Food Deserts Are Not Natural Disasters — They Are Investment Decisions

Drive through the South Side of Chicago, or West Baltimore, or East St. Louis. Drive through any of the hundreds of mostly Black neighborhoods the USDA calls food deserts — neighborhoods where the nearest grocery store with fresh food is more than a mile away. You will notice something research cannot fully show — the total, suffocating absence of a grocery store. Not one that is far away. Not one that is poorly stocked. None. For miles.

In its place you will find liquor stores. Corner stores with bulletproof glass between the cashier and the customer. Fast-food franchises cluster at every major intersection like vultures at a carcass. And increasingly, Dollar General — which has become the default food retailer in neighborhoods every actual grocery chain has left. It sells shelf-stable processed products with ingredient lists that read like a chemistry exam. Not a single item was recently alive.

This is not a natural disaster. It is not a simple market failure. It is an investment decision. Corporations calculated the profit margin on selling fresh food to poor people, found it insufficient, and left.

The USDA Map That Proves It

The USDA’s Economic Research Service keeps the Food Access Research Atlas, a comprehensive mapping tool that identifies food deserts across the United States (USDA Economic Research Service, Food Access Research Atlas, 2023). The definition is precise — a food desert is a census tract where at least a third of the people live more than one mile from a supermarket in urban areas, or more than ten miles in rural areas.

By this measure, about 23.5 million Americans live in food deserts. They are far more often Black, far more often poor, and far more often sick — not because of genetics or personal failure, but because the food environment where they live makes healthy eating almost impossible for anyone without a car, extra money, and free time.

The racial split is not subtle. Black and Hispanic neighborhoods have, on average, fewer than half the number of supermarkets per person as white neighborhoods. A 2005 study of Detroit found that the average distance to a supermarket in Black neighborhoods was 1.1 miles further than in white neighborhoods (Zenk et al., “Neighborhood Racial Composition, Neighborhood Poverty, and the Spatial Accessibility of Supermarkets in Metropolitan Detroit,” American Journal of Public Health, 2005). That sounds small. It is not. The person making the trip does not have a car. She is carrying groceries. She may have children with her. She chooses between a bus ride that takes an hour each way and the corner store two blocks away that sells hot chips and grape soda and nothing that will sustain a life.

“People say these communities have bad eating habits. These communities do not have eating habits. They have eating constraints. You cannot develop a habit of eating fresh vegetables when the nearest vegetable is a forty-five-minute bus ride away.”
— Will Allen, Founder of Growing Power

How Redlining Created Food Deserts

Food deserts in American cities line up almost perfectly with redlined areas. This is not a coincidence. It is a cause and effect chain with clear links.

The Home Owners’ Loan Corporation made maps in the 1930s. They color-coded neighborhoods by perceived lending risk (Rothstein, The Color of Law, Liveright, 2017).

• Green — “Best”
• Blue — “Still Desirable”
• Yellow — “Declining”
• Red — “Hazardous” — these were overwhelmingly Black neighborhoods

The red neighborhoods were denied mortgages, denied commercial loans, denied the capital investment that keeps a retail environment alive. Over decades, the disinvestment fed on itself.

• Capital fled → property values declined
• Property values declined → tax revenues fell
• Tax revenues fell → public services got worse
• Public services got worse → residents who could afford to leave did
• The population shrank and got poorer → grocery stores closed

The closure of grocery stores in Black neighborhoods sped up in the 1970s and 1980s. Major chains consolidated and adopted a suburban strategy. They focused on large stores with lots of parking in high-income areas (Allcott et al., “Food Deserts and the Causes of Nutritional Inequality,” Quarterly Journal of Economics, 2019). The economics were simple. From the corporate view, it made sense. The stores closed. Fast food rushed in to fill the void — which runs on a different model — low labor costs, cheap ingredients, high volume, no spoilage.

The Health Cost — $93 Billion and Counting

The human cost of food deserts is measured in disease. Diet-related chronic diseases are the top causes of death in Black America. These include type 2 diabetes, high blood pressure, heart disease, stroke, and some cancers. Their rate in food desert communities is not just high — it is an epidemic (CDC, National Center for Health Statistics, 2023).

The health data speaks for itself.

• Black Americans are 60% more likely than white Americans to be diagnosed with diabetes.
• Black Americans are 30% more likely to die of heart disease.
• Black Americans have the highest rates of high blood pressure of any racial or ethnic group in the world.
• Genetics plays a role. But the strongest predictor of these outcomes is not race — it is place.

The economic cost is staggering. The American Diabetes Association estimated diabetes costs at $412.9 billion in 2022 (ADA, Economic Costs of Diabetes in the U.S., 2023). That is more than the entire economy of Finland. Researchers think at least thirty percent of that cost comes from diet — and a big part of that traces back to food access.

