Starving for nutrition

Poor diets and inaccessibility to healthy foods are creating a crisis of chronic disease.

By Gracie Bonds Staples | The Atlanta Journal-Constitution

In many ways, Evie and Ricky Sanders are lucky, and they know it.

On a good day, if their used 2004 Honda Pilot isn’t on the blink, it takes them no more than 10 minutes to drive the 10 miles from their home in Cumming to the nearest Kroger.

Ricky, 57, is a former flower nursery worker who is HIV-positive and struggles with the side effects of his medications. His wife, Evie, 58, is a former nursing assistant who suffers from chronic obstructive pulmonary disease. They live in a three-bedroom wood frame house atop a small hill in rural Forsyth County, where they eke out a living from $1,500 in monthly disability checks and $25 a month in food stamps.

What the Sanders have learned is that, for them at least, even good days have a bad side.

“Most of our shopping is done from the carts where the markdowns are,” Evie says. “We can’t afford name brands.”

To make ends meet, they rely on the monthly supply of staples they get from There’s Hope for the Hungry, a nonprofit organization that feeds 26,000 North Georgia families a year, many of whom, like the Sanders, live in what the USDA calls food deserts. Their homes are located in low-income areas more than one mile from a supermarket or other reliable source of fresh fruits and vegetables.

Nearly 2 million Georgia residents, including about 500,000 children, live in food deserts. The USDA has classified more than 35 food deserts inside the Perimeter. More border I-285 in the suburbs of Cobb, South Fulton and east DeKalb counties. Some experts say there is a direct correlation between food deserts and the state’s high rates of obesity and chronic diseases such as hypertension, diabetes and cancers. Stroke and heart disease are among the top three leading causes of death in Georgia, accounting for nearly one-third of all deaths in the state.

One day last January, the Sanders piled into their black Honda and headed to Kroger before the weekend rush. Ricky tuned the radio to 99.3 FM, his favorite country station.

Five minutes later they pulled into the parking lot and headed inside. Evie made a beeline to the restroom on the other side of the store while Ricky secured a shopping cart and waited near the store’s produce section. He doesn’t make a move without her. They are a team, and this day was no different.


Personal Journeys is taking a one-week hiatus to make way for the first in our three-part series on food deserts and their impact on the high rate of diet-related diseases in Georgia. Personal Journeys returns next Sunday with a story about the power of the heartfelt letter and its ability to change the trajectory of one’s life.


Part 2: Diet and Georgia’s chronic-disease crisis, Wednesday, March 11

Part 3: Turning Atlanta’s food deserts into oases, Sunday, March 15

“We don’t go anywhere without the other,” Ricky said in a thick Southern drawl from beneath an Arkansas Razorbacks cap.

When Evie returned, they headed toward a wilted bin of cabbage and collards, to which they turned their noses up and quickly moved on. A store employee assured them he was about to replace them with fresher greens, but the couple kept moving. They have apples, celery and carrots back at the house, Evie said.

Minutes later they happily rummaged through the store’s reduced carts like little kids in a toy box, grabbing a bent can of beets (29 cents), two loaves of Kroger white bread (49 cents each) and a box of Capri Sun juice drinks ($1.49).

With this one exception, they avoided the perimeter of the store where the fresh meats, dairy products and produce are displayed, preferring the inside aisles where they chose mostly store brands of paper towels, toilet paper, three large canisters of coffee and creamer. The $3.49 box of Gorton’s fish sticks they selected near the end of the hour-long shopping trip was considered a splurge.

There are several convenience stores within walking distance in Peoplestown, but the stock of fresh produce at those stores is limited to nonexistent.

Limited options

When it comes to making nutritional foods accessible to all Georgians, food deserts are only part of the problem. Food insecure is the label given people who may live near a grocery store but can’t afford to buy food. According to Feeding America, the nation’s largest domestic hunger-relief organization, 19 percent of all households in Georgia are food insecure. Even in affluent counties such as Cobb and Gwinnett, nearly 15 percent of households qualify as food insecure.

“We’re sixth in the country for food insecure households, fifth for food insecurity among children,” says Amy Girard, assistant professor in Emory’s Rollins School of Public Health.

