Battling food deserts: Can new supermarkets and revamped corner stores curb obesity in cities?

This story is part of a Yahoo News' look at obesity in the United States.

In a busy shopping center in a once blighted neighborhood in North Philadelphia, The Fresh Grocer supermarket attracts an eclectic crowd of customers. On a recent snowy Friday afternoon, some were cruising the grocery store’s upscale sushi bar while others clutched coupons and scoured the store for deals.

Just three years ago, the spot where the gleaming supermarket now sits had been empty for a decade, leaving neighborhood residents without a local grocery store. A Pennsylvania state program aimed at eradicating “food deserts”—poor neighborhoods where residents have to journey more than a mile to find produce—doled out millions in tax breaks and grants to The Fresh Grocer supermarket chain and dozens of other stores to help them open in underserved areas.

Subsidizing supermarkets is one of many aggressive taxpayer-funded experiments policy makers have embraced as a way to battle the country’s high obesity rates. And while it may seem obvious that providing healthier food in neighborhoods helps residents eat better, research so far has been mixed, and no one has found a causal link between the availability of fresh food in neighborhoods and obesity.

First lady Michelle Obama visited North Philadelphia’s Fresh Grocer in 2010 soon after it opened to kick off her “Let’s Move” campaign, which has encouraged local governments to get fresh food into food deserts, among other initiatives. The Obama administration has said it wants to eradicate food deserts entirely by 2017, and the federal government has funded similar grocery initiatives with millions of dollars in several states, arguing that they help combat obesity by providing residents with healthier choices while also creating jobs in economically depressed neighborhoods.

A U.S. Department of Agriculture review of food deserts conducted in 2009 concluded that people who live in food deserts have unhealthier diets than those who don’t. But it’s still unclear whether introducing healthy food to those areas changes eating habits. That gap has led some to question the wisdom of pouring public funds into these initiatives.

The RAND Corporation’s Roland Sturm, one of the chief critics of the movement to subsidize supermarkets in low-income areas, says the problem in urban areas is too much food, not too little. Sturm’s research on childhood obesity rates has found that there’s no correlation between the number of supermarkets near children’s homes and their diet quality or body mass index.

“How about the food swamp idea?” Sturm asked. “People are swamped by food all the time. Don’t worry about fruit and vegetables--people can get it if they really want it. The problem is people are being bombarded by messages to eat.”

Whether fresh food is within walking distance is not necessarily the best measure of availability anyway, Sturm pointed out, since many people in urban areas use public transportation or drive to shop for groceries.

But at The Fresh Grocer, shoppers said they were happy to finally have a supermarket in their neighborhood.

Joyce Duncan, 60, was clutching a sheaf of coupons as she cruised the aisles in a motorized scooter, her home health aide walking briskly beside her. Duncan, who lives 10 blocks away from the store, says she shops there because it’s convenient, even though the prices are high for her taste.

“My part of the neighborhood is atrocious,” Duncan said. “They’ve knocked a lot of buildings down.” Without The Fresh Grocer, her options were mostly “fast food and Chinese food…some vegetables if I can find them.”

The Fresh Grocer CEO Pat Burns said that while the store is now profitable, it would have been a big risk to open a $15 million grocery store in the area without the public financing, since research suggested sales could be low.

“I think it’s been a tremendous boon for the neighborhood,” Burns said.

But data on food stamp usage suggests Philadelphia’s poor are already going outside their neighborhoods to shop.

The largest redeemer of food stamps in Philadelphia is downtown in the bustling and touristy Reading Terminal Market, which is far from any food desert. This backs up studies that show many people are motivated by price and quality of food over location when choosing a grocery store.

One such shopper is Grace Richard, 82, who emerged from the Reading market rolling a suitcase-like cart full of squash, onions, baby potatoes, garlic and other vegetables. She had ridden the bus for half an hour from her home in Allegheny West, a low-income neighborhood in North Philadelphia, to Reading because she thinks its produce is the best value.

“You get a pretty good buy here,” Richard said.

The grocery store initiative in Pennsylvania, which began in 2006, is funded by the state in partnership with a non-profit called The Food Trust. Philadelphia city officials have also been experimenting with cheaper and more creative ways to introduce produce into food deserts without having to coax someone into opening an entire grocery store.

Nearly a third of Philadelphians are obese, and a quarter of them live in poverty, ranking it the worst of the country’s largest metro areas on both measures.

The city has taken a number of steps—funded in part by federal stimulus dollars—to combat obesity, many of them aimed at reaching the estimated 300,000 Philadelphians who live in high poverty neighborhoods without access to fresh food retailers.

Philadelphia’s health department created a program two years ago called “Philly Food Bucks,” which gives food stamp users extra money to use at 33 greenmarkets around the city. For every $5 dollars they spend on fruits and vegetables there, they get $2 more to use in greenmarkets. Food stamp usage in greenmarkets has nearly doubled in just a few years, and the city has opened up new outdoor greenmarkets during the spring and summer in food desert areas.

The Rand Corporation’s Sturm approves of this initiative, saying subsidizing healthy food has a bigger effect on diet and behavior than placing healthy food within walking distance of people. That’s his conclusion in an upcoming study examining the effect of lower produce prices in South Africa. “We don’t find very much in terms of distance,” he said. “It’s about prices.”

In addition to the Philly Food Bucks program, the city has signed up more than 600 corner stores to stock at least four fresh fruits, vegetables or whole grain products. Even the most barren Philadelphia food desert has corner stores, and convincing them—sometimes with grants or loans--to stock produce is a relatively cheap way to introduce fresh food to these areas.

Sal’s corner store in the Fairmount section of Philadelphia stocked a whole wall’s worth of fruits and vegetables, with city-provided stickers placed around the store warning customers to avoid eating too much sugar and junk food. But on Friday afternoon, two customers in a row bypassed the veggies to buy bags of chips with their food stamp cards.

Sal Abballah, the store’s owner, said collard greens, tomatoes and potatoes are among his best sellers, and that stocking produce is profitable for them. He said he continues to stock soda and some less healthy foods because otherwise he wouldn’t be able to compete with other stores.

“I understand there’s obesity in Philadelphia and everybody should try their best to stay away from sodas. But either way if you don’t sell it they’re going to go somewhere else to buy it,” he said.