A health impact assessment (HIA) is a flexible, data-driven approach that identifies the health consequences of new policies, and develops practical strategies to enhance their health benefits and minimize adverse effects.

The Health Impact Project, a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts, is a national initiative designed to promote the use of health impact assessments (HIAs) as a decision-making tool for policymakers. According to their website:

HIAs use a flexible, data-driven approach that identifies the health consequences of new policies and develops practical strategies to enhance their health benefits and minimize adverse effects. 

The Health Impact Project has recently made a huge commitment to researching the correlation between public health and transportation. The first-ever health impact assessment of a major metropolitan transportation and comprehensive growth plan will be led by the Center for Quality Growth and Regional Development at the Georgia Institute of Technology’s College of Architecture. According to the American Association of State Highway and Transportation Officials (AASHTO),

The HIP recently announced nearly $400,000 in grants to four organizations to conduct health impact assessments. One of the grants will be used to examine the health impacts of a 30-year transportation plan in the Atlanta region… [other] projects — to be conducted in Georgia, Illinois, Kentucky, and Oregon — are at the leading edge of a growing movement in the United States in which governments, nonprofit groups, and other organizations use health impact assessments to help ensure that decision makers craft public policies and projects that avoid unintended consequences and unanticipated costs, according to the grant sponsors.

Though this is certainly a great start, $400,000 is, frankly, weak considering the amount of research money invested in other areas. Let’s hope these assessments are productive and persuasive as a sound method for addressing potential and often overlooked health implications of policy proposals.

A vast portion of the modern landscape provides little or no access to food that is needed to maintain a healthy diet. These food deserts are a serious problem for public officials, public health researchers, and city planners. 

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In Retail Concentration, Food Deserts, and Food Disadvantaged Communities, a report by Troy C. Blanchard [Mississippi State University] and Thomas A. Lyson [Cornell University], the authors lay out finding of a number of interesting trends regarding food deserts in the U.S. For example:

A central finding for our study was that food deserts contain a higher number of small grocery and convenience stores. Because these stores often sell lower quality groceries at higher process, food desert residents must travel long distances to access the quality, low priced groceries at a supermarket or supercenter. Additionally, food deserts are less likely to have fruit and vegetable markets (farmer’s markets).

So not surprisingly, food desert most usually contain a higher percentage of impoverished populations, lower median family incomes, a less educated population, and higher rates of unemployment. 

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In response to Troy Blanchard’s findings, FoodMapping Blog notes that, 

According to their figures, 803 of United States counties, or 26%, have low access to food, while 401, or 13%, are food deserts. They found that residents of low-access and food desert counties are more likely to lack a high school diploma or GED, have a lower family income, have higher individual and family poverty rates, and have a population which is older than average. In four food desert counties in Iowa that they focused on more closely, the researchers found that 64% did not consume adequate amounts of vegetables daily, while 45% did not consume adequate fruit, 34% lacked adequate dairy and 30% lacked adequate protein.

While the problem is visible in both urban and rural areas, a look at non-metropolitan counties with “low access” to a large food retailer” (50+ employee grocery store) reveals a greater number of rural counties in the south and south east with low access. 

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“The food desert is not one single problem with one single solution,” says Mari Gallagher or the National Center for Public Research. In her research of Chicago food deserts, she notes one clear strategy, developing new stores, could have broad impact on Chicago’s food access. That’s why the Chicago Grocer Expo project recently identified six priority sites, many city-owned and vacant, on the South and West sides of Chicago best suited for new food stores.  According to Chicago Magazine, ”Unfortunately, the group released its list in September 2008, just in time for the economy’s free fall.” Molly Sullivan of the Chicago Department of Community Development says that while the city has held preliminary discussions with retailers regarding the targeted locations and has appointed its own task force to streamline the process for launching new stores, no lease has been signed on any of the six sites.

DRY CELLS: The three largest clusters in Chicago’s food desert: (1) from Austin in the west to the Near North Side in the east; (2) from the Near South Side in the north to Ashburn and Greater Grand Crossing in the south; (3) most of the Far South Side, including Roseland and Pullman
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According to Chicago Magazine, “Some Chicagoans aren’t waiting for grocery stores to come to the rescue. The nonprofit God’s Gang, started in the 1970s by residents of Grand Boulevard, a neighborhood classified in part today as a food desert, provides training in urban agriculture to fellow citizens.” According to the Chicago Magazine article, last year at least three underserved communities launched farmers’ markets.

All over the Chicago citizens are putting spare land to use, planting strawberries and tomatoes in backyards and side lots. In several neighborhoods, Growing Home, a nonprofit, hosts weekly farm-stand hours at its urban garden, giving people the chance to buy fresh vegetables. What is happening in Chicago is echoed all over the country. Farmers Markets are all the rage and many community gardens have become a hot issue from the White House down. Hopefully this will be a sustained response to food deserts. 

It is no secret that food accessibility in urban areas is a nightmare for urban planners, city officials, and public health professionals. This problem is not as critical for smaller/less-dense urban areas because of the prevalence of cars and the hearty supply of suburban shopping centers within driving distance. However, larger urban areas (or smaller urban areas trying to encourage revitalization or gentrification) are now confronted with health-conscious, environmentally-concerned residents who want access to healthy food. More important are the thousands of low-income residents without cars who are deprived of fresh fruits and vegetables because of their foodscape.

Even though this subject has been heavily researched, I am surprised that little efforts have been made to change the way food distribution and food accessibility are monitored. The Center for Urban Pedagogy has made a great video that sheds light on some of the social, economic, and consumer forces that combine to create the foodscape of South Bronx. This half-hour video is a must see for anyone interested in learning about the factors involved in deciding what food is distributed in urban areas.

Sorry, I was unable to embed the video, but you can watch Bodega Down Bronx here.