Healthy Eating is About Economics For Many

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Fighting to put a meal on the table is increasingly common for people all over America, especially in urban areas where high prices and poor access to certain resources often limits food choices. More than 48 million households nationwide were food insecure in 2014, with rates rising higher than the national average in many poor households, particularly in African American and Hispanic communities.

While food insecurity is linked with hunger, it can also deter the best intentions of people who want to eat healthy. For the new Academy report, “Food and Nutrition: Hard Truths About Eating Healthy,” the last in the Academy’s “City Voices: New Yorkers on Health” report series, we reached out to low-income adults in four New York City boroughs—the Bronx, Brooklyn, Manhattan and Queens—to ask them what they needed to improve their diets.

Many of those who were gracious enough to sit for our focus groups explained that no matter how badly they wanted to eat healthy, tight budgets and challenging life experiences often made it nearly impossible.

“I spend all my money on food, all my social security. And … I’m not buying really good, nutritious food… the obstacle of having to work with food stamps, work with my rebate cash, sometimes I just need to put food in my mouth.”-  Academy NYC focus group participant

Our study found that while most participants understood the importance of nutrition and wanted to eat healthier, 66 percent reported always or sometimes feeling concerned about affording food and housing, while 36 percent reported that healthy food was not readily available where they lived.

I think our community as a whole does not benefit from fresh fruits and vegetables that would make it more easy for people who would normally prefer to eat healthy. The choice is not there. Academy NYC focus group participant)

Existing Resources Part of the Problem

Others brought up the struggles of buying food from local food pantries, waiting in line for hours only to find unhealthy options. In comments supported by findings from several studies, including a recent survey funded by the Robert Wood Johnson Foundation, food banks have some healthy foods, but also a fair amount a sugar-sweetened items, less nutrition-dense vegetables and unhealthy snacks.

Academy focus group participants found themselves unable to consistently put together nutritious meals at New York City food pantries.  And while pantries are often deemed “emergency” sources of food, millions of people depend on pantries on a daily basis.

Many of these seniors … some of them can’t even afford to buy food, so they’re going from one pantry to the other to try to get sufficient foods. But as we know, canned goods, a lot of canned goods, are not good for our community. There’s a lot of salt in canned goods, and that’s what you get largely through the food banks. You get a lot of canned goods because their shelf life. (Focus Group Participant)

A new study, published in the June issue of Health Affairs, showed that properly stocked food pantries can have a positive impact on health. For the research, pantries in three states added diabetes management experts who provided free screenings and handed out grocery boxes with healthy ingredients and recipes. After six months, study participants were eating more fruits and vegetables, and their diabetes symptoms had improved.

To make healthy eating easier for low-income city residents, participants in the “Food and Nutrition: Hard Truths About Eating Healthy,” research suggested community programs adjust their tactics and goals. They said nutrition education and cooking classes that acknowledged cultural differences and emphasized nutrition over weight loss would encourage healthier eating and wellness, and avoid the stigma linked with weight-loss programs.  We continue to do our part through the Academy’s Designing a Strong and Healthy New York work supporting healthy food retailers.

by Saki Kitadai who studying medicine at Tufts University and is interning in the Academy’s policy department.

Read the City Voices report series.

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