And just because there’s a store nearby doesn’t mean it contains healthy, quality food at an affordable price, she said.

No one knows that better, perhaps, than Joseph Mole, executive director of Emmaus House, a non-profit organization that serves the residents of Peoplestown, a community of 2,700 mostly low-income African-Americans south of Turner Field.

Although there are several convenience stores in Peoplestown, fresh meat, fruits and vegetables are hard to come by. If and when they are available, they are often expensive and poor quality.

If you’re like Cathy Zappa and live in Cumming, you might not know what that looks like. One day last September, Zappa and members of her church got a close-up view of what Mole and others at Emmaus House have been trying to get people to see for years: It can be next to impossible for residents in Peoplestown to purchase the makings of a healthy meal in their neighborhood.

Interactive map

The USDA defines food deserts as low-income communities located more than one mile from a reliable source of fresh produce and other healthy foods. See where Atlanta's food deserts are located.

Dividing themselves into four groups — a mix of mostly black residents and white visitors — they spread out across the neighborhood to shop the four neighborhood stores.

Zappa’s group walked six blocks to Father and Sons Superette on Farrington Avenue, a dark, dank place where a dozen eggs sell for $2.50 and a four-pound bag of sugar goes for $4.50.

The goal was to buy a meal for a family of four that included protein, fruits, vegetables, grains and a starch. At Father and Sons, Zappa and her group settled on a box of Cheerios, elbow macaroni, a bag of black eyed peas, three packages of ramen noodles, a jar of Ragu, and cans of peaches, fruit cocktail and corn. The total was $20.40.

Only one of the four groups scored fresh fruit — an apple and a banana, both of them bruised.

Given the choice, no one would want to shop for groceries at a convenience store, but food deserts and food insecurity are inextricably linked to poor access to transportation.

From Peoplestown, the closest grocery store is Kroger on Moreland Avenue, 2.8 miles away. The Wal-Mart on Martin Luther King Jr. Drive is 3.5 miles away. Without a car, it requires one to two hours round trip on a bus to get there and back. One other option is the Grant Park Farmers Market, a mile east of the neighborhood, but it is only open Sunday mornings April-December.

Even affluent neighborhoods on the south and west sides lack the choices people living north of the city enjoy.

Harvey Davis, a 50-something father of two, lives in Cascade where his neighbors include Atlanta Mayor Kasim Reed, Andrew Young, Joseph Lowery and a long list of other movers and shakers in the African-American community.

“We have grocery stores in our community but are looking for mainstream healthy alternatives such as Traders Joe’s, Whole Foods and Sprouts. The Whole Foods at Avalon is absolutely incredible. We don’t have anything within 15 miles like it.”

Davis, who plans his trip to those markets to coincide with his drive to church on Sundays, said he has reached out to the executive leadership of those businesses, but it’s been difficult to attract any of them south of I-20.

“Folks who live on the north side, it wouldn’t dawn on them what it’s like,” Davis said. “This is not a trivial thing. It’s all about access and exposing people to all kinds of choices, but more than that, it’s how those choices impact people’s life spans.”


2 million

Number of Georgians, including 500,000 children, who live in food deserts.


Food deserts that can be found inside Atlanta’s Perimeter.


Percentage of Georgians who are food insecure, meaning they can’t afford to buy healthy food on a regular basis.


Percentage of Georgia children who live in food insecure households.


Percentage of Georgians who live in poverty. Poverty in Georgia increased from 12.9 percent in 2000 to 19 percent in 2013 – an increase of almost 1 million people.

Source: Hunger in America 2014 Report, USDA

Supermarket wars

The grocery store industry underwent a dramatic transition in the late ’80s and early ’90s that has affected accessibility.

Kroger, Winn-Dixie and A&P once dominated the market, with Kroger leading the pack. Smaller chains such as Food Giant, IGA and Big Star Food Store were happy to take the leftovers.

But then Publix entered the market, primarily north of the city. Their stores were new, modern and bigger. They could move more volume, which translated into lower prices. Their customers were less restricted in terms of budget and thus created a strong consumer base. Wal-Mart followed in 2000. The smaller grocery chains couldn’t compete and began shutting down. Now there are not only fewer grocery store chains in the city, but the market has become concentrated in more affluent neighborhoods.

