Theoretical issues in the ‘food desert’ debate and ways forward


Food is essential to life—yet the spatial and economic configuration of the conventional food system does not meet nutritional needs and exacerbates issues of food insecurity. Relevant options for policy change have been explored in light of evaluations of geographic disparities in food access, but the dominant ‘food desert’ discourse often focuses uncritically on insufficient conceptions of access. Understanding the complexity of food deserts is important for moving into meaningful policy action. We present a theoretical position to inspire future empirical research. The ecological model recognizes both endogenous and built environment factors in shaping health. Interventions in the food environment, however, often concentrate exclusively on structural determinants of health (e.g. retail-based initiatives). Yet retail-based interventions are difficult to implement due to governance systems which limit the ability of government bodies to influence private retail development. As well, recognizing the complexity of debates over the influence of structure and agency, we apply structuration theory to food deserts. Behavioral economics further informs both structural and behavioral determinants of health. This approach sidesteps the issue of victim-blaming, as all consumers are viewed as ‘predictably irrational’ in decision-making. In combining these theories, we challenge methodological and theoretical assumptions by showing the complexity of food desert interventions. Policy recommendations focus on behavioral determinants of health and the opportunities for empowerment through local food systems. These recommendations recognize the limits of translating research into policy and in devising effective food based interventions, and are sensitive to social, economic, and political constraints uncovered throughout the paper.

This is a preview of subscription content, log in to check access.

Access options

Buy single article

Instant unlimited access to the full article PDF.

US$ 39.95

Price includes VAT for USA

Subscribe to journal

Immediate online access to all issues from 2019. Subscription will auto renew annually.

US$ 199

This is the net price. Taxes to be calculated in checkout.


  1. Alaimo, K., Packnett, E., Miles, R. A., & Kruger, D. J. (2008). Fruit and vegetable intake among urban community gardeners. Journal of Nutrition Education and Behavior, 40(2), 94–101.

  2. Algazy, J., Gipstein, S., Riahi, F., & Tryon, K. (2010). Why governments must lead the fight against obesity. McKinsey Quarterly: Healthcare Payor and Provider Practice, October, 1–19.

  3. Alkon, A. H., & Mares, T. M. (2012). Food sovereignty in US food movements: Radical visions and neoliberal constraints. Agriculture and Human Values, 29(3), 347–359.

  4. Allen, P. (1999). Contemporary food and farm policy in the United States. In M. Koc, R. MacRae, L. J. A. Mougeot, & J. Welsh (Eds.), For hunger-proof cities. International Development Research Centre: Ottawa.

  5. Allen, P., & Hinrichs, C. (2007). Buying into ‘Buy Local’: Engagements of United States local food initiatives. In D. Maye, L. Holloway, & M. Kneafsey (Eds.), Alternative food geographies: Representation and practice. Elsevier Science: Oxford.

  6. Ashton, D. (2004). Food advertising and childhood obesity. Journal of the Royal Society of Medicine, 97(2), 51–52.

  7. Beaulac, J., Kristjansson, E., & Cummins, S. (2009). A systematic review of food deserts, 1966–2007. Preventing Chronic Disease, 6(3), 1–10.

  8. Bedore, M. (2013). Geographies of capital formation and rescaling: A historical-geographical approach to the food desert problem. The Canadian Geographer, 57(2), 133–153.

  9. Blanchard, T., & Matthews, T. L. (2006). The configuration of local economic power and civic participation in the global economy. Social Forces, 84(4), 2241–2257.

  10. Borron, S. M. (2003). Food policy councils: Practice and possibility. Congressional Hunger Center, Hunger-Free Community Report. Eugene, OR: FOOD for Lane County.

  11. Branas, C. C., Cheney, R. A., MacDonald, J. M., Tam, V. W., Jackson, T. D., & Ten Have, T. R. (2011). A difference-in-differences analysis of health, safety, and greening vacant urban space. American Journal of Epidemiology, 174(11), 1296–1306.

  12. Brown, K. H., & Jameton, A. L. (2000). Public health implications of urban agriculture. Journal of Public Health Policy, 21(1), 20–39.

