Food Access 3.0: Insights From Post-Katrina New Orleans on an Evolving Approach to Food Inequities

Racial and economic disparities in access to healthy food have been well documented in urban areas throughout the United States. Inadequate food access is a social justice issue, an indefensible inequity, especially in a land of abundance. It also contributes to poor-quality diets—typically low in fruits and vegetables and high in sugar, salt, and saturated fats—which can increase the prevalence of various chronic diseases.

Large-scale efforts to address this access problem, such as the original Food Stamp Program, initially focused on increasing purchasing power, because inadequate household income was viewed as the cause of this problem.¹ We refer to this problem definition and response as Food Access 1.0.

The second wave of food access interventions, or Food Access 2.0, focused on expanding groceries in underserved areas across the country.² Distant grocery stores make shopping for healthy foods difficult because of added costs and inconvenience, especially in cities with a poor transportation infrastructure and a low rate of car ownership.^3,4 In New Orleans, Louisiana, food access disparities worsened in the aftermath of Hurricane Katrina,⁵ heightening awareness of the problem and precipitating a multistakeholder response that helped lead this wave. The issue is a problem in urban and rural areas throughout the country, but the disaster in New Orleans demonstrated stark racial disparities. Federal disaster funds were eventually used to support the first locally directed, healthy food retail incentive program.⁶

Perhaps because of the existential nature of the disaster or the delayed and muted federal response, rebuilding after Hurricane Katrina generated an unprecedented degree of citizen involvement. With it came a tremendous surge of social innovation in all sectors, particularly in food and nutrition (https://bit.ly/NOLA-food-nutrition-resources). This led to a third wave of interventions, Food Access 3.0, which sees the problem as structural in nature, originating in socially determined inequities (Table 1). The response is based on innovative, multidimensional, cross-sectoral participatory interventions that promote agency in those affected and address underlying systemic influences. These interventions address disparities in healthy food access in terms of both social justice and health outcomes.

TABLE 1—

Characteristics of Different Types of Approaches That Address Food Access Inequities

	Food Access Approach
	1.0 Purchasing Power	2.0 Availability	3.0 Structural Change
Problem definition	Lack of household income to purchase healthy food	Lack of geographic access to healthy food	Underlying structural and policy inequities that lead to lack of household resources and healthy food stores
Intervention approach	Food assistance	Financing of grocery stores in underserved areas; small-store stocking programs	Alternative food system interventions that increase employment, mentor youths, and advocate system change, while improving healthy food access and purchasing power
Example program or organization	Supplemental Nutrition Assistance Program	Healthy Food Financing Act	Grow Dat Youth Farm, Fresh Moves Mobile Markets, Propeller, Detroit Black Community Food Security Network
Operation	Federally run	Federal, state, and some private financing, state or locally run	Usually locally run by nonprofit or socially oriented businesses, with some federal, state, local, or private sector support
Community participation	Little to no input in operations but contributes to advocacy for change	Some input on programming, including store locations	Extensive input and oversight in design and implementation

Grow Dat Youth Farm is one example of this type of innovative intervention in New Orleans. It is simultaneously an urban agriculture, youth development, and community food-supplying organization. It improves food access, and it educates high schoolers about a sustainable food systems approach, building leadership skills through mentoring and after-school employment. The Sankofa Community Development Corporation runs fresh produce markets, including a mobile market stop in the Lower Ninth Ward, as well as healthy cooking and gardening classes. Liberty’s Kitchen employs local youths in the food sector, focusing on food preparation and service skills. Demonstrating the multidimensional aspect of this new wave of interventions, it runs a restaurant, has catered healthy school meals to local schools, and has supplied warehousing facilities to a local corner store initiative.

