Introduction
According to the USDA’s Economic Research Service, around 13.5 million people in the United States live in food deserts. Lack of access to nutritious food has countless downstream impacts on people’s health, including diabetes, heart disease, and obesity. Per the CDC, one consequence of obesity is an increased risk for 13 types of cancer. An estimated 40% of all cancer diagnoses in the United States are related to obesity. With such staggering impacts, improving access to healthy foods is vital to reducing obesity and obesity related cancer rates.
Defining Food Deserts
A food desert is an area where a significant portion of the residents have limited access to healthy food. This is generally defined as living more than one mile away from a supermarket, especially without a car. People living in these areas are more likely to be low-income, with 20% of those living in food deserts living at or below the federal poverty line. Additionally, neighborhoods with limited access to healthy food are often predominantly made up of people of color. People living in food deserts often rely on fast food or convenience stores, which lack fresh, nutritious food options. A related term is a food swamp, which is a region where there is access to healthy food, but also increased exposure to fast food and other unhealthy foods.
Obesity in Food Deserts
In the United States, the prevalence of obesity is 41.9%, meaning that more than 100 million adults are considered obese. There are numerous factors that have led to such high obesity rates, including lack of access to healthy foods. A study in the Journal of Obesity examining unhealthy behaviors found a significant association between obesity rates and food deserts. People who lack access to healthy foods or cannot afford them often turn to fast food and other highly processed options. These foods are higher in calories and lower in nutrition, contributing to obesity.
Connection to Cancer
The International Agency for Research on Cancer has determined that obesity increases the risk for many types of cancer, including endometrial, esophageal, pancreatic and colorectal cancers. Further, those who are obese when diagnosed with cancer have a higher likelihood of developing a second type of cancer in the future. Some of the mechanisms that could contribute to this increased risk include fat tissue producing excess estrogen, higher likelihood of diabetes due to insulin resistance, chronic inflammation, and production of certain hormones by fat cells. Given that people residing in food deserts have higher rates of obesity, this means their risk of cancer is higher as well.
Not only are people living in food deserts more likely to develop cancer, they also face higher mortality rates even with the same treatment. A study from JAMA Oncology found a positive dose-response relationship between food deserts and obesity related cancer mortality. The researchers found 77% increased odds of having high obesity related cancer mortality in counties with high food swamp scores. Another study in Annals of Surgical Oncology examined the association between food deserts and mortality from breast and colorectal cancer. They found that those with breast cancer living in food deserts had a 2% lower survival rate and those with colorectal cancer had a 5% lower survival rate.
Improving Food Access
Combatting the high mortality caused by obesity related cancers starts with improving access to food. People need healthy food that is both affordable and accessible. Building more supermarkets in food deserts or creating community gardens can increase access so people are not reliant on convenience stores for grocery shopping. Improving public transportation or working to make more walkable cities can also make it easier for people to reach supermarkets even if they are far.
A study from the American Journal of Preventive Medicine found that while distance to store and price were both correlated with obesity, when modeled jointly, only price was significant. This indicates that building more supermarkets alone is not sufficient to address the issue of food deserts. While distance to grocery stores is certainly a factor, the researchers suggest that reducing the prices of healthy foods compared to unhealthy ones and promoting healthy foods in stores is more important. Fresh produce is often more expensive than ultra processed foods, making it difficult for those struggling to make ends meet to choose the healthier options.
For those who are at an increased risk for cancer, making preventive screening options more accessible could also be beneficial. The CDC recommends screenings for breast, cervical, colorectal, and lung cancers. People living in food deserts may also have lower access to healthcare due to cost or distance. Mobile screenings, annual doctor’s visits, and insurance-covered preventive care can all help lower these barriers. Cancer is often much more treatable when detected early, thus reducing the mortality rate.
Conclusion
Obesity rates in the United States are on the rise, drastically increasing people’s risk for many types of cancer as well as mortality rates from cancer. Lack of access to healthy foods for those living in food deserts is one major factor that can lead to obesity. Resolving the issue of food deserts requires increasing access to supermarkets, as well as ensuring that healthy foods are affordable.