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Housing and Food Insecurity

Image of Rachelle Levitt, Director of PD&R's Research Utilization Division.Rachelle Levitt, Director of PD&R's Research Utilization Division.

HUD is interested in improving access to healthy food in low-income communities and supporting positive health outcomes for residents. Low-income neighborhoods that lack supermarkets with a diverse selection yet have many fast food and convenience stores can lead to unhealthful diets that increase the risk of obesity and diabetes. It is universally agreed that food security is a fundamental tenet to a healthy and productive lifestyle. Simply adding a supermarket to a neighborhood, however, may not be enough to change residents' unhealthy eating habits. These stores must also sell healthy food that is affordable, high quality, and appealing to shoppers, says Janne Boone-Heinonen, PhD, one of a 2011 study's coauthors and an assistant professor of epidemiology at Oregon Health and Science University, in Portland. Also, people must be educated on how to eat healthfully and productively.

Limited Resources and Lack of Access to Healthy, Affordable Foods

Some Americans lead sedentary lifestyles and consume larger portions of food, which make maintaining a healthy diet and weight difficult. The Food Research & Action Center in Washington, DC, explains that although food-insecure and low-income people may both adhere to these behavioral patterns, people lacking food security face unique challenges to adopting and maintaining healthful behaviors.

Several studies indicate that residents with better access to supermarkets tend to have healthier diets and a reduced risk of obesity and diabetes. As I noted, research shows that low-income neighborhoods frequently lack full-service grocery stores and farmers markets where residents can buy high-quality fruits, vegetables, whole grains, and low-fat dairy products. Instead, residents — especially those without reliable transportation — are to shopping at small neighborhood convenience and corner stores, where the supply of fresh produce and low-fat items is limited, if they are available at all.

According to the U.S. Department of Agriculture, "vehicle access is perhaps the most important determinant of access to affordable and nutritious food." Households with fewer resources (including households participating in the Supplemental Nutrition Assistance Program or the Women, Infants, and Children nutrition program, as well as food-insecure households) are considerably less likely than households with more resources to have and use their own vehicle for their regular grocery shopping. Those without cars may have their food choices and purchases constrained by how much they can carry when walking or using public transit. Consumers without cars may also be limited to one large shopping trip a month with a friend or family member to buy most of their food, which could result in the purchase of fewer perishable items like fresh produce. Purchasing a car to access healthy food may be out of reach for low-income households, because transportation costs cut into their already limited resources. Although some services such as "Healthy Harvest" deliver healthy but damaged produce at a reduced cost, food insecure residents are not always aware of these services.

When available, healthy food — especially fresh produce — is often of poorer quality in lower income neighborhoods, which diminishes their appeal to buyers. Healthy food options may also be more expensive. In addition, the potential for waste is higher for perishable items than for foods with preservatives. Refined grains, added sugars, and fats are generally inexpensive, palatable, and readily available in low-income communities. Households with small food budgets often purchase cheap, energy-dense foods that are filling — that is, they try to maximize their calories per dollar to stave off hunger. These less-expensive, energy-dense foods are typically lower in nutritional quality and, because of overconsumption of calories, have been linked to obesity. Low-income communities have a greater availability of fast food restaurants, especially near schools, and these restaurants serve many energy-dense, nutrient-poor foods at relatively low prices. Fast food consumption is associated with a diet high in calories and low in nutrients, and frequent consumption may lead to weight gain and diabetes.

A Community-Driven Solution

Many communities are trying to overcome food insecurity. For example, Lawrence, Kansas, as described in a previous article in PD&R Edge, has implemented the Common Ground community gardens program. The Common Ground program is helping address food insecurity by using underutilized and vacant city-owned land for food production through community gardens, a community orchard, a market farm, and a market farm incubator. Food insecurity is an issue in the city of Lawrence, where "more than 10,000 residents have limited access to grocery stores and healthy food choices, 54 percent of residents are considered overweight or obese, and less than 0.1 percent of farmland in the tri-county area is devoted to vegetable production - the ingredients of a classic 'food desert' scenario. Common Ground was developed both to respond these needs and address several related social and economic goals, including the following:

  • Supporting the local food economy by providing land for entrepreneurs looking to start or scale up a food production business.
  • Supporting neighborhoods and creating vibrant spaces for community building.
  • Avoiding the maintenance costs (such mowing and litter removal) associated with idle land.
  • Addressing food access issues through licensing agreements that include a community benefit component (such as donating a percentage of the food produced to a local pantry or civic organization)."

Food insecurity continues to be an issue for many low-income communities. Because food insecurity can result in negative outcomes for communities and households, it is an important issue for communities to address. Through better food retail, community services, and education, healthy communities will result.

Source:

Janne Boone-Heinonen, P Gordon-Larsen, CI Kiefe, JM Shikany, CE Lewis, and BM Popkin. 2011. “Fast food restaurants and food stores: longitudinal associations with diet in young to middle-aged adults: the CARDIA study,” Archives of Internal Medicine 171(13):1162-70.

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Source:

Julie Beaulac, Elizabeth Kristjansson, and Steven Cummins. 2009. “A Systematic Review of Food Deserts, 1966–2007,” Preventing Chronic Disease 6:3, A105; N.I. Larson, M.T. Story, and M.C. Nelson. 2009. “Neighborhood Environments: Disparities in Access to Healthy Foods in the U.S.,” American Journal of Preventive Medicine 36:1, 74–81; Judith Bell, Gabriella Mora, Erin Hagan, Victor Rubin, and Allison Karpyn. 2013. “Access to Healthy Food and Why It Matters: A Review of the Research,” PolicyLink and The Food Trust.

