Blog Behavioral/Mental Health Health Equity

Action toward food equity

Written by Alyna Sibert, MS, operations manager for the North City Food Hub and Institute for Public Health 2018 Annual Conference speaker

The CDC defines health equity as “everyone has the opportunity to be as healthy as possible.”  Healthy People 2020 defines health equity as the “attainment of the highest level of health for all people.”  Everyone deserves to be healthy, but there are disparities that get in the way of achieving the goal of health equity.

A person’s health can be impacted by the availability of food access, housing, education, transportation, and health care just to name a few. One of the biggest barriers to optimal health for some people, is the low availability of quality food in low income communities. Low income communities have been bombarded with fast food restaurants, but grocery stores remain limited or nonexistent. I often see families traveling on public transportation with bags of groceries and I can’t help but think of how much of an inconvenience that must be for them. Some families shop at local corner stores or even gas stations, but there are few options for food and prices are sky high. Many times, the food options that are available are processed and not the healthiest. My biggest concern is that the inadequate access of food in low income areas will continue to contribute to high rates of obesity and other chronic diseases.

Obesity is one of the major conditions affecting Americans right now. The National Health and Nutrition Examination Survey 2013-2014 investigated the prevalence of overweight and obesity in the United States. This survey found that more than 1 in 3 adults were overweight (32.5%). More than 1 in 3 adults were obese (37.7%) and about 1 in 13 (7.7%) adults were extremely obese. These rates are quite alarming but are lower than the estimated overweight and obesity rates here in the city of St. Louis.

In 2015, the City of St. Louis Department of Health conducted a study using self-reported heights and weights from driver’s license records of city residents at least 16 years of age. Researchers used this data to get an estimate of overweight and obesity rates in the St. Louis city.  This study included 171,894 people and 61% of those included in the study were overweight or obese. The data also indicated that 48% of city residents under the age of 40 were considered overweight or obese. Approximately, 70% of people over the age of 40 were overweight or obese. The highest rates of overweight and obesity (73%) were found in the northern part of the city which is majority African American. This isn’t surprising considering 70% of black residents in the city of St. Louis live in low income low food access areas.  The Missouri Coalition for the Environment, states that 56% of residents in the city of St. Louis are low income and do not have easy access to quality food.

Many of these low-income and low food access areas were not always this way. Last summer, I conducted research that looked at the food provision in The Ville neighborhood from 1870-2017. I noticed that as white flight began to take place around the 1950’s and the city’s population began to decline and north St. Louis experienced business closures and deterioration of the community. Over time, neighborhood grocery stores, restaurants, and bakeries disappeared. By food no longer being within walking distance, I’m thinking that this probably caused less physical activity as well. I am almost certain that this has a lot to do with the increased obesity rates over time. The Ville is just one of many neighborhoods in St. Louis impacted by low food access and high incidence of overweight and obese residents. This community currently lacks grocery stores and has very few restaurants.

I have noticed that there has been an increase in food banks and community gardens throughout St. Louis over the last couple of years. I truly believe that we can make a difference by starting with one neighborhood at a time. We also need to conduct more community based participatory research which will allow residents in communities to have a voice and contribute to change. Creating more food banks, community gardens, food hubs, urban farms, neighborhood grocery stores, and collaborating with organizations looking to improve healthy food access will be very beneficial in terms of lowering obesity rates and working towards achieving health equity.