health disparities, social justice, geography, food politics, medical anthropology
The team at the Chicago Design Museum approached me to contribute some maps and data visualizations to their upcoming “State of Detroit” exhibit. It grew into a collaboration that built off of my research focus on food access in Detroit while also addressing some of the “Detroit is Empty” misconceptions.
The installation has a cool sliding feature so you can view different map layers together.
Visit the exhibit from now until August 30th, 2015. More. . .
Anyone who follows news about Detroit hasn’t missed that Whole Foods is opening its Midtown location on June 5th. Young people are tweeting that they are already writing up their grocery lists, students are excited for the organic produce, and who out there can actually afford to shop exclusively at Whole Foods for their groceries!?
I know that I for one, cannot. It is exciting that Whole Foods is coming into Detroit when all of the chain supermarkets fled the city, but to the tune of huge tax breaks that the city could really use. It must also be noted that Whole Foods in Midtown does NOT address the scarcity or availability of healthy foods in Detroit. Rather Whole Foods taunts Detroit residents with the bright lights of an upscale chain food store, but no change to access in Detroit’s food system.
Classism in Slow Food
“Slow Food Detroit” was founded in Clarkston, MI – 51 Miles away from the city.
“Slow Food is an idea, a way of living and a way of eating. It is part of a global, grassroots movement with thousands of members in over 150 countries, which links the pleasure of food with a commitment to community and the environment.” (SlowFoodUSA.org)
Slow food is inherently easier for those with higher incomes. Access to better foods, organic options, and what some might call “picky” food choices favors those with extra money to spend. In Detroit income is highly correlated with race. A major reason that Detroit has limited grocery stores and high rates of diet-related diseases among African Americans is due to the fact that historically African Americans were either not considered for grocery store hiring or were hired and kept away from management positions. When the riots hit and many people left the city, there was no one with the skills to fill the grocery store void. Likewise, the supermarkets followed wealthy white populations leaving for the suburbs.
The addition of Whole Foods represents a similar imbalance in the “slow food” movement where all items are local sourced, organic, etc. with a price tag to match. Personally, my wife and I only shop at Whole Foods for wine, dessert, and food items that help manage lactose intolerance. Other than that, we would never dream of doing the bulk of our grocery shopping there. If anything Whole Foods has come into Detroit to capture the commuter market in one easy spot before they drive home outside of the city.
The Detroit Drilldown Report 2010 reported on grocery leakage (people spending grocery dollars outside of the city), that Detroit resident spend $200 Million (31% of grocery budgets) outside the city on their groceries. People may start shopping inside the city limits at Whole Foods, but I predict that the majority will take it back home outside the city.
Social Mobility & Transportation
An important aspect of slow food and access to healthy food is unfortunately transportation. Detroit residents are up against a public transit system that is broken and in serious need of repair. In Detroit healthy transportation can mean healthy food access as well. Many families that I have worked with work hard to car pool with their friends and neighbors to be able to shop at a chain grocery store or they utilize a plethora of food options: local stores, buying co-ops, gardens, etc.
When people do not have adequate transportation that also constrains their food options. If you are walking to a grocery stores that is miles away, why wouldn’t you choose the convenience store instead? If you can’t afford personal transportation, that may also limit you to low cost, high calorie food items. If you can’t often go grocery shopping that may also mean you choose items that will last much longer, which also tend to be the least healthy food items.
Social m0bility is linked to transportation, especially in economically depressed urban centers. These issues both disproportionately affect low income minority community the most.
Detroit’s Changing Food Environment
Meijer is also starting to build close to the Westside and that represents a better potential for healthy food access than Whole Food ever could, but there really needs to be tax incentives for local grocery store owners if healthy food access is going to improve. The Fair Food Network has been advocating and now “Double Up Food Bucks” for fruit and vegetables will be available in some grocery stores soon.
There are increasing food and grocery options Downtown, where the 2010 Census shows population growth, however this population growth is from new residents not residents moving from the East and West side into Downtown. Ye Olde Butcher Shoppe has called itself a grocery store, with Papa Joe’s Market coming soon thanks to Dan Gilbert, these are options on top of the new Whole Foods. The growing Downtown/ Midtown populations are not the populations of Detroit who do not have social mobility and do not face the higher prevalence rates of diet-related disease and obesity. The population dense neighborhoods on the East and West side of the city have not seen new grocery stores and in a number of cases local grocers have shut down only to be turned into Family Dollar locations.
