A Solution (Partial) To Obesity?

I have written that I have encountered two really good studies of the effect of environment on obesity (the number two out of control medical cost).  Here is the Economist's take on the most recent one.  You decide.

Poor access to fresh food is a solvable health problem

Oct 29th 2011 | CHICAGO | from the print edition

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THE corner shop on South Honore and West 59th in Englewood is an uninviting sort of place. Those windows that are not bricked up are covered in heavy security grilles; the shopkeeper hides behind a Plexiglas wall. Most of what is on offer is either packaged or carbonated, and is always processed.
This part of Chicago’s South Side is in the heart of one of America’s many food deserts. These are notable not for the absence of food, but for the kind of food available. Though crisps, sweets and doughnuts are easy to come by, an apple is a rare commodity. Yet all the evidence shows that poor access to quality food results in a higher risk of obesity, diabetes and cancer—and more avoidable deaths.

Although cynics might argue that the market gives people the food they deserve, research published this month in the New England Journal of Medicine suggests otherwise. During the 1990s, when the American government paid for around 1,800 women to move out of public housing, the women who had moved showed a 20% lower rate of obesity and diabetes than those who had not. In other words, their improved environment (which many assume would include better shops) led to their better health.
Research published this week by Mari Gallagher, an independent food researcher, suggests that the problem of food deserts may be relatively tractable. Over the past five years, thanks to the arrival of some new grocery stores, Chicago’s desert has shrunk by 40% to a mere 384,000 people. It sometimes takes only one shop to change things vastly for the better. For example, the Food-4-Less store in Englewood improved access to fresh food for almost 41,000 people, most of whom are black.
This is all grist to the mills of Michelle Obama, America’s first lady, and Rahm Emanuel, Chicago’s mayor, who appeared together at a South Side pharmacy on October 25th to promote access to fresh food. Both have been adept in their own ways at twisting the arms of retailers such as Walmart, SUPERVALU and Walgreens to open grocery stores in underserved areas.
Walgreens, a chain of almost 7,800 drug stores, now has a large selection of fresh food in ten “food oasis” stores in Chicago. It has also promised that over the next five years it will provide more fresh food in 19 other sites in the city, most of them food deserts, and in 1,000 other stores across the country. This could make a big difference. The firm’s chief executive, Greg Wasson, says that two-thirds of all Americans live within three miles of one of his shops.
Moreover, the opening of a halfway decent grocery store is often the trigger for the arrival of other better-class shops in the area, which then spurs a local economic revival. This could go some way towards reversing a worrying trend pointed out by Ms Gallagher. She says that there tend to be more diet-related deaths in places where “fringe” retailers accept food stamps. Fringe retailers, by her definition, are those shops that specialise in food high in salt, fat and sugar, plus non-food items such as fizzy drinks. The sad thing, as she points out, is that food stamps are supposed to protect the poor from malnutrition, not make them ill.
Mrs Obama made a point of saying that nobody in government is telling anyone what they should, or should not, be eating. But good food does have to be available. As any parent can tell you, the fruit bowl always needs to be easier to reach than the cookie jar.

from the print edition | United States