Too Fat to Fight

In several recent articles, the New York Times has revived the debate around “food deserts” and, in suggesting that they are not as pervasive a problem as once thought, stirred up controversy in food policy circles.  Whether the Times is accurate in its suggestion that food deserts are not a major contributor to the lack of proper nutrition in the United States, the debate serves as a salient reminder that fighting the epidemic of obesity is a complex task and not one that lends itself to easy bromides like “increasing access.”

That obesity and lack of nutrition are an enormous problem in the United States should not be open to debate.  Over 30% of American children are overweight or obese.  Unfortunately the problem is exacerbated by existing socio-economic and racial inequality; more than 40% of African-American and Hispanic children are classified as overweight or obese.  Obesity and malnutrition translate into increased health care costs for the country as a whole.  The effects go beyond higher healthcare costs.  Obesity is the number one reason why young Americans are turned away from military service today.  As food writer Mark Winne has suggested, world peace is a laudable goal but being “too fat to fight is perhaps not the best way to achieve it.

The inequitable distribution of obesity cases – with so many focused in urban, low-income environments – led to a focus on the notion of food deserts as a prime cause in the rise of obesity.  A food desert is defined as a census tract containing low-income populations, a third of which live more than a mile from a supermarket or a grocery store.  The definition provides a powerful intuitive reason to believe that food deserts are a primary cause of obesity; if low-income families cannot access high quality, nutritious food at a supermarket, it is not surprising there exist high-levels of obesity in these neighborhoods (implicit here is the view that the corner shops that take the place of supermarkets do not offer the same level of food quality – a fact often born out by reality).  It follows then that to solve the problem of obesity, one must provide access to high quality food by opening farmers markets, vegetable carts, and supermarkets in these low-income communities.

Unfortunately, the reality of what causes obesity is much more complex than a simple narrative of food deserts.  Several recent studies have shown that access to supermarkets and nutritious food does not have the desirable effects on obesity rates that it was assumed they would (subs. Req’d).  Not only that, but the presence of food deserts may have been dramatically over-estimated.  By some accounts low-income areas have higher access to large grocery stores than high-income areas and differences in access only weakly explain changes in Body Mass Index (BMI).  Looking at the evidence, a U.S. food policy expert has estimated that only 2-6% of Americans lack good access to a supermarket.  If that it is the case, food deserts are clearly not sufficient explanation for the obesity epidemic.

The majority of people fighting to fix food policy in this country are not surprised that food deserts are insufficient to explain the entire obesity epidemic in the U.S.  As one of the original coiners of the term ‘food desert’ points out, no reputable agency or individual in the food arena believes it was only an issue of access.  In Michelle Obama’s Let’s Move Campaign to end childhood obesity, fighting food deserts is only one of a five pillar approach.  The other pillars include providing healthy food in schools, increasing exercise, and educating about nutrition.

In a larger sense solving the obesity epidemic requires changes in policy to shift the incentive structure of American food production.  The subsidization of starchy foods means that on a dollars per calorie count, vegetables are some of the most expensive food you can buy and therefore out of the reach of many even if they can get to stores that stock the produce.  It requires cultural and policy shifts that make cities and towns more walkable.  Today, distances beyond 110 of a mile are beyond walkable for American children but the average American child spends 7.5 hours in front of TV/computers/video games.  Finally, addressing inequality may also directly help to fight the obesity epidemic by reducing the attractiveness of fast food.

The new controversy over food deserts is mostly a manufactured one.  The media latched onto the simple notion that access could explain the rise in obesity in American cities.  When it, unsurprisingly, failed to be the whole story – or even a majority of the story – they decried food deserts as an unnecessary and overwrought concern.  This simplistic narrative does nothing to solve the real problem.  Food deserts are not the only cause of obesity in the United States.  Lack of access to quality food is a significant problem but it is not the only problem.  Indeed, even access to a supermarket does not guarantee access to quality food.  It is time that the media took up the cause of nutrition and food policy in a serious manner.  By raising awareness of the complex nature of this problem they can put pressure on Washington and local governments to provide serious solutions.