Studies: Poor urban neighborhoods have more fast food restaurants and fresh fruits and vegetables

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    Apr 19, 2012 2:55 PM GMT
    http://www.nytimes.com/2012/04/18/health/research/pairing-of-food-deserts-and-obesity-challenged-in-studies.html#h[]

    It has become an article of faith among some policy makers and advocates, including Michelle Obama, that poor urban neighborhoods are food deserts, bereft of fresh fruits and vegetables.

    But two new studies have found something unexpected. Such neighborhoods not only have more fast food restaurants and convenience stores than more affluent ones, but more grocery stores, supermarkets and full-service restaurants, too. And there is no relationship between the type of food being sold in a neighborhood and obesity among its children and adolescents.

    Within a couple of miles of almost any urban neighborhood, “you can get basically any type of food,” said Roland Sturm of the RAND Corporation, lead author of one of the studies. “Maybe we should call it a food swamp rather than a desert,” he said.

    Some experts say these new findings raise questions about the effectiveness of efforts to combat the obesity epidemic simply by improving access to healthy foods. Despite campaigns to get Americans to exercise more and eat healthier foods, obesity rates have not budged over the past decade, according to recently released federal data.

    “It is always easy to advocate for more grocery stores,” said Kelly D. Brownell, director of Yale University’s Rudd Center for Food Policy and Obesity, who was not involved in the studies. “But if you are looking for what you hope will change obesity, healthy food access is probably just wishful thinking.”

    Advocates have long called for more supermarkets in poor neighborhoods and questioned the quality of the food that is available. And Mrs. Obama has made elimination of food deserts an element of her broader campaign against childhood obesity, Let’s Move, winning praise from Democrats and even some Republicans, and denunciations from conservative commentators and bloggers who have cited it as yet another example of the nanny state.
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    Apr 20, 2012 7:42 PM GMT
    An example of the plethora of articles that need to be rewritten:

    http://www.diseaseproof.com/archives/healthy-food-healthy-foods-hard-to-find-in-poor-neighborhoods.html
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    Apr 20, 2012 7:50 PM GMT

    Compare costs between the fast food which is already made and the costs of buying the food and making meals, which includes utility usages which add to monthly utility bills.

    Why would private companies in US healthcare systems want to remove a huge (sorry for the pun) segment of the population (overweight people) when they can make millions upon millions by treating their chronic conditions?



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    Apr 20, 2012 7:53 PM GMT
    meninlove said
    Compare costs between the fast food which is already made and the costs of buying the food and making meals, which includes utility usages which add to monthly utility bills.

    Why would private companies in US healthcare systems want to remove a huge (sorry for the pun) segment of the population (overweight people) when they can make millions upon millions by treating their chronic conditions?





    You treat private companies as a monolith. They aren't. You do also understand there is also a significant incentive for companies to push eating healthier, working out, etc? Do you know what the health products industry is worth?

    Why is it incidentally that it seems like the various government agencies in the US are now pushing the idea that in fact, advanced screening, is actually unnecessary now and does more harm than good? Alternatively, why do you suppose the kinds of foods offered at many grocers have changed over the years and that Whole Foods for instance at least has achieved such phenomenal success? (though I would grant it's not so much in poorer neighborhoods)

    Even so, I assume you weren't aware that the largest retailer of organic produce is... drumroll please... Walmart.
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    Apr 20, 2012 7:58 PM GMT
    'You treat private companies as a monolith.'

    Now you're speaking with childish inaccuracy.




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    Apr 20, 2012 8:01 PM GMT
    meninlove said'You treat private companies as a monolith.'

    Now you're speaking with childish inaccuracy.






    And I quote: "Why would private companies in US healthcare systems want to remove a huge (sorry for the pun) segment of the population (overweight people) when they can make millions upon millions by treating their chronic conditions? "
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    Apr 20, 2012 8:01 PM GMT
    So tell me, is Walmart (the ones with the produce section as many don't have that) in those neighbourhoods? Go check and get back to me.

    I also suggested you do a comparative cost look, and gave examples, which you conveniently ignored.
    This indicates poor people are not your concern at all, but rather finding a subtle way to bash those that are attempting (rightly or mistakenly) to help.

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    Apr 20, 2012 8:05 PM GMT
    riddler78 said
    meninlove said'You treat private companies as a monolith.'

    Now you're speaking with childish inaccuracy.






    And I quote: "Why would private companies in US healthcare systems want to remove a huge (sorry for the pun) segment of the population (overweight people) when they can make millions upon millions by treating their chronic conditions? "



    That you make the mental leap that somehow all those companies are monolithically working together is your interpretational spin on what I said.

