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Limited access to, and availability of, fresh, healthy, and affordable food is a major concern in several communities across the United States of America. Such conditions have long perpetuated a wide variety of negative health outcomes that include, but are not limited to, obesity, diabetes, and other heart-related disease and illness, not to mention socio-economic immobility. Furthermore, the prevalence of limited food access and food insecurity is well researched and documented as an issue that disproportionately affects non-white, lower-income communities. The following research paper aims to better understand the characteristics of food deserts, the communities that are most affected by them, and the challenges that food deserts present to the local community. Additionally, the following research paper seeks to explain why most conventional grocery stores and supermarkets do not enter underserved markets. As such, it discusses the financial difficulties associated with grocery anchored retail developments in underserved markets, and examines why such communities struggle to attract investment in general. / 0 / SPK / specialcollections@tulane.edu

Master of Regional and Community Planning / Department of Landscape Architecture/Regional and Community Planning / Huston Gibson / Tens of millions of predominantly low-income, minority Americans live in food deserts – areas with poor access to healthful, affordable food. Food deserts have been associated with higher rates of diet-related diseases such as high blood pressure and obesity. These diseases carry significant morbidity and mortality and account for hundreds of billions of dollars in healthcare spending and lost productivity per year in the U.S. Establishment of a supermarket is the most effective intervention to eliminate a food desert. However, food deserts have historically been neglected by the retail industry. Local governments are rarely involved in supermarket recruitment. Often, food deserts themselves must recruit supermarkets. This study sought to understand how leadership and community engagement in supermarket recruitment influence its efficacy. The objective was to enable food deserts to more effectively recruit supermarkets. A case study of Argentine, a low-income, minority neighborhood in Kansas City, KS that successfully recruited a supermarket in 2013, was conducted. The heart of the case study was a series of interviews with individuals who were heavily involved in the recruitment. This study found the results of community engagement – specifically a community food assessment – were leveraged to attract funding and financing for a supermarket development. In settings where recruitment of a supermarket is contingent upon obtainment of these dollars, community engagement may be critical. Engagement empowers people to play an active role in shaping the future of their communities. It is a vital component of the urban planning process and government in general. Additionally, in the context of a food desert, engagement of residents can help accomplish the lofty goal of recruiting a supermarket and improving the food landscape – and health – of the community.

Background: Diabetes is one of the leading causes of death and disability among chronic diseases in the United States. Type 2 diabetes, which accounts for 90-95% of all diabetes cases, is a preventable form of disease which can be controlled through diet and physical activity. But residents of places such as ‘food deserts’, with no access to fresh food, often bear the burden of chronic diseases such as diabetes. There have been very few studies which have particularly looked at the association between food environment and diabetes prevalence in such deprived areas. Objective: The study investigated the association between living in food desert and developing diabetes or dying from the disease. It considered factors such as access to grocery stores and supermarkets, convenience stores, food joints and owning a personal vehicle that might affect diabetes related morbidity and mortality. It has also looked at factors such as income and race which might influence the association. Methodology: The study emphasizes on the lack of access to food, in low income and deprived neighborhoods and its impact on diabetes mortality and morbidity at the micro level of census tracts in Fulton County, Georgia. Diabetes related data was obtained from OASIS and Fulton County Department of Health and Wellness for the years 1994-2010 for 204 census tracts of Fulton County. Data for food desert distribution was extracted from the ‘Food desert Locator’ tool of the United States Department of Agriculture (USDA). Data on food stores was obtained through ReferenceUSA. Demographic information was acquired from American Fact Finder of the US Census Bureau. SPSS version 21 was used to calculate Pearson’s correlation to find the association between food environment and diabetes as well as to see whether there is an association between income and vehicle ownership with diabetes occurrence. ArcGIS 10.1 was used to represent data as maps showing the geographical distribution of various factors across the County and their association with the occurrence of diabetes. Results: Low income African American dominated census tracts which have been designated as food deserts have a higher occurrence of morbidity and mortality from diabetes. The correlation between number of supermarkets and grocery stores, convenience stores and full service restaurants has no statistically significant relation with diabetes. Similarly, there is no statistically significant relation between car ownership and diabetes. But the relationship between income and diabetes has a statistical significance. Conclusion: This study did not find any significant statistical association between diabetes and living in food desert. But from the GIS maps it can be observed that the number of food markets (supermarkets and grocery stores) is much less in the low income tracts than elsewhere and these are also the tracts which have higher occurrence of diabetes. Similarly, the numbers of convenience stores, which usually do not have a healthy collection of food, are more in the low income neighborhoods. The weak association between the factors studied might be because other factors such as education and access to healthcare have not been considered for this study. More research in this field is required to get a better picture of the diabetes health status in food desert areas.

Food availability is a serious problem for some low-income neighborhoods. This study examines food access in Eatonville, Florida, a small town in Orlando, Florida. Eatonville was one of the first African American towns incorporated into the United States after emancipation. It is a low-income community with 25% of the overall population and 30% of children living below the poverty line. This study will examine the state of food availability through food store and resident surveys in hopes of diagnosing need in order to alleviate it. There are serious implications for residents of cities with inadequate access to nutritious, affordable food. Children living with unequal access will face many future disadvantages in education, employment, and health. These compounding problems lead to a cycle of poverty that can be alleviated with appropriate public policy measures and other neighborhood changes that address food access in low-income neighborhoods.

