Monday, March 15, 2010

Obesity: A symptom of poverty

This NY times article on the Obesity-Hunger Paradox is worth the read (thanks to Rob for sending my way!).

The article quotes Joel Berg, executive director of the New York City Coalition Against Hunger, who says: “Hunger and obesity are often flip sides to the same malnutrition coin… Hunger is certainly almost an exclusive symptom of poverty. And extra obesity is one of the symptoms of poverty.”

Many poor neighborhoods simply do not have access to fresh fruits and vegetables. People are not starving, but they are “food insecure.” If the only food available/affordable is fried foods, doughnuts, etc, then that is obviously what people are going to eat.

This is a ripe area for some creative and innovative thinking, and New York City has come up with some good ideas. One solution is “Health Bucks,” where the city encourages the use of food stamps at farmers’ markets by giving an extra $2 for each $5 spent there. Other solutions include getting fresh fruit and vegetable carts into poor neighborhoods, and providing tax credits for grocery stores that move to these areas.

In my view, research on healthy food is useless if people aren’t able to apply it to their lives. It seems that before anything else, we need to figure out how to get basic, nutritious, health-full foods to neighborhoods that need them the most.


  1. I agree entirely, and I liked learning about the creative ways NYC has dealt with the issue. As I walk around my neighborhood of West Philadelphia, I know of three supermarkets within a 16-block length of length of Walnut St. Seems pretty good to me, certainly a higher density than my home town. But for people who don't have cars, I wonder just how convenient those stores are. I think tax credits to get supermarkets to move are helpful and needed, but I wonder if transportation is the limiting factor. Imagine this scenario: Mom has a choice between the supermarket 2 miles away, and the corner store two blocks away. To get to the supermarket with no car, she can 1) walk (4 miles total, two of those with groceries in tow, and unless she has a cart of her own, there is a limit to how many bags she can purchase, 2) take the bus (runs every 30 minutes on Saturdays, which is not terrible, but not very convenient either. Yesterday during the nasty rain, I would not have wanted to wait 30 minutes for bus, especially with my groceries. 3) borrow a friend's car or take a taxi / philly car share (definitely works, but not always an option for people).

    So, most times, if I were her, I would choose the corner store. (In fact, I actually own a car, and most times when I need just a few groceries, I will run to the corner store instead of get in my car. They are called convenience stores for a reason.) So, with those factors at play, can supermarkets really thrive in areas where car ownership is low and public transportation isn't at NYC-levels? That is a real question, not rhetorical, and I can guarantee some public policy/urban policy grad student has looked at these issues.

    Any ideas on how to tackle the problem of access from a transportation issue? One solution I have heard of is the following: Supremo, at 43th and Walnut, will let you come to the store, buy your groceries, and then have them delivered to your house by some Supremo delivery guys. This seems to work well. Then there are the grocery stores that let you order your food online. Seems great for some stuff, but I wouldn't want some employee picking out my produce, and the pricing is more expensive than regular stores (to be expected).

    Finally, it always comes down to education, and I want to recognize the unique partnership between Philly and UPenn in supporting urban nutrition.

    A high-quality impact-oriented group that teaches Philly students about nutrition, urban farming, and ways to actually cook and eat quality food.

  2. At UofP School of Public Health...
    Carolyn Cannuscio does work in this area.

  3. I remember reading some time ago that poor neighborhoods in the U.S. with Asian or Indian (and in my experience, also Mexican) populations DO have plenty of stores selling produce, and the prices are great. (How many of us have sought out these stores for just those reasons?!) Where there is a demand for produce, beans, legumes, grains, etc. the stores will be there to meet it. So some of the problem is probably cultural. We Americans have lost our knowledge of how to prepare real foods (I think so much of this happened in the '50s when people didn't want to seem "ethnic" and gave up cooking the foods of their immigrant ancestors). People tend to shy away from this argument because of the danger of the implication that blacks have a bad culture, and Asians a good one, but I think the problem is with Americans of all races and all income levels (rich people can just buy healthier prepared foods).

    I'm not sure what the solution is, but I'm glad people are attacking this problem in so many creative ways.

    I just read in one of my Italian cookbooks that there was a tradition in Italy to have a large bin divided in half for flour and cornmeal (cornmeal was much cheaper). When a beggar came, he was always given a scoop of cornmeal. This just made me think about how strange it would be to give a beggar cornmeal today. Would he have the equipment, time, and knowledge necessary to be able to eat it?

  4. Hey Mike,
    Yeah, that transportation issue is a big one. I'm wondering if farm shares could be one way to help get produce to these neighborhoods (bypassing the transportation problem as farms deliver the pre-made boxes of produce to local stores)?

    That Penn urban nutrition program looks great - thanks so much for sharing that.

    Adam, thanks for telling us about Carolyn Cannuscio, I'd love to learn more about her work!

    And thanks for your comment, Leslie... You are right that it's not only an access issue. A lot of it depends on education and the development of new habits (both individual and cultural).