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Source:

Michele Ver Ploeg Vince Breneman, Tracey Farrigan, Karen Hamrick, David Hopkins, Phil Kaufman, Biing-Hwan Lin, Mark Nord, Travis Smith, Ryan Williams, Kelly Kinnison, Carol Olander, Anita Singh, Elizabeth Tuckermanty, Rachel Krantz-Kent, Curtis Polen, Howard McGowan, and Stella Kim. 2009. “Access to Affordable and Nutritious Food: Measuring and Understanding Food Deserts and Their Consequences: Report to Congress.” U.S. Department of Agriculture, Economic Research Service.

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Source:

Michele Ver Ploeg, Lisa Mancino, Jessica E. Todd, Dawn Marie Clay, and Benjamin Scharadin. 2015. “Where Do Americans Usually Shop for Food and How Do They Travel To Get There? Initial Findings from the National Household Food Acquisition and Purchase Survey,” EIB-138. U.S. Department of Agriculture, Economic Research Service

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Source:

Kristen Wiig Dammann and Chery Smith. 2009. “Factors Affecting Low-income Women's Food Choices and the Perceived Impact of Dietary Intake and Socioeconomic Status on Their Health and Weight,” Journal of Nutrition Education and Behavior 41:4, 242–53; Renee Walker, Jason Block, and Ichiro Kawachi. 2012. “Do residents of food deserts express different food buying preferences compared to residents of food oases? A mixed-methods analysis ,” International Journal of Behavioral Nutrition and Physical Activity 9:41.

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Source:

Donald Rose, J. Nicholas Bodor, Chris M. Swalm, Janet C. Rice, Thomas A. Farley, and Paul L. Hutchinson. 2009. “Deserts in New Orleans? Illustrations of Urban Food Access and Implications for Policy.” University of Michigan National Poverty Center/USDA Economic Research Service Research; Alexandra Evans, Karen Banks, Rose Jennings, Eileen Nehme, Cori Nemec, Shreela Sharma, Aliya Hussaini, and Amy Yaroch. 2015. “Increasing access to healthful foods: a qualitative study with residents of low-income communities,” International Journal of Behavioral Nutrition and Physical Activity 12:(Suppl.) 1, S5.

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Larson et al., 2009; Bell et al., 2013.

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Source:

T. Andreyeva, D.M. Blumenthal, M.B. Schwartz, M.W. Long, and K.D. Brownell. 2008. “Availability and Prices of Foods Across Stores and Neighborhoods: The Case of New Haven, Connecticut,” Health Affairs 27:5, 1381–8; Evans et al., 2015.

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Source:

Anju Aggarwal, Pablo Monsivais, Adam Drewnowsi. 2012. “Nutrient Intakes Linked to Better Health Outcomes Are Associated with Higher Diet Costs in the US,” PLoS ONE 7:5, e37533; N. Darmon and A. Drewnowski. 2015. “Contribution of food prices and diet cost to socioeconomic disparities in diet quality and health: a systematic review and analysis,” Nutrition Reviews 73:10, 643–60; Katherine Isselman DiSantis, Sonya A. Grier, Angela Odoms-Young, Monica L. Baskin, Lori Carter-Edwards, Deborah Rohm Young, Vikki Lassiter, and Shiriki K. Kumanyika. 2013. “What “Price” Means When Buying Food: Insights From a Multisite Qualitative Study With Black Americans,” American Journal of Public Health 103(3): 516–522; A. Drewnowski, 2010. “The Nutrient Rich Foods Index helps to identify healthy, affordable foods,” American Journal of Clinical Nutrition 91(4):1095S-1101S

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Source:

DiSantis et al., 2013; Drewnowski, 2009; Kathryn Edin, Melody Boyd, James Mabli, Jim Ohls, Julie Worthington, Sara Greene, Nicholas Redel, and Swetha Sridharan. 2013. “SNAP Food Security In-Depth Interview Study: Final Report.” U.S. Department of Agriculture, Food and Nutrition Service.

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A.K. Kant and B.I. Graubard. 2005. “Energy density of diets reported by American adults: association with food group intake, nutrient intake, and body weight,” International Journal of Obesity 29:8, 950–6; Rafael Pérez-Escamilla, Julie E. Obbagy, Jean M. Altman, Eve V. Essery, Mary M. McGrane, Yat Ping Wong, Joanne M. Spahn, and Christine L. Williams. 2012. “Dietary Energy Density and Body Weight in Adults and Children: A Systematic Review,” Journal of the Academy of Nutrition and Dietetics 112:5, 671–84.

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Source:

S.E. Fleischhacker, K.R. Evenson, D.A. Rodriguez, and A.S. Ammerman. 2011. “A systematic review of fast food access studies,” Obesity Reviews 12:5, e460–71; Angela Hilmers, David C. Hilmers, and Jayna Dave. 2012. “Neighborhood Disparities in Access to Healthy Foods and Their Effects on Environmental Justice,” American Journal of Public Health 102:9, 1644–54; Y. Kestens and M Daniel. 2010. “Social inequalities in food exposure around schools in an urban area,” American Journal of Preventive Medicine 39:1, 33–40.

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Source:

Larson et al., 2011; Mark A. Pereira, Alex I. Kartashov, Cara B. Ebbeling, Linda Van Horn, Martha L. Slattery, David R. Jacobs Jr, David and S. Ludwig. 2005. “Fast-food habits, weight gain, and insulin resistance (the CARDIA study): 15-year prospective analysis,” Lancet 365, 36–42; L.M. Powell and B.T. Nguyen. 2013. “Fast-food and full-service restaurant consumption among children and adolescents: effect on energy, beverage, and nutrient intake,” JAMA Pediatrics 167:1, 14¬–20; Food Research and Action Center. 2018. “Why Low-Income and Food Insecure People are Vulnerable to Poor Nutrition and Obesity.”

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