Food deserts are a growing problem in the United States, and occur in areas of low-income where people have limited access to healthy foods. In response, the presence of farmers’ markets has grown exponentially, and improved healthy food access. Additionally, the USDA has strived to connect families to healthy foods through food assistance programs such as the Supplemental Nutrition Assistance Program (SNAP), the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and the Senior Farmers’ Market Nutrition Program (SFMNP). This study investigated the relationship between farmers’ markets, their acceptance of food assistance benefits, and their locations within Tennessee food deserts census tracts. Using the 2017 Farmers’ Market Directory, this study merged market data, including geocoded addresses, with the appropriate census tract data from the 2015 Food Access Research Atlas. Chi-square tests of independence and spatial visualizations were used to assess the relationship of census tracts, farmers markets, and food assistance benefits. Of the 1,497 Tennessee census tracts, 18.0% were food deserts. Of these food deserts, 9.3% had at least one market present. Of these food deserts, 92.0% were urban. Of 130 farmers’ markets in Tennessee, 34.6% accepted any food assistance benefits. Additionally, 56.9% of all markets were in areas of high socioeconomic status (SES). Results indicated that markets were clustered in urban areas, and few were identified as food deserts. Additionally, few markets were in food deserts and accepted any food assistance benefit. Due to these findings, the definition of food deserts should be expanded to include additional food retailers other than supermarkets. Also, additional policies and research is needed to reinforce farmers’ markets and food assistance programs as food access interventions.

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The tremendous need for comprehensive healthcare among underserved populations has been well documented. Most of the healthcare resources have been allocated to major metropolitan areas and largely populated cities. In Massachusetts alone, 500,000 people are not serviced by proper healthcare because they are unemployed or underinsured. They do not have a home base for their needs, most visit emergency rooms or minute clinics for care. They lack continuity of care. For minorities and underserved populations, there is a gap in the healthcare system. Statistics have shown that the lower your socioeconomic status, the more advanced the disease has progressed before it is diagnosed, leading to fewer treatment options and poorer outcomes. This is often due to Healthcare Deserts / Health Professions Shortage Areas in the US where there is a true lack of access to healthcare resources. One effective system for healthcare belongs to the Cuban government. Since the revolution in 1949, one of the main goals of the Cuban government was to provide primary care to all its population. The system before the revolution was centralized in the cities and was available mostly to the wealthy and urban populations while the remaining population was left with a substandard and underfunded system like many developed and undeveloped countries. In this paper, we will explore the success of the Cuban system and extrapolate some aspects of its system to use in the underserved populations that inhabit Healthcare Deserts. Implementation of systems will create an Oasis of providers that will naturally improve the well-being of populations leading to the well-being of federally funded state and local resources. The Cuban system divided the country into a grid system and each grid was subsequently divided into even smaller areas with a population of approximately one thousand. A primary care team consisting of a doctor and a nurse was assigned to each grid, including a dental component, and charged with the health and well-being of the population. This system was so successful that it was exported to other countries such as Venezuela, and it was adopted by the World Health Organization as the healthcare model standard to be followed in their world efforts. These programs have been implemented in Latin America, Africa, and Asia with different levels of success due to resource availability and financial constraints. In Venezuela during the Chavez administration, the system was implemented and achieved its highest level of success by benefiting the poor and underserved while Chavez was in power, creating thousands of clinics and improving the healthcare of the population. In Africa, Tanzania adopted the primary care approach at its new dental school and is producing strong clinicians versed with this approach. In Asia, the WHO has made progress in some areas; however, success has proven dependent on the country’s political and financial situation. The primary care approach that the system embraces, emphasizes prevention and education at a very early stage. This is key, and the data proves the success of campaigns even with limited resources provided there is the involvement of the local population. In contrast, United States resources are concentrated on the coasts and urban locations such that the rural areas have the least resources, and people in rural locations often travel long distances to access healthcare. A few states in the US have implemented programs that have been successful – Colorado, North Carolina, and New Mexico. If we successfully transplant teams of healthcare providers, including doctors, dentists, nurses, pharmacist, optometrist, obstetrics /gynecology, pediatricians, and a complete and sustainable health center into empty grids, slowly a series of Oasis will be created and access to care will improve. This change needs to happen at multiple levels, it is a task that must be taken collectively, from the teaching institutions exposing healthcare students to the need for providers in these rural and underserved areas, increasing funding to provide more scholarships and programs that funnel recent graduates into these areas with a sustainable and self-replenishing model, and most important, emphasizing education and prevention in dental school curriculum as the key to improving healthcare, and creating Oases in the current deserts.

