We Can’t Talk About Healthy Eating Without Discussing Who Has Access to ‘Healthy’ Foods

And the pandemic is making things worse. According to Feeding America, workers who have service occupations or work in the leisure and hospitality industries—those especially hard-hit by the pandemic—are more likely to be food insecure. The organization projects that 42 million people (including 13 million children) could be food insecure in 2021.

Food deserts play a major role in the issue of food access—or lack thereof. A food desert is typically defined as an area that has limited access to affordable, healthy food options (including fresh fruits and vegetables) due to a large grocery store being too far away. However, some experts believe that “food apartheid” is a more appropriate term, since it takes into account the role racism and inequities play in our food system.

For people who have always had easy access to a grocery store or had fresh produce available whenever they wanted, grasping the issue of food access can be difficult. I got to witness a lack of food access firsthand when I worked as a nutrition educator. First, in New York City, I conducted cooking demos and nutrition education workshops at farmer’s markets strategically placed in areas with low food access throughout Harlem, the Bronx, and Brooklyn. Whenever we did a cooking demo, we made sure to use ingredients that were accessible to them. But I was able to see firsthand that outside of what was provided at those farmer’s markets, there was a real lack of places where people could buy fresh fruits and vegetables. For many, the closest—and most convenient—place to buy food was the bodega, which in my experience usually didn’t have many fresh or frozen produce options.

Food access was also a major concern when I was working at a federally qualified health center in East Oakland. The clinic was located in the same facility as many fast-food chains, but fresh food was hard to come by. And, no, I’m not saying that there is anything inherently wrong with fast food. But when that is the only option present, variety is limited. There was one grocery store near the clinic, but the options for fresh produce were abysmal at best. In fact, many people weren’t interested in incorporating fruits and vegetables into their diet if it meant eating the ones from there. I often did weekly cooking demos with my patients at this store for ingredients, and one time I bought yogurt there to incorporate into a meal we were making. When I opened it, it was completely molded inside.

I used to spend my lunch break driving five miles to the nearest Trader Joe’s to purchase appetizing produce options for my cooking demos. This was, of course, incredibly privileged, and not something most of my patients could do. Many didn’t have cars to get there, or enough of a grocery budget to shop at a place like that. When you have a large family to feed and are trying to stretch the food dollar, Trader Joe’s ain’t it.

This experience reinforced my belief that instead of blaming the individual for what food choices they are making—which is generally the default in our society—it’s time to wake up and acknowledge the bigger picture: Your environment plays a big role in the food you eat. Instead of separating food access from “healthy eating,” we need to think about the two concepts together when making recommendations, especially as dietitians. The role of the health provider isn’t to preach what someone should be eating, but rather to help people obtain access to decent food in general if that’s a barrier. That may mean assisting the client in enrolling in programs for food aid or facilitating transportation to a grocery store that has more nutrient-rich options.

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