The term “food desert” has been mentioned widely. Many have questioned whether living in a food desert contributes to obesity because of the preponderance of fast foods and convenience stores and the dearth of healthy options, including grocery stores selling fresh fruits and vegetables.
To tackle the food desert problem in one South Memphis neighborhood, Aligning Forces for Quality grantee Healthy Memphis Common Table supported the efforts of the South Memphis community partners to fill a void in a nutritional wasteland by bringing in a farmers market, an approach being tested by many urban communities across the United States. The short-term goal focused on increasing a community’s access to healthier food choices. The long-term hope is that by having greater ease to purchase affordable fresh fruits and vegetables, individuals can reduce their risks for obesity and related health conditions.
A Public Health Epidemic
Obesity is one of the top public health threats in the United States and a high priority for the Robert Wood Johnson Foundation, which initiated Aligning Forces. According to the Centers for Disease Control and Prevention (CDC), 35.7 percent, or about 78 million Americans, are clinically obese—meaning their body mass index, a calculation based on height and weight, is 30 or higher. Tennessee has the 15th-highest obesity rate in the nation at 29.2 percent. Moreover, obesity is strongly associated with lowincome status and increases the risk for other debilitating chronic conditions, including diabetes, hypertension, stroke, heart disease, and even certain types of cancer. Combating obesity on many fronts can result in many benefits, including improving a population’s overall health, reducing the risks for several types of chronic illnesses, and reducing health care expenses. The medical care costs for obesity are about $147 billion in 2008 dollars, according to the CDC.
How can farmers markets help fight obesity? The thinking is that providing farm-fresh fruits and vegetables to low-income communities often overrun by convenience stores stocked with processed, packaged foods will give these residents access to healthier options. Healthy Memphis Common Table, a regional healthcare improvement collaborative serving the greater Memphis area, and the University of Memphis were members of the committee organized to assist The Works, a community development corporation founded by St. Andrews AME church that supports residents in South Memphis in establishing the farmers market. Memphis is an area in dire need of intervention: In 2010 the Food Research and Action Center, a national nonprofit in Washington, DC, that studies under-nutrition, ranked Memphis the “hunger capital of the United States” and first in food hardship had difficulty obtaining healthy foods between 2008 and 2009.
“Health isn’t at the top of the agenda for low-income areas,” said Renee’ S. Frazier, chief executive officer of Healthy Memphis Common Table. “These folks have other pressing needs. The foods at convenience stores are cheap but loaded with sugar, salt, and fat. Finding affordable, fresh produce in South Memphis requires multiple bus stops, lugging groceries several blocks. Supporting those who could bring in a farmers market aligns with the Robert Wood Johnson Foundations’ goals of promoting equity and empowerment. A farmers market provides people in struggling communities the opportunity to make healthier choices.”
How Farm Fresh Can Make a Difference
The new South Memphis Farmers Market is on Mississippi Boulevard and South Parkway in South Memphis and opened in July 2010. It’s open from April to the end of October, every Thursday from noon to 6 p.m., and attracts about 350 shoppers during that period, said Curtis Thomas, deputy executive director for The Works, Inc. During the change in seasons, the number of farmers selling goods ranges from six to 10. The farmers accept USDA and Tennessee-provided food vouchers and food stamps. In fact, in 2009 the Healthy Memphis Common Table received a grant from the Assisi Foundation for a program called Lift Every Voice, which helped provide support for a double coupon program, allowing food supplemental program beneficiaries to double the amount of fruits and vegetables purchased at the market. A beneficiary could receive $10 of fresh produce for only $5.
“South Memphis is your classic distressed inner city community that’s seen several decades of disinvestment,” explained Thomas, who has worked in the area for 11 years. “That’s evident in the lack of grocery stores. Our community has a Kroger grocery store about 2.5 miles away and another Kroger 3.2 miles away in the other direction. Two and- a-half miles might not sound like a lot, but if you are coping with chronic conditions or are elderly and carrying groceries, getting on and off buses, it’s a burden. The farmer’s market brings some optimism about investing in the future.”
“What was great about this project is that it was entirely community-led,” said Frazier. “Residents had a say on where the market should be, who participates, all of that. It’s by the community, for the community, and the response has been very positive, which gives us hope that the market will be sustainable and lead to similar long-term venues that will further support South Memphis in providing access to healthy, fresh foods.”
The South Memphis Revitalization Plan, a resident-driven community revitalization facilitated by the University of Memphis Graduate Program in City and Regional Planning and the Department of Anthropology, identified the community’s desire and vision for a farmers market.
How access to the market will affect obesity and type 2 diabetes rates remains to be seen and will be a subject of future study. Nationally, public health officials are encouraging the development of farmers markets in urban areas to counter obesity rates, but whether access to these markets has directly resulted in greater fruit and vegetable consumption, and, as a result, weight loss or lower rates of obesity in a population, remains unknown. For example, a July 2011 study published in the American Journal of Preventive Medicine found that availability to farmers markets selling produce within one mile was associated with a lower risk of being overweight or obese among young girls. But much more research is needed to understand better how farmers markets are making a difference and where they are having the greatest impact. Thomas says they want to survey South Memphis residents about their fruit and vegetable intake from the market and partner with the University of Memphis to evaluate the health impact as well as identify populations the farmers market isn’t reaching.
There are also plans to do a year-round market in 2013, which would nearly double the market’s calendar. In the meantime, Frazier said there also is interest in bringing a grocery store into the community now being served by the farmers market. “Aligning Forces For Quality is about building community-level trust and engaging folks,” she said, “and funding from the Robert Wood Johnson Foundation allowed us to plant various community seeds of trust by having hands-on staff involvement in the planning of the farmers market. Now we can build on that trust, build on these relationships, and scale up.”
Despite the popularity of the farmers market, it took a lot of paperwork and effort to see the project through, with some surprises along the way. Both Frazier and Thomas remarked on developing a more savvy understanding of city, county, and state regulations when it comes to agricultural commerce. Memphis is unique in that “the local community is right across the Mississippi River and state line,” said Frazier. “Arkansas is part of the South Memphis local community, so any border state would need to pay attention to any ordinances. Sometimes the ordinances seem very outdated, and that was a challenge for us in bringing the farmers to South Memphis.”
Moreover, food vouchers don’t carry the same value state to state. “A South Memphis resident can use a Tennessee-issued Senior Farmers Market Nutrition Voucher with a Tennessee farmer but can’t use that food voucher with a farmer from Arkansas or Mississippi, which is confusing for shoppers when you’re a state border community like ours,”said Thomas.
Frazier said they have their work cut out for them in terms of navigating city, county, and state regulations. “We need to be sure,” she said, “that the local ordinances meet the evolving needs of the community. There’s so much potential, but we have to be sure we dot our i’s and cross our t’s.”