Obesity is still on the rise. In many cities there have been decade-long campaigns to improve healthy food access, spread information about health risks, and new national efforts to get children active – are they not working? Latest estimates predict that by 2030 almost half the adult population will be obese. Recently, the CEO of the Robert Wood Johnson Foundation (RWJF) wrote in the Washington Post about their latest report and the future impact of obesity on our economy. She noted the decline of productivity and increasing health care costs associated with obesity. While we often think about fast food, inactivity, and individual choices related to being obese, how often do we consider the economic causes and effects?
I have never met anyone who said that they specifically chose to suffer the health effects of being obese because they thought it would be a great way to live. However, beyond personal choices, obesity can be correlated with a number of social and environmental factors, namely: poverty, urban areas, as well as minority and low-income populations.
Just as individuals cannot choose their parents, they also cannot choose their life circumstances, which unfortunately can sometimes hinder efforts to live a healthier lifestyle. Research has shown that rising rates of obesity disproportionately affect Black and Hispanic populations. This demonstrates a confluence of factors with roots in racially motivated housing policies, lack of social mobility due to historical discrimination, and the absence of adequate health services for these communities.
Impoverished communities are filled with companies looking to take advantage of the marketplace of poverty. Dollar menus, frozen dinners, and corner store snacks – not to mention the advertising which helps build a psychological belief that it is quicker and cheaper to eat unhealthy foods.
In short, obesity is just as much an economic reality as it is a need for healthier lifestyles. It represents a by-product of mass producing foods to reduce costs and increase profits. People do not choose to live in poverty nor do they choose to be obese. Economic constraints on top of fast food advertising drives a culture of unhealthy eating.
The debates have raged about recent plans to tax the size of soda pop in New York City or in other countries the tax on fatty foods. There is a growing field of research on behavioral economics, which argues that people will choose the option that is most beneficial to themselves.
This is, however, not always true. People do not always make the most rational decision especially when it comes to their food and eating habits. Increasing the economic burden on people who typically choose unhealthy foods is not necessarily the best option. If a tax is placed on high-calorie or high fat foods it allows the food and beverage companies to continue avoiding responsibility. It isn’t about personal freedom, it is about being able to compete in a marketplace where the cards are constantly stacked against the poor.
Food and beverage companies will still find a cheap way to produce their products that works around any tax or restrictive policy. These companies have a primary goal to make a profit. If making that profit means burdening the population with unhealthy foods and the long-term health effects, they have no qualms. This is where people generally argue that it is about personal choice. This is partly true, but also relates to my first argument that you can’t always choose your life circumstances. All around the world now people are struggling with obesity and healthy eating. Food and beverage corporations are able to take advantage of global income and food disparities to generate their profits.
Using a “fat tax” to increase the economic difficulty of buying unhealthy food is doing no good when there is a psychological war on TV and advertising campaigns.
“It’s the behavior stupid!”
We can talk all day about the responsibilities that corporations have to give people healthy foods as well as the responsibility of individuals to keep themselves healthy, but in the end it all comes down to behavior. When I say behavior I’m talking about the eating habits that people have learned since their childhood, the behavior influenced by the food commercials seen on TV, the behavior informed by the massive portion-sized, “give me what I paid for” food culture.
When we are constantly bombarded by images of juicy burgers, steaming pizzas, and actors telling us how amazing it is to get quick, cheap food – we will eventually believe it. Food and beverage companies employ their own teams of psychologists to be able to manipulate their advertising to be the most convincing. These companies have found out the best ways to exploit the disparities that people face in order to get more people to buy their unhealthy foods. Don’t have time to make dinner? Bring your kid through the drive-through. Buying groceries on a budget? Get 3 for $5 cases of pop or 2 for $5 bags of potato chips.
