Dr. Autumn Marshall, Department of Nutrition, Lipscomb University
What foods do your students eat at home, in the cafeteria, on the run? How much does the availability of specific foods around them drive their choices? What is their understanding of how food availability affects people with limited income and mobility—their choices as well as their health? What behaviors are required to promote health and prevent disease?
In this activity, students explore connections between risk factors for hunger and health promotion activities. They use Google Maps to examine the relationships between the availability of nutritious food, income levels, and access to transportation. Then they present their findings—including maps and graphs—to their classmates and electronically to a community medical clinic.
A food desert is a low-income area where a substantial proportion of the residents have low access to a supermarket or large grocery store. According to The Advocate’s “Lexicon of Food,” this term is misleading: “Food ‘desert’ is a bit of a misnomer—it isn’t that there is necessarily a lack of food in under-resourced communities, but rather, these communities are flooded with unhealthy, highly processed, low-nutrient food combined with disproportionate advertising for unhealthy food compared to wealthier neighborhoods, making “food swamp” a more appropriate description of these areas.” For purposes of this Pearl, we will go a step further and more narrowly define these areas as “calorie swamps” due to the juxtaposition of a lack of access to whole foods and an abundance of empty calorie, highly processed foods.
If the individuals living in food deserts eat only those foods available and affordable in the food establishments closest to their homes, they may easily miss nutrients necessary for health. Once students understand the health implications of nutrients, and thus the health implications of the lack of nutrients in food deserts, they can begin to invent creative solutions to food deserts in their community.
Courses Into Which This Activity Could Fit
The success of this activity relies on students’ having a basic understanding of calories, macronutrients (proteins, carbohydrates, and fats), and micronutrients (vitamins and minerals); and how the human body digests, absorbs, and metabolizes nutrients. It is therefore better suited to upper-level courses or the latter weeks of introductory courses.
- Principles of nutrition
- Nutrition across the lifespan
- Nutrition education and health promotion
- Introduction to public health
- Food security and public policy
A moderately active adult needs between 2000 and 2500 calories per day to maintain body weight. But not all calories bring the same nutritional content. The diets of most Americans contain—and sometimes are even dominated by—“empty calories” from fats and sugars in snack foods and beverages that are low in nutritional value.
In this activity, students explore the diversity and complexity of food availability and distribution. They investigate tradeoffs faced by some consumers, such as between fresh food that takes time and money to obtain and cheap food that’s more widely available and more easily accessible.
- First, students discuss nutrient needs at different stages of life, and the biochemical results of food choices (health promotion vs. disease treatment). They then discuss the concepts of nutrient density and food cost, and the possibilities for obtaining nutritious food on a budget.
- Using Google Maps, pairs of students create maps on which they identify retail food establishments (e.g., grocery stores, convenience stores, fast food restaurants, other restaurants, farmers markets) within assigned zip code areas of their community. Next, they identify public transportation options available to residents without cars who want to purchase food from these establishments.
- Students use this information to create a representation of how far people in the assigned zip code(s) must travel to purchase healthful food or reach health care appointments.
- Students use their representations to examine the relationship between income and the distance traveled to reach food options. They also can research the cost of food by neighborhood: for example, how much a gallon of milk, an apple, a jar of peanut butter, a can of chili with beans, and a loaf of white bread costs in different zip codes.
- The primary goal is to promote healthful behaviors in the limited-resource audience. How likely is it that they know what foods to eat to promote good health or to treat chronic disease? How likely is it that they will choose nutrient dense foods over empty calorie foods? Is there a way to utilize technology to promote healthful behaviors (for example, through an app for a smartphone that would identify sources of healthful food and/or sale prices on foods at grocery stores within a certain distance from places they visit regularly)?
- Students present their findings in electronic format to a community medical clinic. The presentation includes an electronic map with both food deserts and calorie swamps identified (via the identification of types of food available in each establishment,) a map of bus routes to identify transportation resources for those who need them, and a graph of the cost of food staples by the type of establishment that sells them (for example, a gallon of milk costs $2.99 in a grocery store vs. $5.99 in a gas station convenience store).