    However you bring up a good point. Such practices have been uncovered most recently in Ontario with gas-price fixing at the pump. Now they're all getting fined. So yes, you're quite right in your thinking that some companies operate as a monolith.

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    Apr 20, 2012 8:15 PM GMT
    meninlove said So tell me, is Walmart (the ones with the produce section as many don't have that) in those neighbourhoods? Go check and get back to me.

    I also suggested you do a comparative cost look, and gave examples, which you conveniently ignored.
    This indicates poor people are not your concern at all, but rather finding a subtle way to bash those that are attempting (rightly or mistakenly) to help.



    Walmart is introducing them in as many stores as they can - particularly their new larger stores.

    Compare the costs? I make most of my own food and I am more of a price motivated shopper - as are many I assume based on the volume that the local cheap grocer does in my neighborhood. Perhaps you should compare the costs. It's considerably cheaper for me to make food than it is for me to even go to McDonald's on a daily basis so much so that I tend to entertain a lot for a lot cheaper than the cost of my going out to eat (and there are a number of RJ'ers who can attest to this).

    I ignored it because it seems so out of touch. I'd agree that there are some cases where it can be cheaper to buy out than eat in (particularly since energy costs are so minimal to the cost of preparing food - to the point I have to wonder do you even pay your own electrical bills?). As for those trying to help? No, sorry, try those trying to push an ideological agenda to insert themselves into the lives of others. Whether one costs more than the other is irrelevant to the simple fact that the premise on which their actions were based is wrong.

    Not only are there more fast food joints in poorer neighbourhoods (which many seemingly want to "helpfully" regulate), but that they also have far more of all kinds of foods - sit down restaurants and grocers included.
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    Apr 20, 2012 8:24 PM GMT
    meninlove said
    riddler78 said
    meninlove said'You treat private companies as a monolith.'

    Now you're speaking with childish inaccuracy.






    And I quote: "Why would private companies in US healthcare systems want to remove a huge (sorry for the pun) segment of the population (overweight people) when they can make millions upon millions by treating their chronic conditions? "



    That you make the mental leap that somehow all those companies are monolithically working together is your interpretational spin on what I said.

    However you bring up a good point. Such practices have been uncovered most recently in Ontario with gas-price fixing at the pump. Now they're all getting fined. So yes, you're quite right in your thinking that some companies operate as a monolith.



    It's amusing how you are consistent in your attempts at infantalizing me. Do you enjoy being schooled? As for the price fixing at the pumps, I'm assuming you are aware that it has been sporadic in the local companies owned by local franchisees?

    The exception was Suncor which was fined because it cooperated with Pioneer on pricing which it thought it could do because they own part of Pioneer - so basically they were fined on a technicality (why shouldn't you let your own companies coordinate on pricing with each other?).

    Your assumption that private companies in US healthcare systems would work against "the millions upon millions to reduce chronic conditions" is indicative of the rather juvenile approach you seem to enjoy taking to issues.
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    Apr 20, 2012 8:30 PM GMT

    "Your assumption that private companies in US healthcare systems would work against "the millions upon millions to reduce chronic conditions" is indicative of the rather juvenile approach you seem to enjoy taking to issues."

    Now let's compare the above to what I said,

    "Why would private companies in US healthcare systems want to remove a huge (sorry for the pun) segment of the population (overweight people) when they can make millions upon millions by treating their chronic conditions?"


    A tad mixed up, are you?


    For profit healthcare needs an ever growing pool of consumers, like any business.

    Now then, like yesterday, I've lost interest as you are deliberately obfuscating.

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    Apr 20, 2012 10:28 PM GMT
    Prehaps it's because we stopped teaching Health in schools. Now people dont know what to eat and how to prepare it; why they should exercise and the ramifications if they dont. So you can put a produce store anywhere you want and people dont know why they should be shopping there.
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    Apr 21, 2012 8:27 AM GMT
    meninlove said
    "Your assumption that private companies in US healthcare systems would work against "the millions upon millions to reduce chronic conditions" is indicative of the rather juvenile approach you seem to enjoy taking to issues."

    Now let's compare the above to what I said,

    "Why would private companies in US healthcare systems want to remove a huge (sorry for the pun) segment of the population (overweight people) when they can make millions upon millions by treating their chronic conditions?"


    A tad mixed up, are you?


    For profit healthcare needs an ever growing pool of consumers, like any business.

    Now then, like yesterday, I've lost interest as you are deliberately obfuscating.