When it all comes down to what will or won’t work, people need to understand what they are up against, they need to be informed on what foods will benefit their health, and they also need to be able to have the tools to make healthy lifestyle changes. While many food companies watch their profits grow, many individuals watch their weight grow due to their own economic disparities. Helping people address these learned behaviors and economic barriers will help to reduce health care spending and increase the productivity of our economy.
This new recipe comes by way of my little sister which she found on a food blog, whose author ate at this restaurant in Grand Rapids, MI and found the original recipe on a cooking website.
When my little sister first made them for us they turned out to be massive patties of vegetable goodness falling everywhere out of the bun. I swore there must be a way to make them stick together better. My wife and I attempted a second time with the leftover veggie mixture for a longer cooking time, but again they fell apart. The third time (pictured) I sprayed more oil on the grill pan and made the patties a little bit smaller. After reading through the food blog and cooking website I think I’ve discovered my error. The cooking website notes to use:
“Pour a generous amount (8” depth) of grapeseed, canola, or vegetable oil in the bottom of a large skillet. Heat the skillet to high heat, taking care not to let the oil smoke.”
Basically, you need to fry the patties so that they will stick together – not as healthful as I hoped. I’m thinking using a bit of egg in the mixture will help it congeal and keep the vegetable goodness less fried.
Here is the recipe that we adapted from the two listed online.
Ingredients:
Steps:
Whether they are starving or eating too much, children around the world are malnourished. A full belly doesn’t necessarily mean that a child is getting proper nutrition from the food that they eat. Obese children are just as nutritionally deficient as children who have bloated bellies from hunger. The result is a global generation of unhealthy children who will experience a shorter life expectancy than normal from complications with their health and related diseases. The double burden of malnutrition is seen in both a complete lack of access to food and an overabundance of unhealthy foods.
A recent World Health Organization (WHO) report stated that combating five major health factors could eliminate millions of premature deaths. Among those top five is childhood nutrition. Lacking nutritious food has serious implications for health, but consuming too much food without nutritional value, which contributes to obesity, is more likely to lead to a premature death. For the first time in 15 years, children in the US have a lower life expectancy than their parents. By the same token, children in countries defined as “developing” have faced low life expectancies for many years, but what they eat (or don’t eat) is less likely to kill them. Who would have imagined that being overweight is more likely to kill you than being underweight?
On the flip side of childhood nutrition is the near complete lack of access to food in developing countries. There were any number of crises this past year that qualified the “need” for food aid from “developed” countries. Floods, earthquakes, droughts, famines, etc. – but what is the state of food aid? Is it excellent nutritious assistance in difficult times? Bill Easterly and the Aid Watch blog ask: “Can the story on US food aid get any worse?,” noting that the US continues to support relief agencies that use a corn-soy food blend that doesn’t even meet the 1960s international nutrition standards of food aid. Children in developing countries don’t necessarily die from a lack of nutritious food, but rather from the diseases that attack their weakened immune systems. The food we eat is a first line of defense by keeping the rest of our body systems healthy. Some of the best examples of the importance of food and health come from Paul Farmer, who often says that, “the treatment for hunger is food.” Many times food is overlooked as a critical treatment in health crises, which makes it that much more important to invest in nutritious alternatives for food aid and support local farmers around the world.
Unfortunately here in the US, corporations have a firm grip on what we eat. There are a small number of major factory farming corporations that produce our food. They use coercive actions and their money to keep control of farmers and the food industry. This hurts our families and communities here in the US and contributes to the nutritional inadequacy of what Americans eat, but it also has far reaching implications in developing countries. Because of the control by US corporations of the food industry and the US government’s subsidies for farmers, food prices have been rising steadily around the world. This impact is hitting small farmers in developing countries hardest as they struggle to find markets to sell their produce and support their families. These small farmers can’t compete with US farmers who are government subsidized or the US corporations who are mass producing and shutting them out. Even as people in developing countries struggle to buy food to eat, one in six Americans are struggling with hunger. This is largely a result of the economic downturn and has affected more than just those already considered poor in the US. It is estimated that nearly one billion people do not have access to a secure source of food around the globe.
