Running head: POLICY BRIEF PAPER 1

Policy Brief Paper on Access to Healthy Foods Among Low-Income Populations

Nickole Argentieri, BS, MPH(s)

Jeanette J. Montoya, BS, MPH(s)

Department of Health Science and Human Ecology

HSCI 660D: Advanced Topics in Health Science & Human Ecology

Dr. Nicole Henley

California State University, San Bernardino

June 11, 2019

Executive Summary
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Obesity is a very large public health concern in the United States of America. Its rising

obesity rates affect many individual lives and increases their risk of being diagnosed with a

chronic condition. According to the State of Obesity (n.d.), Louisiana ranks sixth highest in adult

obesity and eighth highest in youth ages 10 to 17. A contributor to the rising obesity rates is the

lack of consuming healthy foods such as the recommended daily amount of fruits and vegetables.

The accessibility and affordability of junk food, make it a more desirable meal for underserved

communities. Another contributor is the inaccessibility to stores with fresh and nutritious food

options. In order to get to a supermarket, nearly 60% of residents reported having to drive more

than 3 miles (New Orleans Food Policy Advisory Committee, n.d.). The current policy through

the National Healthy Food Financing Initiative is to increase healthier food retail in underserved

communities. Through this initiative, it provides financial assistance or incentives encouraging

the sale of fresh foods. Unfortunately, the initiative has not conquered the desired outcome.

Concerns with the area due to history of natural disaster, security, and inaccessibility and lack of

transportation have posed as large issues that have hindered the initiative from being effective.

With recommendation such as environmental justice, providing additional funding and

transportation services and education for the community, these items can strengthen the current

policies to effectively increase fresh food consumptions and decrease risk of obesity and chronic

conditions.

Context and Importance of Problem

There continues to be a rise in obesity among individuals residing in Louisiana.

According to the American Heart Association (2019), Louisiana has one of the nation’s highest

obesity rates, and has some of the largest per capita food deserts. There is a lack of access of

high quality foods and is one of the key reasons why Louisiana is named the most unhealthy
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state for the past couple of years. Louisiana faces one of the most severe issues with access to

healthy foods in the nation. “Heart disease is a primary cause of death in Louisiana, accounting

for 25 percent (11,008) of all deaths in Louisiana” (Louisiana Department of Health, n.d.). The

lack of healthy foods can have a big impact on individuals lives.

A study found that 20 percent of adults in Louisiana eat five or more servings of fruits

and vegetables per day, while 32 percent eat snack or junk food and 42 percent drink soft drinks

daily (American Heart Association, 2019). In regards to this study, the lack of vegetable and fruit

consumption and the high intake of junk food and soft drink explains why there is an obesity and

diabetes issue. According to Louisiana Department of Health (n.d.), Louisiana has the highest

diabetes related death rate in the nation. The consumption of soft drinks highly affects the high

rate of diabetes. In order to improve obesity in the state of Louisiana, we must connect the

community members to resources that will allow them to improve their access to healthier food

options.

The Louisiana Healthy Food Retail Program was implemented to increase the access to

healthy affordable foods. “It is estimated that 1.3 million Louisiana residents currently have low

access to grocery stores. In Baton Rouge alone, approximately 75,000 residents live in areas that

have unacceptably low access to grocery stores” (American Heart Association, 2019). The goal

of this program is to improve diets and health in the state of Louisiana. The program also

mentioned it will, “promote the sale and consumption of Louisiana’s grown fruits and

vegetables, and support expansion of economic opportunities in low-income and rural

communities” (Department of Agriculture & Forestry, n.d.). Food Trust is a non profit

organization that also works with the Louisiana community in increasing access to grocery

stores. All communities should have access to healthy, affordable foods no matter where they
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live. Unfortunately, Louisiana is an area that desperately needs help in decreasing food deserts.

However, with the implementation of the program it lacks funding for the initiative. The program

had a good purpose, but no money to help support the implementation to be successful.

