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The Goodman Institute Health Blog

Drain the Food Swamp!

Posted on February 5, 2023 by Devon Herrick

Do you live in a food swamp? I’ve read that food swamps are dangerous places to live. I had never heard of food swamps before reading about them. I’ve heard of food deserts. These are supposedly inner-city metropolitan areas where there are few grocery stores that sell fresh vegetables and healthy foods. I thought if your primary food choices were McDonalds, Texaco and Dollar General you lived in food desert, but that’s not necessarily true.

A food swamp is a new term that describes geographic areas that have an oversupply of fast-food establishments and convenience stores selling prepackaged foods. A food swamp doesn’t necessarily have to be devoid of full-service grocery stores. Let the writer explain the difference.

A number of studies have looked at the health consequences of living in a so-called food desert — areas with few grocery stores or other options for buying fresh food.

Food swamps are different: The term was coined to describe communities where fast food restaurants, convenience stores and other junk-food purveyors heavily outweigh healthier options like grocery stores and farmers’ markets.

Does living in a so-called food swamp cause bad health or do some unhealthy people gravitate to swampy food?

The new study looked at whether Americans’ stroke risk varies based on how far their county of residence veers into food swamp territory.

It turned out it did: Among nearly 18,000 adults age 50 and older, those living in U.S. counties high on the food swamp scale had a 13% higher risk of suffering a stroke, compared to those in areas with more healthy options.

According to the lead researcher many factors affect stroke risk, so it is difficult to tease out the effect of food swamps from other variables. According to Dr. Dixon Yang:

In fact, he said, the food swamp issue is intertwined with other factors in those communities. People living there may have lower incomes, little time or places for exercise, or less access to health care, for example.

Yet, the researchers fall back on the idea that geographic areas and their shopping choices are to blame for bad health.

But food swamps themselves can be a barrier to people living healthy lives.

“The results of this study are not surprising to me at all,” said Dr. Anne Thorndike, immediate past chairwoman of the American Heart Association’s Nutrition Committee.

Thorndike, who was not involved in the study, said that the foods typically available in food swamp areas — often heavy in salt, sugar and unhealthy fats — are the types that contribute to obesity, high blood pressure and diabetes. Those conditions are major risk factors for stroke.

Thorndike goes on to say that highly processed, convenience store foods are often cheap and convenient. Busy, low-income people value convenience and cost. In the study people in food swamps were only slightly more prone to have a stroke than those who lived in areas with more full-service grocers, however.

Over six years, just under 4% of study participants suffered a stroke. The risk was 13% higher in food swamp areas.

If convenience stores saw a market for fresh produce, they would probably stock it. Let’s not forget that dollar stores often sell canned and frozen vegetables that are just as good for you as fresh. Thus, food swamp residents have access to fruits and vegetables. They aren’t forced to eat canned Vienna sausages, microwaved pigs in a blanket and those hotdog wieners that have been drying out on 7-Eleven’s rotisserie for hours.

There is so much wrong with this study’s premise that it’s hard to know where to begin. With so many confounding variables and intervening variables, a 13% difference is hard to pin on anything. Health is highly correlated with wealth and education. Lower-income people are more likely to suffer from chronic conditions that can lead to stroke. In terms of food swamps, it’s a chicken and egg type problem. Which came first, are food swamps the cause of diabetes and obesity? Or does consumer demand result in food swamps? You could build a Krogers in every food swamp and food desert and the health outcomes are unlikely to change.

Full-service grocers tend to avoid areas where they have a hard time earning a profit, whether that be customers on a tight budget, lower sales compared to similar stores or higher rates of shoplifting and shrinkage.

That got me to thinking: I wonder how many food geographies there are? Is a food prairie an area with too much red meat and potatoes? Is a food ocean a geographic area that’s too high in seafood, and the mercury that accompanies it? How about food forests? Are those areas where diets are too high in nuts, berries, slugs and pinecones? Let me know in the comments if you think there are some food diet areas that I have missed.

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For many years, our health care blog was the only free enterprise health policy blog on the internet. Then, when the NCPA closed its doors, the health blog stopped as well.

During this five-year hiatus no one else has come forward to claim the space. So, my colleagues and I have decided to restart the blog in connection with the Goodman Institute. We invite you and others to use this forum to share your views.

John C. Goodman,

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