Food Deserts

Nutrition suffers when a 7-11 is your oasis

By LAUREN MAGNUSON

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Organic, local, natural, trans-fat free, free-range, grass-fed ... the supermarket offers enough options to send even the savviest list-maker wandering for hours. But for many Bostonians, those choices are out of reach.

Some of Boston's neighborhoods are becoming "food deserts," where little to no healthy food can be found nearby. Even when nutritious food is available, prices and other limitations are forcing families to shop at convenience stores or choose between eating and other necessities.

Dr. John Cook, an associate professor of pediatrics at the Boston University School of Medicine recently conducted research assessing the affordability of healthy food in Boston. "There are areas around Boston that can legitimately be called food deserts," he says, naming Mattapan and East Boston as candidates. "There are no major supermarkets in Mattapan's boundaries." Cook adds that there is one medium-sized market, but because public transportation is so minimal in the area, "gypsy taxis" often hover near the doors.

If residents don't have the time or resources to travel miles to a supermarket, they shop at convenience marts and corner stores that rely on tobacco and lottery sales for their revenue, and carry mostly canned or processed foods.

"The least expensive foods are the most calorie-dense and most nutrient-sparse," Cook says.

Hunger and food insecurity has risen dramatically in the state in recent years. A study by the Greater Boston Food Bank found that the number of people who sought food assistance increased by 14 percent between 2005 and 2001, while one-third of those with assistance reported their children weren't eating enough because they couldn't afford it.

In 2007, Project Bread's "Status Report on Hunger in Massachusetts" found a 22 percent increase in food insecurity since 2004. They also reported that low-income children receive more than half of their daily calories from public schools. Meanwhile, over 71 percent of Boston public school students qualified for the city's free or reduced price lunch program in 2006, which means their household incomes were below 130 percent of the poverty line, according to the Boston Foundation's Boston Indicators Project.

A healthy diet for low-income households, especially those receiving food stamps, has become nearly impossible. Boston Medical Center (BMC) tested the price of the Thrifty Food Plan (TFP), the dietary and monetary framework by which the USDA determines food stamp allotments, in Boston and Philadelphia. BMC found the monthly cost of TFP is $27 more than the maximum monthly food stamp allowance. The deficit is even more serious considering that the average food stamp benefit is far below the maximum.

"In Boston and Philadelphia you cannot buy the Thrifty Food Plan with the dollar amount that the government says you should be able to," Cook says.

BMC also priced out a healthier cheap diet than the outdated TFP, using whole grains and fresh produce, to comply with the American Heart Association's diet recommendations. That plan was even less affordable.

"There was a deficit of about $150 a month that the family would need over and above the maximum food stamp allotment," says Dr. Vivien Morris, Community Initiatives Director for BMC's Nutrition and Fitness for Life Program, who was involved in the study.

"It's not that they are not good shoppers," says Morris, who added that a family will often turn to the cheapest, most calorie-dense food when under budget pressure. "If they had an adequate food budget, they wouldn't be forced to make these unfortunate choices."

Morris places more of the blame on agricultural policy, the loss of New England farmland and the associated transportation costs that make food here so expensive.

"Produce costs have risen tremendously," Morris says. Although food costs vary nationally, "the federal government, when setting up food stamp rates, doesn't make a distinction."

Boston's food dilemma parallels a growing crisis across the nation and the globe. Staples like wheat, rice and dairy products are skyrocketing in cost. The price of peanut butter has jumped 19 percent, and spaghetti has increased 63 percent since last May. Milk now costs more than $4 a gallon.

"I think it's always been a public health problem," Morris said of food security in Boston. "I think what's new is recognizing its impact on obesity, and not only under-nutrition."

Morris, a long-time Mattapan resident, founded the Mattapan Food and Fitness Coalition (MFFC), a grassroots organization aimed at improving the community's access to, and awareness of, healthy food and physical activity. The MFFC began a small farmers market in Mattapan last summer, accepting food stamps and Women, Infants and Children (WIC) and seniors' coupons.

"What we're trying to do in Mattapan mirrors what we're trying to do citywide," Morris says, referring to the Boston Collaborative for Food and Fitness (BCFF), an organization that hopes to curb obesity and increase physical activity in the city. The BCFF aims to increase the amount of locally grown and consumed food in Boston from 2 to 10 percent.

In its second year, the BCFF is assessing Boston's least-advantaged communities, including Mattapan, Dorchester, Roxbury, and East Boston. Kate Howell, executive director of Red Tomato (a nonprofit that connects local farmers with markets), and a member of the BCFF's executive committee, says anecdotal evidence shows concern for Boston's food situation.

