**Preface to "Urban Food Deserts: Perspectives from the Global South"**

#### **Food Deserts in the Global South: Mirage, Metaphor or Model**

Jonathan Crush and Zhenzhong Si

The rapid and accelerating urbanization of the Global South has been accompanied by a major transformation in food systems, growing food insecurity and unhealthy food consumption (Crush et al., 2020). A recurrent question is whether concepts and methodologies used to understand deprived neighbourhoods in cities of the Global North have any relevance to the unfolding dynamics of urbanization in the Global South. One such concept is the representation of urban spaces as "food deserts". Over the last two decades, the terminology of the "food desert" has generated vigorous debate across the social and health sciences on issues of definition, identification, measurement, location, characteristics and health impacts (Sadler et al., 2016). The term first entered the policy and research arena in the UK in the 1990s as part of a government effort to understand and address the issue of lack of access to foods integral to a healthy diet in low-income neighbourhoods in British cities (Wrigley et al., 2002; also Cummins and McIntyre, 2002; Whelan et al., 2002). As part of a major study of the city of Leeds, Wrigley (2002) defined food deserts as "the complex nexus of interlinkages between increasing health inequalities, retail-development induced differential access to food retail provision, compromised diets, undernutrition and social exclusion." From here, the genealogy of studies of food deserts took two different directions. In the UK, it initially led to a complex classification of different types of food desert (Shaw, 2006) but increasingly came to be seen as a potentially stigmatizing metaphor (McEntee, 2009) and fell out of general use. Shannon (2014, 2016a) and Widener (2018) imply that everyone should, in effect, follow the British example and retire the term altogether.

In North America, however, food deserts were increasingly viewed as real entities with specific quantifiable characteristics demanding particular public and private policy interventions (Walker et al., 2010). Wrigley's complex and somewhat awkward formulation was stripped to the bare essentials, with the United States Department of Agriculture defining a food desert in technocratic fashion as "a low-income census tract where a substantial number or share of residents has low access to a supermarket or large grocery store" (USDA, nd). The assumption was that supermarkets and large grocery stores were the optimal, indeed only, purveyors of healthful foods, and that food deserts were urban spaces in which the residents enjoyed limited or no access to these food retail outlets. As Dutko et al. (2012) noted with statistical precision, food deserts are "low-income tracts in which a substantial number or proportion of the population has low access to supermarkets or large grocery stores" and in which at least 500 people or 33% of the tract population reside more than one mile from a supermarket or large grocery store in urban areas. Others disaggregated further and suggested using census blocks rather than tracts as the basic unit of food desert analysis (Alviola et al., 2013). Dutko et al. (2012) concluded that 4175 census tracts in the US fit their urban food desert criteria (or 23% of all low-income tracts and 8% of all urban tracts). Chen et al. (2016) later found that the food desert status of census tracts was positively associated with rates of obesity

While the appeal of statistical exactitude for interventionist policy-makers battling poor diets and the obesity pandemic in American cities is clear, various critics have taken issue with this formulation of the food desert and the implication that expanded access to supermarkets will inevitably have positive nutritional and health-related impacts. Researchers have argued, for example, that the idea of food deserts is more a mirage than a metaphor (Winegar, 2020). First, they suggest that food access is not the only, or indeed the primary, driver of dietary behaviour, as posited by the food deserts literature. In this vein, Rodier et al. (2017) and Wright et al. (2016) argue that access to supermarkets is not the main factor in whether or not households consume healthier foodstuffs. Second, some have questioned whether the advent of supermarkets in food deserts automatically leads to greater availability, access and consumption of healthy food (Allcott et al., 2019; Dubowitz et al., 2015; Ghosh-Dasditar et al., 2017; Shannon, 2016). Third, equating healthy food access with supermarket presence/absence ignores the presence and role of other actual and potential sources of healthier foods, including farmers and ethnic markets (Brinkley et al., 2017; Joassart-Marcelli et al., 2017). Finally, there is the argument that the conventional literature on food deserts downplays or overlooks the key role of unhealthy but accessible food sources, including fast food outlets and supermarkets themselves (Vaughan et al. 2017). The newer focus on unhealthy eating has led to the labelling of some urban spaces as "food swamps" rather than deserts, defined as areas with a high density of establishments selling high-calorie fast food and junk food relative to healthier food options (Cooksey-Stowers et al., 2017; see also Lucan et al., 2020; Osorio et al., 2013; Otterbach et al., 2021; Yang et al., 2020). The alternate term, "obesogenic environments", is sometimes used to describe a combination of poor food consumption and sedentary lifestyle (Townshend and Lake, 2017).

