Food desert fantasies

From Food deserts may play little role in obesity, Rand study says by Soumya Karlamangla.

For the past few years there has been a lot of happy clappy talk about food deserts (urban locations with few or no retailers of fresh or otherwise healthy food) and their role in the obesity epidemic, particularly among minority children. It has become a partisan issue owing to the desire by some to intervene in many ways to address the food desert issue. Some want crony-capital incentives to encourage grocery stores to build in particular locations, others want to ban or punitively tax some types of food. Others want to restrict EBT cards from being used for non-healthy foods.

This wave of concern followed many public policy arcs. Declaration of firm cause-and-effect based on skimpy or non-existent evidence. Then questions about whether food deserts actually exist (see here .) Then questions about whether,even if you increase food choices it will have any effect (see here here.) And now, Karlamangla touches on unintended consequences.

But back to the story.

Conventional wisdom suggests that if you live in an area devoid of fresh, healthy food, you won't eat well. These so-called food deserts, the logic goes, are a root cause of the obesity epidemic.

But new research indicates that the picture is much more complicated, with food choices being affected by several factors, including the cost of food, cultural preferences and marketing. Eliminating food deserts, researchers say, may only marginally improve people's health.

"I wouldn't put it at the top of my policy agenda," said Roland Sturm, a senior economist at the Santa Monica-based Rand Corp.

He and his colleagues published a study this month in the journal Preventing Chronic Disease that found virtually no link between the type of food and drinks that Los Angeles County adults consume and the proximity of fast-food outlets, grocery stores and convenience stores to their homes. In the last few years, he has published other papers evaluating the connection between the food environment — the distribution and number of food shops — and people's eating habits and, for the most part, found little connection.

[snip]

The study released last week evaluated 150 effects that food environments could have on people's health and found only two that were statistically significant. For the most part, there was no connection found between the location of certain kinds of food stores — whether it be a fast-food outlet a block away or a grocery store a mile away — and how much soda or fruits that residents consumed per week, or whether they were overweight.

The final movement of the arc of good intentions is the realization that there might some unintended negative consequences. A finding which, no matter how reliably it happens, is always a surprise.

In 2008, Los Angeles lawmakers banned new fast-food restaurants in South Los Angeles as part of a campaign to improve residents' health. The law aimed to stem high rates of obesity and diabetes that afflict African American areas.

Sturm published a study earlier this year that found that from 2007 to 2012, the percentage of people who were overweight or obese increased everywhere in Los Angeles, but the increase was significantly greater in areas covered by the fast-food ordinance, including Baldwin Hills and Leimert Park.

"There is just nothing easy. That's the problem," he said.

Part of the problem is the existential need for the crisis on the part of self-interested institutions. Another part of the problem is ideological blinkers which blind advocates to different ways of understanding the world than the abstract ideological convictions. Clare Fox illustrates both. Executive Director of the Los Angeles Food Policy Council, she needs there to be food deserts which cause obesity. No food deserts, no need for the LAFPC. Plus, note how she introduces the ideological non sequitur.

Clare Fox, executive director of the Los Angeles Food Policy Council, said there's no single solution to the obesity epidemic. However, she said she feared that studies such as Rand's discount the importance of fighting for healthy food options. There are long-standing disparities in food access across neighborhoods, she said.

She said advocates should be "empowering stores that are residing in low-income communities to market and brand healthy food in new ways so that we can interrupt these systemic and historic inequities."

Ideologically, it might be quite critical that there are or are not "long-standing disparities in food access across neighborhoods" but that is not the question. Who cares about inequalities unless it affects health outcomes. What the Rand study is indicating is that inequalities are not the causative factor in neighborhoods, it is eating habits. Food deserts and inequality are both red herrings that distract from critically thinking about the important outcome desired - how to help people eat more healthily.