Fruits of their labor

Millions of people around the country face obstacles to fresh food. What they eat instead often leads to obesity, diet-related illnesses and premature death. Three activists from Los Angeles, New York and Nashville take different approaches to reversing the trend, and sowing organic solutions for the future.

PAUL ROBINSON
Geographical Scientist

As we cruise through a bleak section of South Los Angeles, Paul Robinson, PhD, and I pass auto repair shops, a free-roaming pit bull, fast food joints and corner markets that sell as much liquor as they do groceries.

“This is the core of the food desert,” he says as we park outside a corner store and walk in, close behind an obese boy and his slender friend. The heavier child scores some potato chips and the two kids leave, while Robinson and I continue to walk around, pretending to be shopping. We’re really just looking at all the processed foods that are sealed in boxes, cans or bags to ensure that they can last on store shelves. We discover a few fresh items in a refrigerated case—a row of apples and a row of lemons—next to a drink called Big Juicy.

This is Robinson’s turf. If you are licensed to sell food in Los Angeles County, he knows where you’re located. A geographical scientist at both Charles Drew University and UCLA, he has created a computer map with a variegated pattern of dots representing the county’s food sellers. In wealthier, whiter parts of town, the dots cluster tightly together and frequently overlap, while in this area, populated by poorer African-Americans and Latinos, the dots are few and far between.

“Based on our data, I’d estimate that around 800,000 people in the LA area live in inner-city food deserts,” Robinson says later as we drive through the city’s blocks-long produce district downtown.

“Los Angeles is a breadbasket,” he observes. “Tons of food comes in by truck and by train to the produce district and other regional distribution centers, which are owned by multinational food retailers. It comes in in massive amounts. Where does it go, and why does it not reach certain areas?”

There are various definitions of the term “food desert,” but it is, essentially, an area with limited access to affordable, nutritious food, especially in low-income communities. The lack of access is a concern because “food is the first medicine,” says Robinson, whose focus is medical geography. “The doctor tells you you’re pre-diabetic and to eat healthy, but [if you live in a resource-deficient area] where do you go to get the food that the doctor has told you to eat?”

The geographical scientist and four of his colleagues at Drew University have a National Institutes of Health grant to find out. They’re visiting more than 800 supermarkets and doing a geographically strategic sampling of the other 30,000 or so small markets and corner stores in the greater LA area, in an effort to catalog what foods are actually available.

Robinson’s research team is particularly interested in what items stores carry that would enable a person to eat a DASH (Dietary Approaches to Stop Hypertension) diet, which doctors prescribe to limit salt intake and prevent or lower high blood pressure—measures that can fight the effects of osteoporosis, cancer, heart disease, stroke and diabetes.

Multiple, ongoing efforts seek to address the lack of healthy, available food in LA:

•  Recently, the city council effectively banned new fast food restaurants in the southern section of the city, citing higher rates of poverty and obesity there. =
•  A new Food Policy Council, made up of more than two dozen individuals from a wide range of disciplines, including store owners, farmers, and policymakers, formed to improve the infrastructure and distribution of food.
•  California FreshWorks, sponsored in part by the US Department of Agriculture and the California Endowment, a private health foundation, has earmarked $200 million to bring grocery stores and healthy food outlets to underserved communities.

It may be months, even years, before the results of these efforts are known. Meanwhile medical geographers at Drew collect and analyze food found on shelves today.

SHELF LIFE

Robinson has an office in Lynwood, CA, 14 miles southeast of LA, in an area that he labels a food desert. He recalls going to a nearby liquor/grocery store one day a year or so back. As he was buying batteries, he overheard a conversation that has stayed with him:

“You can’t give your kids that sugar water!” an older woman told a young woman with a baby stroller and two toddlers.

The younger woman defended her purchase. “This is just to hold the kids over,” she said, “until I can get to a grocery store.”

