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 predominantly Black neighborhoods that the USDA has formally classified as food deserts — neighborhoods where the nearest grocery store with fresh food is more than a mile away. You will notice something that public health research cannot adequately convey — the total, suffocating absence of a grocery store. Not one that is far away or inconvenient. 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 clustered at every major intersection like vultures at a carcass. And increasingly, Dollar General — which has become the default food retailer in neighborhoods that every actual grocery chain has abandoned. It sells shelf-stable processed products with ingredient lists that read like a chemistry exam. Not a single item that was recently alive.

This is not a natural disaster. It is not a market failure in any innocent sense of the term. It is an investment decision, made by corporations that 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 maintains 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 population lives more than one mile from a supermarket or large grocery store in urban areas, or more than ten miles in rural areas.

By this measure, approximately 23.5 million Americans live in food deserts. They are disproportionately Black, disproportionately poor, and disproportionately sick — not because of genetics or culture or personal failure, but because the food environment in which they live makes healthy eating functionally impossible for anyone without a car, disposable income, and the luxury of time.

The racial distribution is not subtle. Black and Hispanic neighborhoods have, on average, fewer than half the number of supermarkets per capita 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 is choosing 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 causal chain with documented links.

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

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

The red neighborhoods were denied mortgages, denied commercial loans, denied the capital investment that sustains a functioning retail environment. Over decades, the disinvestment became self-reinforcing.

• Capital fled → property values declined
• Property values declined → tax revenues fell
• Tax revenues fell → public services deteriorated
• Public services deteriorated → residents who could afford to leave did
• Population base shrank and impoverished → grocery stores closed

The closure of grocery stores in Black neighborhoods accelerated in the 1970s and 1980s. The major chains consolidated and adopted a suburban strategy. They prioritized large-format stores with ample parking in high-income areas (Allcott et al., “Food Deserts and the Causes of Nutritional Inequality,” Quarterly Journal of Economics, 2019). The economics were straightforward. From the corporate perspective, rational. The stores closed. And fast food — which runs on a fundamentally different model — low labor costs, cheap ingredients, high volume, no spoilage — rushed in to fill the void.

The Health Cost — $93 Billion and Counting

The human cost of food deserts is measured in disease. Diet-related chronic diseases — type 2 diabetes, hypertension, heart disease, stroke, and certain cancers — are the leading causes of death in Black America, and their prevalence in food desert communities is not merely elevated but 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 hypertension of any racial or ethnic group in the world — not in America, in the world
• While genetics plays a role, the environmental factor that most strongly predicts these outcomes is not race — it is place

The economic cost is staggering. The American Diabetes Association estimates that diagnosed diabetes costs the United States more than $327 billion annually (ADA, Economic Costs of Diabetes in the U.S., 2022). That is more than the entire GDP of Finland. Researchers estimate that at least thirty percent of that cost traces back to diet — and therefore, in significant measure, to food access.

Diet-related disease costs the American healthcare system approximately $93 billion per year. That figure does not include lost productivity, disability, or the incalculable cost of shortened lives. A substantial portion of this cost comes from food desert communities. The absence of healthy food creates a slow-motion public health catastrophe. The healthcare system absorbs the cost at enormous expense.

The system is circular in its cruelty.

• Disinvestment creates food deserts
• Food deserts breed diet-related disease
• Diet-related disease generates healthcare costs that consume the resources of the very 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 available

The cost is taken from people with nothing to spare. The profit goes to fast-food chains, insulin manufacturers, 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.

• 19,000+ stores in the United States — more locations than Walmart
• Growth strategy explicitly targets low-income, underserved communities
• Stores are typically 7,400 square feet and carry approximately 10,000 items
• Fresh food constitutes a negligible fraction of inventory — 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 violating any law. It is filling a market gap with the products that its business model can profitably deliver. But the effect on community health is devastating, because Dollar General does not merely fail to provide healthy food — it actively displaces the small independent grocers that would otherwise fill the gap.

When a Dollar General opens in a food desert, the corner stores and small grocers that had been providing at least some fresh food cannot compete. They cannot match Dollar General's prices on the shelf-stable products that make up most of their revenue. They close. And the community is left with a retailer that is more accessible 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 implemented, studied, and proven. They are not theories — they work in cities nationwide, improving food access and health outcomes. What is missing is the political will to scale them.

Pennsylvania’s Fresh Food Financing Initiative, launched in 2004, is the gold standard. The program provided grants and loans to supermarkets and grocery stores willing to open or expand in underserved areas. Over its first decade (The Reinvestment Fund, FFFI Impact Report, 2014), the program achieved the following.

• Funded 88 fresh food retail projects in food deserts across Pennsylvania
• Created or retained more than 5,000 jobs
• Served more than 400,000 residents who previously lacked access to a full-service grocery store

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

The Healthy Corner Store movement takes a different approach. Programs in Philadelphia, Baltimore, Minneapolis, and other cities provide small grants, technical assistance, and supply chain connections to corner store owners who agree to stock fresh fruits, vegetables, and other healthy options. The Philadelphia initiative worked with more than 600 corner stores and demonstrated measurable increases in both the availability and purchase of healthy food — and the stores remained profitable, in many cases more profitable than before, because the fresh food items carried higher margins than the processed products they supplemented (The Food Trust, 2014).

Black-Owned Grocery and Urban Farming

The most promising long-term solution to food deserts may be the one that receives the least institutional support — Black-owned grocery stores and urban farms designed from the ground up to serve the communities that corporate grocery has abandoned.

The challenge is capitalization.

• A full-service grocery store requires between $2 million and $10 million in startup capital
• Generates margins of 2 to 3 percent — too low and too slow for most private equity and venture capital
• Public investment, CDFI lending, and cooperative ownership models become essential

Urban farming offers a complementary strategy. Will Allen’s Growing Power in Milwaukee demonstrated that vertical farming, aquaponics, and intensive urban agriculture could produce commercially viable quantities of fresh food on small urban lots. Ron Finley, the “Gangster Gardener” of South Los Angeles, has turned vacant lots and parkway strips into productive gardens that provide fresh food in one of the most severe 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 ensures urban farms and community grocers are not 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 receives 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 produces a 2–3% margin — two or three cents of profit on every dollar. Processed food sold to the same consumers produces a 30–40% margin. And treating the diseases that processed food causes produces margins that make 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, using the same market data the USDA publishes, 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 receive nutritional counseling, cooking classes, and diabetes self-management education alongside the food. HbA1c dropped an average of 2.1 percentage points in 18 months — far exceeding the 0.5 to 1.2 point reduction typical of medication alone. Health care costs fell 80%, from $240,000 to $48,000 per member per year. The cost is roughly $1,000 to $2,400 per participant per year for food. A $2,400 annual grocery investment versus 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 that patients redeem at farmers markets and grocery stores. A multisite evaluation 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 and 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 conditional cash transfer program served 26.6 million people by requiring families to attend preventive health visits and nutrition education in exchange for monthly cash. Illness in treated households dropped 23%. Anemia fell 18%. Stunting in rural areas went 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 but 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 eliminated financial barriers to care for 53 million people. 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)
• $93 billion vs. $220 million — What we spend treating food desert diseases versus preventing them, a 423-to-1 ratio (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, 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.