The built environment has long been an obstacle in fighting the obesity epidemic, and food deserts specifically have increasingly become a major public health priority for Minnesotans. Food deserts (or food swamps, as a better analogy) are areas with poor access to affordable, healthy food. The term isn’t just a statement on the poor availability of healthy food—it’s also often correlated with an abundance of unhealthy food options that are cheaper and more convenient. A good example is living within walking distance of several gas stations and fast food outlets, but not a grocery store. Another would be having no food retailers for miles, almost exclusively in rural areas. Minnesota has several examples of both, and they are among the drivers of obesity and the comorbid diseases associated with obesity, like diabetes and hypertension. Addressing these issues is vital to lowering the obesity rate and improving the quality of life for Minnesotans.
A recent report published by Wilder Research examined Minnesota’s grocery store landscape and compared it to the rest of the United States. The researchers found that Minnesota ranked as the seventh-worst state in the US in terms of low retail access to healthy food. 1.6 million Minnesotans have low retail access to healthy food, which is nearly a third of the entire state’s population. Additionally, around 230,000 Minnesotans living in rural areas are at least 10 miles away from a grocery store. 16% of the census tracts in Minnesota qualified as federally designated food deserts, meaning that those tracts have a large low-income population as well as significant distances from healthy food. These census tracts are both in rural and urban areas of Minnesota. The urban census tracts had a larger population of people impacted by food deserts, but the rural tracts had a disproportionate number of food deserts relative to population size. The populations that had the worst access to healthy foods were Greater Minnesotans, seniors, the poor, and racial minorities. Below is a map generated by the USDA, showing the areas considered food deserts in Minnesota, along with one for the Twin Cities metro area. The green areas are census tracts that have a significant portion of people living in poverty AND low vehicle accessibility. For those interested, this link leads to the data showing the census tract-level data for every census tract in the United States.
The report also found that income was inextricably linked to geography and food purchasing behaviors. The researchers noted that simply having a healthy food retailer nearby didn’t guarantee healthy food purchases, but also depended on having the income to buy those foods. Otherwise, poorer Minnesotans went with the cheaper groceries further away or with equally convenient convenience stores and fast food. Worse health outcomes were more strongly linked to income than distance from a healthy food retailer. Additionally, the researchers found that “supercenters” such as Walmart and Target, while being the only food retailer to meaningfully grow in Minnesota since 2007, were more strongly linked to unhealthy food purchases than traditional grocery stores. This presents many challenges when facing the obesity epidemic in Minnesota.
Food deserts are a complicated problem to solve for several reasons. For one, even if we decided to drop a Whole Foods into a food desert (as if we can just “decide” something like that), that alone wouldn’t necessarily improve access or change food purchasing and consuming behaviors. A lot of healthy foods are expensive, and often require hours of prep work that busy Minnesotans might not have. For example, learning how to make a cauliflower crust pizza (is difficult, expensive, and time-consuming (while a cheap frozen pizza is easy to make and takes less than half the time to prepare).
This is all to say that an effective intervention would not only add grocery stores to areas that need them, but also to provide ways to make healthy eating more affordable. The Minnesota Department of Public Health already partners with dozens of programs that accomplish just that via Statewide Health Improvement Partnership (SHIP) grants. Expanding their healthy eating initiatives would help to lower the obesity rate even further: SHIP programs contributed to Minnesota’s improvement in obesity rate compared to regional trends. SHIP programs can both address food affordability, as well as shift the food-purchasing culture of individual communities.
Other possibilities could be to help pay for small grocery stores to upgrade their refrigerators to accommodate more fresh food, something that is rarely economically feasible to do. These programs used to be funded in Minnesota by Good Food Access Fund, but were recently cut. Minnesota already funds a similar program for urban convenience stores, but similar to other convenience store initiatives around the country, the health outcomes are unclear.
Finally, one way to stem the tide of closing grocery stores is to pay for services that would keep them running after the current owners decide to retire or change careers. A recent survey of rural grocery store owners found that 62% of store owners don’t intend to continue operating their store for more than 10 years, and almost none have a transition plan for the store once they leave. Keeping these stores running is vital for healthy food access and the local economy of Minnesota communities, and ensuring these small businesses can continue to serve rural Minnesotans will be one of the primary forces in preventing obesity in Minnesotans.
The state of Minnesota has a great history of pursuing innovative public health programs to prevent obesity and obesity-related illnesses. Eliminating food deserts and fostering a culture of healthy eating in the Twin Cities and Greater Minnesota alike are vital steps in improving the health and well-being of Minnesotans across the state.