Top Box Foods supplies preordered boxes of discounted foods to low-income individuals for pickup at local churches and other drop spots. It also serves as a distributor to a new city-funded project to stock corner stores with fresh produce and healthy snacks. That corner store project is run by Propeller: A Force for Social Innovation, a local incubator and accelerator that promotes equitable outcomes in the food, health, education, and water sectors. The project educates and equips store owners to sell fresh produce, and it supports community education, including in-store cooking demonstrations.

These and many other innovative organizations all use the food system as an entry point, but they cut across various sectors—education, employment, community development, business development, agriculture, environment, and health. They are based on local needs and participation and often focus on youth leadership development. They are all multidimensional, operating at various points in the food system, with a perspective rooted in past structural inequities that provides a holistic response to the problem. They often collaborate with other mission-driven organizations for synergy in achieving common goals.

Many of these organizations are part of a growing local culture of social innovation, which seeks “a novel solution to a social problem that is more effective, efficient, sustainable or just than existing solutions and for which the value created accrues primarily to society as a whole rather than private individuals.”^7(p36) The hybrid organizations span private and public sectors. They attack complex social problems with entrepreneurial and systems-thinking skills, coupled with the commitment of motivated individuals living these problems. They start small, experiment, learn from mistakes, and adapt without growing too large, too soon. This approach contrasts with large bureaucracies (like governments and some corporations) whose top-down structures discourage the experimentation needed in our complex reality.

This third wave is not new or unique to New Orleans. Rather, it is a resurgence of activities that have been around for decades and exist throughout the country. The Freedom Farms Cooperative, started in the late 1960s by Fannie Lou Hamer, was an agricultural cooperative that focused on economic development using various strategies to support the needs of African American sharecroppers and tenant farmers in Mississippi. The Edible Schoolyard began in Berkeley, California, in the mid-1990s as an effort to transform children’s connection to food. Also focused on mentoring youths as well as alternative agriculture and food provisioning, Growing Power began in Milwaukee, Wisconsin, in 1993.

The Urban Growers Collective brings healthy locally grown food to Chicago’s communities through mobile farmers markets run on converted city buses. It also runs youth job training and urban farmer development programs. Started in Los Angeles, California, the Good Food Purchasing Program encourages large institutions, such as school districts, to orient their purchasing toward core values, such as supporting local economies, environmental sustainability, and nutrition. Coalitions, such as the Detroit Black Community Food Security Network and the National Black Food and Justice Alliance, use food system entry points to build community, transform structural inequities, and promote food and social justice (for references, see the Appendix [available as a supplement to the online version of this article at http://www.ajph.org]).

These and other local organizations that form the vanguard of this new movement may be strong, but they are not invincible. There is a significant turnover in grassroots food organizations. The federal government has funded some efforts to increase the self-reliance of communities in providing the food needs of its citizens. For example, the Community Food Projects Competitive Grants Program, run by the US Department of Agriculture, provides funds that promote comprehensive responses to local food access, farm, and nutrition issues. But the grants require a 100% match, and the entire program is funded at a level less than a hundredth of a percent of the Supplemental Nutrition Assistance Program. As creative as locally led efforts are in developing resources to support their activities, external, institutionalized, and substantial support will be important in their sustainability and scale-up. Comprehensive evaluations will also be important for understanding and promoting best practices.

The New Orleans experience can provide insights to communities throughout the country that suffer nutritional inequities, face increasing risks from natural disasters, and respond to the current food security crisis resulting from the COVID-19 pandemic. The community-driven response, focused on socially innovative approaches to food access problems and their underlying determinants, holds promise for reducing food and social system inequities. To be sure, this approach is not a panacea, nor is it a replacement for the resource supports that are the foundation for Food Access 1.0 and 2.0 interventions. Adequate income to purchase food and geographic access to healthy food at reasonable prices are necessary—although not sufficient—conditions for an adequate diet. All three—effective demand, adequate supply, and a participatory gumbo that strengthens individuals, communities, and local institutions through education and action on pressure points in the local food system—are needed to make inroads on the food access problem and the underlying structures that create it.