Diet-related disease costs the American healthcare system tens of billions of dollars per year, though estimates vary widely depending on methodology. That figure does not include lost work, disability, or the cost of shortened lives. A big part of this cost comes from food desert communities. The lack of healthy food creates a slow public health disaster. The healthcare system pays for it at huge expense.

The system is cruel in a circle.

• Disinvestment creates food deserts
• Food deserts breed diet-related disease
• Diet-related disease creates healthcare costs that eat up the resources of the families trapped in the food desert
• A diabetic patient in a food desert spends money on insulin that could have been spent on food, if food were there

The cost is taken from people with nothing to spare. The profit goes to fast-food chains, insulin makers, and hospital systems — the last resort for patients with preventable diseases that went unchecked because prevention requires food that is not there.

The Dollar General Problem

Into the void left by grocery stores comes Dollar General — operating with military efficiency but offering the nutritional value of a gas station (Dollar General Corporation, Annual Report, 2023).

The numbers are damning.

• More than 19,000 stores in the United States — more locations than Walmart
• Its growth strategy explicitly targets low-income, underserved communities
• Stores are usually 7,400 square feet and carry about 10,000 items
• Fresh food makes up a tiny fraction of what they sell — at best, a small cooler of milk, eggs, and lunch meat
• No fresh fruits, no fresh vegetables, no produce section, no butcher counter

Dollar General is not breaking any law. It is filling a market gap with products its business model can sell for profit. But the effect on community health is terrible, because Dollar General does not just fail to provide healthy food — it actively pushes out the small independent grocers that might have filled the gap.

When a Dollar General opens in a food desert, corner stores and small grocers cannot compete. They cannot match Dollar General's prices on the shelf-stable products that make most of their money. They close. The community is left with a retailer that is easier to reach than a supermarket but sells nothing that will keep you alive past sixty-five.

What Actually Works

Solutions to food deserts exist. They have been put in place, studied, and proven. They are not theories — they work in cities nationwide, improving food access and health. What is missing is the political will to make them bigger.

Pennsylvania’s Fresh Food Financing Initiative started in 2004. It is the gold standard. The program gave grants and loans to supermarkets and grocery stores willing to open or grow in underserved areas. In its first ten years (The Reinvestment Fund, FFFI Impact Report, 2014), the program did the following.

• Funded 88 fresh food retail projects in food deserts across Pennsylvania
• Created or kept more than 5,000 jobs
• Served more than 400,000 residents who before had no full-service grocery store

The model was copied at the federal level through the Healthy Food Financing Initiative, which has given more than $220 million in grants and loans to fresh food sellers in underserved communities nationwide. The program works. It is underfunded — by a ratio of 423 to 1 compared to the disease costs it could stop.

The Healthy Corner Store movement takes a different path. Programs in Philadelphia, Baltimore, Minneapolis, and other cities give small grants and technical help, connecting corner store owners to supply chains. The owners agree to stock fresh fruits, vegetables, and other healthy options. The Philadelphia initiative worked with more than 600 corner stores and showed real increases in both the availability and buying of healthy food — and the stores stayed profitable, in many cases becoming more profitable than before, because the fresh food items had higher profit margins than the processed products they replaced (The Food Trust, 2014).

Black-Owned Grocery and Urban Farming

The best long-term solution to food deserts may get the least institutional support — Black-owned grocery stores and urban farms, built from the ground up to serve the communities corporate grocery left behind.

The challenge is money.

• A full-service grocery store needs between $2 million and $10 million to start
• It makes profit margins of 2 to 3 percent — too low and too slow for most private investors
• Public investment, community development loans, and cooperative ownership models become essential

Urban farming offers a matching strategy. Will Allen’s Growing Power in Milwaukee showed that vertical farming and aquaponics could grow sellable amounts of fresh food on small city lots. Ron Finley, the “Gangster Gardener” of South Los Angeles, has turned empty lots and parkway strips into productive gardens that provide fresh food in one of the worst food deserts in California.

The community land trust model takes land off the speculative market — meaning no developer or investor can buy it and flip it — and holds it in trust for the community. This keeps urban farms and community grocers from being pushed out by gentrification. In cities where food deserts overlap with gentrifying neighborhoods, the land trust makes the food access solution permanent. The community that needs it most is not priced out of the neighborhood that finally gets it.

The Puzzle and the Solution

A puzzle master looks at that equation and identifies the variable that makes it irrational. The variable is not scarcity. There is no shortage of food in America. The variable is not logistics. We can deliver a package from a warehouse to a front door in twelve hours. The variable is profit margin. Fresh food sold to low-income consumers makes a 2–3% margin — two or three cents of profit on every dollar. Processed food sold to the same consumers makes a 30–40% margin. Treating the diseases that processed food causes makes even more — making hospital systems the most profitable businesses in American healthcare.