For Robinson, it was a paradigm for a much larger problem: people putting off till a more convenient time—or perhaps never—when they can start shopping at a real market, finding a wider array of choices and preparing healthier meals for their families. In the meantime, they eat food high in calories, salt, sugar and preservatives, but lacking in nutrition, which can lead to obesity, sickness and early death.

Some have suggested that the obesity prevalent in low-income neighborhoods is a reflection of poor self-control. Robinson disagrees. He argues that the lack of healthy choices is compounded by spotty transportation, and few, or unsafe, green spaces where people of modest means can exercise without high fees as a barrier. “People are hostage to their environment, and their mobility decreases as they get sick or they age,” he adds.

It is generally agreed that a number of businesses that used to serve traditionally black and Latino neighborhoods in South Los Angeles and surrounding areas, including grocers, fled and refused to return after the Watts Riots of 1965, which started after white officers used force on a black man suspected of driving under the influence. Five people died, over a thousand were injured and $40 million in property was damaged. A report by then governor Edmund G. “Pat” Brown identified the root causes of the riots to be African-Americans’ anger over high unemployment and inferior schools and living conditions.

In 1992, nearly 30 years later, another race-fueled uprising occurred around the time of the acquittal of four white police officers in the brutal beating of African-American motorist Rodney King. A second event also added fuel to that fire: A Korean grocer shot and killed an African-American girl who, the grocer asserted, was trying to steal a carton of orange juice. Evidence at the scene raised doubts, but this much is clear: The distribution of food, in a society divided by race, class and material resources, is a volatile issue that has wracked Los Angeles for decades and continues to scare off many businesses.

THE BRISTISH HAVE COME

Fresh & Easy supermarkets, owned by the British firm Tesco, are an exception. The corporate website says, “We believe in making fresh and high-quality food accessible in every neighborhood,” which they seemed to back up when they set up shop in recent years in such entrenched food deserts as South LA, and its neighbor to the south Compton. When Prince Andrew, the Duke of York, showed up to for the grand opening of the latter location, he was dubbed the Fresh Prince of Compton.

A little over eight miles to the northeast of that store is the Hubert Humphrey Comprehensive Health Center, which is “definitely in the food desert,” says Robinson, who has been working with doctors at the inner-city clinic. “They know their neighborhood and that their patients have challenges. So we presented them with this medical application where they can use Geographical Information Services, and they’re excited.”

One doctor told the medical geographer that the clinic’s patients, typically, are morbidly obese and diabetic and that he warns them, “ You can take medicine, but you also have to do the lifestyle stuff.” Robinson and his colleagues are working to support the lifestyle changes:

“We’re developing a system where they can put a patient’s address at the center of a map, and then add the closest grocery-chain stores, parks, fitness clubs and health clinics” in a concentric circle around where the patient lives. A doctor can then print out a list of nearby facilities and give it to the patient at the end of their visit.

Recently, after Robinson’s doctor told him that he was pre-diabetic, the scientist bought a glucose monitor and began testing his blood. He also adjusted his eating habits and successfully downshifted out of the pre-diabetic range over a period of months. But he has to bring his food in from home, because there’s little to choose from around his office.

AMELIA LODOLCE
Urban Gardener

Sunset deepens into twilight as Amelia LoDolce rides her bicycle to the Binghamton, NY, community garden that she manages. She pedals past homes due for a paint job or a porch repair in the neighborhood that she calls home. It’s October, and she stops to talk and pick the final peppers and tomatoes of the season for a salsa she plans to make later this evening.

Though naysayers tried to talk her out of locating on the city’s Northside, concerned about its reputation for drugs and violence, LoDolce felt they were stereotyping the low- to moderate-income area, and bought a home there anyway.

“I’d done some community organizing with [the local grassroots group] Citizen Action and gotten a feel for the neighborhood,” she says. “It’s really quiet, and I like living in an urban area.”

Purchasing a budget-friendly home means that she can afford her mortgage and graduate-school loan, while growing food in the Liberty Street garden, just blocks from her kitchen table.