Turner et al.'s (2020) recent survey of food research in the Global South identified "a significant research gap given the fundamental differences between HICs [High-Income Countries] and LMICs [Low- and Middle-Income Countries] with regard to food systems, food environments, food acquisition and consumption practices, and public health nutrition challenges." They find only a smattering of case studies focused on whether food deserts, conventionally defined, exist in cities of the Global South (Su et al., 2017; Bridle-Fitzpatrick, 2015; Davies et al., 2017; Gartin, 2012; see also Gartin, 2015). A similar review of research on urban food environments in Africa makes no mention of food deserts at all (Osei-Kwasi et al., 2020), although the same authors use the more generic term "deprived neighbourhoods" in their study of unhealthy eating practices in urban Ghana and Kenya (Holdsworth et al., 2020). The emerging African urban food security literature has argued, in essence, that in African cities, classic food deserts are at best a metaphor and more likely a mirage (Battersby, 2012; Battersby and Crush, 2014; Crush and Battersby, 2016). In other words, this essentially mechanistic Northern conception seems to have no place in the new urban lexigraphy of Africa and the South more generally (Parnell and Oldfield, 2014).

The limited application of the concept of food deserts in the Global South is certainly not because poverty and food access insecurity in towns and cities is not a problem. On the contrary, lack of access to healthy foods is endemic in many cities and spatially concentrated in informal or slum settlements (Crush, 2016; Ruel et al., 2017; Tacoli, 2020). Evidence is rapidly mounting about the nature, extent and drivers of the access dimension of urban food insecurity and inequality in Africa (Battersby and Watson, 2019; Crush et al., 2018; Frayne et al., 2018, Owuor, 2018; Raimundo et al., 2018; Tuholske et al., 2020), Asia (Anand et al., 2019; Rautela, 2020; Koduganti et al., 2019) and Latin America and the Caribbean (Capron et al., 2018; Kinlocke et al, 2019; Rossi et al., 2017). Various reasons have been advanced for why the concept of food deserts has been marginal to date in the growing literature on urban food insecurity in the Global South (Crush and Battersby, 2016; Tacoli, 2020). First, there are currently significant data limitations at the city level, constraining the kind of spatial mapping and analysis common in the literature on food deserts. Such data could certainly be collected, but current city-wide data on food consumption and sourcing behaviour has to be generated at some cost (in a context where much research funding is directed towards rural rather than urban food issues) (Crush and Riley, 2019). Second, the association of supermarkets with healthier consumption patterns that was central to the earlier food deserts literature has never been replicated in the Global South. On the contrary, the well-documented "supermarket revolution" (das Nair, 2020) is more often associated with a nutrition transition involving increased consumption of unhealthy foods and an associated pandemic of obesity and non-communicable disease (Hawkes, 2008; Kimenju et al., 2015; Popkin, 2017; Popkin and Reardon, 2018; Zhou et al., 2015). While supermarkets have a limited presence in many low-income neighbourhoods and informal settlements, they do not appear to have a significant positive nutritional impact when they become more physically accessible (Battersby and Peyton, 2016; Demmler et al., 2017; Holdsworth et al., 2020; Khonje and Qaim, 2019; Peyton et al., 2015; Wanyama et al., 2019). This finding, at least, is consistent with the emerging critique of supermarkets and food deserts in North America cited above.

Third, as Battersby and Crush (2016: 12) argue, the dynamism and complexity of the informal food economy offers a particular set of challenges to the conventional food deserts approach. The informal food sector (which includes informal markets, street vendors, mobile vendors, home-based traders and informal shack structures) is an essential component of the foodscape in all cities of the Global South, despite the best efforts of governments to eliminate, control or circumscribe its activities (Young and Crush, 2020). In many countries, informal and formalized small-scale food vendors operate out of publicly sanctioned food markets, which, along with other forms of informal vending, play a critical role in making food more accessible in low-income and impoverished urban neighbourhoods, many of which are also informal (Si et al., 2019). Although the jury is out on the importance of non-market food sources, both urban and peri-urban agriculture and rural–urban food remittances are also potentially important routes of access to food in deprived neighbourhoods (Conforti et al., 2020; Crush and Caesar, 2020).