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This dissertation explores the complex interactions between the Cold War military-scientific apparatus, the idea of a culture of the Cold War, and the desert environment of the Tularosa Basin in south-central New Mexico. During and after World War II, the War Department and then the Department of Defense established several military reserves in the region. The massive White Sands Missile Range (at 3,200 square miles the largest military reserve in North America and larger than Rhode Island and Delaware combined) and other military attachés would increasingly define the culture and economy of the Tularosa Basin. Historians have cast places such as White Sands Missile Range as cratered wastelands. Yet the missile range and surrounding military reserves became a contested landscape that centered on the viability of the nonhuman natural world. Diverse communities sought to find their place in a Cold War society and in the process redefined the value of a militarized landscape. Undeniably, missile technology had a profound impact on south-central New Mexico and thus acts as a central theme in the region's postwar history. However, in the years after 1945, environmentalists, wildlife officials, tourists, and displaced ranchers, amongst many others, continued to find new fangled meanings and unexpected uses for the militarized desert environment of south-central New Mexico. The Tularosa Basin was not merely a destroyed landscape. The design and sheer size of the missile range compelled local, national, and transnational voices to not just make sense of the economic implications of the missile range and surrounding military sites, but to rethink its cultural and environmental values in a changing Cold War society. It was a former home to ranchers still tied to the land through lease and suspension agreements. New Mexico Department of Game and Fish personnel cast the site as perfect for experimentation with exotic big game. Environmentalists and wildlife biologists saw the site as ideal for the reintroduction of the Mexican wolf. Tourists came to know the landscape through the simple obelisk at the Trinity Site. While missiles cratered the desert floor, the military bureaucracy did not hold absolute power over the complex interactions between cultures, economies, and the nonhuman natural environment on the postwar Tularosa Basin. / History

<p dir="ltr">The origins and deposition of nitrate in dust traps in Mojave Desert are examined in this thesis. Two main hypotheses are tested: (1) most of the dust in the traps comes from local soil, implying that the nitrate content is primarily derived from the soil; and (2) wet deposition is the primary source of nitrate found in the environments, implying that precipitation processes play an important role in nitrate accumulation. To test these hypotheses, we collected data from 11 dust trap from locations in of the US Geological Survey's long-term investigation of dust composition and influx rates. Dust and soil samples were analyzed for ions to determine their origins and the contributions of local vs distant sources. Our findings show that the fraction of soil-derived nitrate (<i>f</i>_soilNO₃^-) is consistently low at all traps, hardly reaching 0.03, whereas the atmospheric nitrate percentage (<i>f</i>_atmNO₃^-) is usually close to or equal to 1. This shows that atmospheric sources play a substantial role in the nitrate levels detected in dust traps. Nitrate contributions are also significantly influenced by sedimentary and geological settings, such as the distinctions between alluvium and playa regions. Playas, which are composed of silt and clay, may have higher nitrate concentrations than alluvial plains, indicating that external dust inputs are significant. The second hypothesis's results show that nitrate deposition in the study area is primarily from dry sources, with dry deposition values ranging from 0.68 to 10.84 NO₃⁻/kg/ha/yr, averaging 4.12 NO₃⁻/kg/ha/yr, and wet deposition values averaging 1.09 NO₃⁻/kg/ha/yr. This observation challenges the hypothesis that wet deposition is the primary source of nitrate. The dominance of dry deposition is further supported by low amounts of precipitation and a weak correlation between precipitation and dust deposition. This study concludes that although local soil has a role in nitrate levels in dust traps in the study site, it is not the primary source, external sources and dry deposition account for the majority of nitrate in the dustpan</p>