In addition to tomatoes and peppers, LoDolce’s summer crop included kale, collards (“my favorite”), basil, beets, cabbage, green beans, radishes and spinach. Now fall dictates that she switch out her garden bed for the winter growing season. Beets are on the menu. “They like the cold,” she says.

Though graduate school took her from upstate New York to Boston, LoDolce was eager to return to Binghamton, where she had gotten her undergraduate degree. “I started to come back and visit Volunteers Improving Neighborhood Environments [VINES] meetings when I was still living out of town. I’m passionate about sustainable food production,” she says. “I can’t think of anything much more rewarding than growing your own food.”

An employee of the city’s planning department by day, LoDolce coordinates one of four community gardens run by VINES in her off hours. A couple of times a year, she goes door to door to say “Hi” to her neighbors, and to drop off flyers inviting them to join the organizations’ members for a meal.

WEEDING OUT PRIVILEGE

“Even though I live a few blocks from the garden,” she says, “I’m still seen as an outsider sometimes. Some people think I might be a student, or they think I’m just some white girl from another neighborhood. I try to be friendly so people can get to know me, and I work to avoid making any assumptions about the people I meet here as well.”

Race and class can be a minefield, so LoDolce navigates carefully, downplaying any special privileges others may perceive.

“The sustainable agriculture movement has been a predominantly white movement,” she says, “but the urban agriculture movement tends to be more diverse. I think the urban ag movement is helping to make the sustainable ag movement relevant to people of all ages, incomes, cultures and races.”

VINES members routinely talk about potential challenges in relating to Binghamton’s various communities. LoDolce says the organization makes cultural-competency and anti-racism training a priority. “The whites in our group have to be aware of how we wear our privilege, and make sure that we’re not going about our work in an insensitive way.”

Volunteers have undergone training with an African-American city official named Larry Parham, who takes them through “exercises that show us how our backgrounds can be very different, and how we may have had some privilege growing up that we didn’t know that we had.”

LoDolce cites an article titled “White Privilege: Unpacking the Invisible Knapsack,” by the scholar Peggy McIntosh, from which she learned this exercise: “You ask people in the room to form a line, shoulder to shoulder. If, for example, they had 100 books in their house when they were growing up, you ask them to take a step forward. If they were the first person in their family to go to college, you tell them to take a step backwards. After all the questions have been posed, often the people who have taken the most steps forward are white, and the people who have been left behind are Latino and African-American. It’s eye-opening stuff.”

LoDolce became aware of the joys of gardening while growing up on her family’s farm in Otisco, NY. It was nearly 200 acres of mostly wooded property. “I fed sheep, cleaned barns, weeded gardens, made jam, chopped wood, mowed the lawn. My parents involved us in everything, because they believed it was important to see that the food we ate and all the things we enjoyed didn’t just come from nowhere; you had to work for it.”

GARDENS FOR TROOPS

Prior to the recent increase in urban gardening, LoDolce says, the practice enjoyed a boom during World War II, “when it was essential to produce enough food for our nation. Growing victory gardens was a huge part of the patriotic movement of the time. I remember an old poster that said, ‘Support your troops. Plant a garden.’ People really banded together to grow food in urban settings.”

After the war, she continues, “people didn’t have to be tied to the land anymore, which they thought was progress. Wealthier people had cars and could live in suburban areas and drive to urban areas. I don’t believe a lot of victory gardens stayed around much after World War II.” That perceived progress led the multitudes to sever their agricultural roots altogether.

Dependence on others to grow our food comes at a price, as evidenced by the fact that Binghamton’s Northside routinely makes headlines for its efforts to attract a supermarket that residents can walk to. The last one closed more than 15 years ago. Those without a car often resort to convenience stores, gas-station mini marts or other higher-priced options. They may also spend part of their shopping money on transportation to other neighborhoods with better markets, which limits how much they can carry, and also may force them to forgo perishable items such as meat and frozen goods.

