A Corner Store as the Cornerstone: How Do We Increase Access to Healthy Produce?
Here’s an op-ed that I wrote as part of my first semester at Columbia University Mailman School of Public Health. The assignment was to write on any public health issue, and I used the opportunity to write about an issue that has been plaguing my mind since I first moved to LA in 2014.
Faith is eleven years old, hoping that her mom will pack her a snack to supplement her free school lunch. She knows that her friends at school will also be bringing snacks from home, which they usually share to avoid eating the inedible food that the district provides. Sure enough, her mom returns from the bodega with a bag of Takis. Though Faith is content, her mom frets: with money tight, heavily processed chips are the easiest way to provide food that is cheap, filling, and ready-to-eat.
For 23 million Americans like Faith and her mother, low-cost and healthy food options are a rarity. Inadequate supermarket access creates food deserts — geographical regions where the nearest supermarket is over one mile away in urban areas and ten miles away in rural areas. About half of all low-income American neighborhoods are said to be food deserts. Those living in a food desert have increased incidence rates of myocardial infarctions (heart attacks) and chronic conditions including diabetes, high BMI, and high cholesterol.
Conversely, a food swamp falls victim to the opposite: an oversaturation of high-calorie fast food establishments and junk food availability within a neighborhood. Though these establishments provide filling and affordable portions, they worsen health outcomes. The average food swamp provides four unhealthy options for every healthy option, and its existence is often a stronger predictor of obesity rates than the existence of a food desert — though the two are intertwined.
Faith and her mom live in a community that is both a food desert and a food swamp. Every day, she and her friends eat what is available to them: high-calorie, processed snack foods. If she was to learn that she should have 2–3 servings of fruits and vegetables daily but does not have any in her fridge, then this lesson was irrelevant. Education, especially in public health, can be powerful. But it cannot be the sole approach to improve dietary habits — it is meaningless without the provision of healthy foods and produce.
How do we increase the availability of healthy produce in areas where it does not currently exist? Tempting as it is to reinvent the grocery store through trendy alternatives, we must also curtail the fast food empire’s involvement in vulnerable communities. A culturally competent and sustainable solution should get fresh produce into corner stores and local markets to increase its abundance and affordability and drive out fast food chains. In major cities and in rural areas, grassroots programs coordinated by local health departments have great potential to improve local health.
In 2008, the Minneapolis City Council adopted a city-wide ordinance, requiring licensed grocery stores (including corner stores) to stock foods from four staple categories: dairy, grains, protein, and fresh fruit and vegetables. Low compliance a year later prompted the Minneapolis Health Department to launch the Healthy Corner Store Program in 2010. By 2018, despite the addition of 6 more categories, 92% of the stores were compliant in 6 or more categories, with 38% meeting all ten. Furthermore, store owners reported increases in sales and demand for produce. Similar efforts are already underway through New York City’s Healthy Bodega initiative and San Francisco’s Healthy Retail program.
Corner stores, oftentimes central parts of a community’s identity, are perfectly positioned to improve neighborhood health. Transforming a food swamp requires an increase in affordable healthy food options. We need corner stores and grocery stores in greater numbers, and we need to increase their use. Expansion of the Electronic Benefit Transfers (EBT) and Women, Infant, and Children (WIC) programs to allow corner store purchases would also provide an additional economic incentive for corner stores and program recipients to invest in healthy produce.
The nutritional landscape of the nation — namely, the existence of institutional failures that create food deserts and food swamps — currently costs us $71 billion annually in health care costs. Our government spends 10 times more per person to treat chronic diseases than to prevent them. Though poor nutrition is just one part of the vicious feedback cycle of systemic poverty, investing in programs that improve access to low-cost, healthy foods will intervene on its impact on vulnerable communities, paving the way for additional initiatives that address the root causes of poverty.
The basic tenet of public health is that interventions that authentically engage education and systems-based thinking can really improve health outcomes. To eliminate the disparities that exist in accessing healthy food, we must use this framework to bolster corner stores with healthy options and shake the influence of fast food conglomerates. For Faith, her mother, and 23 million like them, this community-level long-term solution is the first step in improving health outcomes through the food they eat.
