I am attending the American Public Health Association conference, where yesterday I presented some early findings of my research on access to healthy food in Manhattan. While the work is preliminary, it shows there is clustering in the availability of healthy food throughout the area (see map below; thanks to Laura Hansen of Clark University for the map. The index refers to the percent of 24 healthy food products available in a store.) While the patterns are not as striking as those for the availability of organic food, the findings confirm what we all know: the availability of healthy food is not evenly distributed across the landscape. The other presenters in my session looked at equally interesting questions: where Green Carts (roving produce carts) are located in the South Bronx; the food environment around schools in the state of California; and how the different types of purchased food environment data compare.
The presentations gave me plenty to mull over, and led to me conclude that there are two critical points to consider when thinking about food access:
1. The discussion would benefit from considering food availability rather than store location; after all, we eat food, not stores. I understand that establishment data are the easiest to locate and use, but I think reliance on this type of data necessarily pushes our research into the direction of asking questions that are dependent on store location rather than food availability. An additional implication is that proposed policy solutions focus on encouraging the creation of new stores, through tax incentives and such. I am not arguing that new stores are not needed; instead, I am suggesting that new stores will likely be just one part of a working solution.
2. Understanding how markets function helps us understand why food markets look the way they do, which includes where stores are located and which products they sell. I can not overemphasize the importance of understanding that firms are profit maximizing entities, and are not socially motivated businesses that seek to bring healthy food to everyone. If healthy food is available in a neighborhood, we can conclude that selling healthy food is what maximizes the profits of the stores in the neighborhood. If healthy food is not available, that means its sale is not profitable. Policies intended to increase access have to directly address the profitability angle, otherwise they will not succeed.