Growing reservations about the concept of food deserts in the Global North and limited uptake in the Global South raise an obvious set of questions. Do conventional food deserts actually exist in rapidly urbanizing cities and towns in the South? Or is the concept of food deserts simply a helpful metaphor to highlight profound spatial inequities in healthy food availability and access in urban spaces? Or should it simply be dismissed as a misleading mirage without form or substance? Another alternative is to (re)model the concept and redefine the term to "fit" Southern urbanization and food system realities. Crush and Battersby (2016: 13) argue that any use of the food deserts concept in the South requires a much more sophisticated understanding of multiple market and non-market food sources, the spatial mobility of informal food retail and poor consumers, the changing dynamics of food security over time, the inter-household differences that lead to different experiences of food insecurity, and the specific conditions that lead to compromised diets, undernutrition and social exclusion. They propose an alternate definition of Southern urban food deserts as "poor, often informal, urban neighbourhoods characterised by high food insecurity and low dietary diversity, with multiple market and non-market food sources but variable access to food." While the chapters in this book do not necessarily subscribe to this alternative definition, most address questions and hypotheses about the spatial dimensions of food retailing, food accessibility, food consumption and food outcomes suggested by such a (re)modelling of the Northern concept of food deserts.

Article 1, by Jane Battersby, revisits the relevance of the food desert as a concept and policy tool in Africa and concludes that it offers both opportunities and risks. She argues that the policy fix for food desertification of promoting supermarket expansion rests on three problematic assumptions: that supermarkets improve access to healthy food, that residents of low-income areas have poor access to healthy foods and that food insecurity in urban areas is simply about economic and physical access to food outlets. Based on data from South Africa, Zambia and Kenya, she systematically deconstructs each assumption, concluding that supermarkets are not providing access to healthy food but rather are increasing the consumption of processed foods and accelerating the nutrition transition; that many residents in low-income areas do have very food access to fresh produce through informal vendors; and that food utilization (not availability and access) is the key determinant of food insecurity in urban centres. As a result, the model of supermarkets as a pathway to food security derived from the orthodox food deserts literature is inherently problematic as a policy fix.

Article 2, by Jeremy Wagner, Lucy Hinton, Cameron McCordic et al., suggests and tests three alternative models from the food deserts literature—what they refer to as classic food deserts (Model 1), food deserts plus (Model 2), and food deserts in the Global South (Model 3 as redefined by Crush and Battersby (2016)). They then test the validity of each of these models using household survey evidence from two contrasting cities: Mexico City and Nairobi, Kenya (Capron et al., 2018; Owuor, 2018). Through testing various hypotheses about the relationship between food insecurity and consumer purchasing behaviour, they conclude that food deserts in the South "should not be understood through the proxy measurement of supermarket access," since this ignores the plurality of food sourcing options that residents patronize. They conclude with a call for greater understanding of the complexity of food deserts that includes factors such as mobility, transportation, time, education, structural inequalities and neighbourhood policy environments.

Article 3, by Jonathan Crush, Ndeyapo Nickanor and Lawrence Kazembe, suggests that city-wide surveys may help identify food and nutrition security inequality and spaces of deprivation, but it is important to drill down into the food environment in these urban spaces and assess whether they resemble any of the orthodox and newer definitions of food deserts. They build on the earlier analysis of Nickanor (2013) and Nickanor and Kazembe (2016), labelling urban informal settlements in Namibia as food deserts and showing that these are spaces of extremely high vulnerability to food insecurity. However, at the same time, they are not food-deprived. Formal and informal retailers ensure that food is available. Poor households do not patronize supermarkets for fresh produce but rather find it more economical to buy staple cereals in bulk on a monthly basis from distant supermarkets and rely on informal vendors for daily food purchases. In these informal food deserts, however, poverty and irregular income mean that most are unable to access food in sufficient quantity, quality, variety and regularity.

Article 4, by Cameron McCordic and Ezequiel Abrahamo, develops the core idea that residents of low-income food deserts are not all equally deprived or food-insecure. One of the major failings of the conventional food deserts approach is that it does not incorporate a gender analysis of food inequality and accessibility (Riley and Dodson, 2020). Using household survey data from the twin cities of Maputo and Matola, Mozambique, their paper demonstrates that compromised household access to water, electricity, medical care, cooking fuel, and cash are all associated with increased odds of severe household food insecurity. In addition to the spatial accessibility of food retailers and food items, they argue that social support networks (including family structure) influence the degree of vulnerability to food insecurity associated with urban food deserts. Their analysis confirms the findings of others that female-centred households (with a female head and no male spouse or partner) are more susceptible to severe food insecurity than other household types (Riley and Legwegoh, 2018; Riley and Caesar, 2018).