- Students discuss current public policy related to food access. What food resources are available to those living in food deserts? Is it possible for individuals receiving Supplemental Nutrition Assistance Program (SNAP) benefits to purchase enough whole foods to provide adequately for nutrient needs? Will WIC vouchers (from the Special Supplemental Nutrition Program for Women, Infants, and Children) provide enough food and nutrients to supply the needs of pregnant women, infants, and children? Do the people who receive SNAP or WIC benefits have access to nutritious food outside their community on their way to or from their place of work? Is it feasible to take public transportation to and from a grocery store, and would that require changing buses? Would disabled persons living in a food desert be able to purchase nutritious food in this way? What solutions might exist for policymakers who wish to improve their constituents’ access to whole, nutritious foods?
By sharing with local health clinics their findings about availability and accessibility of healthful food, students help those clinics provide health-promoting information to clients with limited incomes and limited transportation options. Students help patients learn about the health value of nutrition and about how to make the most efficient use of their food budgets.
By researching public transportation and sharing their findings with local policymakers and other stakeholders, students can also discuss possibilities for improving food access through public transportation. Students can learn about the process of creating policy for better health outcomes and the importance of civic engagement to improve public health.
Scientific Concepts Addressed and Related Civic Issues
Human beings have certain nutritional and metabolic requirements that must be met if we are to live healthy lives, and these requirements have been scientifically established. At the same time, humans must obtain their food from sources available in their cities or neighborhoods, according to the accessibility and affordability of these sources.
This activity increases students’ receptivity to scientific concepts in biology and biochemistry such as calories, macronutrients (proteins, carbohydrates, and fats), and micronutrients (vitamins and minerals); and the digestions, absorption, and metabolism of nutrients. The activity does not itself teach these concepts, but provides a social issue through which students’ learning of them can be solidified. The activity poses social/civic questions such as, “What are factors that determine whether people in our city have easy, equal access to nutritious food?” “Is there a relationship between socioeconomic factors and food availability and security?” What does the latest science have to say, and what are the implications for food security?” “What public policies support or inhibit the elimination of local, national, and global hunger?”
Students spend approximately 10 hours on the project over the course of the semester, with some work done in class and the bulk of the work done outside of class. The final presentation is made to the community clinic at the end of the semester.
Prior knowledge required
- A basic understanding of the nutrient needs of adults, governmental food assistance programs such as SNAP, and the terms “food desert” and “calorie swamp”
- Basic graphing skills in order to compare food cost in various types of establishments
- Communication skills to educate the patients of health clinics on how to eat healthfully on a budget
- Access to Google Maps
- Information from the Centers for Disease Control and Prevention (CDC) on the Social Determinants of Health and the Built Environment (this information is provided to the students and discussed in class). Additionally, information is available from the World Health Organization (WHO). A description of the Social Determinants of Health and call to action can be found at: http://www.who.int/social_determinants/sdh_definition/en/index.html.
- A list of foods whose cost is to be researched
- Access to the most recent USDA Thrifty Food Plan so that students can see how the federal government expects people with SNAP benefits to utilize their food dollars: http://www.cnpp.usda.gov/USDAFoodPlansCostofFood/reports
Context and Concepts for Instructors
- Classroom materials
Sample assignment(s) for students with assessment rubric:
Nutrient Mapping in Nashville
Assessment Rubric for Nutrient Mapping in Nashville
- Venues for investigation
If students are unable to visit a grocery store in person, they can use online shopping sites, such as freshdirect.com or walmart.com, or local services in their area. They may also call retail establishments to inquire about prices, whether the establishment accepts Electronic Benefit Transfer cards from the Supplemental Nutrition Assistance Program, etc.
- What would students eat if limited to a very small food budget?
Another possible activity would be to conduct a simulation to see what students would eat if they were limited to a certain dollar amount per week. Their knowledge will allow them to evaluate those food choices.
