(Not) My Plate: The Factors That Affect the Diets of Impoverished Communities

It is well known that America is dealing with a nutrition crisis as underserved communities deal with poor diets and health concerns such as diabetes and obesity. While some communities have access to fitness and nutrition resources, many do not have such luxuries. The imbalance in resources has resulted in a disproportionately high rate of obesity in poorer areas.  However, many politicians, lobbyists, and policy organizations have debated over what factors are causing the imbalance and how food health concerns should be addressed.

Many policies have been put in place, such as food stamps and systems to entice grocery store corporations to open in underserved areas, but there is still a question if these policies are addressing the correct factors. Are the impoverished communities able to access the grocery stores? Are they purchasing the right foods? Should their food choices be controlled? The problem is that many policies only address one or two factors that might be affecting the nutritional health of underserved communities, but the issue is actually more complex. In reality, there are five factors that have been identified as affecting the nutritional health of underserved communities, and all five factors need to be addressed for effective policymaking. The factors are food insecurity, food deserts, food swamps, mobility, and nutritional education.

Food insecurity addresses the affordability of healthy food. Research has shown that a person's ability to afford healthy food, such as fresh fruits and vegetables, plays a large role in the person's<\/g> nutritional health and risk of obesity and diabetes.  Communities that cannot necessarily afford health food have been found to have higher obesity rates, higher glucose levels, and higher rates of uncontrolled diabetes. Researchers have concluded that for food insecurity to be addressed, healthy food costs need to be closer to the cost of junk foods to make the healthy food more accessible as well as entice the buyer to buy the healthy food. As long as junk food is less expensive, the junk<\/g> food will be considered a smarter economic choice to the buyer, regardless of the long-term health effect. Therefore, the cost of healthy food needs to be more competitive when compared to junk food.

Food deserts are areas that have limited or no access to grocery stores. A food desert is determined based on the distance to the nearest grocery stores. Food deserts typically affect impoverished communities because grocery stores, like many businesses, do not want to be located in lower-income areas. There is some debate as to how much food deserts affect the health of impoverished communities, but there is a general consensus that there is an effect. Researchers have found that communities that are in food deserts have higher rates of obesity.  Limited access to grocery stores means there is limited access to healthy food, and the communities become more reliant on stores that sell higher-calorie, less-nutritional food. Therefore, to help improve the health of impoverished communities, geographic access to healthy food needs to be addressed.

In the same vein, food swamps are areas that have more stores selling high-calorie, less-nutritional foods than stores selling healthy food. A food swamp does not necessarily have to be a food desert. The community could have a grocery store that is stationed within the community, but if the grocery store is surrounded by fast-food restaurants, the community is considered to be in a food swamp and still tends to have a nutritional health problem. Studies have shown there is a strong correlation between food swamps<\/g> and obesity rates.  Some policymakers have suggested addressing this issue by restricting areas where unhealthy stores are allowed to exist, though that may lead to heavily concentrating the food swamp that will inevitably exist. Instead, it may be better to entice more healthy food stores to settle in the underserved communities.

Another factor that affects the health of impoverished communities is the mobility of the communities. Mobility is defined as the ability of the community to travel from their homes to the grocery stores using either their personal transportation or public transportation. To increase a person's ability to have access to healthy food and limit their risk of obesity, the person must have access to reliable transportation. (Id.) Therefore, policies that increase public transportation options also have an effect on the nutritional health of the underserved communities.

Finally, health education is an important factor that cannot be ignored. Without the proper nutritional education, underserved populations will not know what it means to choose healthy food options and what options are available. Researchers have found that when the above factors are addressed, there are still high rates of junk food consumption and obesity in impoverished communities if they aren't educated about healthy food options.  Therefore, the communities require proper education about purchasing healthy food and what a balanced meal looks like. 

Nutrition policies and decreased diet-related diseases in impoverished communities must go beyond simple actions such as providing food stamps or enticing grocery stores to build in food desert areas. The five factors addressed above, food insecurities, food deserts, food swamps, mobility, and nutrition education, must all be addressed. Moving forward, policymakers, lobbyists, and policy researchers should consider all five factors to truly address diet-related health risks in impoverished communities.

Mariam K. Ahmed is a health care attorney at Healthcare Legal Solutions, LLC and specializes in Medicare and Medicaid regulation and compliance. She also has an interest in studying how laws and policies affect public health.