food desert data and released the report this spring with a suite of recommendations. Leaders now are moving forward with adopting an ordinance to appropriate $3 million to increase food equity and authorize the first program to result from the report, which involves economic incentives for food retail creation and retention.

Putting public dollars into a grocery store is "not traditionally what we do. But you can use our traditional model… to help the capital side of the equation," Wendland said. However, some of the more innovative recommendations that are largely untested — such as subsidized grocery delivery within food deserts — are more challenging. 

"They can have a good effect, but you also have to protect those public dollars," he said. "You don't want to start something up and then have it fail in a couple months."

Another recommendation the city is working to implement is a program to assist convenience stores with dedicating a portion of their floor space to fresh foods, even if that means setting up fresh food kiosks outside the store.  

Birmingham — where a staggering 69% of people live in a food desert — also hired a consultant to study the issue. Leaders recently received a report and presentation detailing the city’s food desert situation and areas of opportunity. Last week, leaders approved the $500,000 Healthy Foods Fund to finance food equity initiatives that could include food retail incentives. One of the more inventive ideas is to create mobile grocery stores that bring fresh foods directly into neighborhoods.

The city "wanted to take a comprehensive, smart city approach" and has been using data-driven tactics to recruit grocery retailers and inform decisions about programs to increase food equity.

Leaders in Birmingham and Jacksonville sought successful modern strategies from other cities tackling food desert mitigation, but few mature strategies existed. "We didn't see many who were in the advanced stages. It looked like everybody who was starting to get into this space was pretty new at it and was feeling their way through," Wendland said.

Baltimore stood out as being further along than most other cities. It has its own food access maps, created in partnership with the Center for a Livable Future in the Bloomberg School of Public Health at Johns Hopkins University, to drive food strategies and policies. Its comprehensive healthy food environment strategy centers on eight key points, including maximizing nutrition assistance programs, supporting urban agriculture and addressing transportation gaps that affect food access.

Holly Freishtat became Baltimore’s first food policy director in 2010 when only a handful of cities had such positions. She’s now among a pool of nearly two dozen others who collaborate through the U.S. Conference of Mayors’ food policy task force. She helps to oversee and integrate all of Baltimore’s food equity work because “we know that food does not fall into any one agency, it's in many agencies,” she said. "This is the synthesis of the role of city government and operations and how we address food security and food access issues."

The city’s newest initiative is its establishment of Resident Food Equity Advisors(RFEAs). The 16 RFEAs are paid Baltimore residents who meet with officials to provide insight on healthy food policy and planning strategies.

"They give us recommendations that we never would have been able to come up with on our own," Freishtat said. "It’s looking at a different model of how we get community engagement in a deep, meaningful way to help drive our strategies related to food issues."

Private plans

In addition to local government action, the private sector is stepping up both to partner with cities and implement wholly separate healthy food access programs.

Last year, Lyft launched a six-month pilot in Washington, DC, dubbed the Lyft Grocery Access Program, to tackle one of the main barriers to low-income residents' healthy food access: transportation. Families identified as living in food deserts received a number of reduced, flat-fare trips to and from grocery stores each month. Last month, Lyft expanded the pilot program to Atlanta, and days later it announced a formal project launch with 15 additional participating North American cities and more coming later this year.

The newly-launched foodQ pilot program in Chicago and Dallas tackles food access from a transportation and technology standpoint. The joint effort from the Blue Cross Blue Shield Institute and Health Care Service Corporation is an online-based delivery service to bring nutritious, affordable and fully-cooked meals to people living in food deserts, and to "develop an innovative approach to overcoming some of the barriers" to eating healthy foods, Dr. Derek Robinson, vice president and chief medical officer at Blue Cross and Blue Shield of Illinois, told Smart Cities Dive.

The team identified 25 ZIP codes in Chicago and 15 in Dallas where pilot participants use a mobile-optimized website to choose their meals and enter the date and time they want it delivered. Cellphone ownership is high even in low-income communities, Robinson said, so foodQ users receive a text message confirming an order and notifications when it is in transit and has been delivered.

The two cities were chosen for the pilot not only because of their food deserts, but also their population density and infrastructure that allow for a successful pilots to leverage modern technology and resources that weren’t available five or 10 years ago.

"It’s important to participate in the innovation process and help accelerate ideas that allow us to approach problems and health challenges in a way that's different than it may have been in the past," Robinson said. "There’s a unique opportunity to move further upstream from the chief medical issues that occur and try to address some of the social barriers and behaviors — such as what you eat — that impact the health of individuals and communities."

Meal delivery services are not a new concept, but foodQ modernizes the original idea first made mainstream by Meals on Wheels. Although other modern meal kit services exist, they tend to be out-of-reach for low-income residents. The foodQ meals are available at a price point intended to be competitive with some of the lower-cost,  unhealthy foods people may consume in a food desert. 

"This is not a solution that will solve all problems, but it definitely moves us in right direction," Robinson said.

Measuring impact

A primitive measure of success for food desert mitigation is simply establishing food retail in an underserved area. But broader and continued food equity requires ongoing work and different metrics for determining success, experts say.

Some of Baltimore’s food policy successes so far include incentivizing retail in food deserts, incentivizing community supported agriculture (CSA) participation, developing a healthy vending machine procurement policy and changing zoning and animal husbandry regulations to remove barriers for urban farming. Future success with increasing food equity will be based on the metrics in the newly adopted Baltimore Sustainability Plan.

The city also was influential in getting Maryland to change its Supplemental Nutrition Assistance Program (SNAP) benefits distribution from 10 days to 20 days, because grocery retailers who accept the benefits had complained they only received substantial business in food deserts during the SNAP distribution period and not the rest of the month. The distribution alteration has helped to even out monthly sales. 

For new food equity programs, like Jacksonville’s, success "would probably be measured 10 to 15 years out [with] your health outcomes. But you can't wait 10 or 15 years to say it looks like this is having a positive impact," Wendland said. Therefore, his team analyzes whether they’re getting food products into the hands of those who need it, and the cost of doing so. "You could have a wildly successful program as far as getting product where you want it to go, but if it’s cost prohibitive that you can’t continue to do it on ongoing basis, then maybe it’s not successful," he said.

Birmingham has the goal of halving the number of residents living in a food desert by 2022. "That’s an ambitious goal," Carpenter said. A near-term goal is to bring food retail to the areas of most need.

"We're taking an all hands on deck approach to this... The problem has gotten so difficult. It is the number one conversation in our community," Carpenter said. "I'm hopeful we can have this conversation… maybe a couple years from now, and we will have reduced that number. But I think it’s going to take a systematic and strategic approach to do so."

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