Over the past 40 years, Baltimore has lost much of its industry and half of its population.
This exodus has contributed to the loss of dozens of grocery stores and supermarkets. As a result, many people in inner-city Baltimore must rely largely on corner stores, fast-food restaurants, and carryout spots for sustenance.
This makes it much harder for them to eat nutritious food — and much easier for them to end up overweight or obese.
Overall, the city has an average of 1.75 square feet of grocery store space for each inhabitant; experts recommend that cities should have almost twice that. In many places the situation is worse than this data suggests, because the supermarkets are not spread evenly throughout the city. Ryan Petteway, an epidemiologist with the Baltimore
City Health Department, says that large areas of the city’s east and west sides — the most densely populated parts of the city — are food deserts.
Last year, the city health department decided to do something about this grocery gap. It started Baltimarket, a program that allows people in three neighborhoods to order online from a supermarket, and then pick up the food close to home, such as at the library or post office. The program serves neighborhoods that lack a local supermarket.
The city pays for much of the program’s costs, but the Walmart Foundation and the United Way gave $100,000 and $55,250, respectively.
The project began by surveying the entire city, mapping supermarkets, fast-food restaurants, and carryout places. The results surprised even the surveyors. Baltimore has 43 supermarkets —most of them clustered in more affluent neighborhoods— as well as 150 fast-food restaurants and more than 800 carryouts. Not surprisingly, most of the carryouts, which typically sell a range of unhealthy food, including fried chicken and fish, pizza, and burgers, were located in lower-income neighborhoods without grocery stores.
Next, the health department compared this data with other neighborhood information, including poverty levels, vehicle ownership rates, and rates of heart disease and diabetes. Baltimore does not collect information about obesity by neighborhood, so planners used these measurements instead, because high rates of these chronic diseases typically indicate high rates of obesity.
Using this information, the health department chose three neighborhoods that seemed to have the greatest need for healthier food options: Cherry Hill, Washington Village/Pigtown, and a section of east Baltimore. The east Baltimore neighborhood has six fastfood restaurants, 15 corner stores, and 40 carryouts, and no supermarkets.
The area’s median income is a little over $11,000 per year, and almost three quarters of households don’t own a vehicle.
“There are so few healthy choices in these communities,” says Petteway. “Eating routines are shaped not only by the absence of healthy food but by the presence of unhealthy options.”
Given the dearth of supermarkets, online ordering might seem like a good solution. But for many people in inner city Baltimore, this solution was impossible. Very few supermarkets will deliver to these neighborhoods; the stores say that it doesn’t make financial sense because they get so few orders from these neighborhoods.
Even if stores did deliver, the delivery fee is typically between $15 and $20. For many neighborhood residents, this extra charge is too much. In any case, many people in these neighborhoods don’t have Internet access at home.
The health department found a local grocery store, Santoni’s, which was willing to deliver anywhere in the city. To make sure residents without web access could participate, officials set up a weekly ordering schedule at two neighborhood public libraries. One afternoon a week, people can place orders on computers at the library, with help from health department staff, if necessary.
Participants who are computer-savvy can order from any computer, at any time. Participants pay regular prices for any food they order, but the health department pays the delivery fee for all orders made through the program.
To streamline the process for Santoni’s, delivery takes place once a week, a day after ordering, at the library where orders are submitted. Customers have a one-hour window to pick up their orders.
Participants are asked to spend at least $20 per order, but they can spend less. The program also allows customers to order any food they want. To encourage people to buy more nutritious items, the city gives each Baltimarket customer a $10 coupon that can only be used on healthy food, such as fresh fruits and vegetables, low-fat dairy products, and whole-grain bread.
We’re very strict. It has to be healthy,” said Laura Fox, who manages the program along with Petteway.
Even so, she notes that the project’s goal extends beyond encouraging better eating habits. Simply by buying items from Santoni’s rather than a corner store or a carryout, lower-income residents can save some money and time. Fox has found that many people in the target neighborhoods do go to supermarkets in addition to closer places. But for most residents, supermarket shopping eats up valuable time and money; each trip typically involves buses and taxis, which can take hours each way.
Not surprisingly, Petteway and Fox said, people in these neighborhoods, and in many other parts of the city, buy much of their food at corner stores.
They’ve found that some shop at a corner store almost daily. In this environment, it is extremely hard to eat right. “You can’t reasonably expect people to not be at risk for obesity if there aren’t any healthy food options,” Fox said.
So far, the program has approximately 85 regular users. Most customers are women, a mix of older, retired people and young mothers trying to feed their families. In January 2011, Santoni’s delivered 240 orders, which totaled more than $13,000 in grocery sales.
Eventually, the health department hopes to attract 200 regular customers and take at least 1,000 orders a year. Department researchers also plan to evaluate how the program has changed the participants’ eating habits and overall health. Fox said that if enough residents join the program, it could be expanded to other stores.
The program is just one of several city initiatives to help residents eat better. Baltimore now has 14 farmer’s markets, which take place once a week around the city. Many of the markets accept food stamps, which makes it easier for lower-income shoppers to buy healthy food. Baltimore food czar Holly Freishtat says there are plans to add two more markets this summer.
Freishtat, who started last year in the newly created position, has also set up a program to teach city elementary school students to read food labels so they can become more discerning about the difference between junk and healthy food.
As part of the effort, students are designing ads for a range of fruits and vegetables; the best ads will appear on the sides of city buses starting this summer.
“It’s really important to help Baltimore residents eat better,” she said. “If we can make doing that a little easier, we’re succeeding.”
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