Food Deserts, Chronic Disease, and Technology’s Potential Role in Mitigation

Today’s blogpost is by guest contributor Nina Pine.

Nina Pine is a Health Promotion specialist who uses growth marketing, health design, and technology to improve health equity globally. Say hello: @Nina_Pine

Food deserts refer to geographic areas with limited access to nutritious and affordable food, which contribute to disparities in diet-related health outcomes. Data has long shown strong links between poor diet and excess body weight, and the consequential association with type 2 diabetes, cardiovascular disease, and even some cancers. This is evident on the Navajo Reservation, where a survey found that 80 percent of the Reservation’s supermarkets’ stock had little to no nutritional value. The Indian Health Service also reports that one in three Navajo Reservation residents lives with diabetes. Thus, when addressing chronic disease, analysis of the social determinants of health is crucial. Essentially, how do you maintain a balanced diet when your local gas station is your one groceries resource?

Though research on global food deserts often incites debate, a peer-reviewed systematic review affirms there is abundant evidence that food deserts are a public health issue within the US in particular, and that low-income and minority communities have poorer access to healthy food. The review found that low-income areas and those with high African American populations had fewer supermarkets per capita and those available had less selling space than their counterparts in higher-income communities. As a result, being a resident of a food desert is a risk-factor for an unhealthy diet.

Technology-Based Interventions Addressing Food Deserts

While geographic information system (GIS) mapping and data mining has assisted advocates in locating food deserts, technology has also been applied to increasing food access. In rural Sweden, Robert Ilijason, opened Näraffär, an online store managed through an app. Ilijason states: “The internet already makes it easier to live outside the big cities. If you add unmanned stores, delivery with drones, and similar things, you will make it even better.”

Tech Policy Daily points to the potential of online supermarkets in delivering healthier food options to food desert residents. They highlight Peapod in particular, an online supermarket which serves the Chicago food desert. While online marketplaces have further reach than brick-and-mortar businesses, Tech Policy Daily also highlights that not all online supermarkets accept Supplemental Nutrition Assistance Program benefits, which could impede access for low-income users.

Is Access the Sole Barrier?

Food access public policy in the US to date has been grounded in observational evidence linking the lack of nutritious food with poor diet, and thus an increased risk of chronic illness. However, a study in 2014 found that there is currently no evidence to suggest that increasing food retail development within food deserts would lead to healthier diets and thus, a decrease in diet-associated illness. While the Pennsylvania Fresh Food Financing Initiative is often noted as a successful food desert intervention–as it has increased access to healthy food for an estimated 500,000 children and adults–the program has had no formal evaluation to measure its long-term effectiveness in improving diets.

The study did show however, that an increase in healthy food access had a positive effect on perceptions of food accessibility throughout the tested community. This shift in communal outlook is arguably, the first step in developing long-term behavior change interventions.

Technology and Behavior Change, Meet Access

Simply increasing access to nutritious food has yet to show solid associations with healthier diets, obesity-reduction, and chronic disease prevention; as these interventions do not often take other social, economic, and political drivers into consideration. For example, increased access to fresh produce does not directly translate into time to prepare meals, nutrition education, or the behavior change required to maintain a healthier diet.

Access is a crucial factor when addressing food deserts, but there is also potential for technology-based interventions to focus on behavior change and health coaching, as there has been proven efficacy in such interventions. If these technologies were coupled with the work of food justice advocates and food retail development, a more sustainable approach to reducing chronic disease within food deserts may occur. What do you think about technology’s potential role in food desert mitigation? Tweet your thoughts: @WelkinHealth.