While the fact that many Americans struggle with food security is shocking, the spike in rates of obesity demonstrates the pressing need for communities to rethink how they eat and live. Obesity gives a blatant visual representation of how much control we have lost when it comes to our food. The WHO states that “globesity” is spreading across the globe and millions will suffer if we don’t make changes. A recent study conducted by Wayne State University showed that one third of infants in the US are obese or at risk for obesity. This allows us to easily assume that an obese infant will become an obese adult. Hunger and food security are extremely important issues when it comes to talking about health and nutrition. Many who suffer being underweight have suffered through natural disasters, but the immediate threat to children and the global population is the man-made disaster of being overweight.
Thankfully there are many people who are working to fix the food industry, support local farmers, and promote healthy eating to children in schools. President Obama recently signed the Child Nutrition Bill to increase access to healthy foods in schools. Where there have been numerous policy barriers nationally and internationally, this is a step in the right direction to bring policies in line with the health needs of our global population. We must commit to supporting the basic health of our children if we care about a building a healthy future.
Originally featured and posted at, Americans for Informed Democracy on 18 January 2011.
My wife and I don’t eat a lot of beef, so that leaves us with chicken. Its not always easy to find a new chicken recipe that is different enough to be fun if you eat chicken on a regular basis, but this is on recipe that has turned out to be a staple of our dinner repertoire. It is quick, full of delicious flavors, and very easy to make without having dry chicken.
Ingredients:
Steps:
The food desert term has been readily applied to Detroit’s food system. However, the majority of academic and other research fails to take a comprehensive look at Detroit’s food system or its history. Following the New York Times article questioning whether the “food desert” term is just media buzz, I decided to share some of my initial findings in Detroit. I began researching Detroit’s food system about a year ago and started surveying grocery stores in Detroit 6 months ago because I could not believe the research coming out of the University of Michigan and other institutions that Detroit was devoid of fresh foods or healthy options. NPR recently published an article titled, What Makes a Food Desert Bloom, but fails to note the importance of food education on healthy eating to accompany increased visibility and access to healthy foods.
The map image accompanying this post is not the best illustration, but it is a complication of the best data sources on Detroit’s food system. The map represents the flaws and misunderstandings of outside consulting agencies and more general displays of either out-of-date or misguided information. Rob Linn has been creating some excellent maps of Detroit food stores data and now works with Data Driven Detroit. His maps are more current and show a cleaner picture of the actual data in Detroit. The surveys conducted by outside agencies have missed the mark and have published misguiding research to back up the “food desert” claim. The biggest problem with maps is that they are very “planner” focused and it is very easy to make broad claims based on maps. A recent PhD. out of the UM School of Public Health conducted research on African-American’s perceptions of food choice in Detroit and I’m very excited to read her findings. Understanding community perceptions and choices is going to be more important than placing food stores on a map.
Currently, there is only one black-owned grocery store in Detroit where 4 out of 5 residents are African-American (DFPC Annual Report of Detroit Food System, 2009-2010). Detroit is a city with historic racial and economic divisions. These divisions often played out within the food system and its evolution up to today.
Small neighborhood grocery and convenience stores also hired few blacks. […] Few blacks worked where they shopped. Fewer felt any loyalty to neighborhood stores. Only a decade after the survey, inner-city grocery stores were among the most prominent targets of young looters. White-owned and -operated stores were the most prominent businesses in Detroit’s African American neighborhoods and the most convenient symbol of the systematic exclusion of blacks from whole sectors of the city’s economy. (Sugrue, Origins of the Urban Crisis, 113-114)
The title of “food desert” has been both accepted and refuted in Detroit. The majority of academic researchers lean towards labeling Detroit as a food desert, however others have come to that conclusion without adequate research into price and accessibility of foods the term is not helpful. Counting chain supermarkets and the 1 mile radius around those locations doesn’t give an accurate picture of food availability or access to quality fresh foods. Shannon Zenk (PhD ’04) while at the UM School of Public Health reported that Detroit was a food desert based on her research of “chain” supermarkets and their proximity to large numbers of residents. Her research found that, “supermarkets were farther away from African-American neighborhoods with the highest levels of poverty than they were from white neighborhoods with the highest levels of poverty (SPH Findings Spring/Summer 2009). This is an extremely inadequate picture of healthy food access and environment within the city.
