Food Swamps: A Big Problem in the American Health Crisis

By now, most of us have heard of “food deserts,” a term for lower-income neighborhoods that lack a local availability of grocery stores, forcing already disenfranchised residents with limited means of transportation to travel far for healthier food. Many experts have argued that the lack of healthy food options in these communities has contributed to the American health crisis, an obesity epidemic.

However, a recent study has established that the opposite is true. While these neighborhoods may lack local grocery stores, the more significant dilemma is that they are "crammed with unhealthy food options like corner stores and fast-food places."[i]

iStock-477088424 drive thru.jpgA key indicator of the research was a comparison of the obesity rates of U.S. counties to their ratio of fast-food restaurants and convenient stores to grocery stores and supermarkets. The food swamps had about four unhealthy options for each healthy one, and the relationship between food swamps and obesity was especially strong in communities where people lacked viable access to transportation.[ii]

What is also troubling is that in cases where grocery stores or at least healthy food options are available or accessible, the obesity growth rate remains constant

According to Kelly D. Brownell, dean of Duke University’s Sanford School of Public Policy (whose team conducted the research in partnership with experts from the University of Connecticut’s Rudd Center for Food Policy and Obesity), "… if you are looking for what you hope will change obesity, healthy food access is probably just wishful thinking."[iii]

Ben Pallant and Kelly Close of diatribe maintain that making healthy food available is not enough to tackle the growing obesity rates. "We also need to consider how to reduce the number of unhealthy options that so often overwhelm the healthy ones, especially in communities with the fewest resources to invest in health."[iv]

One of the recommendations from the "food swamp study" called for municipalities to place zoning measures to restrict the number of fast-food places, while concurrently increasing the number of grocery stores in specific zones. 

This sounds great in theory, but it is not a panacea for the obesity epidemic.

  • In 2008, the city of Los Angeles banned new fast-foot joints in low-income neighborhoods, but the ordinance failed after obesity rates continued to rise. One reason was that new healthy food establishments did not enter these areas, and the decree did not preclude strip malls from recruiting the fried-food concepts.[v]
  • A 2012 New York Times article on the same topic pointed to a neighborhood in Camden, NJ, where 80% of the children were eligible for a free school lunch, yet opted to buy empanadas, sodas, and candy at a nearby grocery store.[vi]

While the "food swamp" study is effective at debunking the food desert theory as the cause for obesity in lower-income neighborhoods, it would be interesting to see research on what we believe to be a food swamp prevalence in middle- and higher-income communities.

iStock-472485878 shopping cart.jpgIn higher- to middle-income communities there are seemingly more healthy food options and perhaps a "better-educated" demographic that would appear to be making more nutritious choices. Yet, we would argue that the average shopping cart would still be overwhelmed with processed foods, "bad fat" snacks, and juices that are loaded with added sugars. We concede that in lower-income neighborhoods, there are ethnic populations that have an affinity for cultural staples that may be fried and/or filled with bad carbohydrates. This certainly explains why there are higher rates of obesity and diabetes among these groups. 

Notwithstanding, there exists the same affinity for these ethnic cuisines, as well as the fast-food, junk food and sugar-added choices in the mainstream suburban communities. The unhealthy options are on the surface more attractive to the palate, but even for the well-intentioned parent, they offer a higher convenience as they navigate today’s work-life balance.

Aside from the somewhat challenging allure of healthy foods (French fries vs. carrots…), there also exists a financial consideration. Healthy foods are more expensive, and they often come in smaller portions. Consequently, the value proposition for healthy foods in lower- to middle-income neighborhoods has become increasingly challenging and unless there is a better educated consumer the trends for obesity and diabetes will continue to rise. 

How do we change this dynamic?

As well-intended as those municipalities are who are trying to zone out bad food options, this is not something that can be legislated away. The work has to be done with education. The average American is woefully ignorant of what makes a food healthy.

Even when people believe they are trying to eat healthy, there are still things like fruit juice, granola bars, yogurt (non-greek), fruit smoothies, rice, cereal, pasta, bread, and other starches, that most people see as being "healthy," when in fact they are loaded with sugars, or are very high glycemic index foods

iStock-544443200 little girl shopping healthy.jpgWe have asked much of our schools and our teachers, although we need to re-prioritize how early and how often we teach our children about healthy food options.

Consider this: the American Lung Association and the American Cancer Society spent millions every year on television and print advertisements against smoking. Two generations later ... about one-third the number of people smoke (as a percentage of our population; from 42% to about 14%). Imagine if we could do the same for obesity and diabetes? 

 How to Be a Smart Food Shopper


[i] https://www.theatlantic.com/health/archive/2017/12/food-swamps/549275/
[ii] https://www.theatlantic.com/health/archive/2017/12/food-swamps/549275/
[iii] http://www.nytimes.com/2012/04/18/health/research/pairing-of-food-deserts-and-obesity-challenged-in-studies.html
[iv] https://diatribe.org/foundation/about-us/dialogue/obesity-availability-unhealthy-options-may-outweigh-healthier-ones?utm_source=diaTribe&utm_campaign=08e4bd2bfbEMAIL_CAMPAIGN_Mailer_148_2018_01_26&utm_medium=email&utm_term=0_22467a8528-08e4bd2bfb-151103749
[v] https://www.theatlantic.com/health/archive/2017/12/food-swamps/549275/
[vi] http://www.nytimes.com/2012/04/18/health/research/pairing-of-food-deserts-and-obesity-challenged-in-studies.html

Sean Browne

Sean Browne

Chief Revenue Officer, CCS Medical

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