For diabetes patients, oases in the food desert

Rhonda Moore has her health back.

Diagnosed with Type 2 diabetes in 2009, Moore, 58, has reduced her blood glucose levels significantly through healthy eating and daily exercise. But a lack of supermarkets in her North Chicago neighborhood makes it difficult to maintain a nutritious diet — a crucial ingredient in controlling the disease.

"In North Chicago, there are no grocery stores," said Moore, 58. "Buses don't run on weekends. Cabs are expensive. I try to stock up on frozen things. I'd prefer to eat more salads and such, but you can't buy in bulk. It lasts only so long."

Others with Type 2 diabetes face similar hurdles in a number of Chicago neighborhoods and suburban pockets, so-called food deserts where supermarkets are a rarity. In Chicago, the problem persists largely in predominantly African-American neighborhoods on the South and West sides, where access to grocery stores, farmers markets or other vendors selling fresh, high-quality, affordable food is either limited or nonexistent.

"Think what it takes to get back and forth to a grocery store: public transportation, relying on a bus with all those bags," said Monica E. Peek, an assistant professor of medicine at the Chicago Center for Diabetes Translation Research at the University of Chicago. "If you have kids? Trying to coordinate all that can be something else."

Like Moore, Cedric Chambers, 61, of North Chicago, has Type 2 diabetes and struggles to find quality food.

"We have a bunch of little stores but nothing bigger than a corner store," Chambers said. "For me, it's a problem. I don't have a car. I try to get rides to Waukegan."

Chambers and Moore participate in Be Well-Lake County, one of a few new initiatives that have sprouted in the suburbs and the city to increase access to healthy food for Type 2 diabetics and others in food deserts. A community health initiative started by NorthShore University HealthSystem, in collaboration with the Lake County Health Department and its Community Health Center, Be Well-Lake County provides diabetes care and education for medically underserved patients in North Chicago.

"(Type 2) diabetes may not require medicine but it does require lifestyle management with regards to diet and exercise," said Madeleine Shalowitz, a pediatrician at NorthShore. "In a food desert, things like healthy fruit and vegetables, a balance of whole grains and protein are difficult to get."

The Be Well program provides dietitians, nutrition education and healthy cooking methods as well as manage a community vegetable garden where program participants can grow and harvest fresh food.

"We offer education on how to pick healthy food even if a convenience store is your only option," said Christina Arnold, Be Well-Lake County diabetes program coordinator. "We look at what a patient can afford and what is available to them. We've gone out to convenience stores to find healthy choices: apples, bananas, oatmeal."

Also targeting access to healthy food for Type 2 diabetics is the Greenlight Select program, launched in 2010 by Northwestern Medicine, Walgreen Co. and Near North Health Service Corp. for Near North diabetic patients. Its recipients receive "prescriptions" for healthy foods that are redeemable for discounts at certain Walgreens food desert locations.

Because convenience stores are often the only markets in food deserts, the Healthy HotSpot Corner Stores pilot program was launched in November in more than 20 small, local stores in eight Cook County suburban neighborhoods.

In Mount Prospect, for instance, convenience store Mi Mexico is participating in the program, administered by Communities Putting Prevention to Work, a partnership between the Cook County Department of Public Health and the Public Health Institute of Metropolitan Chicago.

With its help, Mi Mexico owner Francisco Perez was able to find potential distributors that could deliver fresh, healthy food items.

"Every day, we increase our healthy foods … wheat bread, fruit," Perez said. "Customers have been more interested in healthy items and have been demanding them."

Daily food choices can be influenced by factors other than the proximity of a supermarket. Healthy foods are generally more expensive on a calorie-by-calorie basis compared with processed junk foods, deterring many shoppers from making healthy choices.

"Calorie-dense food may seem less expensive if you don't take into account food volume and weight," said Rasa Kazlauskaite, an assistant professor in the preventive medicine and internal medicine departments at Rush University Medical Center. "If you approach it by volume, a bag of vegetables is cheaper than a candy bar. You get more for your money, can eat a lot and it's not bad for you."

Still, trying to eat healthfully on a budget is a challenge. "For me, the problem is cost," said diabetic patient Rhina Linares, 56, of Park City. She has a car and only has to drive 10 minutes to the Jewel-Osco between Gurnee and Waukegan.

"I want to buy fish, but it can be as much as $5 a pound."

Brandon Johnson, executive director for the South Side community corporation Washington Park Consortium, said that bringing in more stores won't necessarily mean more affordable, quality foods.

"We work with residents to figure out sustainable solutions to healthy food access," he said. "We're concerned with the quality of food and its affordability. Opening stores without thought of what's being sold does not solve the problem."

Meanwhile, Moore of North Chicago has taken matters into her own hands. She grows tomatoes, cucumbers and other produce at home and freezes them to save herself a trip to a distant supermarket.

"I've learned to plan meals," Moore said. "I try to be smarter about it but accept my diet won't be perfect. I can't worry about it. Worry won't bring a supermarket to town."

Copyright © 2014, Los Angeles Times
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