Sorry, we're closed: How everyone is hurt when grocery stores shut down

Editor's note: Across Louisville, more than 120,000 people are living with food insecurity, meaning they don't have reliable access to healthy, affordable food. The issue is linked to higher rates of illness and lowered life expectancy in predominantly low-income neighborhoods. And it's costing taxpayers in Louisville and around the nation millions of dollars in emergency health care.

In June 2018, Courier Journal reporter Bailey Loosemore received a six-month fellowship from the Center for Health Journalism to learn how food insecurity affects Louisville and how the complex problems could potentially be solved.

This series addresses the local food insecurity crisis. This article explains how food access issues arise and how they affect people of all backgrounds. We also examine the city's response to the crisis and how the community as a whole can make long-term change. 

Michele Dutcher has to take two buses to reach a Valu Market grocery store just 2 miles from her apartment in Old Louisville. The only nearby supermarket closed in 2017, and without a car, the 64-year-old has to make the trek outside her neighborhood — learning quickly to place bags of frozen vegetables atop her packs of fresh meat to keep the food cold on her 30-minute trip home.

There's no grocery store in Russell, either. So Dana Thompson is forced to borrow her mother-in-law's car to reach a supermarket one neighborhood over. Before the 36-year-old got access to the vehicle, she paid friends to give her a ride, the fee biting into the already-limited dollars she had to spend on groceries for her family of four.

In Audubon Park, two grocery stores closed in 2018, leaving Alex Croley with fewer places to buy food for himself and his elderly mother. The 46-year-old also doesn't own a car, and he pushes a fold-up cart almost a mile to reach the closest store, often pausing at a bus stop to rest his injured knee.

For thousands of people like these three, there is no easy run to a grocery store just around the corner. Instead, as supermarkets close across Louisville at an astonishing rate, residents of neighborhoods from Shively to Shelby Park have had to learn how to extend their money and manage the time they need to keep food on their tables.

In 2015, the U.S. Department of Agriculture identified large swaths of Louisville as food deserts, meaning the 44,000 people who lived in those areas did not have the money or transportation they needed to buy healthy, affordable food.

In the three-plus years since, more than a dozen grocery stores of different sizes have shuttered citywide, often surprising customers who'd relied on them for years.

The closings have had a profound daily impact for some of Louisville's most vulnerable residents, including adults with disabilities, children living in poverty and seniors on fixed incomes. But they've also affected those who work full-time jobs and who own cars but who still struggle to get affordable groceries.

Inadequate access to healthy food can lead neighborhoods to develop higher rates of such chronic illness as diabetes, heart disease and even asthma, lowering residents' life expectancy and costing communities millions of dollars in extra health care expenses.

And the problem in Louisville has gotten worse, despite research that proves the damaging effects that limited food access can have on health.

"When you look at ... transportation and food access and pockets of poverty, it should make everybody, to me, angry," said Ryan Burt, a wellness manager with Passport Health Plan, a nonprofit community-based health care provider.

"We have concentrated people who do not have money, who do not have resources, who do not have transportation and we've taken away food. It's insane."

Louisville Mayor Greg Fischer said increasing citizens' access to groceries is a priority for the city, and three departments are working together to identify long-term solutions — such as an incentive program that could attract stores to underserved areas or a grant that could assist Dare to Care Food Bank in launching a mobile market.

But the city's power only stretches so far, he said, when it comes to addressing an issue that's heavily influenced bylarge corporations, which often make decisions based on profit margins.

"Ultimately this is a private market system serving what is a very basic human need," said Mary Ellen Wiederwohl, chief of Louisville Forward, the city's economic development arm. "Those two things are sometimes in conflict."

An unending cycle

Michele Dutcher didn't always have to spend half her day going to the grocery store.

When she first moved to Old Louisville two decades ago, Dutcher could shop at either a Winn-Dixie or a Kroger — both located less than a mile from her home.