In recent years, the Center City neighborhood also lost its supermarket but gained the Binghamton Urban Farms Project, an offshoot of VINES.

While VINES, which was launched in 2007, doesn’t rent out garden beds at the farm, it does operate a produce stand there once a week. On other days, the team sells fruits and veggies at farmers’ markets in different parts of the area. The farm, which is on four adjoining parcels where abandoned houses were razed, is leased to the nonprofit organization by the city of Binghamton. The organization has invested approximately $50,000 in the land through grants and donations, and will likely put in an offer to purchase the property before its five-year lease runs out, says LoDolce. The plot now includes a greenhouse, constructed by 30 to 40 volunteers.

“Overall, VINES had a really successful year,” LoDolce notes. Aside from farm sales, “we have 60 beds in four gardens, and they were all rented out.”

As manager of Liberty Street garden, she collects the rents, distributes the rules and makes sure that the beds are well-tended. Rental fees for the four Binghamton community gardens range from $15 to $30 per year per bed. VINES holds workshops on urban food production, which provide information on growing crops in the raised beds, spacing plants and preventing disease. Garden managers are also on call to offer advice throughout the growing seasons.

RAISING FUTURE GREEN THUMBS

Although she doesn’t bring it up in conversation, LoDolce has an undergraduate degree from Binghamton University in environmental studies, and a graduate degree from Tufts University’s Friedman School of Nutrition Science and Policy. The latter includes coursework in nutritional science, agriculture and food production. She also learned how to overcome common urban-gardening conditions, such as traces of lead paint in the soil, which often leaches in when paint chips off of the old houses.

“We produce affordable food that is sustainable and organic,” she says, “and more people are finding their way to our farm stand.” Proceeds go back into the soil and also into a youth-training program, which is coordinated by VINES and Broome County Gang Prevention. Last summer, 12 teens got an education on how to grow fruits and vegetables.

LoDolce is committed to steering future generations away from conventional supermarkets and back to the land. Her neighborhood garden is built on the foundation of a house that was torn down a few years back; it is sandwiched between the two wood-frame houses that remain. While roughly a dozen beds have people’s names on them there, including hers, a community bed provides herbs and some vegetables for neighbors to take, and a children’s bed offers produce for them to sample.

“We grew some cauliflower with the kids, and then we cooked it and ate it,” she says. “I find that children are a little more willing to try something when they’ve grown it themselves.”

LoDolce believes the experience of tending the soil enhances one’s childhood. “It’s really important to give urban youth something that connects them with the natural environment,” she observes. “I’ve seen them transform over the course of a summer, especially the ones we’ve had for a few years in a row. I’ve seen shy kids work in a group environment, develop leadership skills and build confidence.

“One young man in the VINES summer program told me how he got stung by a bee, took some plantain, chewed it and then put it on the sting, and it didn’t hurt anymore.” She goes on, “They’re learning that plants can be used for medicinal purposes. They’re learning about insects and getting over their fear of bugs. Some of these things seem small, but they add up to a big transformation.”

RAVI PATEL
Market Man

During his first and second years of medical school at Vanderbilt University in Nashville, TN, Ravi Patel worked at the student-run Shade Tree Clinic in the city’s East Nashville neighborhood. It’s a community that used to have 15 supermarkets, but now—because of urban renewal, chain supermarkets closing, and store owners aging out of the business—has none.

“One day, four patients complained about not having access to healthy food,” he recalls, “and all four of them had diabetes, hypertension and high cholesterol.”

Although he’d learned about food deserts two years earlier, the medical student had put them out of his mind as he got caught up in an East African research project. Now four sick people reminded him that there were pressing problems closer to home.

“We did a research study and found that the biggest obstacles to fresh food were distance, time, transport and childcare,” he says. “We asked ourselves, ‘How can we deal with distance and time?’ It took people without cars two hours and several buses to get to and from the store,” not to mention the awkwardness of hauling “gallons of milk on a bus,” he adds.

