Laundromats to support a Healthier Diet?

The role of Nontraditional Food Sources in creating and addressing diet and health disparities

[Also available through U.S. News & World Report]

If you shop in department stores this holiday season, you might expect displays of home goods, clothes and accessories. What you might not expect are aisles of candy, cookies, chips, and soda. After all, food is not a traditional department in department stores.  

Nonetheless, department stores often sell food (and drinks). 

In fact, department stores might be categorized as less-intuitive “food stores,” and they are far from alone among business selling foods and beverages not traditionally thought to.

My own research finds foods and beverages being sold from a wide variety of businesses: from pharmacies, gas stations, and newsstands, to barber shops and beauty salons, auto shops and car washes, sporting goods stores and apparel shops, banks and check cashing outlets, hardware stores, laundromats, dollar stores, office depots … even medical offices. 

The proportions of such businesses selling food or drink vary considerably by neighborhood. The items offered by such nontraditional food sources also vary.

For instance, in the Bronx, nearly 40% of all businesses offer some kind of food or beverage with nearly half of these businesses offering less-healthful items exclusively (items like sodas, candies, cookies, cakes, and frozen confections). The Bronx, which is home to most of my patients, is a borough of predominantly lower-income minority communities where obesity and diabetes are particularly prevalent, and sugary beverage consumption is frequent.

In contrast, the Upper East Side—a higher-income neighborhood in Manhattan with relatively low levels of obesity, diabetes, and sugary-drink consumption—is an area where the number of businesses offering foods and beverages is only a little more than one in four. Of all businesses offering food there, only a small minority (<10%) provide less-healthful offerings without healthier alternatives.

In both areas—the Bronx and the Upper East Side—food is found in surprising places. Supermarkets may be sparse, but food is everywhere. The problem is not so much the absence of something to eat (a true “food desert”); the problem is that what is available to eat—particularly  for those most-vulnerable—is not nourishing (what might be called a “food swamp”). 

In areas where supermarkets are hard to come by, nontraditional food sources can be part of the solution, to help more people access healthy foods. Fruits, vegetables, nuts, seeds, and whole grains might do a lot to offset the influence of ubiquitous sweets and treats. Shelf stable items like dried and fresh fruits, jarred salsas, bagged nuts, and trail mixes offer real potential.  With the introduction of healthier items, “swamps” could look more like … well, like gardens. 

A swamp-to-garden approach characterizes an ongoing public health activity through the health system for which I work, Montefiore Medical Center.  For example, Montefiore’s Office of Community & Population Health, in collaboration with Shop Healthy NYC, created the Healthy Store Initiative.  Store owners participating in the initiative agree to follow specific strategies such as placing fruit and vegetables near registers at the check-out. The idea is to encourage purchases of healthful items, to help combat diet-related diseases afflicting our communities.

Diet-related diseases afflict communities across America. Obesity is everywhere and until recently, diabetes incidence in the U.S. had been rising stubbornly. Although recently there have been some  improvements in diabetes rates along with improvements overall in American’s diet quality, these changes are not benefitting all communities. Income and racial disparities have only widened. For many people, like many of my patients in the Bronx, diet issues and diet-related health problems persist.  Food swamps are not helping.

If we must have food in our department stores and at our laundromats, perhaps we can introduce more healthful options into the mix. Promoting more whole foods could turn our swamps into gardens, and perhaps could better allow our communities to flourish.

Dr. Lucan is supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health under award K23HD079606. The content of this manuscript is solely the responsibility of Dr. Lucan and does not necessarily represent the official views of the National Institutes of Health. Dr. Lucan would like to thank Arielle Sklar for her contributions and editorial assistance.