Yes / Supermarkets, with vast product ranges and relatively low prices, are an established solution to problems of availability of healthy foodstuffs in areas of limited retail access. However, where they may indeed raise consumption of desirable goods they also open up new opportunities to buy less healthful items for less, a situation which potentially undermines their ability to improve diet. Using under-reported diary data from the Seacroft Intervention Study in the United Kingdom takes this paper beyond the extant fruit and vegetable focus, giving it scope to explore the full effect of supermarkets. Quantile regressions show existing behaviours are reinforced, and intervention stores may do little to improve diet. Switching to Tesco Seacroft is shown to increase the portions of unhealthy food consumed by almost 1 portion per day for the least healthy. Managing demand through promoting balanced diets and restricting offers on unhealthy items will be more effective than intervention, and is an essential accompaniment to new large format retailers if they are not to entrench dietary inequality further. Policymakers and practitioners alike should avoided being distracted by aggregate conclusions if food deserts are to be truly tackled.

Master of Arts / Department of Sociology, Anthropology, and Social Work / Gerad Middendorf / In the last 70 years, there has been a decline in population of rural Kansas. For example Gove, KS, the county seat of Gove County has seen a population decline of 355% from 284 in 1940 to 80 residents in the 2010 US Census (US Census). Along with general population decline in rural areas, is decline the overall number of farms, while the average farm size has increased (Kansas Dept. of Agriculture). The decline of the population of rural communities has caused the erosion of basic infrastructure, leaving many communities lacking access to basic services. One of the crucial components of the rural infrastructure is the rural grocery store. Since 2007, in Kansas communities with populations under 2,500 people, 82 grocery stores have closed. On average, rural Kansans now drive over 10 miles each direction to obtain their groceries. Proctor (2013) describes how the loss of a grocery store can affect a community: “Rural grocery stores are part of the economic engine that sustains rural communities," “they are a significant source of local taxes, powering the creation and maintenance of civic services and amenities. They provide essential, stable jobs – butchers, cashiers, managers, and stockers – at a time when we are desperate for employment opportunities.” The objectives of this study are to describe the food desert conditions of three rural communities in Kansas, to understand the trends regarding rural grocery stores, and to better understand the issues of access to healthy foods faced by people living in these areas.

The main goal of this study was to investigate whether residents of rural areas especially in deprived communities in BC have reasonable geographic access to healthy and affordable food providers (e.g., supermarkets, grocery stores, and farmers’ markets), and if lack of access impacts their weight status. As well, I investigated the extent to which farmers’ markets improve food accessibility in BC’s rural food deserts. In order to identify food deserts, the methodology which has been developed by USDA was modified and adapted to BC’s rural situations. In the first step, using Principal Component Analysis, deprived rural regions were identified based on selected socioeconomic and demographic variables. Then, using ArcGIS Network Analyst extension, the distance based on driving time from the Population Weighted Centroid of each rural region to the closest supermarket or grocery store was calculated on BC road networks. A 15 minute driving time cut-off was set to identify low access areas. Deprived rural regions which were also classified as low access were identified as food deserts. The impact of food accessibility on the weight status of rural British Columbians was investigated using the 2013-14 Canadian Community Health Survey (CCHS). A hierarchical regression model was constructed with weight status of residents as the dependent variable and distance to the closest supermarket or grocery store as the independent target variable. I found that food deserts are more concentrated in the Central Coast, Cariboo, and Peace River regions of the province. In addition, farmers’ markets play no role in providing healthy foods to the residents of food deserts. Lastly, distance from food stores is not significantly associated with the weight status of rural respondents in CCHS data. The findings of this study can be highly beneficial to government officials within different jurisdictions and health practitioners to develop or refine food policies toward providing healthy and affordable food to deprived residents and Aboriginal peoples in rural and remote communities. / Graduate

Food accessibility was determined for each Mississippi County, based on data obtained from the Retail Survey regarding common fruits and vegetables in available in food stores. Availability data were correlated with four social-economic/demographic variables: race, median household income, SNAP enrollment, and education. There were negative low magnitude correlations between percentages of Africans American and fresh fruit and vegetables availability, and percentages of SNAP benefits recipients and fresh fruit and vegetables availability. Positive low magnitude correlations were found between income and fresh fruit availability, and education and fruit availability. Lastly, moderate positive correlations were found between education and fruit availability and income and availability. This research can be used to help extension agents and farmers’ market managers better understand places that may have a lack of fresh food available. This research will also allow SNAP-Ed professionals a chance to have an idea of where their services are needed.

Segregation has many negative consequences for marginalized populations, including poor health, increased poverty, low-quality housing, and limited education and employment opportunities. Scholars have recently recognized access to food as another piece of this “advanced marginality.” This study illuminates how lagging food and transportation infrastructures exacerbates these interlocking inequalities and whether new ride-hail technologies' promise that ride-hail services like Uber and Lyft will help affected populations access food stores with lower prices and higher food quality. As a descriptive understanding of the intersection between food, transportation, and racial residential segregation in Chicago, Illinois, this study analyzes two questions: (1) how often are ride-hail trips crossing food desert census tract boundaries; and (2) are ride-hail trips that cross food desert census tract boundaries accessing food stores? Using spatial analyses of the City of Chicago’s ride-hail transportation data, food store location data, American Community Survey data, and USDA food desert classification data, this study finds that ride-hail services are accessing food desert neighborhoods, but they are doing so at a very low rate, and very few ride-hail rides are used to access food stores after departing from food desert neighborhoods.