Detroit has a long history of local grocers supplying neighborhoods while there have only been a few chain supermarkets to ever exist within the city limits. As of 1954-55, there were 69 supermarkets operated by Kroger, A&P, and other small local suppliers in Detroit. One of these small local suppliers was Food Fair, which in 1955 merged with Lucky Stores which operated as Food Fair markets under the Borman Food Stores Inc. In 1959, Borman bought up other smaller chains (State Super Markets, American Stores Inc., Lipson-Gourwitz Co.) and expanded to 46 stores in Detroit and Ferndale. In 1966, Borman announced the opening of three superstores under the name of Farmer Jack.
Farmer Jack was A&P’s most profitable division after the merger, but by the 2000s was having trouble competing with larger supermarkets like, Kroger, Meijer, K-mart and Walmart. Farmer Jack is recognized as the last chain supermarket to remain in Detroit before A&P put the stores up for sale and all locations closed in 2007. Kroger acquired twenty former locations while independent grocers collectively bought 21.
The flip side of the grocery and chain supermarket story in Detroit’s food system is that of community and urban gardens. Detroit Public School (DPS) student handbooks from the 1950s included a chapter on how to create a community garden. Urban farming and community gardens is a whole aspect of access to healthy food that needs its own post, so I won’t go into it here.
Contrary to popular belief and to oft-cited media, I have found that Detroit is not a food desert in its entirety. Detroit has a few neighborhoods and areas that lack a good number of options, but as a whole Detroit is a food swamp or as some say a “food grassland, rain forest, and jungle” (Rob Linn).
The families that I work with across Detroit tell me a similar story. They access food resources from a plethora of sources. One family told me that they try to get to Kroger whenever they can (outside Detroit), but otherwise get good fresh produce from a food bank since the Caregiver is out of work, they participate in the community garden, and visit an independent grocery store when they need to restock staple foods. Other family’s have told me similar stories of utilizing multiple food access points.
A food desert is defined as:
“any area in the industrialized world where healthy, affordable food is difficult to obtain. Food deserts are prevalent in rural as well as urban areas and are most prevalent in low-socioeconomic minority communities. They are associated with a variety of diet-related health problems. Food deserts are also linked with supermarket shortage.” (wikipedia)
Access is a key word when talking about food deserts and this is where many researchers count the number of stores and measure the distance from supermarkets to given populations. However, this often paints an inaccurate picture. There is more to access than the number of stores and how far away they are. Just because a grocery store is close by doesn’t mean that it has a huge fresh foods section or many healthy options. New research has noted that distance to healthy food may be psychological. This is where greater education on healthy food is necessary to create a more direct connection between people and healthy eating. I have been using the Nutrition Environment Measures Survey (NEMS) in order to attempt to get a more accurate picture of access to healthy foods. NEMS criteria focuses on comparing availability, price, and quality of foods between healthy food options and less healthy food options. Access is more than just distance and can include issues with the stores not stocking healthier food options, the quality of healthy foods available, and most importantly the price: is it cheaper to buy a bag of chips?
I have used the NEMS criteria to survey 20 grocery stores in Detroit (see Detroit Food Map) and what I have found has been entirely different from the large body of research that pegs Detroit as a “food desert.” All of the grocery stores had availability of fresh and healthy foods. Some produce sections were bigger than others and some carried more varieties, but all in all fresh foods were available and in good quality. The only items that were regularly low in quality were strawberries and cantaloupe. Likewise, I found in many stores that price could potentially be a hindrance for purchasing a healthier option, particularly with fruits, baked goods, meats, and juices. I spoke with a number of store owners and employees. Many said that they too have had a hard time with the “food desert” label and want people to know that they carry fresh foods. In some stores the owners noted that customers don’t regularly buy the healthier food options (i.e. ground turkey) or their fresh produce is purchased slowly, so it goes bad more quickly.
“It’s not enough. People always want more. We carry everything, many options, but people would rather shop at the super markets: Meijer, Wal-Mart. . . Is it because we don’t have the options? Look around!” – Staff Interview, Independent Grocer 02/02/12
My coworker, who has lived in Detroit her whole life and has been involved in improving the food system, has seen over the past 2 years an increase in farmer’s markets and community gardens in what she thinks is a response to food desert hype. Potentially, Detroit’s independent grocers have done the same and hopefully will continue improving their price, quality, and availability of healthy and fresh foods.
