The Flea: Not just a vector of disease, but a source of health promotion

In his post on “Feeling is Believing,” Evan described how public health professionals may see “factors such as fresh produce as insignificant, since we often come from areas where fresh produce is readily available.” Over the course of the last decade, food deserts have emerged as a public health issue. Although there is no standard definition of a food desert, the CDC defines food deserts as “areas that lack access to affordable fruits, vegetables, whole grains, low fat milk, and other foods that make up the full range of a healthy diet.”  George Kaplan, the founding and former Director of the Center for Social Epidemiology and Population Health at the University of Michigan, defined food deserts as “areas with no or distant grocery stores” (In “Examining the Impact of Food Deserts on Public Health in Chicago”). The Rio Grande Valley (RGV) has one grocery store chain, HEB, and big box stores like Wal-Mart sell fresh produce.

In addition to these retail outlets, our project also sought to discern other sources of fruits and vegetables and whether there was interest among RGV residents to increase the proportion of food they grew themselves. Over the course of three days of survey administration and engaging conversations with RGV residents, I learned about these “other” sources of fruits and vegetables. From the nopales (cactus) that grew wild in residents’ backyards to las pulgas (flea markets), RGV residents utilized a wide array of retail and non-retail outlets for their food.

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Heather, Kevin, Evan, and I were able to obtain fresh fruit and vegetables from a vast majority of places. We bought tomatoes from HEB, mangoes from la pulga, papaya from the puesto de comida al lado de la carretera (fruit stands on the side of the road), and were given oranges by a friend. We didn’t get a chance to try the cactus (next time!), but I felt that the four of us had engaged in community-based participatory research. Our experiences at la pulga and the puesto de comida al lado de la carretera allowed us to make a personal connection with RGV residents. When we talked about the mangoes we had purchased, we learned about why la pulga was a source of fresh produce for many (price, quality, and ambience). Evan mentioned that “it isn’t until we listen to stories…where we truly can see the impact of something as simple” as fresh produce.” Fresh produce, we learned, was just as much about health and nutrition as it was about community and social gatherings.

When defining a food desert, Dr. Kaplan also emphasized that the “verb “desert” focuses on action and agency, emphasizing that the lack of access to good food in some areas is not a natural, accidental phenomenon but is instead the result of decisions made at multiple levels by multiple actors.” These actors range from the owners of grocery stores and the vendors at the flea market (and their decision to sell fresh produce at the level of quality and prices they do) to the consumers (and their decision to purchase and consume fruits and vegetables). For known and unknown reasons, these decisions are often out of the hands of many of the RGV residents. And, this is where action and agency on the part of residents and public health is imperative to reduce barriers and facilitate the access, affordability, and availability of healthy food choices. If we are to reduce the obesity and diabetes rates in the RGV and other communities in the US, we need to address the social, political, and economic factors that lead to health disparities. And, more importantly, we must consider the unique attributes of each of these communities that will assist or hinder our efforts to achieve health equity.

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