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Agency says WNC has 11 food deserts; some observers say number may be underestimated
The inside of the Crossroads Grocery on the edge of Asheville’s city limits looks like many other corner store or gas station in neighborhoods across the region.
The walls are lined with refrigerators crammed with beer and soda. The shelves are stocked with convenience foods — chips, jerky, candy bars – and a handful of grocery items. A box of Frosted Flakes, a bag of rice, flour and sugar. Not as evident are a couple dozen cartons of eggs, milk and bags of corn tortillas packaged in Georgia.
With the exception of a handful of limes, fresh produce is absent.
Although several chain supermarkets operate roughly two miles away, there appears to be no other options within a reasonable walk to purchase healthy, fresh foods.
This store is in a food desert: a geographical island where residents in census tracts with poverty rates above 20 percent have limited access to nutritious food, as measured by the U.S. Department of Agriculture.
The observation that low-income neighborhoods have relatively fewer healthy food options may be nothing new. But, lately, policy makers and health advocates are taking special notice of the problem, particularly here in Western North Carolina.
Food deserts like the one surrounding Crossroads Grocery aren’t just in Asheville and other places with relatively dense populations. The problem may be especially acute in rural areas, too.
“Hunger is very invisible in the mountains,” said Ella Kliger, of Franklin, who is the western outreach coordinator for MANNA FoodBank. “We don’t necessarily see it, but we have a lot of people just scraping by.” She coordinates the organization’s distribution programs and volunteer staff in the six far western counties.
“Hunger in America,” a 2010 study released by Feeding America, reported that one in six Western North Carolinians receive emergency food each year through MANNA’s network of providers. Last year, MANNA served over 100,000 clients and distributed nearly 10 million pounds of food to residents in its 16-county territory.
The concern among advocates and policy makers is that poor access to healthy food leads to unhealthy diets and contributes to a wide range of health problems, such as obesity and diabetes.
Understanding where, and if, food deserts exist may have implications on policies addressing hunger and poor nutrition in rural mountain communities.
Low wages, high unemployment and the general lack of economic opportunities in rural mountain communities all play a factor in the inability to place a healthy meal on the table.
But it may be more complicated than that.
Observers say problem may be underestimated
The availability of healthy food choices and access to places that provide them may have an impact too.
For one, says Kliger, transportation is an issue.
“A few miles in the mountains can be virtually impassable, particularly in the winter, and most of the region has no public bus service,” she said. “Walking with a gallon of milk with a bunch of groceries more than a mile is not easy, especially without sidewalks.”
While most of the western counties have at least one or two towns with a chain supermarket and other shopping possibilities, residents of rural communities, such as Otto in Macon County, have to travel eight miles to Franklin or beyond the Georgia state line to shop at a supermarket.
The USDA Food Desert Locator is an online tool that maps census tract data and identifies 11 food deserts in Western North Carolina, seven of which are in urban areas. They span from Rutherfordton to Hendersonville and Asheville, up to large portions of Haywood, Madison and Mitchell counties.
The federal government’s measure of food deserts does not consider small groceries and conveniences stores – ones such as Crossroads Grocery — to be providers of healthy food since they are less likely to provide fresh produce and other relatively nutritious foods at affordable prices.
Kliger, of MANNA, points out that the map may understate the availability and access to fresh food in rural southern Appalachian communities since the USDA may not accurately factor in mountain geography.
On the other hand, some experts question the existence of rural food deserts since low-income rural residents tend to be more mobile relative to impoverished families in urban areas.
Stephanie Bell Jilcott, an assistant professor in the Department of Public Health at Eastern Carolina University, has studied the issue and believes rural North Carolinians do face mobility issues.
“My opinion is that rural food deserts do exist,” Jilcott said. “The fact that you have to travel twenty minutes to get fresh produce means you’ll get it less often. The less you buy it, the less you’ll eat it.”
Supercenters as a solution?
But it’s not just where the stores are located; it’s what they are offering. And it makes sense to assume that individual food choices are strongly influenced by what foods are available to buy.