    How was it even remotely mixed up? You seem to think even for profit healthcare acts as a monolith as if there aren't segments within it that compete against each other or the incentives that exist for consumers to use prevention and maintain their health.

    Like yesterday you have again been shown to be demonstrably wrong and so you move on. As usual your infantile attempts at belittling me have fallen flat. But again, the reality is this - not only are there more fast food options available in poorer neighborhoods, there are also double the number of supermarkets. The rest of your commentary is just as you so aptly describe it, is obfuscation.
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    Apr 21, 2012 8:28 AM GMT
    Caslon18453 saidPrehaps it's because we stopped teaching Health in schools. Now people dont know what to eat and how to prepare it; why they should exercise and the ramifications if they dont. So you can put a produce store anywhere you want and people dont know why they should be shopping there.


    Yep because people just randomly put stores in places where they will only randomly find customers. Oh woe be the poor who can't figure out how to cook if they aren't told how to through Health class in schools icon_rolleyes.gif
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    Apr 21, 2012 11:22 PM GMT
    http://americancity.org/daily/entry/are-food-deserts-an-urban-legend-study-says

    Yesterday, the New York Times ran a front-page story on two recent studies that challenge some widely held notions about “food deserts,” or poor urban areas that lack healthy food options nearby. One study, by the Public Policy Institute of California, found that when compared to wealthier neighborhoods, poorer ones “had nearly twice as many supermarkets and large-scale grocers per square mile.” The other, courtesy of the RAND Corporation, goes so far as to say that there’s “no robust relationship between food environment and consumption” — implying that people living in impoverished areas could easily adopt healthy eating habits, but choose not to.

    We spoke to Allison Karpyn, Ph.D., director of research and evaluation for the Food Trust, about the research highlighted in the Times article and why not every grocery store — or study on grocery stores — is created equal.


    Next American City: As a researcher who has observed a correlation between healthier eating and food access, were you surprised by the Public Policy Institute of California and RAND Corporation studies? Do you have any comments on their methodology?

    Allison Karpyn: Well, yes. To start off, the Public Policy Institute of California study baseline sample size was 20,000. In the end, they could only analyze 7,000 because it was a longitudinal study and many of the children didn’t remain in the study sample. The authors admitted that the kids that stayed in the study were more likely to be of higher socio-economic status than the original baseline sample or more broadly, kids across America. The kids in the sample were more likely to come from dual-parent households, more likely to have parents with higher levels of education and more likely to be white. [This disclaimer, given on page three of the study states:“Compared to children who were in the kindergarten (baseline) wave but lost to follow-up, children who remained in the kindergarten-fifth grade panel were more likely to be white, older at kindergarten entry age, live in a rural residence, come from a dual-parent family, live in a household with fewer children, and have mothers with slightly higher educational levels, but they are not significantly different in their BMI at baseline.”]

    NAC: So it sounds like what you are saying is that the sample does not reflect the demographics of many urban neighborhoods, and many of the urban neighborhoods where work is being done to address food access issues.

    Karpyn: Yes.

    NAC: And the RAND study?

    Karpyn: With the RAND study, the researchers asked the participants to tell how many fruits or vegetables were consumed in a day. That’s a bit unusual to ask a study participant to calculate the amount of fruit or vegetables consumed rather than use a index or scale to determine diet. If you asked me how many servings of fruit or vegetables I ate yesterday, I am pretty sure I’d be wrong. Think about a teenager. The younger you are, the less reliable the memory, especially where food is concerned.

    One of the other issues with both studies is the lack of control for quality of store. Or what I call the contextual factor of shopping, when it comes to supermarkets. I know for myself they are not all equal. Some are higher priced. In some grocery stores, the smell from the fish is so bad you almost can’t stand to be in there. Sometimes there is produce but it is has been there for too long, or is damaged. So the quality of store can be very different though all considered to be supermarkets. Without a control for quality of supermarket, the data showing the existence of the supermarket is less meaningful.


    NAC: Has anyone done research that does tease out for those issues of food quality and price access?

    Karpyn: Yes. There has been significant research done using nutritional and environmental measures. Karen Glanz, Ph.D. MPH, who is now at Penn, has done significant work looking at price, availability, quality and access. So I think what we are bumping up against [with the RAND and Public Policy Institute of California study] is the reality that how people shop and how they eat is nuanced. Attempts to glaze over that and reduce nuance may also reduce perceived impact.

    NAC: So what is your takeaway from the RAND and PPIC findings that food access isn’t an issue?