Louisiana Response to obesity includes the implementation of the School Wellness

Policy. “Mini-grants were awarded to 25 school districts who were ready to adapt stronger

wellness policies and create school health advisory councils to drive the policies” (Center for

Disease Control and Prevent [CDC], 2012). Providing advisory councils will promote the

success of the policy. This policy will include 30 minutes of physical activity grades K-12, and

will also be receiving nutrition information, like healthy foods and beverage choices in a school

cafeteria. Providing education in schools is a major step in helping decrease obesity rates in

Louisiana.

Critiques of Policy

According to Academy of Nutrition and Dietetics (2015), research has shown that the

environment in which we live, learn and work impacts an individual’s diet. In order to promote

the increase of the consumption of fruits and vegetables, we must increase the access and

availability of healthy and affordable foods and decrease the access and availability of unhealthy

foods. Food deserts pose as a large factor in why individuals are not consuming the

recommended amount of fruit and vegetables. Neighborhoods and communities that offer limited

access to healthy and affordable food options are contributors to these food deserts (Astho, n.d).

In order to combat the issue of availability and affordability of healthy food options,

public health has recommended improving the retail food environments to better provide to

underserved communities (CDC, n.d.). In the State Initiative supporting healthier food retail, the

National Healthy Food Financing Initiative was created to increase access to healthy foods in
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underserved communities. Through this initiative, it provides financial assistance or incentives to

attract healthier food retail outlets. These incentives include a tax incentive to encourage the sale

of fresh foods, grants or loans to create new establishments or to cover cost with remodeling or

refurbishing for existing establishments (CDC, n.d.). Supermarkets and grocery stores provide

consumers with a large variety of fresh and nutritious food options at competitive prices. This

also provides opportunity to create more job and skills training for its residents.

In Louisiana, the current policy to increase the accessibility of fresh foods is

unfortunately, failing for the state. Access to fresh foods in Louisiana is very limited. Due to

Hurricane Katrina, the availability of nutritious food has become scarce. Prior to the natural

disaster there were 38 full-service supermarkets and since the natural disaster, only 18

supermarkets in the New Orleans area have reopened and smaller stores are unable to meet the

demand of fresh foods (New Orleans Food Policy Advisory Committee, n.d.). The state is still in

the recovery process and strategizing how to rebuild its communities. The initiative intends to

create more establishments in underserved communities. Many retailers are hesitant to open in

underserved communities fearing their safety due to the lack of security. Theft rates are found to

be higher in underserved communities. Lastly, research suggests that individuals who live closer

to full-service grocery stores have healthier diets, consume more fruits and vegetables and are

less likely to be obese. Though the current policy addresses the increase of establishments to

provide fresh foods, it does not address the lack of transportation to supermarkets, grocery stores

and farmers markets (New Orleans Food Policy Advisory Committee, n.d.). In a survey

conducted by Tulane University, nearly 60% of the residents reported having to drive more than

three miles to get to a supermarket and only half of the surveyred have their own vehicle (New

Orleans Food Policy Advisory Committee, n.d.).

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Policy Recommendations

In result of high obesity and diabetes rates in Louisiana, there has been policies

implemented to improve Louisiana overall health as a state. As mentioned, there is a serious

issue with the lack of access to healthy food due to the lack of grocery stores. Improving

individual’s diets by increasing the consumption of fruits and vegetables and increasing

accessibility to grocery stores will aid in reducing an individual’s risk of becoming obese and

lowering their risk of being diagnosed with a chronic condition. “Environmental justice is

concerned with an equitable distribution of environmental burdens. These burdens comprise

immediate health hazards as well as subtle inequities, such as limited access to healthy foods”

(Hilmers et al., 2012). In economically distressed areas, there can be a lack of distributions of

healthy foods due to the limited amount of grocery stores. In food deserts there tends to be more

convenience stores and fast food restaurants. This causes individuals to have easier access to get

junk food from convenience stores, fast food, and soft drinks. There is a limited access to

grocery stores which makes it more difficult to receive healthy foods, for example, fruits and

vegetables.

