Limited Access to Healthy Food Impacts Certain Neighborhoods

Walk into Mello's Market, a bodega in Lawrence, Massachusetts, and you are immediately greeted with a selection of fresh fruit and vegetables.

Co-owner Juan Checo will point it out for customers, an unusual range of bananas, pineapples, oranges, grapefruit.

Unusual, because not everyone in Lawrence is so lucky.

The NBC10 Boson Investigators and health reporter Kristy Lee examined new survey data from the Centers for Disease Control and Prevention "500 Cities" project, which burrows down to Census tracts in 500 American cities to show how specific neighborhoods fare across a range of health metrics, from a community’s mental health to obesity and exercise to unhealthy behaviors such as binge drinking, smoking, and lack of sleep.

The data shows that where you live can have a huge impact on wellness.

The Obesity Gap

Source: CDC, Census Bureau
Credit: Sam Hart/NBC

According to the Massachusetts Food Trust Program, more than 80 percent of the city's population live in what's called a "food desert," defined by the CDC as limited access to whole grains, low-fat milk and other foods that are included in a healthy diet.

Because of a lack of transportation and few full-service supermarkets, thousands of the mostly immigrant residents of Lawrence must walk for groceries to their corner store, where the selection is extremely limited.

Lawrence's city leaders are aware of the problem.

"For them, they can only eat what the bodega sells," said Elecia Miller, of the Mayor's Health Task Force. "And unlike El Mello, many don't carry a large selection of healthy food."

The CDC data showed that Lawrence ranked high in the number of people considered obese compared with the rest of Massachusetts.

"When you see the numbers, that's when you go, whoa," Miller said.

Numbers that according to the CDC put Lawrence among the worst in the state for obesity and lack of exercise. According to the "500 Cities" project, more than 40 percent of people in Lawrence don't regularly exercise and more than a third are obese. Data from the Massachusetts Department of Public Health suggests it's even worse than that. They found nearly half of the children in Lawrence schools are overweight or obese as are two-thirds of the adults in the city.

"We knew it was there we just didn't know it was that bad," Miller said.

So Lawrence has declared war on obesity, led by Miller and the Mayor's Health Task Force.

Access to healthy food and fresh fruits and vegetables have long term benefits, including acting as a sort of preventative medicine that can help regulate weight, diabetes, stroke and heart disease. So when someone can't find affordable produce, they often turn to cheaper and less healthy processed foods.

"At one time we had one supermarket in the city limits, but we had corner stores everywhere. We call them bodegas," Miller said.

Lawrence has targeted the bodegas as the places to make the biggest impact.

It's a big undertaking considering at least 86 bodegas fill an area of just 7 square miles.

Checo and El Mello were one of the first to team with the Mayor's Health Task Force by adding the "healthy aisle," which includes more fresh fruits and vegetables.

Checo said the demand is there.

"They buy more fruits and more vegetables," he said.

While bodegas have long offered canned and packaged food from Hispanic countries, fresh fruits and vegetables have long been absent. That's because the bodegas are small shops, and many don't have the means to buy and store fresh produce. And shop owners worry the items won't sell.

"Nobody buys it, it stays on the shelf, it goes bad," Miller said. "We don't have the space for it. It is easier for us to stock things that have a longer shelf life."

But with longer shelf life tends to come more calories and lower nutritional values.

So that's when Lawrence General Hospital stepped in with $2.5 million as part of a community health initiative to encourage bodegas to make more space in their stores for healthy food. Twenty-nine of the 86 bodegas now participate in "Healthy on the Block/Bodegas Saludables."

The money helps pay for refrigeration, and for training for shop owners about how to display fresh produce to make it more appealing.

Harvard University health policy expert Dr. Subu Subramanian said that being obese in a low-income city often brings a higher rate of heart attacks and death than in wealthier communities.

For example, the CDC data show high rates of coronary heart disease, diabetes and stroke in neighborhoods in Lawrence, compared to wealthier areas in the state.

"Even though they are both obese, what they can do about it are very different because of their life opportunities and resources they have access to," Subramanian said.

In Newton, with about the same size population as Lawrence, the median household income is 3.5 times higher there—$127,402— than Lawrence—$36,754.

According to the CDC data, Newton also ranks among the best in Massachusetts when it comes to obesity rates.

Newton Mayor Ruthanne Fuller said many of the city's characteristics contribute to better health outcomes.

"We've got great parks and sidewalks, combined with being one of the safest communities in the United States that lets people outside to have a healthy lifestyle," she said. "Then you add in we have so many wonderful grocery stores here. People have access to fresh fruits and vegetables."

Newton also has banned all drive-thru restaurants, except for one.

"Our regulations make it really hard to have a drive-thru here. In Newton we're lucky to have a lot of good healthy alternatives you can also get fast," Fuller said.

Subramanian believes change can happen for cities like Lawrence, but it takes time.

"Take smoking cessation. It started with the high social group and did eventually go down from there," he said.

And challenges will continue to exist.

"It will always be very unequal," he said.

Lawrence is among the top 10 areas in the state when it comes to a lack of grocery stores, so bringing more nutritious food to the bodegas come as a welcome change for many there.

Lawrence ranked sixth in that food desert list from The Food Trust. The others include Chelsea, Springfield, Taunton, Everett, Revere, Lowell, Lynn, Brockton, and Chicopee.