  13. Brownson, R. C., Hartge, P., Samet, J. M., & Ness, R. B. (2010). From epidemiology to policy: Toward more effective practice. Annals of Epidemiology, 20(6), 409–411.

  14. Byrom, J. W., Bennison, D. J., Hernandez, T., & Hooper, P. D. (2001). The use of geographical data and information in retail locational planning. Journal of Targeting Measurement and Analysis for Marketing, 9(3), 219–229.

  15. Camerer, C., Issacharoff, S., Loewenstein, G., O’Donoghue, T., & Rabin, M. (2003). Regulation for conservatives: Behavioral economics and the case for “Asymmetric Paternalism”. University of Pennsylvania Law Review, 151(3), 1211–1254.

  16. Carpiano, R. M., & Daley, D. M. (2005). A guide and glossary on postpositivist theory building for population health. Journal of Epidemiology and Community Health, 60(7), 564–570.

  17. Chou, S. Y., Rashad, I., & Grossman, M. (2005). Fast-food restaurant advertising on television and its influence on childhood obesity (No. w11879). National Bureau of Economic Research.

  18. City of Flint (2013). Imagine Flint Master Plan. Accessed 8 Feb 2015 from

  19. Coveney, J., & O’Dwyer, L. A. (2009). Effects of mobility and location on food access. Health and Place, 15(1), 45–55.

  20. Cummins, S., Curtis, S., Diez-Roux, A. V., & Macintyre, S. (2007). Understanding and representing ‘place’ in health research: A relational approach. Social Science and Medicine, 65(9), 1825–1838.

  21. Cummins, S., Findlay, A., Petticrew, M., & Sparks, L. (2008). Retail-led regeneration and store-switching behavior. Journal of Retailing and Consumer Services, 15(4), 288–295.

  22. Cummins, S., Flint, E., & Matthews, S. A. (2014). New neighborhood grocery store increased awareness of food access but did not alter dietary habits or obesity. Health Affairs, 33(2), 283–291.

  23. Cummins, S., & Macintyre, S. (2002a). “Food deserts”—evidence and assumption in health policy making. British Medical Journal, 325(7361), 436–438.

  24. Cummins, S., & Macintyre, S. (2002b). A Systematic study of an urban foodscape: The price and availability of food in greater Glasgow. Urban Studies, 39(11), 2115–2130.

  25. Cummins, S., Petticrew, M., Sparks, L., & Findlay, A. (2005). Large scale food retail interventions and diet. British Medical Journal, 330(7493), 683–684.

  26. Curtis, S., & Jones, I. R. (1998). Is there a place for geography in the analysis of health inequality? Sociology of Health & Illness, 20(5), 645–672.

  27. Dean, K. (2004). The role of methods in maintaining orthodox beliefs in health research. Social Science and Medicine, 58(4), 675–685.

  28. DeLind, L. B. (2011). Are local food and the local food movement taking us where we want to go? Or are we hitching our wagons to the wrong stars? Agriculture and Human Values, 28(2), 273–283.

  29. Donald, B. (2013). Food retail and access after the crash: Rethinking the food desert problem. Journal of Economic Geography, 13(2), 231–237.

  30. Dowler, E., & Caraher, M. (2003). Local food projects: The new philanthropy? The Political Quarterly, 74(1), 57–65.

  31. Downs, J. S., Loewenstein, G., & Wisdom, J. (2009). Strategies for promoting healthier food choices. American Economic Review, 99(2), 1–10.

  32. Dunn, J. R. (2006). Speaking theoretically about population health. Journal of Epidemiology and Community Health, 60(7), 572–573.

  33. Egger, G., & Swinburn, B. (1997). An “Ecological” approach to the obesity pandemic. British Medical Journal, 315(7106), 477–480.

  34. Escaron, A. L., Meinen, A. M., Nitzke, S. A., & Martinez-Donate, A. P. (2013). Supermarket and grocery store–based interventions to promote healthful food choices and eating practices: A systematic review. Preventing Chronic Disease, 10(120156).

