Access to Healthy Food and Why It Matters

Posted by Content Coordinator on Monday, November 25th, 2013



Healthy food retailers—grocery stores; farmers’ markets; cooperatives; mobile markets; and other vendors of fresh, affordable, nutritious food—are critical components of healthy, thriving communities. As the country inches its way out of the Great Recession and seeks to grow a more sustainable and equitable economy, ensuring that healthy food is accessible to all is crucial. Without access to healthy foods, a nutritious diet and good health are out of reach. And without grocery stores and other fresh food retailers, communities are also missing the commercial vitality that makes neighborhoods livable and helps local economies thrive.

Moreover, the challenge of access to healthy food has been a persistent one for communities of color. Beginning in the 1960s and 1970s, white, middle-class and working-class families left urban centers for homes in the suburbs, and supermarket chains went with them, leaving many inner-city neighborhoods with few or no full-service markets—often for decades. Limited access to healthy food also plagues many rural communities and small towns, where population losses and economic changes have diminished food retail options. Even in agricultural centers where fruits and vegetables are being grown, residents may not have a retail outlet nearby. Many of the communities that lack healthy food retailers are also oversaturated with fast-food restaurants, liquor stores, and other sources of inexpensive, processed food with little to no nutritional value. For decades, community activists have organized around the lack of access to healthy foods as an economic, health, and social justice issue.

Healthy food retailers can generate significant economic stimulus by serving as anchors for further commercial revitalization, creating local jobs, generating tax revenues, and capturing local dollars within the community, among other economic and community development outcomes.For example, it is estimated that 24 new jobs are created for every 10,000 square feet of retail grocery space, so a very large market can generate between 150 and 200 full- and part-time jobs.1 Attracting and incentivizing new or improved healthy food retail in communities of color and low-income, urban, and rural communities is an important component of a comprehensive strategy to revitalize disinvested areas by improving health and economic outcomes in the places that need it most.

As concerns have grown over the worsening obesity epidemic, access to healthy and affordable food has moved to the forefront of community, civic, and policymakers’ agendas. A shared recognition of the role that healthy food access plays in promoting stronger local economies, vibrant neighborhoods, and healthy people has sparked support for different projects and initiatives, bringing an array of approaches from grocery stores to farmers’ markets, mobile markets, food hubs, and community gardens.

Even as recognition of the problem is growing and progress is being made, between 6 and 9 percent of all U.S. households are still without access to healthy food. Nearly 30 million people live in lowincome areas with limited access to supermarkets (defined as the closest store being more than a mile away). The problem is particularly acute in lowincome communities of color. People living in these neighborhoods must either make do with the foods available in smaller local stores, which are very often less healthy and more expensive, or spend nearly 20 minutes traveling to the nearest large retailer or even more time in rural communities where a full-service grocery store may be more than 20 miles away.

There has been a proliferation of innovative approaches to bringing healthy food retail into underserved communities in recent years. The bestknown large-scale innovation is the highly successful Pennsylvania Fresh Food Financing Initiative—a statewide public-private effort that helped develop or improve 88 supermarkets, smaller independently owned grocery stores, farmers’ markets, and other fresh food outlets in underserved urban communities, small towns, and rural areas throughout Pennsylvania. Launched in 2004, the initiative leveraged more than $190 million in healthy food retail projects over six years and is responsible for creating or retaining more than 5,000 jobs in Pennsylvania communities. This program has so far been adapted and funded in six other states and cities, bringing much-needed financial resources and development know-how to communities seeking to improve healthy food access. Several more jurisdictions are in the process of starting funding for similar initiatives.

The federal Healthy Food Financing Initiative (HFFI), established in 2011, has, in three years, distributed more than $500 million in grants and tax credits to improve access to healthy food in communities across the country. The President has proposed to expand the program further in 2014. In total, more than $1 billion in private capital has already been leveraged to support an array of different projects and approaches—not only full-scale grocery stores but also consumer co-operatives, farmers’ markets, mobile markets, and food hubs. Thousands of jobs have been created, and hundreds of thousands of people have new access to healthy food.

The local and state-level efforts confirm that support for healthy food retail can come in many forms and that new models are emerging at a fast pace. Improving offerings at corner stores and bodegas, starting or expanding farmers’ markets and mobile markets, enhancing community gardens and other forms of urban agriculture, and initiating new forms of wholesale distribution through food hubs are among the promising strategies that bring economic and health benefits to neighborhoods. The local economy, development resources, community leadership and support, political will, and other factors determine what is possible and viable.

In 2010, PolicyLink and The Food Trust published The Grocery Gap: Who Has Access to Healthy Food and Why It Matters, a comprehensive review of the previous two decades’ worth of food access research. The review found overwhelming evidence that access to healthy food was particularly limited for lowincome communities, communities of color, and rural communities. The research also suggested that access to healthy food corresponds with a good diet and lower risk for obesity and other diet-related chronic diseases. A third, more emergent, theme in the literature was that new and improved healthy food retail in underserved communities creates jobs and helps to revitalize low-income neighborhoods.

Given the proliferation of research since the 2010 Grocery Gap publication, it was determined important to systematically review the new studies and reevaluate the evidence base. This new report does that, providing an up-to-date summary of what is known about access to healthy food and why it matters. The majority of the evidence continues to support—or strengthen—three primary findings:

  • Accessing healthy food is still a challenge for many families, particularly those living in low-income neighborhoods, communities of color, and rural areas.
  • Living closer to healthy food retail is among the factors associated with better eating habits and decreased risk for obesity and diet-related diseases.
  • Healthy food retail stimulates economic activity.

While most of the newer research continues to point to positive health and economic impacts, some contradicting results have also surfaced. As this report documents, however, the majority of research still indicates that in order for people to improve their diets they need to have convenient access to good quality, healthy food.

The proliferation of local efforts to provide access to healthy food has drawn attention to the factors that can determine the impact of these innovations, including transportation access and the quality, price, and cultural appropriateness of the offerings. As more studies of local circumstances are published, a more complete picture is emerging of the realities for people living in low-income urban neighborhoods, communities of color, and rural areas with limited access. There is also more clarity about what happens to purchasing, consumption, health outcomes, and the local economy when access changes. The following summary of the state of the research can inform policymakers, advocates, researchers, philanthropic organizations, and others in identifying, designing, and implementing strategies to ensure all people have access to healthy food.

Challenges of Access


Download full version (PDF): Access to Healthy Food and Why It Matters

About PolicyLink 
“PolicyLink is a national research and action institute advancing economic and social equity by Lifting Up What Works.® PolicyLink work is guided by the belief that those closest to the nation’s challenges are central to the search for solutions. With local and national partners, PolicyLink is spotlighting promising practices, supporting advocacy campaigns, and helping to bridge the traditional divide between local communities and policymaking at the local, regional, state, and national levels.”

About The Food Trust
“The Food Trust’s mission is to ensure that everyone has access to affordable, nutritious food and information to make healthy decisions. Working with neighborhoods, schools, grocers, farmers and policymakers, we’ve developed a comprehensive approach to improved food access that combines nutrition education and greater availability of affordable, healthy food.”

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