When Healthy Food is Hard to Find

I just came back from a wonderful vacation. But before and after the glorious beaches and food of St. Martin, we of course had to go through airports.

Whenever I go through an airport with my hungry family (because travelers – especially young ones – always seem to be hungry), I think to myself, is this the first impression we want to give of our city? Or our country? Are these food choices the best we can offer a hungry traveler?

Most airports are environments in which there are almost no healthy choices available. It’s almost only fast-food. One has to look very hard, or bring something from home (in other words, be prepared) or face the grease.

At least closer to home we have healthy choices. Or do we? Some neighborhoods don’t offer much beyond fast-food joints and convenience stores. Lower income communities in particular are typically places where healthy meals and healthy ingredients are hard to come by.

So when I read the aptly titled report “Designed for Disease”, released by the California Center for Public Health Advocacy (CCPHA), the UCLA Center for Health Policy Research, and PolicyLink this week, it really got me thinking.

The report demonstrates that people who live near an abundance of fast-food restaurants and convenience stores compared to grocery stores and produce vendors, have a significantly higher prevalence of obesity and diabetes regardless of individual or community income.

To summarize the findings:

o The average California adult has more than 4 times as many fast-food and convenience stores near home as they have grocery stores and produce vendors.

o Twenty eight percent of Californians have no grocery stores and produce vendors in their immediate vicinity.

o Obesity is most prevalent in California adults who have the most fast-food and convenience stores relative to grocery stores and produce vendors.

o Diabetes is most prevalent in California adults who have the most fast-food and convenience stores relative to grocery stores and produce vendors.

o Although lower income and a minority ethnicity background are independently associated with obesity and diabetes, after controlling for these factors the link between the retail food environments (how many fast-food/convenience stores vs. grocery and produce stores) remains as an independent risk factor.

The authors conclude:

“These findings suggest that improving the retail food environment—in both lower-and higher-income California communities—may be a promising strategy for decreasing the prevalence of obesity and diabetes in California adults.”

They then offer policy recommendations because “although healthy eating habits are ultimately a matter of individual choice, local food environments influence those choices”:

o “Increase access to healthy foods by providing incentives for retail store development and improvement.”
o “Promote retail innovations, including smaller-scale markets selling healthy foods.”
o “Maximize the opportunities presented by the changes in the WIC (the Special Supplemental Nutrition Program for Women, Infants, and Children, ALC) food package.”
o “Implement zoning designed to limit fast-food restaurants in overburdened communities.”
o “Require menu labeling.”

I couldn’t agree more.

It is so hard to make healthy choices and follow dietary advice in an environment with easy access to junk food, and limited access to healthy food options. If we want to reverse the trend of obesity and its consequences we have to make healthy food readily available. Fast-food restaurants seem to be especially concentrated within a short walking distance from many schools, and I’m sure that’s been done intentionally.

Sometimes, seeing things over and over again makes them seem normal and acceptable. I’m sure that our great grandmothers would not think of what’s served in fast-food joints and gas stations as food at all. But now, since most of the food around us is shares that kind of dubious nutritional quality, we think of it as perfectly fine to eat. We even contrast it with “health food,” which is what almost all food was before fast-food took over the landscape.

So on the way back to Juliana Airport in St. Martin we stopped at a small, locally-owned café, where they wrapped us a few sandwiches with Greek feta cheese, tomatoes, kalamata olives and alfalfa sprouts, on fresh whole wheat baguette baked on premises, and threw in a few local bananas. I felt especially grateful when I later passed by the airport food court. We were set.

To end on an optimistic note: I actually think that food choices at airports are slowly improving, and some airports now do have a few decent options. I believe that if consumers continue to demand good food, their desires will be met. We need to keep asking.
Ayala