  35. Frohlich, K. L., Corin, E., & Potvin, L. (2001). A theoretical proposal for the relationship between context and disease. Sociology of Health & Illness, 23(6), 776–797.

  36. Gatrell, A. C., & Elliott, S. J. (2009). Geographies of health: An introduction (2nd ed.). Hoboken: Wiley-Blackwell.

  37. Geyskens, K., Pandelaere, M., Dewitte, S., & Warlop, L. (2007). The backdoor to overconsumption: The effect of associating “low-fat” food with health references. American Marketing Association, 26(1), 118–125.

  38. Gittelsohn, J., & Lee, K. (2013). Integrating educational, environmental, and behavioral economic strategies may improve the effectiveness of obesity interventions. Applied Economic Perspectives and Policy, 35(1), 52–68.

  39. Gortmaker, S. L., Swinburn, B. A., Levy, D., Carter, R., Mabry, P. L., Finegood, D. T., et al. (2011). Changing the future of obesity: Science, policy, and action. Lancet, 378(9793), 838–847.

  40. Green, L. W., Richard, L., & Potvin, L. (1996). Ecological foundations of health promotion. American Journal of Health Promotion, 10(4), 270–281.

  41. Guthman, J. (2008). Bringing good food to others: Investigating the subjects of alternative food practice. Cultural Geographies, 15(4), 431–447.

  42. Guy, C. M. (1998). Controlling new retail spaces: The impress of planning policies in Western Europe. Urban Studies, 35(5–6), 953–979.

  43. Guy, C. M. (1999). Retail location analysis. In M. Pacione (Ed.), Applied geography: Principles and practice. London: Routledge.

  44. Handy, S. L., & Clifton, K. J. (2001). Local shopping as a strategy for reducing automobile travel. Transportation, 28(4), 317–346.

  45. Harper, A., Shattuck, A., Holt-Gimenez, E., Alkon, A., & Lambrick, F. (2009). Food policy councils: Lessons learned. Institute for food and development policy.

  46. Harris, J. L., Pomeranz, J. L., Lobstein, T., & Brownell, K. D. (2009). A crisis in the marketplace: How food marketing contributes to childhood obesity and what can be done. Annual Review of Public Health, 30(1), 211–225.

  47. Jacobs, A. J. (2009). The impacts of variations in development context on employment growth: A comparison of central cities in Michigan and Ontario, 1980–2006. Economic Development Quarterly, 23(4), 351–371.

  48. Johnson, E. J., Shu, S. B., Dellaert, B. G. C., Fox, C., Goldstein, D. G., Häubl, G., et al. (2012). Beyond nudges: Tools of a choice architecture. Marketing Letters, 23(2), 487–504.

  49. Just, D. R. (2006). Behavioral economics, food assistance, and obesity. Agricultural and Resource Economics Review, 35(2), 209–220.

  50. Just, D. R., & Payne, C. R. (2009). Obesity: Can behavioral economics help? Annals of Behavioral Medicine, 38(1), 47–55.

  51. Kearns, R. A. (1993). Place and health: Towards a reformed medical geography. The Professional Geographer, 45(2), 139–147.

  52. Kearns, R., & Moon, G. (2002). From medical to health geography: Novelty, place and theory after a decade of change. Progress in Human Geography, 26(5), 605–625.

  53. Khan, F. (2011). Combating obesity through the built environment: Is there a clear path to success? Public Health Reform, Spring, 387–393.

  54. Kumar, A., & Levinson, D. (1995). Chained Trips in Montgomery County, Maryland. ITE Journal, May, 27–32.

  55. Lang, T., & Caraher, M. (1998). Access to healthy foods: Part II. Food poverty and shopping deserts: What are the implications for health promotion policy and practice? Health Education Journal, 57(3), 202–211.

  56. Lawrence, M., & Swinburn, B. (1993). The role of policy in preventing childhood obesity. In E. Waters, B. A. Swinburn, J. C. Seidell, & R. Uauy (Eds.), Preventing childhood obesity: Evidence policy and practice. Oxford: Blackwell Publishing.