North Carolina scored above the national average for the Modified Retail Food Environment Index [state tables here; PDF], an indicator of access to retailers that sell healthy foods, according to a report from the Centers for Disease Control and Prevention. The higher the score, the greater the access.
In its metric, fast food restaurants and convenience stores are considered “less healthy food retailers” since they are the least likely to provide fresh produce.
Yet aggregate measurements, such as the Food Environment Index, may overlook places where healthy food is available in rural communities, such as homegrown vegetables and food stands that may be more abundant in rural areas.
Another shortcoming of aggregate data is that residents may be transient or there may be seasonal fluctuations in the fresh food supply.
The size of the retail establishment may also have an impact on what people eat.
ECU’s Jilcott and her colleagues studied associations between the Food Environment Indexes and body mass index in 30 counties throughout North Carolina. However, Jilcott’s study excluded food supercenters, such as WalMart or Target, which are included in the CDC’s index.
“I don’t think supercenters encourage healthy eating habits,” she said.
Jilcott suggests that people in rural areas have an incentive to buy in larger quantities since they may travel to retail areas less often.
“The mantra of supercenters is to buy in bulk and you’ll save,” she said. “Even if you are buying tangerines in bulk, you’ll also be tempted to buy ice cream in bulk. That’s fine to eat, just not everyday.”
Smaller stores may face problems with waste, pricing
But if mega stores stocked with produce don’t necessarily encourage healthy eating, then who does?
To address the availability of healthy foods in stores, the N.C. Division of Public Health started a “corner store” initiative to encourage small groceries and convenience stores in low-income communities to offer a healthy selection of food and beverages at reasonable prices. So far, the division has piloted the program in Pitt County.
Still, providing fresh produce and other healthy foods at small groceries may be more difficult than it seems.
The lack of healthy food at small groceries may be influenced by several factors. For one, since convenience stores operate on such a small scale, they’re unable to charge low prices for foods that may go to waste. Another factor is that small shops in rural areas don’t have direct competition, giving them the ability to charge a premium.
“If you don’t have easy access to a supermarket, there is a fee to eating healthy,” said Kliger, of MANNA. “Gas stations have limited supply, and what few healthy choices are there tend to be very expensive.”
Increasing demand for healthy options may drive change, some say
The effort to encourage retail stores to provide healthier food may be in vain if people don’t want to buy fruits and vegetables or prefer relatively more inexpensive and easier, though less nutritious, processed foods.
That’s why educating families on healthy food choices is also a tactic.
In a 2009 report, Haywood County leaders identified “overweight/poor nutrition” as their top health priority.
Steffi Duginske, the coordinator of Healthy Haywood, a program of the Haywood County Health Department, said that survey results among county residents asking why they don’t eat a healthy diet runs the spectrum: from lack of access to quality/healthy foods to poor diet choices and just not knowing how to eat healthy.
In fact, access, choice, and knowledge may be closely related.
The Fresh, Easy, Affordable, Sustainable, Tasty project of Slow Food Asheville, also known as FEAST, offers free, hands-on cooking classes, primarily to kids, to develop healthier cooking habits. Kate Justen, FEAST’s director, points out that eating and cooking habits are developed at home, and lower income communities may have less access to information about cooking with healthy foods.
“When our students see produce, we want them to know what to do with it so there’s a comfort level and its not so scary and daunting,” Justen said.
Justen argues that if people develop better habits it may spill over into a greater demand for fresh produce at corner stores. It may also give groceries the incentive to stock the shelves with more fresh foods.
Food banks are also on the front line of educating families by printing out recipes with food that’s hard to use, such as eggplant or overripe bananas.
“Most people couldn’t come up with five recipes with eggplant, but sometimes we get 50 pallets of eggplants,” said Kliger, whose primary aim is getting food to households that need it.
“Most people I meet just want to work,” she says. “There’s a lot of pride in these counties. That’s worthy of respect, but when it starts impacting the health of our people and their ability to thrive, then we need to change the conversation around hunger.”