“The population shifted north, the supermarket wars and the shift north in grocery store locations came simultaneously, with each trend reinforcing the other,” said Bill Winders, associate professor of sociology at Georgia Tech and author of the “Politics of Food Supply: U.S. Agricultural Policy in the World Economy.”

In the southwest Atlanta neighborhood of Pittsburgh, for instance, A&P, Winn-Dixie and Big Star Foods served the area for years, but they have since all closed and no new stores stepped in to fill the void.

It isn’t that a predominantly black or low income community can’t support a supermarket, Winder said, they just have less to spend each week compared to middle-income customers who have more flexible budgets.

At the same time that grocery stores were leaving low-income neighborhoods, a large number of fast food restaurants moved in. Suddenly McDonald’s, Long John Silver’s, Church’s Chicken and Krystal were vying for space along major thoroughfares, tempting cash-strapped diners with dollar menus.

But some experts say it will take more than putting grocery stores in poorly served communities to fix what ails them because there is another factor affecting the quality of Georgians’ diets: Choice.

“(Grocery stores are) just a Band-Aid solution,” said Girard. “If you don’t change people’s buying power, if you don’t increase the demand for healthy food, if you don’t build up our culinary skills and work on our food preferences, plopping down a grocery store is not going to solve the problem.”

Shopping on a budget

  • Ricky and Evie Sanders spend most of their shopping trip on the interior aisles instead of the perimeter, where the fresh foods are displayed. Photo: Bob Andres /
  • Ricky and Evie Sanders spend most of their shopping trip on the interior aisles instead of the perimeter, where the fresh foods are displayed. Photo: Bob Andres /
  • Ricky Sanders and his wife, Evie, checking the price on a bag of potatoes. They shop for sale and bulk items at Kroger in Cumming. Photo: Bob Andres /
  • Ricky and Evie Sanders shopping for discounted items at a nearby Kroger. Photo: Bob Andres /
  • Anna Siegfried, Mallory Watkins, and James Owen join residents and members of Episcopal congregations from metro Atlanta at Emmaus House for a walk to four neighborhood stores in Peoplestown with $20 to purchase a meal for four people. Photo: David Tulis
  • Suzanne and her son Nicholas Haerther hug outside Emmaus House where community residents and members of Episcopal congregations from Atlanta gather before setting out with $20 to purchase a meal for four people to help illustrate the difficulty residents have purchasing healthy ingredients within the neighborhood. Photo: David Tulis
  • Christopher Carr, 13, brings donated food to Emmaus House where community residents and members of Episcopal congregations from metro Atlanta gathered to walk to four neighborhood stores in Peoplestown with $20 to purchase a meal for four people to help illustrate the difficulty residents have purchasing healthy ingredients. Photo: David Tulis
  • Community residents and members of Episcopal congregations from metro Atlanta select food at Peoplestown's Father and Sons Superette with $20 to purchase a meal for four people to help illustrate the difficulty residents have purchasing healthy ingredients within the neighborhood. Photo: David Tulis
  • Community residents and members of Episcopal congregations from metro Atlanta select food at Peoplestown's Father and Sons Superette with $20 to purchase a meal for four people to help illustrate the difficulty residents have purchasing healthy ingredients within the neighborhood. Photo: David Tulis
  • To demonstrate what it's like to live in a food desert, Emmaus House invited participants to Peoplestown where they set out on foot to buy enough ingredients from all the major food groups to make a meal for four people for $20. Photo: David Tulis
  • Rosa Lewis, a participant in the Emmaus House initiative, analyzes ramen noodles at the Father and Sons Superette in Peoplestown. Photo: David Tulis
  • Community resident Rosa Lewis analyzes a receipt at the Father and Sons Superette neighborhood store in Peoplestown. With just $20 to choose a meal for four people, every penny counts. Photo: David Tulis
  • Community workers, residents and members of Episcopal congregations from metro Atlanta gather to walk to four neighborhood stores in Peoplestown with $20 to purchase a meal for four people to help illustrate the difficulty residents have purchasing healthy ingredients within the neighborhood. Photo: David Tulis

Knowledge and choice

Back at the Cumming Kroger last January with the Sanders, Evie considered hog jowls at 98 cents a pound a steal. She purchased three packages.

