There's more to Richmond residents' health problems than just nutrition

Driving across the Bridge from Marin to Richmond is not just a trip across the Bay. It’s also a trip across a social divide. On one side of the bridge, Marin’s rolling green hills and roadside bird sanctuaries are laced with bike lanes and trails.

But poverty is visible just across the water. Residents of Richmond’s poorer neighborhoods live with ill-kept parks and without easy access to fresh food. Convenience stores abound, and grocery stores are scarce. That’s why the city of Richmond and local organizations have launched campaigns to increase access to healthy foods and encourage better eating habits. But experts wonder: can the health problems on the rise in Richmond really be defeated by getting people healthier food? Reporter Heather Gilligan finds that the solution may be much more complicated.

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HEATHER GILLIGAN: Easy access to healthy food is a part of life in Marin County. Standing in the produce aisle of Paradise Market, a grocery store in Corte Madera, shoppers are surrounded by a bounty of shiny, fresh fruit. Manolo Aki is the produce manager. He tells me that he tastes the fruit himself before he buys it for the store from a San Francisco wholesaler. 

MANOLO AKI: I look for sweetness. And the looks of the fruit. 

Drive over the Richmond Bridge, and you’ll find a very different food environment. Low-income neighborhoods in Richmond don’t have easy access to the good food so abundant in neighboring Marin. That could be because fresh produce is harder to find in Richmond. But how much food costs is important, too. This is Ellen Wu, the executive director of the California Pan Ethnic Health Network:

ELLEN WU: People who are low-income usually buy meals that are cheap, and high caloric and high in fat.

And city planner LaShonda Wilson says that has a ripple effect. 

LASHONDA WILSON: Obesity and diabetes is a huge issue in the city of Richmond, and it’s increasing.

People like Adam Boisvert want to do something about that. 

ADAM BOISVERT: It's kind of like, you know, go to the quick mart, go pick up a bag of Cheetos, or something. No, you can just go to the apple tree and go get an apple.

He works for Urban Tilth, an organization that’s trying to improve health by improving Richmond’s access to good, fresh food. Urban Tilth started and manages several community gardens in Richmond, including one at Richmond High School.

BOISVERT: So we can go see the actual raised beds themselves.

GILLIGAN: Oh, there’s more?

BOISVERT: Oh, yeah. This is just the student garden. 

Boisvert walks me through the student garden, past tomatoes and collard greens, giving me a leaf of pineapple sage and taste of strawberry fresh off the vine. The strawberry is a little green, but it’s still delicious: tart and sweet at the same time.

BOISVERT: The urban ag class uses most of these things for their own food. The boxes out there, the raised beds out there, are more so for the CSA boxes, the community-supported agriculture project. For the whole community to give food for families, low-income families, in the high school itself.

Community supported agriculture, or CSAs, connect farmers with city dwellers who want fresh, seasonal produce. They grow the food and distribute it to their neighbors.

But Coire Reilly says better health is about more than just how you eat. It’s about the general health environment of your neighborhood.

COIRE REILLY: Parks across Richmond were pretty messed up. Really, out of 55 of those parks, I think there were eight that had bathrooms. And like over half of those eight were in the Marina, which is a very affluent neighborhood.

Reilly is the director of West County HEAL, an organization that’s also working to improve health in Richmond and neighboring San Pablo. HEAL is a public-private collaboration funded by Kaiser, and their reach is wider than Urban Tilth’s.

REILLY: We’re looking to change the built environment. If the environment is healthier, then the people themselves will become healthier. That’s kind of our philosophy, our theory of change.

Reilly worked with stores along Richmond’s 23rd Street to accept payments from WIC, the government’s food assistance program for women, infants and children. He says these changes can add up to a big difference in people’s overall health.

One of the stores working with HEAL is Discolandia. This small Richmond store sells a little of everything, from tortillas to fresh nopales. Thanks to working with HEAL to accept WIC payments, Discolandia’s dairy cases now hold baby formula, yogurt and milk alongside their queso fresco to comply with WIC regulations.

JORGE LERMA: The Latino and minority communities historically have had good eating habits.

Jorge Lerma is the go-between for small local stores and HEAL. He says that Discolandia puts more emphasis on traditional foods to encourage better eating choices.

LERMA: We’ve always relied on the abundance of natural foods. Now is the time to sort of reclaim the good side of all that.

Both Urban Tilth and HEAL are trying to increase access to healthy food, and both organizations seem to reflect a real need in the community for this access. But will access really change how people eat? Experts aren’t so sure.

Helen Lee is a health researcher at the Public Policy Institute of California. She says why people eat what they eat is a complicated question–one that nutritionists and health researchers grapple with.

HELEN LEE: Why bad foods taste good to us … and  they are, in a way, comforting. You know, salty and rich and fatty foods. People of all classes like, for example, potato chips.

And Lee says these comfort foods might end up in the grocery cart–even if the produce is just as cheap.

LEE: It might be true that bananas are really pretty cheap. Cabbage is cheap and it stays a pretty long time. You know, all of these things that, you know, we can point to produce that actually isn’t that expensive. And that can feed a low-income family. You know, if your kids don’t eat it, then it’s a waste of money.

So what is it about being low-income in Richmond and health? Lee says that some health problems can’t be changed by making better food choices available.

LEE: There is something else going on. And that something else–most health researchers think–is stress. And it’s stress in a way that is not being picked up by the things that we usually throw into a statistical model.

In other words, good health is made up of tangible things–what we eat, how much good food we can afford to buy–and intangibles too, like how we feel. 

This takes us back to what Coire Reilly called the "built environment," something that makes good health complicated in cities like Richmond. Reilly used the example of the parks, and it’s a good one. It’s true, some of the city parks are crumbling. But people are afraid to use the parks, even the nicer ones. Richmond’s homicide rate was said to be one of the highest in the country last year. Going outside to play isn’t just fun and games. This is Richmond community affairs coordinator Rochelle Monk:

ROCHELLE MONK: The environment isn’t safe, they don’t feel safe taking their kids to the park to participate in exercise activities. They don’t feel comfortable walking down the street, walking their dog, even, to participate in exercise activities.

So living with violence creates serious stress. It also reduces access to healthy activities like exercise, which also increases stress. Add unhealthy food available at corner stores everywhere, and that’s a recipe for bad health. Experts and community organizations know that Richmond ultimately needs more resources, not just better food, before they city's residents can taste the health benefits enjoyed by their wealthy neighbors.

In Richmond, I’m Heather Gilligan for Crosscurrents.

Do you think bringing fresh food to Richmond may solve the city’s health problems? Or will it take more than that? Chime in with your views. Email us, and comment on this story.