- Possible creation of a smartphone app
Our students are interested in creating a smartphone app that the clients at a health clinic would use in deciding the best places to shop for the staple foods that they need. For example, is it more cost effective to stop by the grocery store to buy milk on the way home from the doctor, so that it not only costs less but can be purchased separately from other groceries to prevent carrying too much on the bus on a grocery trip? The client would be able to plan food shopping based on bus routes and appointments around town. We are investigating the options for partnering with a class in the College of Computing and Technology.
What students will be able to do
Depending on how the instructor employs this activity, students may learn to:
- Apply social science survey methods, including data collection, analysis, and presentation
- Evaluate the nutrient density of specific foods and discuss whether those foods are likely to promote health or to promote disease
- Evaluate a region of the city to determine whether it would qualify as a food desert (by legal definition), and evaluate whether a food desert is also a calorie swamp by virtue of an abundance of empty calorie foods
- Use their awareness of the logistical and financial challenges that some people face in gaining access to nutrient-dense food and information about a healthful diet to brainstorm potential ways to alleviate the problem of limited access to affordable healthful foods
- Discuss public policy as it applies to nutrition, and the efficacy of governmental nutrition programs (the role of the nutritionist as an advocate). Are people who receive SNAP benefits likely to have the knowledge and skill necessary to meet the budgetary demands of the Thrifty Food Plan?
Ways that this activity enriches the engagement of citizens with social and civic problems having underlying scientific issues
This activity connects to several SENCER ideals, including:
- SENCER invites students to put scientific knowledge and scientific method to immediate use on matters of immediate interest to students.
Because purchasing and eating food plays an important role in students’ everyday lives, and since a significant segment of the population is trying, at any given time, to control their caloric intake, this activity is likely to be of immediate interest to students. The instructor has the opportunity to engage students with broader civic questions such as:
- How nutrient-rich is the food distributed by agencies that address hunger and food insecurity?
- What are factors that determine whether people in the community have ready and equal access to nutritious food? Is there a relationship between socioeconomic factors and food availability and security? Or between availability of the latest nutrition recommendations and implications for food security?
- What public policies support or inhibit the elimination of local, national, and global hunger?
- SENCER shows the power of science by identifying the dimensions of a public issue that can be better understood with certain mathematical and scientific ways of knowing.
Because food intake plays an important role in promoting health and preventing disease, students can explore the implications of our dietary choices for public policy. For example, should there be a tax on sugar-sweetened beverages to offset the healthcare tax dollars spent caring for Type 2 diabetics? If restaurants were required to include calorie information on menus, would that motivate change in what the public chooses to purchase or in what restaurants offer?
- SENCER conceives the intellectual project as practical and engaged from the start, as opposed to science education models that view the mind as a kind of “storage shed” where abstract knowledge may be secreted for vague potential uses.
Students immediately see the connections between scientific knowledge of nutrition and health, the legal definition of food deserts, and the use of technology to identify needs in society (e.g., using Google Maps to both identify food deserts and solutions for people with limited access to healthful food).
- SENCER locates the responsibilities (the burdens and the pleasures) of discovery as the work of the student.
In this activity the students research every angle on the problem of food availability: identifying the various zip codes, investigating all of the possible retail outlets where food can be purchased, identifying transportation routes, determining the cost of food in various locations, and evaluating the nutrient density of the available food. The work of discovery is designed to lead to creative solutions to the civic problems of limited access to food and health care.
The College Board’s Enduring Understandings That Connect Most Closely
The Enduring Understandings in biology and environmental science that arise depend on the larger context in which this activity rests. These may include:
Big Idea 2: Biological systems utilize free energy and molecular building blocks to grow, to reproduce and to maintain dynamic homeostasis.
Calories are the connection between basic science and human hunger; energy is required in the form of food calories for people to survive.
Enduring Understanding 2.A: Growth, reproduction, and maintenance of the organization of living systems require free energy and matter.
In humans, energy is required in the form of kilocalories, and non-caloric matter is required in the form of vitamins and minerals; these are obtained from food.
Enduring Understanding 2.D: Growth and dynamic homeostasis of a biological system are influenced by changes in the system’s environment.
The type and amount of food consumed influences growth and homeostasis within the body with regard to inadequate or excessive intake of calories, protein, vitamins, and minerals. The intake of required nutrients is directly affected by what is available and affordable.
