APHJ – Grocery Development and Health with Melissa Laska and Glenn Ford

APHJ – Grocery Development and Health with Melissa Laska and Glenn Ford


Minnesota ranks in the bottom third
among states nationwide for the number of supermarkets
per capita. Not surprisingly,
most of the supermarkets that do exist in Minnesota, are located
in higher-income communities. People who live in communities
without a local grocery store selling healthy and affordable
foods suffer from higher rates of obesity, diabetes, and other
diet-related health problems. A recent report
by The Food Trust, a nationally-recognized
nonprofit, found that nearly 900,000 Minnesota residents,
including over 200,000 children, live in lower-income communities
underserved by supermarkets. Obviously, this is
a public health problem that requires some attention. We’ll be providing some of that
attention on today’s episode of “A Public Health Journal.”
Please stay tuned. (male narrator) Welcome to
“A Public Health Journal,” a program that explores
public health issues facing our society
today and tomorrow. The host of the show
is Dr. Ed Ehlinger, Commissioner of Health
for the state of Minnesota. “A Public Health Journal”
is sponsored by the Minnesota
Department of Health, and the
Hennepin County
Human Services and
Public Health
Department; all working together
towards the goal of healthy people
living in healthy communities. Welcome to
“A Public Health Journal.” Today we are going to look
at how the presence of grocery stores in communities
contributes to improved health. We’ll also look at the reasons
why some communities don’t have access
to grocery stores and what can be done to address
that problem. Joining us in that discussion
are Dr. Melissa Laska,
associate professor in the University of Minnesota’s
School of Public Health and Glenn Ford, CEO and Founder
of Praxis Marketplace. Dr. Laska is an expert
on the environmental, social, and behavioral determinants
of obesity, and Mr. Ford is a former
corporate executive for PepsiCo and Baxter Healthcare who
searched for years to find ways to give back to
urban communities. He discovered
the best method was through
improving access to food. Both were members of a Grocery
Store Access Task Force that came together to explore
how to improve access to grocery stores
in every community. Welcome to our program,
both of you. Good to be here.
Thank you. We’ve been hearing a lot
about access to food, we’ve been hearing a lot
about food deserts, and you come at it from a couple
of different approaches. Melissa, why are you interested
in access to food from your academic perspective? From my perspective, I think
it’s most interesting to think about these food access
issues framed in the context of health disparities,
in that a lot of the things that we care about as a public
health practitioner or a public health researcher, a lot of the disease outcomes
that we see, we really observe some really striking health
disparities around those things. So for example with obesity,
we observe that African American communities and
Mexican American communities, are much more likely to see
higher rates of obesity than Caucasian communities. And we also see
striking disparities by socioeconomic status, particularly within specific
racial and ethnic groups. And so we think
that there may be something in the neighborhoods that we
live in, in the communities that we’ve built up around us,
that really kind of underlie some of those disparities,
and food access, healthy food access
may be one of those things. Glenn, how about you, what
brings you to this topic? Well supermarkets have a huge
role to play in communities beyond simply the purveyance
of food. First of all, they are great
employment opportunities if people stick with it
for a while. We all know that on the very
lowest end, that that’s not a great salary, but grocery
stores are actually the number one industry segment
if you don’t have a college degree that you can
possibly work yourself into. A store manager actually makes
a nice six-figure salary. So I also look at it
from the economic impact, because if you are a believer
of the social determinants of health, which I am and
which I’m sure you are as well, that I can’t truly care
about your health if I don’t care about your
economic conditions as well. Well yeah, and we talk about
health in all policies. Correct. Now there’s health in education, there’s health in
transportation, there’s health in the business community,
and all of those contribute. So I know the two of you
have been part of the Minnesota Grocery Access
Task Force. Melissa, could you tell me
about that task force,
how it came about? Sure, the task force start
was originally convened by The Food Trust, which is
a nonprofit organization that is based out of Philadelphia,
but has done a lot of work around the country in different
states and different cities, and in Philadelphia to move
this issue of food access and other healthy eating issues
forward. And so they convened this group
