What's Preventing Americans From Choosing Healthier Food?

Public Domain. MaxPixel

Some researchers dispute the notion of a food desert, suggesting that it comes down to 'food culture.'

When a recent study revealed that residents of Musselshell County, in south-central Montana, buy the least healthy groceries of anywhere in the United States, it sparked the usual debate about what prevents people from following a nutritious diet.

Do they live in a food desert, where it is difficult to find fresh ingredients? Or do they inhabit a 'food mirage', where fresh fruits and vegetables are available, but cost more than low-income households can afford? (This is an unfortunate consequence of "hipster food towns," as Mother Jones once called them.)

Another possibility is that some American households simply are not interested in eating healthy food. This is the conclusion of a new working paper from the National Bureau of Economic Research, quoted here from the Washington Post:

"[Researchers] analyzed what happened to a household’s food purchases when a new, full-service grocery store opened in the neighborhood, or when the household moved from 'food deserts' to areas with more abundant grocery options. But even major changes in a household’s immediate food environment, the paper found, had a limited impact on the foods that people purchased."

This has led the paper's authors to conclude:

"We reject that neighborhood environments have meaningful effects on healthy eating. Using a structural demand model, we find that exposing low-income households to the same availability and prices experienced by high-income households reduces nutritional inequality by only 9%, while the remaining 91% is driven by differences in demand. These findings contrast with discussions of nutritional inequality that emphasize supply-side factors such as food deserts."

The Washington Post uses the term 'food culture' to describe this phenomenon. Certain households, such as those in Musselshell County, adhere to a food culture that has a big effect on their food preferences. As baffling as it may seem, their grocery decisions are not affected by improved access to fresh foods or more affordable prices because they're comfortable within their food culture.

Another study that looked at how low-income households spend additional cash when they do have it backs this finding, stating that there's more to the problem than lack of access:

"The study doesn’t rule out access as a problem that prevents people from buying healthier food, but the numbers also raise the possibility that food deserts are at least partly an effect of poor diet rather than a cause — that stores don’t stock what people won’t buy."

This should not be surprising. Food preferences are shaped from childhood. We grow up liking what we're fed from a young age and disliking what's unknown. There is a practical side to this, too. We learn to cook by watching our parents, and if they never use certain ingredients, we don't think to use them either.

The NBER working paper's lead author Hunt Alcott agrees in the Post:

“We know that your early life experiences play a large role in how you eat. That suggests there’s a possible intergenerational transmission of [regional food] preferences."

I was raised by a mother who cooked Greek and Indian food on a regular basis, so I became familiar with ingredients that were foreign to many of my childhood friends. Even to this day, I'm frequently asked by cashiers how to use something as seemingly ordinary as cilantro, fennel, phyllo pastry, or ginger. It's always surprising that these foods I consider normal in 2018 are still strange to many.

While improving access to fresh, nutritious food must remain a priority for every county across the United States, I think cooking classes should go hand-in-hand with this. If health care providers, teachers, legislators, and insurance companies want to see a significant uptick in Americans' health -- and it is in everyone's best interest to work toward this -- then low-income individuals must be taught how to prepare food from scratch. In doing so, they'll learn how to take advantage of the many ingredients available to them. Without those practical tools, it's unrealistic to expect households to wean themselves off a heavily-processed diet.