Big Idea 4: Living systems store, retrieve, transmit and respond to information essential to life processes.
The body as a living system stores information regarding energy needs and transmits information in the form of hunger and fullness signals, deficiency disease symptoms, or chronic disease symptoms.
Enduring Understanding 4.A: Interactions within biological systems lead to complex properties.
Obesity is a particularly complex example of interactions within biological symptoms, resulting from genetic code, personal habits, food availability and affordability, food preferences, exercise habits, and personal relationships, among others.
Enduring Understanding 4.C: Naturally occurring diversity among and between components within biological systems affects interactions with the environment.
Different people respond differently to foods, especially with regard to food allergies and sensitivities, functionality of body organs, and consumption of non-food substances (such as medications) that may affect food preferences or food safety.
What we eat is influenced by our environment, and also has an impact on the environment; we are interdependent.
Enduring Understanding 3.B: Living things are composed of, and hence require, the elements and compounds that make up their biological components.
The human body is made up of carbohydrates, proteins, fats, vitamins, minerals, and water; while the body can make some of those nutrients, all of them are required in the diet in some quantity in order to maintain health; thus, we must eat a variety of nutrient-rich foods in order to provide what is needed.
Enduring Understanding 5.B: Humans engineer systems in order to (1) maximize outcomes to meet societal needs, (2) moderate system extremes, and (3) control or change interactions. Engineered systems, as all systems, have many interactions with the rest of the environment.
Modern food systems are capable of production of mass quantities of inexpensive food. However, that food may be overabundant in calories and fat while lacking in essential vitamins and minerals necessary for good health. Science can help us engineer food production systems that are capable of feeding the world, but they must also feed the world in a healthful way. The interaction of humans and the environment in this way has the potential to be either helpful or harmful, and the individuals in society serve as agents of change for good or ill.
The Advocate: Lexicon of Food. “Lexicon of Sustainability: Definition of Food Swamp.” Online at https://www.lexiconoffood.com/definition/definition-food-swamp
Centers for Disease Control and Prevention: Impact of the Built Environment on Health. Online at http://www.cdc.gov/nceh/publications/factsheets/ImpactoftheBuiltEnvironmentonHealth.pdf.
Centers for Disease Control and Prevention: “Social Determinants of Health: Know What Affects Health”. http://www.cdc.gov/socialdeterminants/.
United States Department of Agriculture: Food Access Research Atlas. Online at http://www.ers.usda.gov/datafiles/Food_Access_Research_Atlas/Download_the_Data/Archived_Version/archived_documentation.pdf.
The following resources from the KQED QUEST project (http://science.kqed.org/quest/) relate to this assignment:
Federis, Marnette. 2013. “Want To Get People to Eat More Fresh Produce? Give Them A Little Money.” http://blogs.kqed.org/stateofhealth/2013/05/31/in-san-diego-matching-funds-help-people-eat-more-fruits-and-vegetables/
Miezkowsi, Katharine. 2013. “Open-Campus Policies Eat Away at School Nutrition.” http://blogs.kqed.org/stateofhealth/2013/05/09/eating-away-at-school-nutrition/
Other resources on food deserts around the country include:
Desautels, Theresa. 2010. “Hungry for Health: A Journey Through Cleveland’s Food Desert.”. http://www.neofoodweb.org/video/hungry-health-journey-through-clevelands-food-desert.
Shute, Nancy. 2013. “How to Find a Food Desert Near You.” National Public Radio. http://www.npr.org/blogs/thesalt/2013/03/13/174112591/how-to-find-a-food-desert-near-you.
U.S. Department of Agriculture. 2013. “Food Access Research Atlas.” Washington, DC. http://www.ers.usda.gov/data-products/food-access-research-atlas.aspx#.UkF0yWRgZQp.
Wehunt, Jennifer. 2009. “The Food Desert.” Chicago Magazine. http://www.chicagomag.com/Chicago-Magazine/July-2009/The-Food-Desert/
Wellman, Eric. 2010. “Inside a Food Desert.” Ideastream. http://www.ideastream.org/news/feature/inside_a_food_desert.