of people and experts that represent a wide range
of expertise to kind of come together and talk about
Minnesota’s specific issues and what we need to do
in Minnesota and how we need to kind of frame
our priorities in Minnesota in addressing access
to healthy foods. Glenn, how did you get engaged
with the task force? Believe it or not,
I was actually invited by another grocer,
who informed the task force that I should be on that
committee as well, and so I joined it
and was happy to be there. Now I’m assuming that with most
task force, you sort of looked at the needs. What were some of the problems
that you identified as part of the task force, Glen? You know actually,
one of the biggest issues that I think inner cities
suffer from sometimes is because they have lower
median incomes, that people don’t feel like
there is enough income there to support a grocery store,
and that’s anything but true. While sometimes they don’t have
as high of a median income, let’s say North Minneapolis does
not have as high a median income as Eden Prairie; let’s take
a real life situation. If I looked at an area around
Eden Prairie, there’d be 7 grocery stores,
and they’re all chasing that median income
for let’s say $56,000, you’d find that that median
income is so competitive that it is actually
less competitive than going into some of our inner city areas. And so I don’t think
that we really think through those problems
very well. And then there’s also
this misconception that the death rates, or shrink
as it’s called in the inner city areas, is a problem, and yet
there’s only a 1% difference between the shrink level
in an inner city and the suburban area, and so
it’s something that the hype, if you will, behind it, is far
different than the reality. Now you talked about, “we” don’t
think about this issue. When you talk about we, are you
talking about the grocery store owners, the supermarket chain
owners, public policy makers, local officials,
who are you talking about? That’s a very good question,
and that, that we is, represents people who care,
and that should include all of those groups that you
just mentioned. It should be policy, it should
be community activists, it should be anyone who cares
about this issue, because those health issues
that she stated just earlier, that impacts all of us, and as
much as we’d like to think that we can, can
compartmentalize who we are, I don’t think that we can
when the health, or when insurance rates go up
for health, it impacts everyone. So we’re in it together,
whether we realize it or not. Melissa, what did,
from your perspective, what were some of the findings
on this task force? Well I think Glenn brought up
some really important points. Just building on those,
it seemed to me one of the big take-home messages was
getting over that initial hurdle of getting stores into some
of these communities. So getting past
the startup costs, getting past the kind of initial
development phase, and then getting them to realize
that these are kind of real situations where they could
make money and be sustainable and serve the community
in a successful way. Another thing that came up a lot
on the task force is thinking about our urban city communities
that are underserved, also thinking about
kind of out-state and thinking about
our rural communities that are really lacking in
grocery stores, and what are the similarities and
recommendations that we can make between addressing
those two communities and are there differences
and how do we think forward on those issues? And we were talking about
health in all policies. Who was involved
in this task force? What were sort of the general
areas that people came from to bring the different
perspectives? Yeah, well you had several
of the local grocers, and you had other grocers that
might consider Minneapolis. You had academics,
you had some people from the finance community
as well, you know, economic development people, so I mean you had
a pretty well-rounded group. I don’t remember if we had very
many public officials there, I don’t, but I think you easily
at any meeting had 20 to 25 people there. I want to talk about
the recommendations that came out of the task force, but
first, we need to take a break. We’ll be back,
right after this message. (woman)
There’s a crisis in America. More than half of us
are overweight. The advice experts agree on
is to eat more fruits and vegetables
as part of a healthy diet and be physically active. Eating 5 to 9 servings
of colorful fruits and vegetables
and being active every day will help our kids
stay healthy and fit. Eat smarter, be active,
and get healthy America– because the figures don’t lie. Welcome back, we’re talking
about access to grocery stores in urban communities
and rural communities with Dr. Melissa Laska
and Glenn Ford, who are members of the Grocery Access
Task Force. I know the, I have in front
of me actually, the 8 recommendations that
came out of the task force, which is now what,
a year or so ago that the task force…?
