Skip to content
  • About
  • Contact
  • Contribute
  • What Physicians Say
  • My Book
  • Careers
  • Podcast
  • Speaking
KevinMD.com — Social media's leading physician voice
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
    • All
    • Physician
    • Burnout
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • About
    • Contact
    • Contribute
    • What Physicians Say
    • My Book
    • Careers
    • Podcast
    • Speaking
KevinMD.com — Social media's leading physician voice
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
    • All
    • Physician
    • Burnout
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • About
    • Contact
    • Contribute
    • What Physicians Say
    • My Book
    • Careers
    • Podcast
    • Speaking
  • About Kevin Pho, MD, Founder of KevinMD
  • Aging and dementia: what physicians say, in their own words
  • Artificial intelligence: what physicians say, in their own words
  • Be heard on social media’s leading physician voice
  • Cancer: what physicians say, in their own words
  • Children’s health: what pediatricians say, in their own words
  • Contact Kevin
  • COVID-19: what physicians wrote as it happened
  • Custom enhanced author page pricing
  • Diabetes and obesity: what physicians say, in their own words
  • Direct primary care: what physicians say, in their own words
  • DMCA Policy
  • End of life: what physicians say, in their own words
  • Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices
  • GLP-1 drugs: what physicians say about Ozempic and its successors, in their own words
  • Heart disease: what physicians say, in their own words
  • Immigration and medicine: what physicians say about immigrant doctors and immigrant patients, in their own words
  • KevinMD influencer opportunities
  • Medical errors: what physicians say, in their own words
  • Medical ethics: what physicians say, in their own words
  • Medical malpractice: what physicians say, in their own words
  • Medical school: what students and physicians say, in their own words
  • Mental health: what psychiatrists and physicians say, in their own words
  • Nursing: what nurses and physicians say, in their own words
  • Opinion and commentary by KevinMD
  • Opioids: what physicians and pain patients say, in their own words
  • Physician burnout speakers to keynote your conference
  • Physician burnout: what physicians say, in their own words
  • Physician Coaching by KevinMD
  • Physician keynote speaker: Kevin Pho, MD
  • Physician personal finance: what physicians say about their own money, in their own words
  • Physician Speaking by KevinMD: a boutique speakers bureau
  • Physician suicide: what physicians say, in their own words
  • Physicians and administrators: what physicians say about who runs medicine, in their own words
  • Primary care physician in Nashua, NH | Kevin Pho, MD
  • Primary care: what physicians say, in their own words
  • Prior authorization: what physicians say, in their own words
  • Privacy Policy
  • Private equity and corporate medicine: what physicians say, in their own words
  • Race and medicine: what physicians say, in their own words
  • Recommended services by KevinMD
  • Residency: what residents and attendings say, in their own words
  • Scope of practice: what physicians, nurse practitioners, and PAs say, in their own words
  • Subscribe to the KevinMD enhanced author page
  • Subscribe to the newsletter
  • Surgeons and surgery: what surgeons say, in their own words
  • Take-home messages: what physicians say when asked to leave one
  • Terms of Use Agreement
  • Thank you for subscribing to KevinMD
  • Thank you for upgrading to the KevinMD enhanced author page
  • The electronic health record: what physicians say, in their own words
  • Vaccines: what physicians say, in their own words
  • Violence against health care workers: what physicians and nurses say, in their own words
  • What physicians say: the KevinMD records
  • Women in medicine: what women physicians say, in their own words
  • Women’s health: what physicians say, in their own words

Food deserts are incredibly complex problems

Birju Rao
Health Policy
October 27, 2013
Share
Tweet
Share

food-desert-1

Recently, food has become the center of a revival of interest in cultures that make up Chicago.

The smells, tastes, sounds, and even atmospheres created by cuisine allow both tourists and native Chicagoans to sample our city’s diverse cultural heritage. As such, food has become an increasingly popular and a relatively inexpensive way to enjoy what Chicago has to offer. In fact, one of the city’s biggest events — the Taste of Chicago — is a celebration of cultural diversity through food. Food is a huge part of Chicago’s identity.

Even with respect to low-fat alternative foods, Chicago has experienced an exponential growth over the past decade. Even for vegetarians like myself, there are plenty of healthy options out there.

However, for many of us, the availability of the food we want is taken as somewhat of a given, and in 2013 in America, I wish I could say that was true.