But the markets have since closed, leaving the neighborhood with just a Family Dollar and a few convenience stores. Dutcher now plans monthly trips to the closest Valu Market in the Highlands, where she can buy better food at cheaper prices.

Dutcher retired from the American Printing House for the Blind in 2016 and now lives on a fixed income, receiving $700 each month from Social Security and another $30 in federal nutritional assistance. She can't start drawing from her work pension until August.

Dutcher has three adult children who she knows she can turn to in a bind. But her kids have eight children of their own, and she doesn't want to burden them.

Instead, she keeps quiet about the hours it takes to get to and from the store. She doesn't tell her kids about the buses that get overcrowded. She doesn't mention that even when her pension kicks in, buying groceries will still be a constant struggle.

"Even if I had money, I still wouldn't be able to get fresh food and vegetables without taking two buses out and two buses back and spending the whole day," Dutcher said. "It really is the whole day."

Advocates say there's a long-running stigma attached to food insecurity — the state of being without reliable access to affordable, nutritious food. They know people don't want to admit they can't easily feed themselves or their families.

But food insecurity and its correlating health issues are often the result of a person's environment, not their own shortcomings, said Wayne Tuckson, a Louisville colon and rectal surgeon who stresses the importance of healthy eating as a way to prevent health complications.

The 2018 Map the Meal Gap report from Feeding America, a Chicago-based nonprofit, describes the intersection of hunger and health as a cycle.

First, a food-insecure person is forced to make unhealthy choices if they want to eat regularly, often turning to cheaper, high-calorie foods when healthier items aren't available. A reliance on unhealthy food leads people to develop diet-related illnesses, such as diabetes and obesity. And in turn, people can become unable to work — further restricting their food budget.

Once a person or family enters the cycle, the report states, it can be increasingly difficult to escape.

"We chastise individuals who come in with food insecurity as though they're making bad choices," Tuckson said. "We make them make bad choices."

Louisville's broken system

In Louisville, few communities have been harder hit by food insecurity than the West End, where nearly 60,000 people live across nine neighborhoods.

The area is home to some of Louisville's most marginalized residents, including 28 percent of the city's African American population, 12 percent of its disabled population and 23 percent of all households without vehicles, according to 2017 census estimates. More than 8,000 households there received federal food assistance in 2017, and the average individual income across the area is $14,600. 

Yet residents in western Louisville have some of the worst access to fresh food in the city, with dollar stores outnumbering grocers 2-to-1, according to a Courier Journal count.

The disparity has been building for decades.

According to a 2007 report from the Community Farm Alliance, urban renewal in the mid-20th century led African Americans to move into the formerly white West End, while middle-class white families left for the suburbs — taking most of the grocery stores with them.

In the 1970s, corporate-owned supermarkets rose to prominence in an industry disruption that put independent stores out of business.

Today, much of Louisville continues to rely on grocery chains for food, though the system has increasingly failed impoverished communities that don't fit the companies' expanding models.

Regional corporations like Kroger, Louisville's largest grocery chain, operate stores on notoriously tight margins. And in recent years, they've favored supersized markets that can draw from a wider pot of disposable income, sidestepping smaller locations that don't turn a profit.

For residents with cars and credit cards, the larger stores offer a one-stop-shop for everything from freshly sliced deli meats to packaged meal kits. But for residents without transportation, a trip to the grocery can become a daylong effort.

"I understand that you want to grow your businesses, you want to be in competition with everybody else," said Sharita Walker, who sometimes has to use a ride-sharing service to get to a store from her Limerick apartment. "But make it to where we all can survive.

"Not all of us are out here just laying on the streets or living off the system. Some of us have natural struggles. I work every day. Even my income alone isn't enough. ... It needs to be where everybody can get to (the store)."

Grocery industry expert Phil Lempert said corporations consider a variety of factors when deciding where to open or keep stores.

In lower income areas, Lempert said companies often contend with higher insurance rates, instances of theft and wages needed to keep employees in the stores.

