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What Are Food Deserts — and How Are They Impacting Healthcare?

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The term "food desert" paints an accurate picture of a dire situation that many Americans face daily. In short, a food desert is a geographic area where residents' access to affordable, nutritious food is limited or nonexistent because of a lack of convenient grocery stores.

The nonprofit Food Empowerment Project (FEP) rightly points out that the term "food desert," as defined by the U.S. Department of Agriculture (USDA), is problematic because it centers on "proximity to food providers, rather than considering other factors such as racism, cost of living, people being time poor and cash poor, cultural appropriateness of available foods, [and] the ability of people to grow their own foods." The FEP also notes that "food apartheid" and "food oppression," although less common, are more accurate terms because they point to the systemic issues that force folks into food deserts.

So, how widespread is food oppression? According to a 2017 report from the USDA, nearly 39.5 million Americans live in low-income and low-access areas (or what the USDA has termed "food deserts"). Of these nearly 40 million people, half have limited access to full-fledged supermarkets or grocery stores. Without a doubt, food deserts — that is, food oppression — underscore(s) the various inequities that exist in the United States, and, in turn, create additional health-related challenges for folks living within them.

Who Is Impacted by Food Oppression?

If you aren't impacted by food oppression, you might think of the excess of food found in supermarkets and big-box stores. But many Americans don't have the privilege of so many options — or any convenient, nutritious options at all. The Annie E. Casey Foundation has found that so-called "food deserts" often share some, if not all, of the following characteristics: they are located in areas with smaller populations; feature higher rates of abandoned and vacant homes; and are home to folks who have lower income and education levels. Additionally, unemployment rates are often higher in food deserts.

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Researchers at Johns Hopkins University found that the availability of high-quality food and supermarkets is linked to "racial residential segregation, poverty, and urbanicity." Regardless of geographical area (rural vs. urban), Black Americans are disproportionately impacted, often living in areas deemed food deserts.

The same inequality and lack of access disproportionately affect Indigenous and Latinx people as well. That is, neighborhoods and communities with predominantly BIPOC residents feature fewer stores, greater distance between homes and stores, and fewer community resources that could help folks access food and supermarkets, such as a lack of viable public transportation and infrastructure.

There isn't just one factor that causes food deserts. Several contributing factors include transportation challenges, convenience food and income inequality. "When researchers from Brown University and Harvard University studied diet patterns and costs, they found that the healthiest diets — meals rich in vegetables, fruits, fish and nuts — were, on average, $1.50 more expensive per day than diets rich in processed foods, meats and refined grains," the Foundation notes. "For families living paycheck to paycheck, the higher cost of healthy food could make it inaccessible even when it's readily available." Moreover, folks who receive SNAP benefits don't always have access to nutritious foods, based on the parameters of the program.

How Does Food Oppression Relate to Healthcare?

So, how does food oppression relate to healthcare and your well-being? In many ways, it boils down to a person's ability to choose. In so-called food deserts, there's not only a lack of options, but cost can also figure into the decision. "Many food deserts contain an overabundance of fast food chains selling cheap 'meat' and dairy-based foods that are high in fat, sugar and salt," FEP notes. "Processed foods (such as snack cakes, chips and soda) typically sold by corner delis, convenience stores and liquor stores are usually just as unhealthy."

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Moreover, folks navigating food oppression may also have difficulty accessing foods that align with their dietary needs or restrictions. For those with celiac disease, lactose intolerance or other food allergies, this can cause an abundance of problems. Without larger chain stores, alternatives — like nut-based milks, for example — simply aren't available. But just because the options may exist in certain areas doesn't mean folks can always access them. FEP reports that "urban residents who purchase groceries at small neighborhood stores pay between three and 37% more than suburbanites buying the same products at supermarkets."

Although relying on fast-food products and other processed goods may be the only financially feasible option for some, diets that center on these foods in the long term can have lasting consequences on your health. These lower-quality foods are often linked to higher rates of Type 2 diabetes, cardiovascular disease and other health conditions. Pair this with the fact that both fatphobia and racism have been long ingrained in the healthcare and medical industries, and you can start to understand the challenges folks face when seeking care and support.

So, what can be done to dismantle food oppression? While funding programs that tell us all to eat healthy may be nice in theory, these campaigns do very little to address the real problems. That is, such campaigns displace the blame, centering "eating healthy" as a choice. But for many, there is no choice to begin with. Instead, supporting small stores and locally sourced farmers' markets and growers can have a huge impact, for example. Moreover, expanding SNAP benefits, incentivizing grocery stores to move into "food deserts" and offer affordable food, and fighting for policy reform can all help create lasting change.