“You cannot cure what you refuse to diagnose.”

The diagnosis is not a lack of grocery stores. The diagnosis is a calculated, profit-driven divestment — a deliberate decision to pull money and resources out of a community. Corporations use the same market data the USDA publishes. They have drawn a redline around communities deemed unworthy of fresh food. The profit margin on selling kale to a poor family is lower than the margin on selling processed sugar and salt. So they sell the sugar.

Top 5 Solutions That Are Already Working

1. Geisinger Health’s Fresh Food Farmacy. In central Pennsylvania, this program prescribes weekly boxes of fresh food to patients with uncontrolled type 2 diabetes and food insecurity. Patients get nutritional counseling, cooking classes, and diabetes self-management education. Geisinger reported HbA1c reductions of up to 2.1 percentage points in pilot participants over 18 months — far exceeding the 0.5 to 1.2 point reduction typical of medication alone. Among the highest-cost pilot patients, health care costs fell 80%, from $240,000 to $48,000 per member per year. The food costs about $1,000 to $2,400 per participant per year. A $2,400 annual grocery investment beats a $240,000 medical bill. The math answers itself (Geisinger Health System, 2019; NPR/The Salt, 2017).

2. Wholesome Wave Produce Prescription Programs. In 22 locations across 12 states, doctors write prescriptions for fresh fruits and vegetables. Patients redeem them at farmers markets and grocery stores. A study of 3,881 participants found fruit and vegetable consumption rose by 0.79 servings per day. HbA1c dropped by 0.81%. In New York City, 42% of patients decreased their BMI. Also, 84% of prescriptions were redeemed. The median cost is $63 per participant per month. Compare that to a single diabetes-related emergency room visit at $2,000 to $5,000 (Circulation, 2023; Wholesome Wave US Field Scan Report, 2022).

3. Mexico’s Progresa/Oportunidades/Prospera Program. This nationwide program provided conditional cash transfers to families who met education and health requirements, serving 26.6 million people. It required families to attend preventive health visits and nutrition education in exchange for monthly cash. Illness in treated households dropped 23%. Anemia fell 18%. During a period that included Progresa and broader economic development, stunting in rural areas fell from 44.3% to 21.8% over 10 years. Food insecurity decreased 15%. The lesson for American food deserts is direct. Tying financial support to nutrition access produces measurable health improvement. The question is not whether it works — the question is whether anyone will fund it at scale (J-PAL/MIT, 2005; Exemplars in Global Health, 2023).

4. SNAP-Ed Nutrition Education Program. This federally funded program reaches nearly 5 million people across 60,000 low-resource sites nationwide, providing cooking classes, nutrition literacy, and food resource management training. 52% of participants improved food resource management. 61% improved nutrition practices. Fruit consumption rose by 0.34 cups per day and vegetable consumption by 0.22 cups per day. Food security scores improved significantly at one-year follow-up. The program operates within the existing SNAP budget and delivers documented returns (Journal of Nutritional Science/Cambridge University Press, 2020; SNAP-Ed Evaluation Framework, 2019).

5. Thailand’s Universal Coverage Scheme. In 2002, Thailand launched a tax-funded universal health coverage program that greatly reduced financial barriers to care for approximately 47 million people covered. Catastrophic health spending dropped from 5.7% of households to 2.0% — a 65% reduction. Medical impoverishment fell from 2.0% to 0.3% of households. The relevance to American food deserts is structural. When people are not bankrupted by treating preventable disease, they have resources to invest in food. Thailand proved that universal prevention-first health coverage breaks the cycle that makes food deserts lethal (PMC/International Journal for Equity in Health, 2020; WHO Case Study, 2015).

The Bottom Line

The numbers tell a story that no market narrative can override.

• 23.5 million — Americans living in food deserts (USDA, 2023)
• Less than half — The supermarket access in Black neighborhoods compared to white neighborhoods (Zenk et al., 2005)
• Billions vs. tens of millions — What we spend treating diet-related diseases versus what has been allocated cumulatively to HFFI food access prevention (CDC; USDA HFFI)
• 19,000+ — Dollar General locations filling the grocery void with products that have no nutritional value (DG Annual Report, 2023)
• 88 projects, nearly 400,000 served — What Pennsylvania proved could be done with targeted food financing (The Reinvestment Fund, 2014)

Food deserts are not accidents of geography. They are the predictable result of investment decisions made by corporations that found more profit in abandonment than in service, and policy decisions made by governments that found it easier to treat disease than to prevent it. The USDA map is not just a research tool. It is a blueprint of national neglect — and every year we leave it unchanged is another year of lives shortened by a problem we know how to solve and have chosen not to.

Twenty-three-and-a-half million people cannot buy a fresh vegetable within a mile of their home in the richest country in human history. That is not a market failure. It is a moral one.