Providing financial abilities and funding to build grocery stores in areas that are

considered a food desert, will help create access to healthier and affordable foods. “Funds will be

used to help vendors purchase furnishings to increase the inventory and sale of fresh fruits and

vegetables, or provide for equipment installations and upgrades” (The Shelby Report, 2019.).

Funding is very important to achieve improvements of access to healthy foods, Louisiana needs

to see what other states are implementing to be successful in improving health. “Some states

have passed legislation that entice grocery stores and supermarkets to move into food insecure

communities” (Astho, n.d.). If Louisiana provided proper funding into programs, we could
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eventually see an improvement with access to grocery stores. Utilizing supermarkets, farmer

markets for low-income populations implements a stronger food environment. “Offer

transportations routes to existing retailers” (Astho, n.d.).

In a food desert, grocery stores are most likely not in walking distance. Establishing a

transportation service to those with no cars can be a positive outcome. “Food retail outlets, such

as grocery stores and supermarkets, can serve as ‘anchors’ to other types of commercial

development and may increase retail activity, employment rates, and property values in

surrounding neighborhoods” ( Astho, n.d). Developing better infrastructure of stores in low-

income areas can improve the community agriculture and bring in more access to healthier

foods. High rates of chronic diseases can be improved by better coordination of care. “Despite

spending nearly $7 billion of taxpayer funds every year, Louisiana’s current Medicaid system

does little to actually improve the health of our poorest citizens” (Louisiana Department of

Health, n.d). Pursuing more of a demand in preventative care can be beneficial to decrease

chronic diseases that make Louisiana the most unhealthy state.

The importance of implementing policies and programs in relation to helping increase

health rates in Louisiana, will help avoid them becoming the most unhealthy state every year.

There needs to be a difference made in the community of Louisiana, educating individuals of

proper health and decreasing chronic diseases can have a huge impact on overall health.

Becoming the world's most unhealthy state, most obese, and high rate of diabetes is not

something to be proud of. To improve an individuals health and achieve a longer life, there needs

to be improvement with access to healthy foods. Improving health and following policies

provided can improve future generations to live a longer life due to the decrease of chronic

diseases and increase of healthier food options.

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References

American Heart Association. (n.d.). Impact in Louisiana. Retrieved from

http://www.heart.org/HEARTORG/Advocate/VoicesforHealthyKids/FoodAccess/Impact

-in-Louisiana_UCM_476735_Article.jsp#.XP308q2ZN-U

Astho. (n.d). Enable Access to Health Food Choices. Retrieved from

http://www.astho.org/Programs/Health-in-All-Policies/Environmental-Health-in-All-Poli

cies/Enable-Access-to-Healthy-Food-Choices/

CDC. (n.d.). State Initiative Supporting Healthier Food Retail: An Overview of the National

Landscape. Retrieved from

https://www.cdc.gov/obesity/downloads/Healthier_Food_Retail.pdf

Hilmers, A., Hilmers, D. C., & Dave, J. (2012). Neighborhood disparities in access

to healthy foods and their effects on environmental justice. Retrieved from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3482049/

Louisiana Department of Health. (n.d.). Retrieved from http://ldh.la.gov/index.cfm/page/38

New Orleans Food Policy Advisory Committee. (n,d,). Building Healthy Communities:

Expanding Access to Fresh Food Retail. Retrieved from

http://thefoodtrust.org/uploads/media_items/new-orleans-supermarket-report.original.pdf

The Shelby Report. (2019). Louisiana Launches Program To Expand Fresh Food Access.

Retrieved from

https://www.theshelbyreport.com/2019/03/14/louisiana-healthy-fresh-food-access/

State of Louisiana Department of Agriculture and Forestry. (2019). Louisiana Launches Program

to Expand Fresh Food Access. Retrieved from

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http://www.ldaf.state.la.us/news/louisiana-launches-program-to-expand-fresh-food-

access-communities-affected-by-hurricanes-gustav-and-ike-to-benefit/

The State of Obesity. (n.d.). Retrieved from https://www.stateofobesity.org/states/la/