"They're looking holistically at what their cost structure is and what they need to do," Lempert said. "A lot of stores have opened in the past 10 years in low-income areas that have closed because they can't make money there."

A local Kroger spokesperson did not respond to a request for comment about store closures.

But in October, representative Erin Grant said the company is working to improve food security through its Zero Hunger, Zero Waste initiative.

"We are focusing on donating not just more food, but more balanced and nutritious food to our food banks," Grant said by email. "(In 2017) we donated over 2 million pounds of food to Dare to Care Food Bank and over 1.4 million pounds to date for 2018.

"We are committed to ending hunger in our communities we serve, and are taking big steps toward that goal."

Hunger and health care 

It's easier for Dana Thompson, the 36-year-old from Russell, to list what she can eat than what she can't.

Between her treatments for diabetes and gastroparesis, a condition that affects the movement of muscles in the stomach, the mother of two is on a very strict diet that limits her intake of sugar, fiber, leafy greens and even fruits with skin.

"I have to puree a lot of stuff," Thompson said. "They want me to eat a lot of fresh stuff because it has more nutrients and also it's easier to digest through my system."

It's getting harder to find those healthy foods in Thompson's neighborhood. In 2017, a Pic Pac closed on Market Street after more than 30 years in business. And the closest Kroger has a produce section that's half the size of other stores.

Thompson uses her disability payments to purchase fresh fruits and vegetables when she can. But when money is tight, she stops by the food pantry at the Sister Visitor's Center to get whatever it can supply.

"It helps a lot, it really does," Thompson said of the center, operated by Catholic Charities of Louisville. "It might not be what we want, but it's something in our stomachs."

As a resident in western Louisville, Thompson has a higher risk for developing diet-related illnesses that can prevent her from holding a job. She's more likely to rely on publicly funded insurance, and she could end up living 12 years less than citizens elsewhere in the city, according to research from the city's Center for Health Equity.

All of that could be changed with improved food access, said Tuckson, the colon surgeon.

"We make it harder than what it actually has to be," Tuckson said. "... The problem is we're a rescue-based society. You come down with cardiac failure, we'll spend an inordinate amount of money for you to get a transplant, rather than put in a program where you can exercise, get clean air."

In 2017 alone, Kentucky spent more than $9.5 billion on Medicaid coverage for low-income and disabled residents. That year, Medicaid covered 21 percent of the state's population, including 2 in 5 children, according to data from the Henry J Kaiser Family Foundation.

Pediatrician Julia Richerson, who works with low-income patients at the Iroquois Family Health Center, said hunger can lead to health issues in people of all ages, but it can be "extremely consequential" to children's developing brains.

"They're growing muscles and bones, but their brain is starving," Richerson said. "We know that brain development is everything — it's emotional development, behavioral, social, academic learning abilities. ... (Food access) is extremely important in all the work I do."

Family Health Centers operates eight locations across Louisville, and each started screening patients for food insecurity within the past year. 

The screenings have helped Richerson talk to patients about issues they're facing, but she thinks more doctors need to make it easier for people to bring up hunger concerns.

"Hunger is often a hidden issue," Richerson said. "You can't look at someone and tell they're hungry. ... Asking questions may bring to light issues we may not know any other way."

City leaders, health care providers and nonprofit advocates have expressed confidence in Louisville turning the tide on food insecurity.

Groups across Louisville — from Passport Health Plan to Dare to Care Food Bank — are extending their efforts to improve access to healthy food citywide, collaborating on projects like a mobile market and a community-owned grocery store.

But until the community works better together, some say the movement won't foster long-term change.

"What we're doing is very expensive," Louisville Metro Councilwoman Barbra Sexton Smith said. "By continuing to oppress large numbers of our population, which produces poverty, which produces health inequity, which produces violence — that is all incredibly expensive.

"What would happen in a society where we figured those things out?"

[This story was originally published by Courier Journal.]