Easily. What were some of the things
that were really highlights, recommendations, that you could
see were really something that could be implemented
in the near future? Glenn? You know, I think one
of the things that we, we ask is for some of our
public officials and some of the methodologies
for financing would actually be a lot closer
to the realities that business people
such as myself have in trying to go out to the marketplace
and attract capital to these projects, you know,
which can be a challenge. I mean people don’t think of
grocery stores as an investment that is as exciting as say
technology, when in actuality, managed well, it could be
a pretty good investment. So there’s definitely a request
for there to be a tie-in between public policy
and the actual financing of a grocery store, and I would
say that’s one of the top ones. Melissa, what did you see
coming out of this that, things that really could make
a difference in access to food? They were also building
on the financial aspect. There were also recommendations
around regulatory issues and how to kind of streamline
the regulatory process so that it’s easier and more
straightforward for store owners and businesses and chains to
come into these kind of areas. There were recommendations around transportation
considerations, so to make sure that as we’re considering
new sites for businesses, that people can actually get
to those sites, not necessarily just by cars, but with other
means of transportation. One of the things that I think
is really interesting about this task force
and the recommendations that came out of it, is it’s
different from other task force, similar task force that have
been built around the country, is our recommendation around
small food retailers. So recognizing that
supermarkets are important and large stores
are really important, but it’s also really important
to invest in small retailers, that we may have businesses
that are already in operation in some of these communities
that may not be able to provide healthy food, accessing the same
way that they could if they had some financial supports or other
types of supports in place. So those kinds of things are
places like corner stores or small convenience stores that
may be able to provide healthy staple foods as well,
mobile vendors, alternative models of stores,
like co-ops. I think in Minnesota we really
value both large business as well as small business. And that was something really
unique that came out of this group, that I don’t know
that we’ve seen many other places in the country with
these kinds of recommendations. Well I know corner stores
often take a lot of heat from providing bad food
and not having availability, which brings up the issue
of affordability. I mean you can have, you know,
healthy foods, but if people can’t afford it,
it’s not going to be accessed, people are not going to buy it. So how did you get at that? How are you going to make
a corner store an economic model
that actually works and that says I can sell,
you know, green peppers and apples and make money
doing it? Well what bad packaged food
allows you to do is it allows you to not be as
attentive as fresh food would because I can put a chip on
a shelf and it can sit there for a couple months
and no problem. Well that’s not going to happen
with an apple and it’s not going to happen,
you know, with fresh produce. So there’s methodologies to make
them a lot more effective than they really are, but we
also have to be pretty realistic that the margins that are
available to some of those corner stores and the business
models that they are established to produce are in opposition to
a lot of what we want to do from a health perspective. So there are going to be
some challenges there, and then the footprints
of some of those stores would actually have to be
enlarged in some other areas in order to make them do that. Now, would that be
good public policy to assist them in doing that? Well from a health standpoint,
if we looked at our cost, of what we’re paying
on the health side, it absolutely would be. But again, that’s
a comprehensive set of thoughts and that’s not where,
sometimes as a country we’re not real good at that. As I look at
the recommendations that came out of the task force, there
were several that really said the state should, the city
should, local community should, sort of the public side,
and then there was what’s going to happen
on the grocery side? So what is the role
of government, federal, state, local government,
in making access to food a priority and affordable? Well I do believe they have
a role and I do know that it could be quite contentious
when we sometimes say what is the city’s and
the state’s role in business. But quite frankly, when I look
at the cost of building a baseball stadium and a whole
host of those other kinds of issues, and I compare that to
the number of small businesses that could be created for that
kind of capital, and then to watch
the exponential effect that that could have if we were
to be a little bit more forward thinking that way,
it could be astounding. And the number of jobs that
could be created would be great. And that’s the piece that,
by the way, I maybe take the biggest
exception to, that we aren’t focused
in the job creation side of it, because I can put a great store
inside of a community, but if no one has a job
in that community, how do they buy the food, right? So I think that the city
and state, working in conjunction with people
around food, can create a whole lot
of those jobs. As an example, not a lot
of people would realize that in North Minneapolis alone,
there’s 170 small entities that can sell food. So if we worked collaboratively,
and where we used some of the infrastructure city
and state to now help build upon that, there’s a whole lot
of power to be able to increase that economic base
that sits in that area. Melissa,
I’m going to ask you about the grocery store side,
’cause I, you’re flipping, you’re flipping who I was
expecting to answer that. So what do you see, what’s the recommendations
