Food Deserts and Obesity

Addressing the Environmental Risk Factors of Obesity

Policy Brief Assignment by Delores Currie

Executive Summary  

            The purpose of this paper is to expand proposed House Bill 543 “Create a Food Desert Elimination Grant Program” (2025) to include publicly-owned grocery stores. Despite decades of policy proposal to address obesity in Ohio, the problem has only continued to rise. Policies have been put forth in the past to address obesity, with many focusing on making changes to school nutrition to target childhood obesity, but the steady rise in obesity rates within the last decade alone have demonstrated that implementation of multilevel policies that address a variety of factors is necessary to address the complexities of obesity (Odoms-Young et al., 2024). There is clear evidence that the social determinants of health can affect obesity rates. House Bill 543 is already tackling food insecurity, but its expansion would be more beneficial for Ohio citizens residing in food deserts and would serve a dual purpose by addressing the environmental factors of obesity.

Rationale for Action

Obesity leads to numerous health consequences such as diabetes, cardiovascular disease, and hypertension (Odoms-Young et al., 2024). Since 1990, adult obesity rates in Ohio have risen from 11.3% to 36.9% in 2024 (“Obesity in Ohio”, n.d). Managing these conditions takes a toll on our health care system. According to the Centers for Disease Control (CDC), the United States health care system spends $173 billion dollars per year managing obesity and its associated complications (2024). Obesity is partially influenced by diet, and many interventions are focused on personal responsibility and diet education. Indeed, fewer than 1 of 10 eat the recommended number of vegetables per day (CDC, 2024). However, research has shown that residing in food deserts is a significant risk factor for development of obesity (Pineda et al., 2024).

It is difficult for residents to make healthy food choices when healthier food choices are generally more expensive and difficult to obtain. Moreover, research is continuously highlighting the role of social determinants of health on obesity rates and making recommendations for the reduction of obesity-related disparities like food deserts (“The State of Obesity: Better Policies for a Healthier America,” 2023). Opponents of this expansion may highlight the importance of personal responsibility of obesity, but research continuously demonstrates obesity is far more complex. Food insecurity is linked to a complex stress pathway that contributes to increased fat accumulation and inflammation (Odoms-Young et al., 2024).

In summary, there are four core issues with current policy aimed at reducing obesity:

1.     The presence of food deserts in Ohio increases the risk of food insecurity and obesity (Odoms-Young et al., 2024).

2.     Socioeconomic inequalities further increase the risk despite financial assistance and increased grocery store availability (Garrity et al., 2024; Hunter et al., 2026).

3.     Policies have previously focused on personal responsibility and changes to local school nutrition rather than addressing the environmental causes of obesity (Odoms-Young et al., 2024).

4.     These policies have not yet to reduce the rate of obesity in Ohio (Odoms-Young et al., 2024).

Proposed Policy Options

House Bill 543 intends to provide financial incentives for grocers to install new stores in food deserts, but this solution is not enough. Food deserts are commonly located in low-income areas. Installment of grocery stores may not adequately address food insecurity (and therefore, obesity) because affordability is still a major barrier for these residents and grocery stores will likely maintain competitive prices to meet profit margins (Odoms-Young et al., 2024). Further, increased access to food does not guarantee that residents will purchase healthier foods, as low-income individuals opt for cheaper food items which tend to be higher in fat, salt, and sugar (Hunter et al., 2026). Social programs like Supplemental Nutrition Assistance Program (SNAP) are vital to addressing food insecurity, but poor diet quality still persists among SNAP participants because households struggling with food insecurity often sacrifice quality of food for quantity, further contributing to obesity (Garrity et al., 2024).

Policy Recommendation

Expansion of House Bill 531 to include publicly-owned grocery stores offers a practical solution for these issues, and can work in conjunction with already established policies. First, public grocery stores do not prioritize profits, so grocery costs can remain low. Most public grocery stores use established pricing models to focus on affordability rather than profit. Secondly, governmental support can provide resources and funding during periods of economic instability to ensure residents can still access healthy groceries at a reasonable price. While the installment of public grocery stores may seem far-fetched, there are successful examples of public grocery stores already. The United States military already operates several public grocery stores and the St. Paul Supermarket in Kansas is a city-owned grocery store that has been in operation for twelve years (Ocampo & Khadr, 2025).

Many publicly owned grocery stores have partnerships where the building is owned by the municipality, but day-to-day operations are left to the management. In Kansas, which began with the St. Paul Supermarket, they have already implemented three more stores across the state (2020). These publicly-owned grocery stores have been successful in reducing food insecurity (Ocampo and Khadr, 2025). Since food deserts are a known risk factor for obesity, expanding House Bill 543 to include public grocery stores could provide a better solution to food insecurity while also improving obesity rates in Ohio.

Anticipated Barriers

            The most significant barrier to implementation is funding. House Bill 543 has already set aside funding for providing grants up to $200,000 from the state treasury (2025). This money could be utilized to establish public grocery stores in the same areas rather than providing incentives to large grocery chains. There are several federal sources of funding, such as the United States Department of Agriculture (USDA) Rural Economic Development Loan and Grant Program and the Federal Healthy Food Financing Initiative (Lawing et al., n.d.) that could provide additional financial support. Grocery stores could also partner with private donors, universities, or charities (Lawing et al., n.d.).

Summary

            Obesity is a major healthcare problem that has previously been addressed by only focusing on personal responsibility. Research has clearly demonstrated that environmental factors such as residing in food deserts contributes to increased obesity rates. Expanding House Bill 543 to include publicly owned grocery stores is a great way to address food insecurity and rising obesity rates in Ohio. While this may be challenging upfront, the precedent for successful publicly owned grocery stores already exists in several other states, and it can be done in Ohio as well. 

References

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Lawing, T., Jimenez, Y., McNeal, J., & Gupta, R. (n.d.). Public Grocery Stores: A Guide for Policymakers. Vanderbilt University. https://cdn.vanderbilt.edu/vu-sub/wp-content/uploads/sites/281/2024/03/18104854/Public-Grocery-Stores.pdf

Ocampo, O., & Khadr, M. (2025). How City-Owned grocery stores can tackle food insecurity. Inequality.Org. https://inequality.org/article/how-city-owned-grocery-stores-can-tackle-food-insecurity/

Obesity in Ohio. (n.d.). America’s Health Rankings. Retrieved July 16, 2026, from https://www.americashealthrankings.org/explore/measures/obesity/OH

Pineda, E., Stockton, J., Scholes, S., Lassale, C., & Mindell, J. S. (2024). Food environment and obesity: a systematic review and meta-analysis. BMJ nutrition, prevention & health, 7(1), 204–211. https://doi.org/10.1136/bmjnph-2023-000663

St. Paul Supermarket. (2020). In Rural Grocery. https://www.ruralgrocery.org/learn/publications/case-studies/St_Paul_Success_Story.pdf

The State of Obesity: Better Policies for a Healthier America. (2023). In Trust for America’s Health. https://www.tfah.org/wp-content/uploads/2023/09/TFAH-2023-ObesityReport-FINAL.pdf