Food Deserts, Annenberg, and a Spending Problem Worth Noticing

I awoke this morning hungry and groggy.  Today is Harvard’s last day of spring break and the last day the campus dining halls are closed.
Rightfully branded by my friends as too cheap to spend money on Noch’s, Berryline, or even printing, I was thrown into a tailspin upon my realization early this morning that the dining halls wouldn’t actually open until dinner.
Really, Harvard?
Naturally, I considered my economic, health, and above all, satiation options:  (1) an overpriced, processed, high fructose corn syrup-laden snack from CVS, (2) a delicious stack of $3 diabetes-causing pancakes from a cheap diner 10 blocks down Mass Ave towards Central, (3) an artery-clogging Dunkin Donut, (4) something from a more expensive restaurant in Cambridge, or (5)—yes, I might actually have been on to something—fresh, wholesome food from a grocery store.
But where?  And how would I get there? …and would it be worth it?

The more I thought, the more I came to behave like the Mississippi target population that I have been studying over the past few weeks for my SLS class as I look at the connection between low-income and diabetes—and ultimately the nation’s Medicaid and Medicare costs.
So I asked myself the question: if Annenberg didn’t exist, and I was a full-time low-wage earner, where would I eat in the Cambridge area?  Let’s assume I qualified for the SNAP (food stamp) program (net monthly income less than $903 for a single). Using the USDA’s SNAP Retail Locator, I determined the closest locations for me to make use of food stamps (in order of proximity): (1) CVS, (2) the other CVS, (3) the Farmers Market at Harvard (only open seasonally), (4) the Broadway Market (could be expensive?), (5) Rite Aid.  While the locator shows many more options, I cut off my enthusiasm for grocery shopping at about ¾ mile walk away—as do many other Americans who, just like me, rely on public transportation.  The options weren’t great.
Yet as a Massachusetts Public Health Association report found earlier this month, grocery-shopping options in Boston aren’t just not good, they’re pathetic.  Boston ranks third from the bottom nationally in terms of having enough supermarkets with adequate fresh, nutritious food.  Though Cambridge hardly meets the definition of a “food desert” (areas where one must travel more than a mile to the nearest grocery store) the problem of access to affordable fruits, vegetables, whole grains, and milk across America (see the national map) is, nevertheless, real.  And it’s costing us all.
Why?  In a word: diabetes.
Without access to conveniently located quality grocery stores, too many Americans are dining at their local 7-Elevens or CVSs.  Literally.  And as we all know, there’s a dearth of fresh produce and whole grains there—not to mention that prices are higher, meaning monthly SNAP money runs out even faster.  Even if a quality grocery store exists two or sometimes even three bus connections away, the problem is far from solved: busy consumers will frequently spend all of their SNAP money in one shot to save another trip (as I would as well) leading to unhealthy spikes in blood sugar during the first weeks of the month and hunger and low blood sugar in the last.  For a number of reasons, low-income Americans, including those receiving SNAP program benefits, are widely known to be at greater risk for both diabetes and obesity.
But why should we care?  As discretionary programs are being cut left and right in an effort to rein in America’s spending, it seems only logical that the wastes of the costliest entitlement programs should be assessed: Medicare and Medicaid.  Currently, Medicare spending for diabetics is 65% higher than for non-diabetics and diabetics compose 19% of the highest cost beneficiaries of Medicaid.  A 2010 report found that the national healthcare expenditure for people with Type II diabetes is expected to rise from $340 billion in 2011 to $1.6 trillion by 2031.
Yet the approach to solving this problem remains in constant debate. Should America limit the use of SNAP money on soda and candy as NYC Mayor Mike Bloomberg proposed this past fall?  My personal gut answer is no.  Such a move would not only be patronizing, but would most likely fail to tackle a big part of the problem: corner stores.
Because the reality is, if the Farmers Market at Harvard had been open, I would’ve bought my breakfast there this morning.  And if a Shaws had been across the street, I might have purchased my lunch there.  Instead, I too spent too much money on unhealthy food just like the millions of other Americans in this country who choose convenience and accessibility over quality, cost, and health.  But who’d blame us?
As Sandra Lane, Professor and Graduate Program Director of Public Health at Syracuse University told me over break, fixing the food desert problem has been tough, “I’ve tried to see how we can make the corner markets healthy. I have to say nobody thinks it’s possible.  I mean we put a man on the moon, we cured childhood leukemia, and we can’t make the corner markets sell produce.”
Sell fresh produce.  And milk.  And whole-grain bread.  That’s what we need more corner stores to do.  It won’t fix the diabetes problem on its own, but it’s the best first step we have towards preventing Type II diabetes amongst low-income populations.  In the end, all of us (and our medical costs especially) will benefit from it.
Photo Credit: Slate