for grocery stores? So the recommendations
for grocery stores, I think are, I’m trying
to recall back to what the recommendations
were exactly. To kind of come together
and a lot of the recommendations were around thinking
collectively and thinking kind of in a futuristic
type of way, realizing that these recommendations aren’t
just standing kind of as is, that we need to continue
this discussion and continue this group,
both with the private and the public sector,
to realize that the private sector needs to support
the public sector in kind of moving forward
on some of these things. Some of the things were
it was seen how a viable, small and alternative retail
distribution models are there. That was the question,
can some of the larger chains actually partner with some
of the little, smaller stores? Well they could; I have
a wonderful relationship with Super Value, you know,
Corporation, as a wholesaler. And so yes, there are these,
these relationships that have to coexist,
and that we should encourage. And the other part
that I wanted to get back to on the city and the state part,
you know, very few grocery stores in this country
are actually built anymore without some form of city
or state involvement. I don’t know
if very many people know that. Whether that’s being done
by new market tax credits, or whether that’s going to be
TIF dollars or some other form of incentive. So it is a very close connection
that should be involved. That’s including
some of our largest
corporations in this country. I won’t name the largest one,
that they’re at the city and state looking
for the incentive to put a store
in an area as well. I want to talk next steps
from this and look sort of blue sky, what do we
want to do down the road, but we need to take
a break first. We’ll be back
right after this message. (woman)
23 million Americans
are obese or overweight. These people risk health
problems such as heart disease, diabetes, stroke, and cancer. The cost, more than $14 billion
a year. They deserve a healthy start
in life. To learn how you can help visit:
obesityaction.org. That’s obesityaction.org. Welcome back, we’re talking
about the grocery store access project in Minnesota with
Dr. Melissa Laska and Glenn Ford who are members of the Grocery
Store Access Task Force. So since you had this report
that came out a year or so ago, what has happened, has there
been any progress made in addressing some of
the issues that were raised
by the task force? Well I continue to move forward
with the building of our store. We actually have a site on
Plymouth and Penn and we are… Just back up a little bit; tell
us, you’re Praxis Marketplace, tell us a little bit
about that first. Yes, and that’s a 30,000 square
foot grocery store that we’re going to put on the corner
of Plymouth and Penn, but we are, our overall vision is to build 200 of these stores
around the country. So we have been active
in 16 different cities and we have active projects
in 4, you know, 4 cities, all of them a lot larger
than Minneapolis, and Minneapolis sometimes being
our most challenging one because we’re trying to fit
ourselves into a specific space, right where it’s very convenient
for people, dealing with issues such as the ability to walk to
a store as opposed to driving. So we have our hands full, but that’s a part
of what we’re doing. Melissa, what do you see has
happened since this task force? Well there’s been
some other work specifically around
the small retailer piece, and the City of Minneapolis,
for example, has continued their Minneapolis
Healthy Corner Store Program that’s meant to work with
small retailers, particularly small corner
stores, in stocking healthy food, addressing
some of the distribution issues, some of the management issues,
and what does it take to have healthy foods in your store
and how do you maintain stock, and where do you get it, and all
of those kinds of issues. And so we’ve seen that really
move forward, and we’re hoping that there’s some exciting
new steps in the future. Are there any connections
between local stores, corner stores, and some
of the programs, like WIC, the supplemental food program
for women, infants, and children, which really
gives people access to food and electronic benefit
transfers and how to use
those kinds of things? Has there been progress
in those areas? So, there have, over the past
several years I would say, not necessarily in the last
year, but a lot of our small stores, in Minneapolis
at least, do, are WIC partnered, and do participate
in the WIC program, and through a series
of changes that happened to the National WIC Program
in 2009, we now have minimum stocking requirements
for a series of healthy foods for small corner stores
that are participating in WIC. So they’ve had to receive
technical assistance and figure out some of
these issues on their own and we’re hoping that that
message can kind of translate to other stores that aren’t
participating in WIC and small stores can help
other small stores figure out some of these challenges
that maybe they’ve already been through
because of the WIC changes. And have the larger supermarkets
started to pay more closer attention, ’cause you had
mentioned early on, there really is a market there. Huge market. Have they set a change
of practices either in Minnesota
or elsewhere? Maybe not aggressively enough. Quite frankly, I formed Praxis
because it was too difficult trying to convince
some of these larger stores to go into some of these areas. I guess there’s a side of it
that sometimes I understand, but there’s another side of it
that I almost find offensive, but the side of it
that I understand is that they step in front of investors and they ask for millions
of dollars to create a store, and they have an opportunity
to put on in North Minneapolis or they have an opportunity
to put one in Minnetonka. That investor is probably a lot
more comfortable with Minnetonka than they might be
in North Minneapolis. So I understand some of those
pieces, but then beyond that, however, there is
