The competitors

Lindsey Barrow Jr.

Age: 30

Occupation: Former server at Edmund's Oast (Barrow quit his job to devote more time to his project)

Hometown: Roanoke, Va.

Proposal: Lowcountry Street Grocery, a grocery store aboard a retrofitted school bus

Germaine Jenkins

Age: 43

Occupation: None provided

Hometown: Hartsville

Proposal: Fresh Future Farm, an urban farm and retail store

Brittany Mathis

Age: 28

Occupation: Public outreach coordinator

Hometown: Seattle, Wash.

Proposal: Lowcountry Vegetable Center, a produce store housed in a retrofitted shipping container

John Lloyd

Age: 44

Occupation: Organic farmer, personal trainer and massage therapist

Hometown: Not available

Proposal: Greening the South, a CSA serving urban areas

When the South Carolina Community Loan Fund laid out the schedule for Feeding Innovation, a competitive financing program for businesses bringing healthy food to underserved areas, it built a series of elimination rounds into the nine-month calendar. None but the last was needed though, since the majority of the nine original participants self-selected themselves out of the rigors of business plan writing.

The four entrepreneurs who this month were still in the hunt for the $25,000 in seed capital, and potentially up to 20 times that much in loans, recently tried to impress a panel of judges with their relative passion and tenacity. They regaled the evaluators with stories about restaurant partnerships they had proactively established, relatives they had recruited to drive proposed delivery trucks and market research they had conducted at bus stations.

"This one woman told me it takes her an hour round trip to get to the grocery store," marveled Brittany Mathis, who wants to set up vegetable shops in retrofitted shipping containers situated around North Charleston. "That is ridiculous that she would have to travel so far just to get vegetables."

Mathis' outrage was echoed by Lindsey Barrow, who in his Power-Point presentation described food deserts, commonly defined as low-income areas at least one mile from a supermarket, as "the sad, humbling truth behind the problems" of obesity and cardiovascular disease. In response, Barrow was pitching Lowcountry Street Grocery, a rolling produce retailer.

Asked by a judge whether there was any chance residents of North Charleston wouldn't patronize his mobile farmers market, Barrow scoffed, "It can't not work. Because if it doesn't work, people are not smart."

While competitors in the program, which will declare its winner at a ceremony tonight, were given a tremendous amount of leeway to develop market-driven solutions to food access challenges, all of the finalists opted to create new venues for selling fruit and vegetables (a CSA and an urban farm with an on-site market rounded out the ideas.) And all of them emerged equally certain that their plans would ameliorate the health crises afflicting the city's low-income neighborhoods.

Food deserts

Yet hard work and good intentions may not provide an adequate foundation for the competitors' confidence. Scholars have repeatedly failed to show that improved food environments have any significant bearing on eaters' dietary choices and overall health. According to a systematic literature review published in 2011, five out of six studies found no association between grocery accessibility and produce consumption. Although it's widely acknowledged that the topic deserves further research, economists tend to agree that food access has been overemphasized in the fight for better nutrition.

"I think 'food desert' was a bit of a sensationalist term, frankly," says Bisakha Sen, a professor at the University of Alabama (Birmingham)'s School of Public Health. "They aren't as big a deal as they were thought to be."

The term 'food desert' was coined in the U.K. According to the Oxford English Dictionary, it first appeared in print in 1997, when the Financial Times explained, "Poorer citizens without cars have difficulty reaching the 'cathedrals of choice.' " Politicians embraced the concept, with Tony Blair the following year vowing to restore the British corner shop. "He fears so many have gone that run-down inner city estates have become 'food deserts,' which can lead to poor health for worse-off families," The Daily Mirror reported.

One of the first U.S. newspapers to cover food deserts was USA Today, which devoted 186 words to the idea in a 2004 story headlined "Can only the rich afford to be thin?" Five years later, the U.S. Department of Agriculture issued a report on "Measuring and Understanding Food Deserts and Their Consequences," drawing more attention to a problem that Sen says seemed refreshingly solvable from a policy perspective.

"Poverty and obesity go hand-in-hand with a high concentration of disadvantaged minority populations, and it's a fact these neighborhoods tend to not have grocery stores," Sen says. "The association has led to causality, thinking 'the reason behind (high obesity rates) must be they don't have (supermarket) access.' It's become very popular."

Media outlets lapped up the food desert concept, which was easy to translate into anecdotes. Introducing readers to disabled veterans and widows stranded in neighborhoods where the corner stores stock a single shriveled apple proved simpler than delving into income inequality and the complicated relationship between vegetable consumption and obesity rates.

