Currently browsing posts about: Food-access

Priya Fielding-Singh.  How the Other Half Eats: The Untold Story of Food and Inequality in America.  Little, Brown Spark, 2021.

I did a blurb for this book (some of it ended up on the cover)

How the Other Half Eats is a must-read for anyone who has ever wondered why Americans don’t eat more healthfully. Fielding-Singh achieved something remarkable in gaining the trust of families who then let her observe their daily food choices. Her book is a thoughtful, riveting, compassionate, and utterly compelling account of why eating healthfully is so difficult, especially for the poor. What’s more, she offers a superb example of why on-the-ground field research is invaluable for gaining a deep and nuanced understanding of the ways that our industry-driven and highly inequitable food environment affects real people on a daily basis.

What I found so amazing about this book was that Fielding-Singh actually talked to people about how they feel about their diets—and listened.  Her analysis is exceptionally thoughtful.  Some examples:

From page 253

It is one thing to be able to find and afford a head of cauliflower.  But it is another to want to buy that cauliflower, to choose to spend one’s money on that cauliflower (at the expense of other purchases), to have the time and tradition to cook that cauliflower, and to possess the patience to weather one’d child’s complaints and pleas for macaroni and cheese and soldier on to feed that cauliflower to one’s child.  Only a handful of parents I met had all of these things.

From page 255

Personal responsibility has never solved a public health problem or remedied an inequity.  Food is no exception…Many of the families I met had either done so or were trying to figure out how to eat more nutritiously with the resources they had.  But, largely due to the structures implemented by the food industry and federal government, most felt like they were fighting an uphill battle—and losing.

Page 259

Banning marketing to kids would give moms a fighting chance of being able to feed their kids what they want rather than what corporations push on them.  Currently, only those families with the most money, time, and bandwidth have a shot at prevailing against the industry—and even those families often struggle and even fail.  Protection from the food industry should be right granted to all families, not a privilege reserved for the few.

Two new Index Systems rank countries for sustainability and corporations for promoting health.

I.  Sustainability Index.

The Economist and Barilla have devised a new, interactive Index that ranks countries on the basis of food loss and waste, sustainable agriculture, and the ability to meet nutritional challenges.  Its scoring system goes from 0 (terrible) to 100 (perfect).

The top ten scoring countries are:

None of the scores is exemplary.  The US rank is #26.

II.  Access to Nutrition Index

The Access to Nutrition Foundation (Netherlands) ranks corporations on their strategies, policies, and actions to address obesity and diet-related diseases in the US.

The overall rankings, shown here, are relatively low.  Some do better than others on governance, products, accessibility, marketing, lifestyles, labeling, and engagement.

The highest scores are for labeling.  The lowest scores are for accessibility.

Indexes like these are useful for understanding where we are.  They should inspire us to action.

A question from a reader:

Q.  I was wondering if you could comment on the recent article in the New York Times which questions the link between food deserts and obesity.

A.  Sure.  Happy to.  The article talks about two recent studies finding no relationship between the types of foods children eat, what they weight, and the kinds of foods available within a mile and a half of their homes.

These finding seem counter-intuitive in light of current efforts to improve access to healthier foods in low-income communities.

Obesity is more common among the poor than among those who are better off.   Poor people must be eating more calories than they expend in physical activity.

Eating more calories means eating more of foods high in calories, especially fast food, snacks, and sodas.  Kids who are heavier have been found to eat more of those foods than those who are not.

I can think of several reasons why this might be the case:

• Access: healthier foods are less available
• Cost: healthier foods cost more
• Skills: healthier foods require preparation and cooking
• Equipment: cooking healthier foods requires kitchen facilities, pots, and pans
• Transportation: even if stores are available, they might be too far away to walk to
• Quality: even if stores sell fruits and vegetables, they might not be fresh
• Marketing: fast foods, snacks, and sodas are heavily marketed in low-income areas
• Peer pressure: eating high-calorie foods is considered the norm

I can think of ways we might try to improve any of these factors, but I’m guessing that cost is the critical factor for people with limited means.  The Department of Commerce reports that the indexed price of fresh fruits and vegetables has increased by 40% since 1980, whereas the indexed price of sodas has declined by about 30%.

Fast food, snacks, and sodas are cheap.  Fruits and vegetables are not.

Without access to healthful foods, people cannot eat healthfully.  But access alone cannot reverse obesity.

The real issue is poverty.  Unless we do something to reduce income inequality, and to make healthier foods more affordable, fixing the access problem is unlikely to produce measurable results on its own.

Posted from the World Public Health Association annual meeting, World Nutrition 2012, in Rio.