Article 5, by Feyisayo Oduntiwan-Wayas, Kufre Okop and Robert Dover et al., focuses on the food purchasing behaviour and perceptions of supermarket shoppers in the City of Cape Town, South Africa, using data from intercept surveys. The primary objective of the paper is to compare the food choice behaviours of supermarket shoppers from low, middle and higher socioeconomic areas and to show how consumers from these different areas differ in their perceptions of supermarket produce and healthy foods. They also disrupt the notion that food choice behaviour is conditioned purely by the local food environment. Many lower socio-economic shoppers were not from the neighbourhoods where the supermarkets were located, instead engaging in what they and others have called "outshopping", related primarily to the fact that they live in supermarket-deprived areas but work (and food shop) in areas of the city where there are more supermarkets. The practice of outshopping disrupts a fundamental premise of the conventional food deserts approach that implicitly assumes that residents of food deserts only purchase their food within the boundaries of the desert itself.

Articles 6 and 7 reorient the food desert discussion by focusing on the nutrition transition and increased consumption of processed foods (Reardon et al., 2021). They address the question of whether the food environment of urban centres in the Global South is increasingly dominated by unhealthy consumption behaviour and therefore whether the idea of food deserts should be replaced by that of food swamps or obesogenic environments (Bridle-Fitzpatrick, 2015; Drimie et al., 2013; Kimagi-Murange et al., 2015). In this context, Article 6 by Bruce Frayne and Cameron McCordic notes that while the literature on food deserts focuses on the limited availability of food in urban settings, food swamps may better characterize the extensive prevalence and accessibility of cheap, highly processed foods. Their paper focuses on the long-term health vulnerability implications for children of limited access to adequate and nutritious food in rapidly urbanizing cities. Their analysis uses African Urban Food Security Network (AFSUN) data for over 6000 households drawn from low-income neighbourhoods in 11 cities and 9 countries in Southern Africa. They find that children in these households consume a limited diversity of food and are more prone to experiencing both short-term and long-term food and nutrition insecurity.

Article 7, by Florian Kroll, Elizabeth Swart, and Reginald Annan et al., provides a comparative analysis of the drivers of increased consumption of ultra-processed, energy-dense and micronutrient-poor foods, and the associated rapid rise in rates of obesity and NCDs in two different African settings: Ghana and South Africa. Their paper explores correlations and linkages between neighbourhood and household food environments, as reflected in household purchasing and consumption patterns of obesogenic foods in two low-income neighbourhoods in Accra and Cape Town. They find high levels of purchase and consumption of ultra-processed foods in both urban settings, although household food environments promoting obesity are more prevalent in Cape Town and neighbourhood food environments, also make obesogenic foods more accessible and available, despite the greater incidence of poverty in the former. At the same time, households experiencing income deprivation consume far less obesogenic foods. Thus, within food swamps, higher incomes appear to be correlated with greater obesogenic food consumption.

Article 8, by Taiyang Zhong, Zhenzhong Si, and Jonathan Crush et al., examines the very different context of Nanjing, China, where private–public partnerships and a highly interventionist food system policy has all but eliminated severe household food insecurity (Zhong et al., 2019). Central to the Nanjing food system is a city-wide network of open markets selling fresh produce, and although the market share of supermarkets is growing, they tend to be the main source of the processed and convenience foods that are becoming more prevalent in the diets of the city's residents. The paper revisits the whole concept of food accessibility and, by extension, the inconclusive evidence that the neighbourhood food environment impacts diet and obesity (An et al., 2020). Using data from a 2015 HCP household survey, the paper examines whether dietary diversity is in any way associated with physical proximity to the two major food outlets. The resultant insignificant correlations are attributed to high physical accessibility to food outlets and the extensive spatially dense food supply network constituted by wet markets, supermarkets and small food stores in Nanjing.

Article 9, by Camila Borges, William Cabral-Miranda and Patricia Jaime, also focuses on the major food sources in their study of the food environment in Sao Paulo, Brazil, against the backdrop of the Brazilian Dietary Guidelines recommendation to avoid the consumption of ultra-processed foods. They inventory the food items in over 600 different food retail outlets (including grocery stores, bakeries, convenience stores, butchers and fish markets, supermarkets/hypermarkets/wholesalers and municipal markets of fruits and vegetables) and show the availability of unprocessed foods, ingredients, processed foods and ultra-processed foods according to retail types. They actually find that supermarkets/hypermarkets/wholesalers were the outlets with the greatest availability of both minimally and ultra-processed foods. Public markets also had high availability of minimally processed food items and amongst the lowest availability of ultra-processed foods. Spatially, as predicted by the classic food deserts model, they report a lower density of food retailers selling healthy foods in low-income neighbourhoods. Other urban spaces in the municipality are classified as food swamps or, as they observe, "areas that have adequate access to healthy foods but are flooded with opportunities to consume calorie-dense foods and drinks."

#### **References**


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> **Jonathan Crush, Zhenzhong Si** *Editors*