  57. Lee, H. (2012). The role of local food availability in explaining obesity risk among young school-aged children. Social Science and Medicine, 74(8), 1193–1203.

  58. Lytle, L. A. (2009). Measuring the food environment: State of the science. American Journal of Preventive Medicine, 36(4S), 134–144.

  59. Morland, K., Diez-Roux, A. V., & Wing, S. (2006). Supermarkets, other food stores, and obesity: The atherosclerosis risk in communities study. American Journal of Preventive Medicine, 30(4), 333–349.

  60. Murdoch, J., Marsden, T., & Banks, J. (2000). Quality, nature, and embeddedness: Some theoretical considerations in the context of the food sector. Economic Geography, 76(2), 107–125.

  61. Neff, R. A., Palmer, A. M., McKenzie, S. E., & Lawrence, R. S. (2009). Food systems and public health disparities. Journal of Hunger & Environmental Nutrition, 4(3–4), 282–314.

  62. Nestle, M. (2003). Food politics: How the food industry influences nutrition and health. Los Angeles: University of California Press.

  63. Niles, D., & Roff, R. J. (2008). Shifting agrifood systems: The contemporary geography of food and agriculture; an introduction. GeoJournal, 73(1), 1–10.

  64. Oliver, A. (2011). Is nudge an effective public health strategy to tackle obesity? Yes. British Medical Journal, 342(d2168), 898–899.

  65. Pearce, J., Hiscock, R., Blakely, T., & Witten, K. (2008). The contextual effects of neighbourhood access to supermarkets and convenience stores on individual fruit and vegetable consumption. British Medical Journal, 62(3), 198–201.

  66. Pothukuchi, K. (2005). Attracting supermarkets to inner-city neighborhoods: Economic development outside the box. Economic Development Quarterly, 19(3), 232–244.

  67. Prevention Research Center of Michigan. (2009). Speak to your health community survey. Ann Arbor, MI: Prevention Research Center of Michigan.

  68. Pykett, J. (2011). The new maternal state: The gendered politics of governing through behaviour change. Antipode, 44(1), 217–238.

  69. Rayner, G., & Lang, T. (2011). Is nudge an effective public health strategy to tackle obesity? No. British Medical Journal, 342(d2177).

  70. Reidpath, D. D., Burns, C., Garrard, J., Mahoney, M., & Townsend, M. (2002). An ecological study of the relationship between social and environmental determinants of obesity. Health & Place, 8(2), 141–145.

  71. Robertson, A. (1998). Shifting discourses on health in Canada: From health promotion to population health. Health Promotion International, 13(2), 155–164.

  72. Sadler, R. C., Arku, G., & Gilliland, J. A. (2014). Local food networks as catalysts for food policy change to improve health and build the economy. Local Environment: The International Journal of Justice & Sustainability. doi:10.1080/13549839.2014.894965.

  73. Sadler, R. C., Clark, M. A. R., & Gilliland, J. A. (2013a). An economic impact comparative analysis of farmers’ markets in Michigan and Ontario. Journal of Agriculture, Food Systems, and Community Development, 3(3), 61–81.

  74. Sadler, R. C., Gilliland, J. A., & Arku, G. (2011). An application of the edge effect in measuring accessibility to multiple food retailer types in rural Southwestern Ontario, Canada. International Journal of Health Geographics, 10(1), 34.

  75. Sadler, R. C., Gilliland, J. A., & Arku, G. (2013b). A food retail-based intervention on food security and consumption. International Journal of Environmental Research and Public Health, 10(8), 3325–3346.

  76. Sadler, R. C., Gilliland, J. A., & Arku, G. (2013c). Community development and the influence of new food retail sources on the price and availability of nutritious food. Journal of Urban Affairs, 35(4), 471–491.

  77. Sallis, J. F., Cervero, R. B., Ascher, W., Henderson, K. A., Kraft, M. K., & Kerr, J. (2006). An ecological approach to creating active living communities. Annual Review of Public Health, 27(1), 297–322.

  78. Schindler, S. (2013). Understanding urban processes in Flint, Michigan: Approaching ‘subaltern urbanism’inductively. International Journal of Urban and Regional Research, 38(3), 791–804.