My wife discovered an excellent recipe that is great for a “meatless Monday” in the hardy months of cold, wind, and snow.
We’ve made it a number of times now and absolutely love how quick, delicious, and nutritious it is. Sweet potatoes and black beans are both considered “superfoods,” which means that they are full of great nutrients that will make your body (and your stomach) happy! We adapted our recipe from EatingWell.com.
Ingredients:
Steps:
Serving size: 2 cups
Calories: 374 calories (14 g protein & 15 g fiber)
You can quote me on this:
“more big box stores will not equal better food choices”
On January 20, 2011, First Lady Michelle Obama launched an initiative with Walmart and the Let’s Move Campaign to increase access to fresh and healthy foods. The program is supposedly bneing evaluated by the Partnership for a Healthier America, whose Chair, James Gavin said he would like to see Walmart double its US store count.
I don’t often shop in Walmart (actually I try to avoid it), but last month I had a reason to be in a Walmart store. Working in childhood obesity research and surveying food outlets for nutritional quality, I took the time to notice the advertisements and products on display. To say the least, none of the food items advertised or on display were healthy or fresh.
There were none.
Behavior Change & Food
My point is that more Walmart stores in “food deserts” doesn’t necessarily mean that more people are going to be eating healthier. I don’t doubt that Walmart making an effort to improve the nutritional quality of its food products and offering more fresh and healthy foods will have a negative impact, however it is going to take more. When a low-income family has the choice between the on-sale advertised frozen dinners or the larger amount of fresh vegetables they are more than likely going to choose the product where they get more for their money (or at least what seems like it).
“there needs to be more education, access, and a american cultural shift towards healthier eating”
Everyday I work with adolescents and their families on managing childhood obesity. We talk about making healthy changes to their food intake and often times we talk about how to shop for healthy foods on a budget. It is possible and varies in difficulty, depending on your situation. Some families that I’ve worked with went the entire six months of the program without changing much in their eating habits. Changing your food choice is not that easy.
Eating healthier is easier if you are wealthier, have greater options, and have been introduced to ideas of healthy eating from a young age or cultural norm. Classism in the slow food movement is another topic, but extremely relevant as we talk about access to healthy food, urban settings, and growing income inequality often reflected in racial disparities.
Grocery Stores in Detroit
The idea of having more big box stores address “food deserts” and the lack of healthy foods isn’t new. The idea easily makes sense; large chain supermarkets are better able to supply larger amounts of fresh produce on a regular basis if they want to. Save-a-Lot released a report on food deserts in April 2010 and has also signed on to First Lady Obama’s campaign.
For Detroit, Save-a-Lot represents a greater potential than Walmart to be able to address the need to greater access to healthy and fresh foods since there are already ten locations in Detroit, Highland Park, and Hamtramack. I have yet to be able to assess the level and quality of fresh food available at a Save-a-Lot store (coming soon).
Anyone following food in Detroit knows that a Whole Foods store is being built in the Midtown district, near the Henry Ford Health System, Detroit Medical Center, Wayne State University and on the way home for downtown workers leaving the city. This was not the step forward that so many people were hoping for when there was talk of bringing in a national supermarket. Whole Foods is a specialty food store that caters to a wealthier clientele (Midtown avg household income: $113,788), I only go there for wine and dessert. It may bring more fresh food to the Midtown area, but won’t help many Detroiters without access to healthy foods.
A new development with more potential to impact the Detroit fresh food scene is the re-purposing of a former Detroit high school into a Meijer supermarket. Meijer often promotes healthy food options, has a partnership to offer healthy kids recipes, and has a fairly well-stocked produce section.
Big Box vs. Small Grocer
Like many locations that lack necessities, people create solutions to address those needs. Detroit has a number of small grocers and food supply stores, not to mention the largest Farmer’s Market in the US. As the #Occupy protests address money in politics and the ills of corporations, we need to be mindful of where and how food is accessed. Food is a critical piece of our national health and unfortunately our national politics.
People’s needs should be placed over profit and neither ketchup nor pizza are vegetables!
Alex B. Hill 