Over the past several years the term “food desert” has become somewhat of a buzzword. I remember hearing it while in a sleepy daze, which could only have been result of sitting in undergraduate classroom post-lunch. However, at that time, the word “food desert” was just another jargon term to be memorized and regurgitated on an exam. As I parsed through my old, handwritten class notes, I found the definition I had scribbled: “no nutritious food, lots of fast food — bad combination.” This didn’t help me much, so I consulted with some experts in the field. They gave me some devastating figures about life expectancy, costs, and distance to fresh food sources in Chicago:

  • Individuals living in food deserts have a cardiovascular disease death rate of 11.07% and a diabetes death rate of 1.27% compared to respective rates of 5.72% and .56% in non-food deserts—a statistically significant difference.
  • African-Americans inequitably represented in food deserts making up more than 54% of the food desert residents—most of these are single mothers and children.
  • Individuals who live in an African-American majority neighborhood have to travel on average .77 miles to a chain grocer and .81 miles to an independent grocer—dispelling the myth that smaller or independent grocers are more likely than chain grocers to locate in African-American communities.

Though these statistics are frightening, in a vacuum, data tells us little. So, let me provide some context.

On the academic side, the phenomenon of food deserts were uncovered in response to CDC and census report data that showed a curiously strong relationship between an individual’s cardiovascular health outcomes and their zip code. These data anomalies were discounted as spurious correlations for years, and even today many still believe that residents in these neighborhoods simply lack the will to eat healthier. In the clinic, we often forget that this is a food problem and end up calling these people non-complaint.

The biggest food deserts in Chicago are centralized in the West and South sides. Walking through these neighborhoods I counted almost a dozen McDonalds, 7-11s, and liquor stores, but I didn’t see one grocery store. When I asked people on the sidewalks if they knew where the closest grocery store was they either said that they didn’t know or pointed me towards a convenience store. Before visiting some of these neighborhoods, the phenomenon of food deserts seemed to fly in the face of everything I had learned from my undergraduate training in economics. There seemed to be a clear market signal here for businesses — fresh foods grocery stores should be lining up to open up stores in these areas because they could tap into a sizable market without facing any competition from rival stores. But after walking through the neighborhood, I learned that the problem wasn’t something new. Gangs, drugs, shootings these have all conspired to make certain neighborhoods unsafe and far too risky for entrepreneurs to open up a giant grocery store.

So now, when we add the deaths related to violence in these neighborhoods (506 in 2012) to the deaths related to poor nutrition, we arrive at a very large body count, stemming from one source.

From a medical standpoint, the morbidity of these food deserts are stymieing the work of clinicians on top of putting extensive financial burdens on hospital systems that are already underfunded. Piling onto the financial constraints are decreases in funding due to what lawmakers see as “non-compliance.” In many ways, larger social forces outside of the clinic limit clinicians’ ability to ameliorate medical problems. From firsthand experience, I’ve realized it’s ineffective to recommend that the patient improve her diet, when she is lacks access to fresh fruits and vegetables.

The most obvious solution in the face of any market failure is government intervention. Using subsidies or tax breaks city officials could help incentivize the establishment of more grocery stores that carry fresh produce. However, those of us who are familiar with the state of Chicago politics can foresee tax breaks and subsidies escalating to impose a significant financial burden on a political system already struggling to pull its own weight. In fact, according to the Center for Rural Affairs, one in five grocery stores has gone out of business in the last four years in rural areas. Perhaps government intervention could be a short term fix, but over the long term, it’s not economically viable.

Fortunately, some communities across the nation are tackling the problem of food deserts from all sorts of creative angles. After a survey from a Minneapolis food desert revealed that 94 percent of residents would purchase more fresh produce if it were available at convenience stores, city officials enacted the Minneapolis Health Corner Store initiative, requiring all corner and convenience stores to stock a certain amount of fresh fruit on their shelves. Nearby in Indiana, an initiative from Indiana University called Garden on the Go, uses the concept of food trucks to deliver fresh produce at an affordable price and even accepts food stamps.

Food deserts are incredibly complex problems because they are linked to the very problems that humanity has struggled with throughout its history (crime, decay, and violence). Though many of the proposed solutions are not perfect, they are steps in the right direction, and they show, at the very least, that decisions are being made.

ADVERTISEMENT

George Kaplan, a Thomas Francis Collegiate Professor of Public Health at University of Michigan eloquently remarked on the etymology of the word desert. He comments, “A desert is, of course, a place distinguished by the absence of vegetation, rain, etc., which is the sense in which the word is used in this report. Food deserts are defined as “areas with no or distant grocery stores.” But the word “desert” is also a verb — “to leave someone without help or in difficult situation and not come back.” This seems to me to capture an important dimension of food deserts not conveyed by the noun.”

Birju Rao is a medical student.