“They make my blood sugar go up, but I eat them anyway,” she said with a twinkle in her eye.

What would they eat them with?

“Nothing,” she said. “I’ll fry ’em so they get good and crispy. That’s a meal.”

People who are food insecure are more likely to be overweight and suffer from weight-related maladies. Foods high in fat, salt and sugar with little nutritional value often cost less than healthy foods — at least in the short run. And worries over money can lead to stress eating.

But there is also a staggering lack of knowledge about fresh fruits and vegetables among many residents of low income neighborhoods, said Janice Giddens, a registered dietitian and wellness manager at the Atlanta Community Food Bank. She recalls meeting a young woman at one of her mobile food pantries who didn’t know the difference between broccoli and a carrot. Another woman couldn’t eat a carrot because her teeth weren’t strong enough to bite it.

“These weren’t elderly people,” Giddens said. “These were young women with kids on their hips. The toll your diet can take on just your oral health is huge and another reason access is so important.”

Girard attributes the state’s rising chronic health problems to a cultural shift from fresh foods to processed foods.

“I grew up shucking corn, digging peanuts, shelling peas, and that was what I ate,” she said. “But even in high school in 1993, that wasn’t what my friends were eating. There was the trend to packaged foods, Hamburger Helper, mac and cheese. The much cheaper way of eating locally available, healthy foods was dying.”

About the writer

Gracie Bonds Staples is an award-winning journalist who has been writing for daily newspapers since 1979, when she graduated from the University of Southern Mississippi. She joined The Atlanta Journal-Constitution in 2000 after stints at the Fort-Worth Star-Telegram, the Sacramento Bee, Raleigh Times and two Mississippi dailies. Staples was recently promoted to Senior Features Enterprise Writer. Look for her thrice-weekly column, This Life, in Living and Metro.

Seeking solutions

Efforts are underway to change metro Atlanta’s food landscape and reverse the rate of diet-related illnesses plaguing poor and rural communities.

The community garden movement is continuing to grow, bringing fresh produce to urban areas. Today there are more than 300 community gardens spread across metro Atlanta, according to the Atlanta Regional Commission, most of them planted since 1997. And more are coming. Emmaus House is partnering with Atlanta Food and Farm to expand a community garden in Four Corners Park and to teach residents how to harvest and prepare fresh fruits and vegetables.

In addition, the agency is in talks with the non-profit Focused Community Strategies Urban Ministries to provide Peoplestown residents with fresh vegetables, fruits and meats at competitive prices. Mole also hopes to encourage Wal-Mart to invest in under-served communities where there are currently no grocery stores.

“This idea of growing food in the neighborhood, non-profits providing a market and working to bring national level retailers into this area are all important pieces to the puzzle,” Mole said. “There have to be solutions on many different levels.”

Meanwhile, organizations such as Emory University’s Urban Health Initiative, Georgia Food Oasis and Atlanta Local Food Initiative are working on policies and plans to increase accessibility to nutritional foods for all.

“With some innovation and partnerships we can make it so that the good food our farmers grow here in Georgia is accessible to everybody in the state. Not just to the people who can afford it,” Girard said. “And it could be a boon for Georgia’s struggling farmers as well.”

The grocery landscape is changing, too. It’s still following population patterns, but intown residential growth has improved options inside the Perimeter.

Kroger on Ponce de Leon Avenue just underwent a $2 million renovation that expanded its organic offerings from 4 feet of shelf space to 12 feet. The natural-food section grew from 5 feet to 6. There are also plans to open a 109,000-square-foot store along the Beltline in Glenwood Park.

Meanwhile, other chains have come into the market, such as Whole Foods and Trader Joe’s. Still, it’s the affluent areas that are best served by the industry.

But what’s left behind are communities such as Grove Park, English Avenue, Fairburn Heights, Adamsville, Mechanicsville and Evie and Ricky Sanders’ neighborhood in Cumming, among many others.

They are proof, Giddens said, “that your ZIP code can impact health more than your genetic code.”

Presentation by Shane Harrison.