Alternate Food Markets, NGOs, and Health Policy: Improving Food Access and Food Security, Trust Bonds, and Social Network Ties

• DOI: http://doi.org/10.1002/wmh3.190
• Published date: 01 June 2016
• Date: 01 June 2016

Alternate Food Markets, NGOs, and Health Policy:

Improving Food Access and Food Security, Trust Bonds,

and Social Network Ties

Amy L. Best and Jeffrey L. Johnson

Limited access to healthy foods in low-income areas is well documented as part of “the new hunger”

in the United States. Characterized by easy access to nutrient-poor processed food and blocked access

to foods that secure dietary health and sustain well-being, “the new hunger” has been linked in

public health and social science literature to obesogenic environments, def‌ined as both food and built

environments that promote obesity. The paper examines how non-governmental organizations work

within distinct policy ecologies to improve food access and food security and promote community

health, focusing on one high-impact Mobile Farmers’ Market Program that was successful in

building community infrastructure to promote dietary health and improve food security at the

community level through improved food access. We offer this case study of a NGO–community

collaboration to better understand the role of formal and informal social networks between NGO

actors and different community stakeholders, including market customers, in communicating and

realizing city policy goals and positive program interventions in support of community health.

KEY WORDS: food security, food access, community health

Introduction: Policy Initiatives Toward “The New Hunger” in Washington, DC

Limited access to healthy foods in low-income communities is well docu-

mented as part of “the new hunger” in the United States. Characterized by easy

access to nutrient-poor, processed food, and blocked access to foods that secure

dietary health and sustain well-being, “the new hunger” has been linked in public

health and social science literature to obesogenic environments, def‌ined as both

food and built environments that promote obesity (Lake & Townsend, 2006).

According to the Capital Area Food Bank (2011), in Washington, DC, one in

three residents is at risk for hunger. As in other cities, hunger and poverty are

strongly related and are spatially patterned. Poverty prevalence is the highest in

District Wards 7 and 8. According to the D.C. Fiscal Policy Institute (2012), over

30 percent of residents in these two wards lived below the poverty threshold in

2012. Despite the DC policy directive that “no neighborhood be unfairly exposed

World Medical & Health Policy, Vol. 8, No. 2, 2016

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to health risks,” both dietary health and food insecurity correlate with high

neighborhood poverty concentration, thereby creating an “urban health penalty”

in terms of the distribution of health risk for these communities (Fitzpatrick &

LaGory, 2000, p. 6). In Wards 7 and 8 obesity prevalence hovers slightly below 40

percent (District of Columbia Department of Health, 2002). Residents in Wards 7

and 8 are disproportionately African-American, suggesting the demarcation of

urban space as a factor in health disadvantage is also a consequence of the legacy

of racial segregation in cities (Massey & Denton, 1998).

However, the health polic y landscape in Washington, DC has undergone

signif‌icant change in th e last decade, with health a nd well-being, equity and

diversity, and sustainability emerging as impor tant policy priorities. A compre-

hensive, city-wide move ment to address economi c, environmental, and health

issues in Washington, DC h as taken shape and has result ed in identifying a set

of sustainability goals as part of the 2011 D.C. Sust ainability Plan. “Universal

access to secure, nutritious, and affordable food supplies” was identif‌ied as a

key goal, with the specif‌ic target to ensure 75 percent of re sidents live within

one-fourth mile of healt hy and affordable food supp lies by 2032. To work

toward reaching these tar gets, the D.C. Sustainabil ity Plan called upon the

District to “create an ur ban food network to minimi ze food deserts and provide

local food within one half mi le of all District residen ts” (Sustainable DC Plan

2011, p. 19), noting that “lev eraging existing community networks and relation-

ships, the city can expand the ad option of sustainable practi ces through

strategic partnerships to advance community-wide goa ls. There are already

countless groups doin g groundbreaking work th roughout the District and some

are proving themselves t o be local and even national l eaders in sustainability”

(Sustainable DC Plan 201 1, p. 17).

A number of city initiative s to improve health and food acces s at the

community level are curre ntly underway in the Distric t. The Food Stamp

Expansion Act of 2009, which raised the qualifying levels for food assistance

and eliminated the asset mean s cap, enabled thousands more city residents to

gain access to food benef‌i ts, thereby addressing a substantial economic h urdle.

The Healthy Corner Stor e Program, a collaboration of D.C. Central K itchen, D.C.

Hunger Solutions, D.C .’s Department of Small a nd Local Business Devel opment

(DSLBD) and the city’s Depa rtment of Health and Communit y Health

Administration which p iloted in Wards 5, 7, and 8 pro vides assistance to

corner stores seeking t o sell fresh produce and hea lthy foods. The program is

designed to reduce food insecurity by improving the capac ity of corner grocery

stores in communities with limited supermarket access to p rovide healthier

food options, includin g fruits and vegetables, lower-fat snacks, and mor e

nutritious beverages, and thus ref‌lects an effort to a ddress geo-spatial

constraints (see D.C. Hu nger Solutions, 2008, 2016 ). Through the D.C. Food,

Environment,and Economic Development (FEED DC)Act of 2010, the District has

brought new food retail ers into communities whe re food insecurity is high an d

food access is constrai ned. Efforts to bring loca lly sourced fruits, veget ables,

and lean and/or sustainab ly farmed proteins to low-in come communities at

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