"I don't think there's any low-income neighborhood that isn't underserved," Howell says. She adds that inner cities should have a retail food source every mile. "We don't have that," she says. "And sometimes, we really don't have it."

Meanwhile, health issues are an increasing concern among low-income families. The Department of Public Health's DPH WIC program, which provides services to pregnant women and those with small children, now has their highest enrollment to date, at 134,795, according to Donna Rheaume, a DPH spokeswoman.

Deborah Frank is the founder and director of the Grow Clinic at BMC, which treats children who lack the nutrition necessary for normal development. She says the clinic's referrals have jumped 17 percent since this time last year. Forty percent of new referrals seeking immediate treatment are infants less than a year old.

"It's pretty overwhelming," Frank says. With rising living costs, daily stress and increasing food prices, "everything is converging on the bodies of babies."

Obesity rates are also highest in the same communities that are being called food deserts. According to 2005 data by the Boston Public Health Commission, Mattapan has the highest level of people who are overweight or obese at 70 percent, with Dorchester in second place at 64 percent.

A University of Washington study found that the highest obesity rates tend to occur in the poorest communities, and that poverty is associated with low-quality diets that are high in fat and low in fruit and vegetable consumption.

But Howell says that in Boston, geography is the determining factor. "What they've found is people's eating habits have less to do with their income and more to do with accessibility," she says. "What they have around them is unhealthy food."

Cultural differences can also complicate access in underserved communities, which are accustomed to particular foods.

"Frequently if [certain foods] are not available, they will adapt in ways that are not as healthy," Cook says, adding that Mattapan has the largest Haitian-American community outside of New York City, and Latino East Boston residents often have to travel miles to Chelsea's Market Basket to find culturally traditional foods.

The Food Project, a farming organization with offices in Dorchester, Lincoln and Lynn, attempts to abate this pattern, says Jen James, its communications director.

"There are things that we grow in the city that are distinctly grown for the customers we have at the farmers market," James says, adding that products like hot peppers, collard greens and okra are grown specifically for Boston neighborhoods.

The Food Project grows over a quarter million pounds of food each year, donating to shelters and selling produce at their own farmers markets. James noted that many residents have to travel by bus out of their neighborhood to be able to find fresh, healthy produce.

While the Food Project's seven farmers markets all accept food stamps, many others do not because of the high cost of installing a wireless terminal (needed to process the electronic food stamps) coupled with low participation rates, according to Jeff Cole, executive director of the Massachusetts Federation of Farmers' Markets.

The typical demographic for farmers markets is older, college-educated women, with very little traffic in food stamp recipients. In stark contrast, before the switch to electronic stamps (EBT) in the '80s, Worcester's markets saw approximately $12,000 a year in food stamps, according to Cole.

"It's a new generation," Cole said of the drop-off. "After 20 years, people have developed completely different shopping habits. That's a very very difficult thing to overcome."

New Haven's CitySeed farmers markets began accepting EBT food stamps in 2005. Benjamin Gardner, a program coordinator for CitySeed, said their EBT sales of $1,551 last year is a very low proportion of their total sales.

"It has partly to do with awareness," Gardner said. Because EBT stamps have long been out of use in open-air markets, many people do not know when a market near them has the capability.

Alternatively, WIC participants and seniors can receive coupons from the Farmers' Market Nutrition Program (FMNP), which began in 1986, before becoming a federal program in 1992. However, recipients only get $10 per season per family member, according to David Webber, Boston coordination for FMNP.

"It was originally more of a nutrition education and promotional program," Webber says. "It wasn't meant to be a food subsidy."

Between hunger relief efforts at food pantries and selling community shares that often go to the higher-income residents, those in the middle can be left behind.

"There's kind of a gap in terms of who we're serving," says Meg Coward, executive director of Waltham Community Fields, a farm that developed as a hunger relief effort, donating produce they grew to local agencies. But Coward says they are putting together a food map of Waltham and have set up a pilot farmers market in the town.

"We'll offer our produce at subsidized rates to make our produce available to people who are in that gap," Coward says.

Maggie Cohn, executive director of the BFCC, says that when they finish their report on Boston's access to healthy food, they can begin to transform the landscape.

"We're going to try to change the system," she says. They expect to work closely with small businesses and public schools, and address topics like how much land is set aside for farming and the length of the farmers market season.

Dr. Hugh Joseph of the School of Nutrition Science and Policy at Tufts University says that telling people to eat well isn't enough.

"If we really want people to eat more fruits and vegetables, we have to have a policy aimed at that," he says, adding that efforts in education, changes in food subsidies and shifting the national addiction to meat are avenues for initiating change.

"We tend to eat what's available," he says. "I would argue that if people ate a healthier, more sustainable diet, it wouldn't necessarily be more expensive. But it's a gradual process."