this huge opportunity, and the ways that we promote
the activities that are going on in some of these areas,
and we really have to be careful how we communicate them;
they are not helpless. They need investment, just like
any other community does, but they’re not helpless
communities, and I think sometimes we overdo the state of disrepair
in some of those areas. We do them a disservice. And Melissa
you’d brought up earlier what’s going on
in rural communities. Again, this is another
huge issue, again lack of access
to low-priced food, what’s going on in that area,
do you know? I have to say I’m not, I myself
I’m not particularly engaged in the rural community issue,
but I think they’re continuing to have dialog
around these issues again. I want to emphasize
that this task force, and the recommendations that
came out from the task force, were really just seen
as kind of the first step, and that we’re not launching,
we haven’t launched with a series of recommendations
that are necessarily ready to hit the ground running. There’s a lot of continued
dialog, a lot of continued planning and continued work
that really needs to happen. And so my hope is that we
can have a continued kind of task force like discussion as we
develop these recommendations further, and there might be
a 2nd set of recommendations and a 3rd set of recommendations
that really refine some of these issues;
they need some refining. Certainly in my experience
in working in public health, when communities actually say,
this is an issue that we want to address and they understand the issue,
things really happen. Do you think people really
understand the connection, J. Average Public,
understand the connection between access to healthy foods
and their own individual personal health,
and how do we educate them and how do we get them
engaged to say, “Yeah, we want to have something
happen in our community?” I think they understand
the issue of health and how healthy foods might be good
for their overall health. I think the piece that they
really miss is they don’t understand how important
it is to have that store in your community for the jobs
that it might create, that then puts more income into
their communities, which then has the opportunity to bring
both resources and a whole host of those other social
determinants of health upwards. So I think that that’s the part
that’s missing, that to have too singular
a discussion on just the store as opposed to the power
of the store to create, that there needs to be far more
conversations along that vein. I totally agree; I think
bringing in some of these other outcomes, these other
positive things that can happen from grocery store development
is really important. And I also think as we see
models around the country of other businesses that have
really done this through public support, through some public
financing, but then have become self-sustaining and really
profitable and really a great benefit to the community, I
think that can be particularly inspiring and give
a lot of insurance that hey, we need to move forward
with these issues here too. And in the last 45 seconds that
we have, what’s the one thing that you would like to see
happen within the next year to really improve access
to healthy foods?
Melissa. I think again, I think we need
to continue discussion. I think the worst thing we could
do is just stop right here and decide to go
into action mode. We have too many different
people coming from different areas that need to
consider that collective and comprehensive discussion
in moving forward. In the next year, the opening of
my store at Plymouth and Penn, but number two, it would also be
the opportunity to collaborate around
the whole host of these issues. So whether that’s
speaking with someone like Melissa, because
this whole issue of obesity is not going to go away just
because you put the store there. The store is one step
in probably 6 or 7 steps that actually needs to be done,
so if we’re going to do a good job with that, we’re
going to need a lot of help. These are all complex issues
that require all of us, and public health is what we as
a society do collectively, and this is part
of the conversation. This has been fascinating,
thanks for being with us.
Thank you very much. I’ll be back
with a closing comment
right after this message. [man on TV
calling baseball game] [click, whirr] [ding] (man)
Chill raw and prepared foods
promptly. 1 in 6 Americans will get sick
from food poisoning this year. Keep your family safer, check
your steps at FoodSafety.gov. Over 23 million Americans,
including 6.5 million children, live in food deserts,
places where there isn’t a supermarket within a mile. That means people living
in those areas are without ready access to fresh, healthy,
and affordable foods. These food deserts are usually
in low-income areas. The effects of food deserts
are devastating. They contribute to obesity and
other diet-related illnesses, they force families living in
these areas to use valuable time traveling to neighboring areas,
and if you don’t own a car, gaining access to good food
is even more difficult. But just as problematic
as food deserts are food swamps, places where fresh and healthy
foods are available, but they are swamped
by cheap, unhealthy, and highly-marketed foods,
that overwhelm even the most dedicated
and conscientious shopper. If we are to assure access
to healthy foods for everyone, we will need to find ways
to make healthy foods not only available,
but affordable. Implementing
the recommendations from the Minnesota Grocery Task Force,
would be a great first step. We will also need to reduce
or counter the massive advertising
for food that is not healthy. In other words, we need to plant
trees in the desert and drain the swamp
so we can make the healthy eating choice
the easy choice. That’s all for today.
Thanks for watching. I hope you can
join us again next time
on “A Public Health Journal.”

1 Comment

Leave a Reply

Your email address will not be published. Required fields are marked *