Doctor of Philosophy / Department of Human Nutrition / David A. Dzewaltowski / The prevalence of obesity within the U.S. has risen dramatically in the past thirty years. Recent changes in food and physical activity environments may contribute to increased obesity prevalence, suggesting that disparities in these environments may be linked to the increased risk of obesity observed in low-income, and racial/ethnic minority women. This dissertation characterizes the local food environment experienced by low-income women who participate in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Kansas, evaluates whether characteristics of the local food environment contribute to obesity risk, and examines how these relationships vary across the urban-rural continuum. Chapter One reviews the relevant literature examining the association between obesity and local food environments, and identifies three testable hypotheses that serve as the framework for later chapters. Chapter Two characterizes the local food environment and examines geographic, racial, ethnic, and socioeconomic disparities in the availability of small grocery stores and supermarkets. Chapter Three examines the association between store availability and obesity risk at an individual level among participants in the WIC Program, while Chapter Four utilizes multi-level modeling to examine the relationships between tract deprivation, tract store availability and body mass index (BMI). Significant geographic disparities were observed in the availability of small grocery and supermarkets. Racial and ethnic disparities observed within tracts were not observed when examining store availability in a 1-mile radius around the residence of WIC mothers. The majority of women participating in the WIC program resided within a 1-mile radius of a small grocery store, and micropolitan and metropolitan WIC mothers had a multiplicity of food stores available within a 3-mile radius of residence. Food store availability was associated with increased obesity risk only in micropolitan areas. The availability of food stores did not mediate the association between tract deprivation and BMI, which varied across the urban-rural continuum. Overall, these results suggest that the relationship between local food environments and eating behaviors is complex, that limited store availability does not contribute to increased obesity risk in vulnerable populations, and that the association between local food environments and obesity risk varies across the urban-rural continuum.

Reprinted 1994.

<p>Protecting public health is the most legitimate use of zoning, and yet there is minimal progress in applying it to the obesity problem. Zoning could potentially be used to address both unhealthy and healthy food retailers, but lack of evidence regarding the impact of zoning and public opinion on zoning changes are barriers to implementing zoning restrictions on fast food on a larger scale. My dissertation addresses these gaps in our understanding of health zoning as a policy option for altering built, food environments. </p><p>Chapter 1 examines the relationship between food swamps and obesity and whether spatial mapping might be useful in identifying priority geographic areas for zoning interventions. I employ an instrumental variables (IV) strategy to correct for the endogeneity problems associated with food environments, namely that individuals may self-select into certain neighborhoods and may consider food availability in their decision process. I utilize highway exits as a source of exogenous variation .Using secondary data from the USDA Food Environment Atlas, ordinary least squares (OLS) and IV regression models were employed to analyze cross-sectional associations between local food environments and the prevalence of obesity. I find even after controlling for food desert effects, food swamps have a positive, statistically significant effect on adult obesity rates.</p><p>Chapter 2 applies theories of message framing and prospect theory to the emerging discussion around health zoning policies targeting food environments and to explore public opinion toward a list of potential zoning restrictions on fast-food restaurants (beyond moratoriums on new establishments). In order to explore causality, I employ an online survey experiment manipulating exposure to vignettes with different message frames about health zoning restrictions with two national samples of adult Americans age 18 and over (N1=2,768 and N2=3,236). The second sample oversamples Black Americans (N=1,000) and individuals with high school as their highest level of education. Respondents were randomly assigned to one of six conditions where they were primed with different message frames about the benefits of zoning restrictions on fast food retailers. Participants were then asked to indicate their support for six zoning policies on a Likert scale. Subjects also answered questions about their food store access, eating behaviors, health status and perceptions of food stores by type. </p><p>I find that a message frame about Nutrition and increasing Equity in the food system was particularly effective at increasing support for health zoning policies targeting fast food outlets across policy categories (Conditional, Youth-related, Performance and Incentive) and across racial groups. This finding is consistent with an influential environmental justice scholar’s description of “injustice frames” as effective in mobilizing supporters around environmental issues (Taylor 2000). I extend this rationale to food environment obesity prevention efforts and identify Nutrition combined with Equity frames as an arguably universal campaign strategy for bolstering public support of zoning restrictions on fast food retailers.</p><p>Bridging my findings from both Chapters 1 and 2, using food swamps as a spatial metaphor may work to identify priority areas for policy intervention, but only if there is an equitable distribution of resources and mobilization efforts to improve consumer food environments. If the structural forces which ration access to land-use planning persist (arguably including the media as gatekeepers to information and producers of message frames) disparities in obesity are likely to widen.</p> / Dissertation