While groups such as Re/Storing Nashville work on getting healthier foods into convenience stores and expanding transportation between food-desert areas and high-quality supermarkets, Patel wanted his patients to be able to shop near the clinic. But a stand-alone store appeared to be unsustainable. As a student team developed a business plan, residents of the local Edgehill community told them about the old market men who used to drive through their neighborhood in the 1950s and ’60s, selling groceries out of the back of a truck. It made sense that, if patients couldn’t get to the store, the store could come to them.

“As a medical student, I found the idea of helping people to eat healthier kind of cool,” Patel says. “We provide health care to make people healthier, and if we get them healthier food, it works in a circle. These systems all depend on each other.”

BUYING A TRAILER

The team developed a five-year business plan and went to local community food advocates to talk through their ideas and ask for help. They sought a $50,000 grant and ended up getting one for $65,000 from the Frist Foundation, created by the family of former United States senator Bill Frist, MD. With that, they purchased a 28-foot tralier, got licenses and established wholesale partnerships. Nashville Mobile Market started making its rounds in February 2011.

NMM customers walk down a single aisle with a grocery cart, selecting items off of shelves. "We don't have as many brands," Patel acknowledges. "For instance, we have one brand of oatmeal, so we have the biggest diversity of products that we can get." They have about 68 different items all told, including fruits and veggies, milk, cheese, butter and deli meats. (They don't sell other meats, at this point, because they don't have an electrical system, which would allow them to store the merchandise in a freezer.) At the end of the trailer is a checkout counter.

"We have competitive prices, and 92 percent of them are lower than the local market," the medical student says. "We honor food stamps as well. But you have to buy healthy food rather than junk food. We don't have chips and Coke."

At the end of each month, the budding enterprise averages 600 to 800 invoices. Eventually, Patel predicts, the project won't need outside funding.

"Our business is student run, with no employees. We did hire an intern for the summer, who helped me run the project while I was studying for my medical-school boards." The market operates five days a week, serving seven different locations, according to a schedule set by the communities.

NMM did encounter a hiccup early on: two robberies in the first few months. But locals stepped in to prevent future problems.

REPLICATING THE MARKET

"There's a lot of community support and buy-in," Patel says. "Nashville has rallied around us." Still, the robberies heightened the board's concern, and neighborhoods are now required to provide their own security, so that community members have a greater sense of investment both in the project and in keeping their market safe. NMM will create a manual for those who want to start their own mobile market, and is planning to replicate its model in other cities. The nonprofit plans to partner with Memphis; Dallas; Atlanta; Cleveland; Lexington, KY; New Haven, CT; and Chicago's Maywood area to create franchises.

Patel, who grew up in Lakeland, FL, picked up some of his retail know-how from his dad, who owned convenience stores. To run a successful mobile market, the medical student explains, you need somewhere between 5,000 and 15,000 people per ZIP code. Fewer than that and there's not enough market share; more than that and there are likely to be enough people for a brick-and-mortar store.

NMM started out with an unwieldy 54-student executive board and more than 400 volunteers in its day-to-day operation. It needed an army to develop teh trailer and create a business infrastructure. The board has since been trimmed to 19 people, some of whom are community members. It will soon grow again by 12 to tackle its national initiative. Cities it enters will have their own teams, which will include a mix of undergraduate and graduate students, along with community members.

It will take a while to get reliable data about how the mobile market is affecting the health of those who live in Nashville's food deserts.

"We're studying how the mobile market changes behavior: what people were eating before now and what they're eating now," Patel says. "It's like the mobile market is an experimental drgu." But data can't tell the whole story. "Anecdotally, we're making a huge difference," Patel says, "especially in the elderly community."

While NMM operated at a loss for the first few months, it's now turning a profit. In February 2012, using a social-enterprise model, it will take one-quarter of whatever it has earned from sales and reinvest it in the clinic.

The takeaway for the future doctor is the power of what students can do. "The community has been asking for a market for 10 years," he says. "Now we've created one, and it's being replicated around the country."