    Karpyn: These studies certainly contribute to our understanding of how to conduct research, but in recent years, some 200 studies have shown, broadly speaking, that accessing healthy foods is a challenge for many Americans. The majority demonstrate a correlation between this access issue, and healthier eating. These studies buck the trend and because they are counter to the prevailing research, they are newsworthy. I would hope, however, that readers do not arrive at the conclusion that there is indeed no correlation between healthier eating and food access. There is too much evidence in the other direction.
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    Apr 22, 2012 8:05 AM GMT
    First, there were two studies done that seem to support each other suggesting it's not just an outlier. Second, the expert that they rely on for the entirety of this article is a public advocacy group perhaps they should have asked others?

    I'd agree that more studies should be done to look at some of the questions that have been raised as a result of both studies but I note that the expert in this case acknowledges that while there may in fact be considerably more supermarkets the quality may not be as wealthier neighborhoods (to which I say duh!).

    I'm not entirely certain that the expert's views and those of the studies are necessarily contradictory. Do poorer neighborhoods have access to healthy foods? The answer appears to be yes. Do they have even greater access to junk food? The answer also appears to be yes.

    I should note further that while American policymakers try to combat obesity - an effort that has failed miserably, even the food pyramid has been skewed to the advantage of farm lobbyists. So if there is anyone here to blame, it may be government policy. And yet, the reflexive response at least in the case of a few policymakers is to use heavy handed approaches like attempting to restrict fast food restaurants treating the poor as if they need to have choices made for them. Finally, the good news is that at least the public policy concern is obesity not starvation.
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    Apr 22, 2012 1:44 PM GMT
    riddler78 saidFirst, there were two studies done that seem to support each other suggesting it's not just an outlier. Second, the expert that they rely on for the entirety of this article is a public advocacy group perhaps they should have asked others?


    The public policy group refers to the "others." As she noted, there is a wealth of information out there with the body of research in favor of what was advocated. That the two new studies contrast with the larger set of research sources is what made them newsworthy and does call into question, apparently correctly, the methodology behind them. If anything, the respondent did a pretty good job stopping short of dismissing the studies out of hand.
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    Apr 22, 2012 1:48 PM GMT
    riddler78 saidI'd agree that more studies should be done to look at some of the questions that have been raised as a result of both studies but I note that the expert in this case acknowledges that while there may in fact be considerably more supermarkets the quality may not be as wealthier neighborhoods (to which I say duh!).


    It would have been good if the researchers looked at the findings, said, "well, duh!" as well, then stratified for quality before issuing their findings.
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    Apr 22, 2012 2:01 PM GMT
    riddler78 saidI'm not entirely certain that the expert's views and those of the studies are necessarily contradictory. Do poorer neighborhoods have access to healthy foods? The answer appears to be yes. Do they have even greater access to junk food? The answer also appears to be yes.


    The answer appears to be "maybe, maybe not." Means of access (once they do the stratifying for quality) is just as important as as-the-crow-flies distance. Mode of transport to and from the similar-quality stores (and the per-trip costs) will be a factor.

    Also, so much of the research, pro-"food desert" and otherwise, focuses on distance from residential locations, and it may (hypothesis warning) turn out that the "access to" similar-quality stores for poorer residents is not so much from their homes, but from places of work (taking into account the typically longer commutes to commercial and retail areas -- both for jobs AND for shopping). This would be an angle from which, once they get a more representative sample size (one that definitively includes poorer residents, as was not the case with the first study), the researchers could even clarify and bolster their conclusions -- equivalent access comes as a result of where poorer citizens work, not necessarily where they live.
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    Apr 22, 2012 2:13 PM GMT
    riddler78 saidI should note further that while American policymakers try to combat obesity - an effort that has failed miserably, even the food pyramid has been skewed to the advantage of farm lobbyists. So if there is anyone here to blame, it may be government policy. And yet, the reflexive response at least in the case of a few policymakers is to use heavy handed approaches like attempting to restrict fast food restaurants treating the poor as if they need to have choices made for them. Finally, the good news is that at least the public policy concern is obesity not starvation.


    Here in Georgia we have a huge public-information effort to encourage parents to deal with child obesity at early ages. The policy message borders on, "your child is being bullied at school because you are feeding him too much junk. Stop feeding your children junk." And that's about as far as it goes.

    As you note, we're emphasizing policies of nannying citizens on obesity as a priority over making access to healthier and diverse options. It's possible to do both, but the former is cheaper (albeit cost-ineffective) while the latter is costlier and can be easily ignored by policymakers armed with shortsighted and farm lobby-supported research.