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Do YOU live in a food desert?

Do YOU live in a food desert?

First, it was the opening of a Kroger in East Oakland. Now it's the announcement that Tesco's Fresh and Easy is heading to the Bayview. What exactly, you may be asking yourself, makes these stories major headline news?

And why is a doctor spending time writing about grocery stores too?

Turns out, as obesity rates soar to epidemic proportions, even among small children, researchers have been furiously busy trying to find out the factors behind the pandemic's recent explosion. And, just as importantly as in clusters of other diseases, trying to find out why it is that you can even map the distribution of obesity between specific neighborhoods.

As you might imagine, poorer neighborhoods, regardless of race, do worse. Poverty, obesity, and type two diabetes are all closely correlated. Researchers were surprised, however, to find that they could also map, along the same lines, access to a decent grocery store. In other words, they found entire neighborhoods where it was virtually impossible to buy fresh fruits or vegetables. Much less buy them at an affordable price.

Sure, there were a gazillion-humongo-trillion (that's an epidemiologic term) fast food outlets. No shortage of those. And there were even an eye-popping number (that's an opthamologic term) of what's often called "liquor stores," or "package stores." But a Safeway? Or an Albertson's? No such thing - not within an hour or two (each way!) of transit time.

These areas have become known, in the public health literature, as "food deserts." Kind of like being stranded in the Sahara, dying of thirst, but all there is to drink is trans fats. So how bad is it? This is how extreme it's gotten - did you know there's not a single chain grocery store in the entire city of Detroit?

And researchers have found that the problem's not just lack of retail access. Even when larger stores (with better prices and more selection) exist, the quality of the produce, compared to more affluent areas, often, well, sucks. The only things green are the cheeses and breads. The heads of iceberg look like squishy softballs - the rotted outer leaves may have been cut off so many times, all that's left is a flabby anemic core.

And the prices for this type of lame quality, are often higher. Kind of like paraphrasing that Woody Allen joke - the food was terrible, but at least it was expensive.

And at the one-on-every-corner package store, a half-gallon of soda may cost 99 cents, and a gallon of expired milk will cost 4-5 times that price, with not a fruit or veg to be seen anywhere, except for that geriatric orange and bruised-to-the-point-of-coagulation apple. And the poor choices may not all be grocer's fault. The equipment and inspection requirements for fresh produce and meat can be prohibitively high for a closet-sized shop. On the other hand, stocking that furry orange, and those Salmonella-tainted eggs may be enough to qualify a corner store to accept food stamps - while a farmer's market vendor is not allowed to accept them, because of a lack of required food elements that are necessary to qualify as a vendor.

Regional variations in food access have become a big topic in public health, on both a micro and macro level. On a personal note, I know for a fact that my life literally changed when a Trader's Joe's opened up a few blocks from my house. We eat better, and cheaper. We just bought a box of a dozen peaches for $4.99. Still not cheap if you're trying to spend only $30 a week on groceries, but these are the kind of peaches that bring back a flood of memories from growing up in farmland in Georgia, the kind of perfect, blemish-free peach where the sticky juice dribbles down your chin as you bite it and you learn to eat them with a paper towel in your other hand, or hanging over a sink. In the next town over, however, which is not nearly as affluent, their Trader Joe's often has browner, more shriveled produce. And not nearly as many organic options to choose from - despite being the exact same chain, and both stores within five miles of each other.

The opening of Kroger's in East Oakland is the first major chain store there in 20 years. The move by Tesco's to open new outlets in American may mean more access to eating WELL for more people. Grocery stores, and equitable access to healthy food, as our obesity epidemic rages out of control, have become major news indeed.

What do you think? Is obesity an environmentally-induced disorder, caused by retail markets? Do YOU live in a food desert? How long does it take you to get access to decent food? And how does that impact your food choices? Share in the comments section below. Doc Gurley is the only Harvard Medical School graduate, ever, to be awarded the coveted Shoney's Ten Step Pin for documented excellence in waitressing, and is also a practicing board-certified internist. You can get more health posts at www.docgurley.com, or jump on the Twitter bandwagon and follow Doc Gurley. Also check out Doc Gurley's joyhabit and iwellth twitter feeds - so you can get topic-specific fun, effective, affordable tips on how to nurture your joy and grow your personal wellth.

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