Prev

Navigating the health care system is as important as the care itself

October 27, 2013 Kevin 3
…
Next

A gift to bear witness to the changes in my patients’ lives

October 27, 2013 Kevin 5
…

Tagged as: Obesity

< Previous Post
Navigating the health care system is as important as the care itself
Next Post >
A gift to bear witness to the changes in my patients’ lives

 

ADVERTISEMENT

More by Birju Rao

  • What health care can learn from forest preservation

    Birju Rao
  • a desk with keyboard and ipad with the kevinmd logo

    A behavioral economics approach to solve obesity

    Birju Rao
  • What Detroit’s bankruptcy means for patients

    Birju Rao

More in Health Policy

  • The next child

    Medicaid managed care and the case for mutual stewardship

    Steven Merahn, MD
  • How to build a dementia care pathway, not a referral sheet

    Gerald Kuo
  • AI in prior authorization: 3 contract questions for 2027

    Matt Hasan, PhD
  • Private equity in medicine did not kill private practice

    Brian Hudes, MD
  • Why are fewer family physicians delivering babies?

    Frista Gradica
  • Local news and public health: the segment viewers missed

    Ronald L. Lindsay, MD
  • Most Popular

  • Past Week

    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • The conflict of interest that discloses as nothing

      Martha Rosenberg | Medications
    • 4 fibromyalgia myths the current evidence doesn’t support

      Kayvan Haddadan, MD | Conditions and Diseases
    • Why exhaustion can make you see things that aren’t there [PODCAST]

      The Podcast by KevinMD | Podcast
    • AI governance in health care has to reach the exam room

      Amanda Heidemann, MD | Health Technology
    • The Pennsylvania measles outbreak and the cost of forgetting

      Christine King, CRNA | Conditions and Diseases
  • Past 6 Months

    • Why CDC opioid guidelines get the overdose data wrong

      Richard A. Lawhern, PhD | Conditions and Diseases
    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • Sensory processing in autism and the brain’s volume control

      Josette Pelatan, PhD | Conditions and Diseases
    • What maternity care deserts cost a town

      Manisha Kaliaperumal | Health Policy
    • Why medicine needs a national physician license now

      Vaishali Popat, MD, MPH | Physician
    • A cold cost $945. The cost of primary care is broken.

      Susan Newman, MD | Physician
  • Recent Posts

    • Why exhaustion can make you see things that aren’t there [PODCAST]

      The Podcast by KevinMD | Podcast
    • 3 reforms to counter wellness influencers in practice

      Farid Sabet-Sharghi, MD | Physician
    • Shift work and circadian rhythms shape the 24/7 workplace

      Deepak Gupta, MD | Conditions and Diseases
    • Paid for twice

      Physicians paid for G2211 twice. Most never bill it.

      Michael Duben, MD | Physician Finance
    • The next child

      Medicaid managed care and the case for mutual stewardship

      Steven Merahn, MD | Health Policy
    • Choosing a limb lengthening surgeon requires accountability

      Hrayr Basmajian, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 5 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • The conflict of interest that discloses as nothing

      Martha Rosenberg | Medications
    • 4 fibromyalgia myths the current evidence doesn’t support

      Kayvan Haddadan, MD | Conditions and Diseases
    • Why exhaustion can make you see things that aren’t there [PODCAST]

      The Podcast by KevinMD | Podcast
    • AI governance in health care has to reach the exam room

      Amanda Heidemann, MD | Health Technology
    • The Pennsylvania measles outbreak and the cost of forgetting

      Christine King, CRNA | Conditions and Diseases
  • Past 6 Months

    • Why CDC opioid guidelines get the overdose data wrong

      Richard A. Lawhern, PhD | Conditions and Diseases
    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • Sensory processing in autism and the brain’s volume control

      Josette Pelatan, PhD | Conditions and Diseases
    • What maternity care deserts cost a town

      Manisha Kaliaperumal | Health Policy
    • Why medicine needs a national physician license now

      Vaishali Popat, MD, MPH | Physician
    • A cold cost $945. The cost of primary care is broken.

      Susan Newman, MD | Physician
  • Recent Posts

    • Why exhaustion can make you see things that aren’t there [PODCAST]

      The Podcast by KevinMD | Podcast
    • 3 reforms to counter wellness influencers in practice

      Farid Sabet-Sharghi, MD | Physician
    • Shift work and circadian rhythms shape the 24/7 workplace

      Deepak Gupta, MD | Conditions and Diseases
    • Paid for twice

      Physicians paid for G2211 twice. Most never bill it.

      Michael Duben, MD | Physician Finance
    • The next child

      Medicaid managed care and the case for mutual stewardship

      Steven Merahn, MD | Health Policy
    • Choosing a limb lengthening surgeon requires accountability

      Hrayr Basmajian, MD | Physician

Copyright © 2026 KevinMD.com | Powered by Astra WordPress Theme

  • Terms of Use Agreement
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Food deserts are incredibly complex problems
5 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...