Food deserts and fresh food access aren’t the problem. Poverty, not obesity, makes people sick.

Getting Fresh Fruits and Vegetables Into Poor Neighborhoods Doesn’t Make Poor People Healthier

Getting Fresh Fruits and Vegetables Into Poor Neighborhoods Doesn’t Make Poor People Healthier

What to eat. What not to eat.
Feb. 10 2014 7:00 AM

Food Deserts Aren’t the Problem

Getting fresh fruits and vegetables into low-income neighborhoods doesn’t make poor people healthier.

Market in Bed Stuy
Food vendor Daphina Jacobs (center) and friends set up a booth at the Hattie Carthan Community Market on its first day of selling locally grown organic produce in the Bedford-Stuyvesant neighborhood of Brooklyn on July 11, 2009.

Photo by Chris Hondros/Getty Images

A dozen recently and currently incarcerated women gathered in a classroom across the street from their San Francisco jail and considered a bulb of fennel. Crowded around a few small tables, the students peppered their teacher, Vera Pittman, with questions.

“Is that a vegetable?”

“Do we have to eat the hair?”


 “It’s fronds, not hair,” said Pittman, walking the fennel to each table so everyone could inhale its licorice-like smell.

The fennel 101 lesson was part of a cooking class called Soul Food, a program started by a local chef and aimed at teaching low-income women how to cook and eat fresh and local foods. Many women in the class are from the Bay Area’s poorest neighborhoods, places where people suffer more often from illnesses that better diets may delay or prevent, including high blood pressure, diabetes, and cardiovascular disease. They will die, on average, years earlier than wealthier Americans. 

Since 2004 there’s been a sharp spike in the number of programs like Soul Food that are aimed at reducing such health disparities by making fresh food more accessible to low-income people. These programs have earned the support of politicians and the first lady, who’s made fresh food initiatives a cornerstone of her campaign against childhood obesity.

It’s easy to understand why Michelle Obama and other influential figures have promoted fresh food initiatives: Bringing a bounty of fresh produce to impoverished “food deserts” is a lovely idea. But the idea isn’t borne out by evidence. Study after study has shown that the fresh-food push does nothing to improve the health of poor people, who continue to live markedly shorter and sicker lives than better-off Americans.

British politicians introduced the idea of food deserts in the mid-1990s, adopting the term after a few preliminary studies suggested a link might exist between distance to a grocery store and the diets of poor people. The idea had caught on in the U.S. by 2004, when Pennsylvania passed a Fresh Food Financing Initiative, which offered grants and loans to supermarkets willing to open in distressed neighborhoods and helped smaller stores expand their supplies of fresh food. Twenty-two states now have some version of fresh-food financing and there are countless local and nonprofit programs, including cooking and nutrition classes (like Soul Food) designed to get more fresh fruits and vegetables into the lives of poor people.

The first lady became fresh food’s most prominent booster when she announced the Healthy Food Financing Initiative in 2010. The initiative was modeled after the Pennsylvania program and also offers grants and loans, combined with tax incentives, to supermarkets willing to open in low-income neighborhoods and to help bolster the stock of healthful foods in smaller stores. Obama’s announcement followed a visit to a newly opened Philadelphia grocery store where her photo was snapped amid piles of apples, pears, and artichokes while she sipped on a freshly made smoothie. “For 10 years,” Obama explained at a speech following her tour of the Fresh Grocer, “folks had to buy their groceries at convenience stores and gas stations, where usually, they don’t have a lot of fresh food—if any—to choose from.”

The Healthy Food Financing Initiative was more than a victory for the food movement. Aimed in large part at low-income city neighborhoods, which tend to be disproportionately black and Latino, it was—and is—the Obama administration’s most visible policy designed to help poor people of color. The Healthy Food Financing Initiative has distributed more than $500 million to increase fresh food access—at the same time that funding for food stamps, a program proven to improve the lives of people living in poverty, was cut to pre-stimulus levels. Since the reductions, food stamp recipients have received just $1.40 per meal per family member.

Unfortunately, more fresh food closer to home likely does nothing for folks at the bottom of the socioeconomic ladder. Obesity levels don’t drop when low-income city neighborhoods have or get grocery stores. A 2011 study published in the Archives of Internal Medicine showed no connection between access to grocery stores and more healthful diets using 15 years’ worth of data from more than 5,000 people in five cities. One 2012 study showed that the local food environment did not influence the diet of middle-school children in California. Another 2012 study, published in Social Science and Medicine, used national data on store availability and a multiyear study of grade-schoolers to show no connection between food environment and diet. And this month, a study in Health Affairs examined one of the Philadelphia grocery stores that opened with help from the Fresh Food Financing Initiative. The authors found that the store had no significant impact on reducing obesity or increasing daily fruit and vegetable consumption in the four years since it opened.