Friday, November 11, 2011

A Desert within a Desert: NYC’s Green Cart Program Fails to Reach Neediest Areas (Brooke Hixson)

NYC’s Green Cart program, designed to increase the availability of fresh produce in disadvantaged neighborhoods, has not been successful in reaching those the most in need. Researchers at Montefiore Medical Center, a Bronx hospital, investigated the Green Cart program, looking at how well the carts were fulfilling their intended purpose of selling fresh produce in areas where fruits and vegetables were otherwise unavailable. They found the carts were unevenly distributed around the Bronx with clusters of carts in some areas and no carts in others.

A woman buys produce at a Bronx Green Cart
The Green Cart program began in 2008 when the NYC City Council approved a measure allowing mobile food carts selling fresh produce to operate in areas with traditionally low consumption of fresh fruits and vegetables (often caused by a lack of supply in local stores). Neighborhoods where fresh produce and other healthy foods are difficult to find are often referred to as “food deserts.” Green Carts were touted by anti-hunger and child-advocacy groups as one solution to food deserts in poorer areas of NYC.

While the NYC Department of Health backed the Green Cart program and administers the permits, they also acknowledged that it was not a comprehensive solution to community health issues such as obesity and diabetes. Dr. Thomas Frieden, then city health commissioner and current CDC Director, expressed measured support, saying, "This is not going to end the obesity epidemic, but it is an important step to increase access to healthy food in the communities that need it most."

Despite fierce opposition from local bodega owners, support from the NYC DOH and a $1.5 million grant to provide microloans to cart vendors has resulted in Green Carts appearing across all five boroughs. However, the Green Carts must follow specific guidelines on where they can sell (only in food deserts determined by the NYC DOH) and what they can sell (only raw unprocessed fruits and vegetables – no peeling, chopping, etc.). Since the program's implementation in 2008, public reaction has been generally positive with some carts operating 24 hours/day, 7 days/week to meet demand.

Researchers looking at Green Carts in the Bronx, however, found the Green Carts tended to cluster in "hotspots" around hospitals, schools, subway stops, libraries, and the Bronx Zoo. As a result, some of the neighborhoods in the greatest need of fresh produce still did not have local access. Thus, even within an area generalized as a food desert, some areas are “drier” than others. Researchers also found a few carts operating outside the legal zone in areas that are not considered food deserts.


Maps of Green Cart Locations in the Bronx


Most disturbingly, researchers found about 10% of the carts were selling sugary drinks and cookies, defeating the entire purpose of the carts. Although selling anything other than fresh produce is expressly forbidden (and results in a $550 fine), there appears to be little oversight on the street.

During this time of skyrocketing obesity and diabetes rates, any effective intervention that reduces the risk of these diseases is important to invest in and to implement correctly. If NYC can work out the kinks in their Green Cart program and get its most at-risk residents to eat more fresh produce, the program is likely to expand to other metropolitan areas across the country. Government officials need to provider stricter oversight of current Green Carts’ inventory. Program coordinators should work with community groups to create local demand in Green Carts deserts and to enlist local residents to become vendors. Green Carts should also be designed to accommodate electronic benefit transfers (i.e., food stamps). Finally, public health officials must continue to work with established community businesses (such as bodegas) to encourage them to supply their communities with affordable fresh produce rather than relying on Green Carts alone to provide much needed nutrition in food deserts.


Brooke Hixson has worked in various aspects public health for almost 10 years. She is currently a doctoral student in Biostatistics at Emory University studying spatial analysis. She enjoys both fresh produce and NYC.


Source: Lucan SC, Maroko A, Shanker R, Jordan WB. Green Carts (Mobile Produce Vendors) in the Bronx-Optimally Positioned to Meet Neighborhood Fruit-and-Vegetable Needs? Urban Health 2011 Oct;88(5):977-81.

6 comments:

  1. This comment has been removed by the author.

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  2. Cassandra said...

    Hi,

    This was an interesting post. It was very well-written. I liked how you incorporated the quote from the expert into your text. Also, I liked how you linked to different websites within the text. A few small comments:

    1) Maybe define DOH (Department of Health), because people that aren't in the public health arena may not know this abbreviation.

    2) I liked your map image, but maybe a sentence or two of explanation would be good (for those not familiar with GPS maps).

    3) I know you linked to this, but maybe a sentence on why bodega owners were so fiercely opposed to the green carts would be interesting.

    4) How do you think the following - "Program coordinators should work with community groups to create local demand in Green Carts deserts"- would be done? It seems like the clustering of food carts in hotspots is simply following the simple laws of supply and demand (e.g. there is high demand in highly trafficked areas), and food cart owners have no incentive to go to areas where people don't want to buy fresh food...

    -Cassie G.

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  3. Very interesting topic! Why do you think the clustering exists? It would be very interesting to do some in depth exploration of why that is. How would you go about figuring that out?

    Reminds me of bus transportation in Chicago. There are three buses that come within a 45 minute period. Unfortunately it is often three buses coming at the same time, rather than spread out every 15 minutes. Do the bus drivers/cart owners just like to hang out together?

    I really liked your links! That did a nice job of connecting the research with the real life program. : )

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  4. Brooke,

    This is a very interesting solution to a problem that I didn't even know existed. You did a great job of explaining what a "food desert" is and what kind of problems it poses for residents. Also, wonderful links!

    It's quite possible that I am dense and missed it, but where is your ethical concern about these carts/the NYC Green Cart Program? Is there an ethical concern with the Green Cart program?

    Otherwise, this was a very well written and easily understandable blog. One thing to include is in the third paragraph when you say "NYC Department of Health," add "(DOH)" so that when you refer to it as DOH later it is more clear what DOH means. Some people might not pick up on that if they aren't familiar with the acronym.

    These are some questions that came to mind as I read your blog. It would be interesting if you could add a couple sentences in your blog addressing them, but I realize it's not possible to talk about everything.

    What do you think the program coordinators can do to try to solve the problem of deserts within deserts? Do you think subsidies might help cart owners in less trafficked areas survive, so that carts will open up in the areas that still do not have access to fresh foods?

    Are there any measures being taken to encourage residents to buy fresh produce instead of continuing to shop at bodegas that don't sell healthy foods? A program that encourages better eating choices might help fight obesity and diabetes, which could team up with the Green Cart program.

    -Kylie

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  5. Brooke -

    Fascinating post! I did not know anything about this effort in NYC.

    As I was reading your description of the carts clustering in hotspots and even selling sugary snacks, I couldn't help but wonder if the cart vendors aren't just trying to stay in business? Going where the demand is? Selling what's affordable (which may not be the produce)?

    Certainly, we in public health want to do everything we can to make healthy foods available - but what can we do if people are not interested in buying them? Or even if they are interested, cannot afford them?

    It seems like two pieces to add to this program might be:
    (1) a community-based education component to help people understand the value of the produce versus alternatives that their bodies might be used to (or even crave).
    (2) some state and community-based pressure to restructure the farm subsidies that make junk food so much cheaper than fresh produce; or, alternatively, to subsidize the produce in a consistent way so vendors do not have to worry about losing money while they are trying to work to pay back their micro-loans.

    Interesting case study to use for aligning local, state, and national public health objectives!

    -Gillian

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