  79. Schuering, E. S. (2011). “Perennial growth” in a Shrinking City: A case study of urban agriculture policy and planning in Cleveland, Ohio. Unpublished Master’s Thesis. Chicago, IL: DePaul University.

  80. Schwartz, J., Riis, J., Elbel, B., & Ariely, D. (2012). Inviting consumers to downsize fast-food portions significantly reduces calorie consumption. Health Affairs, 31(2), 399–407.

  81. Seiders, K., & Petty, R. D. (2004). Obesity and the role of food marketing: A policy analysis of issues and remedies. Journal of Public Policy & Marketing, 23(2), 153–169.

  82. Shannon, J. (2013). Food deserts: Governing obesity in the neoliberal city. Progress in Human Geography38(2), 248–266.

  83. Shill, J., Mavoa, H., Allender, S., Lawrence, M., Sacks, G., Peeters, A., et al. (2012). Government regulation to promote healthy food environments: A view from inside state governments. Obesity Public Health, 13(2), 162–173.

  84. Story, M., Kaphingst, K. M., Robinson-O’Brien, R., & Glanz, K. (2008). Creating healthy food and eating environments: Policy and environmental approaches. Annual Review of Public Health, 29(1), 253–272.

  85. Strauss, K. (2008). Re-engaging with rationality in economic geography: Behavioral approach and the importance of context in decision-making. Journal of Economic Geography, 8(1), 137–156.

  86. Thaler, R. (1980). Toward a positive theory of consumer choice. Journal of Economic Behavior & Organization1(1), 39–60.

  87. Thaler, R. H., & Sunstein, C. R. (2003). Libertarian paternalism. American Economic Review, 93(2), 175–179.

  88. Tversky, A., & Kahneman, D. (1981). The framing of decisions and the psychology of choice. Science, 211(4481), 453–458.

  89. United States Department of Agriculture (USDA) Economic Research Service. (2012). Food Access Research Atlas. (accessed on 5 January 2013).

  90. United States Department of Health and Human Services (HHS). (2011). Healthy Food Financing Initiative. (accessed on 5 January 2013).

  91. Veenstra, G., Luginaah, I., Wakefield, S., Birch, S., Eyles, J., & Elliott, S. (2005). Who you know, where you live: Social capital, neighbourhood, and health. Social Science and Medicine, 60(12), 2799–2818.

  92. Walker, R. E., Keane, C. R., & Burke, J. G. (2010). Disparities and access to healthy food in the United States: A review of food deserts literature. Health & Place, 16(5), 876–884.

  93. Walmsley, D. J., & Lewis, G. J. (1993). People and environment: Behavioral approaches in human geography (2nd ed.). New York: Longman.

  94. Walter, S. D. (1991). The ecologic model in the study of environmental health. II: Methodologic issues and feasability. Environmental Health Perspectives, 94(1), 67–73.

  95. Weis, T. (2010). The global food economy: The battle for the future of farming. London: Zed Books.

  96. Westphal, L. M. (2003). Urban greening and social benefits: A study of empowerment outcomes. Journal of Arboriculture, 29(3), 137–147.

  97. Williams, P., & Hubbard, P. (2001). Who is disadvantaged? Retail change and social exclusion. International Review of Retail, Distribution and Consumer Research, 11(3), 267–286.

  98. Winne, M. (2005). Community food security: Promoting food security and building healthy food systems. Venice, CA: Community Food Security Coalition.

  99. Wrigley, N., Warm, D., Margetts, B., & Whelan, A. (2002). Assessing the impact of improved retail access on diet in a ‘food desert’: A preliminary report. Urban Studies, 39(11), 2061–2082.

Download references

Author information

Correspondence to Richard Casey Sadler.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Sadler, R.C., Gilliland, J.A. & Arku, G. Theoretical issues in the ‘food desert’ debate and ways forward. GeoJournal 81, 443–455 (2016).

Download citation


  • Food deserts
  • Ecological model of health
  • Structuration theory
  • Behavioral economics
  • Food systems planning
  • Local food networks