Obesity crisis

In 2012, the USDA updated its food desert map based on 2010 data, producing what a summary report called "a mixed picture of the extent of food access challenges." The newer statistics showed growth in the low-income population, an anticipated outcome of the Great Recession, but they also pointed to a surge in vehicle availability. Although nearly 1 in 10 Americans lived in low-income areas more than one mile from a full-service supermarket (smaller shops were excluded from the count), only 1.8 percent of U.S. households located one mile or more from a supermarket didn't have access to a vehicle.

Shelly Ver Ploeg, a USDA economist with the Food Assistance Branch, Food Economics Division, says the latest set of numbers, now under analysis, could reflect a minor decrease in vehicle availability. "Quite a few people have not been able to sustain car payments," she says. But the findings are unlikely to upend the fact that most Americans are able to drive or ride to the nearest grocery store.

As Ver Ploeg points out, they may not stop there. "Maybe people are travelling quite a ways to get a lower price," she says. "Food security is probably bigger than food access."

In other words, it doesn't matter how many rutabagas a grocer stocks if shoppers can't afford to buy them. (According to the USDA, higher-income households consistently purchase more produce than lower-income households.)

Alternately, a shopper may choose to dedicate his food budget to frozen pizza instead of produce. As competitors in the Feeding Innovation program recognized, education is a critical component of successful healthy eating initiatives. "Cultural patterns of eating are incredibly difficult to change," Sen says.

University of Western Ontario researchers recently examined the 2009 opening of an independent grocery store in Flint, Mich., located in a county where 82 percent of residents don't eat an adequate amount of fruits and vegetables, and between 68 and 71 percent of residents are overweight or obese. The store was located in a neighborhood where "the statistics are assumed to be worse."

Studying dietary habits is extraordinarily difficult, since it relies on people accurately reporting what they eat. Often, survey takers say what they think researchers want to hear. But one year after Witherbee's opened in Flint, 92 percent of survey respondents indicated they weren't consuming the adequate amount of fruits and vegetables.

"No relationship was found between proximity to nutritious food and diet," the researchers wrote in a 2013 issue of the International Journal of Environmental Research and Public Health. "Rather than facilitating nutritious food consumption, the grocery store may have actually promoted unhealthy eating, since prepared meals became easier to find."

More than food

Rudy Nayga, chair of the University of Arkansas' department of agricultural economics and agribusiness, has studied whether children's body mass indices change when their surroundings shift from a food desert to a non-food desert. They don't, at least not in any statistically significant way. Still, Nayga says, "Increasing access to healthy foods can't harm. Let's put it that way. It can only help, hopefully."

To state the obvious, if a store sells broccoli, a shopper may or may not buy it. If a store doesn't sell broccoli, the chances of a shopper buying it are nil.

But what if a store sells nothing but broccoli (and other similarly healthy fruits and vegetables)? Researchers have not yet formally assessed whether farmers markets - of the stationary-, mobile- or housed in a shipping container-variety - do a better job than supermarkets of improving health indicators in surrounding areas.

Supporters of food access expansion suggest that may not be the best measure of their work. "For example, a grocery store doesn't only provide food," says Anna Hamilton, the South Carolina Community Loan Fund's strategic initiatives director. "It provides jobs."

The Food Trust, a Philadelphia-based organization, is a pioneer in food access advocacy: Since its founding in 2004, the group has funded 90 grocery projects, credited with "creating or retaining" 5,000 jobs. The Food Trust, which consulted with the Community Loan Fund on the Feeding Innovation program, holds supermarket scarcity is as much a philosophical as a logistical problem.

"All people should have the same choices to eat healthy," says John Weidman, The Food Trust's deputy executive director. "It shouldn't be different."

Bringing fresh food to a community can renew its spirit, he says.

"Are they buying healthier foods?" Weidman asks. "That's hard to say. But (markets) change the way you think about food."

Hamilton, who characterizes Feeding Innovation as "a learning experience for everyone," isn't sure exactly how residents of the Neck will ultimately benefit from the winning project (and, potentially, the also-rans, which the Community Loan Fund is committed to supporting through networking).

"The outcomes and definitions of success are complex," she says. "A reduction in the number of food deserts is the obvious answer. But certainly in five years we'd like to see these businesses open and making money."

Reach Hanna Raskin at 937-5560.