City, academic and nonprofit officials have worked for years to eliminate so-called "food deserts," but they say the latest data from Johns Hopkins University researchers shows the scope of the problem and where good food options are most urgently needed.
"You can see on the ground that a lot of areas are lacking," said Holly Freishtat, who became Baltimore's first food policy director about two years ago. "The next step for the map is to use it for policy."
City officials and other groups already are launching programs to provide healthier eating options for Baltimoreans. They're highlighting healthy foods in city-owned markets and farmers' markets. They're trying to lure new grocery stores. And they're expanding a system for low-income residents to order healthy food online for delivery in area libraries, senior living facilities, and soon, public housing.
Over time, Freishtat said, the initiatives should eliminate food deserts — areas where a grocery store is more than a quarter-mile walk, there are few other places to buy fresh or healthy foods, the median household income is no more than 185 percent above the poverty line, and at least 40 percent of households lack access to cars.
Anne Palmer, a project director at Hopkins' Center for a Livable Future, said researchers began looking at the problem more than four years ago and drew up the first map in 2009. Until then it wasn't clear what was available in stores, restaurants and markets and what barriers there were for those wanting healthier foods.
This year's map is more specific, including, for example, the number of people without their own transportation.
Researchers also went door-to-door to check store shelves and menus around Baltimore, assigning each a score, Palmer said. Not surprisingly, groceries tended to offer the most fresh, healthy foods, while carry-out restaurants and corner stores tended to score near the bottom.
The data offers researchers a clearer picture of the problem. For example, food deserts wouldn't be a problem if everyone could drive and could afford every store's prices.
Palmer said she believes Baltimore is no different than the average metropolitan area in terms of access to healthy food. But Freishtat and others' aggressive use of the data may be unique.
"It still will take years to make changes," Palmer said. "You need to get supermarkets into neighborhoods and find other solutions."
Many people's diets will improve just because they have access to healthier foods, Palmer, Freishtat and others said. So in addition to educational programs in schools and at the city markets, officials have focused on increasing the availability of produce and other health options.
Freishtat started in Baltimore's six public markets, which offer a group of vendors under one roof. Most are located in food deserts, and though they all sell fruits, vegetables and fresh fish and poultry, surveys show about 70 percent of the vendors offer mostly less healthy carryout meals.
Ten vendors at Lexington Market recently volunteered for a program designed to feature items that are lower in calories, fat and sugar and higher in fiber than other menu choices. Managers of the self-sustaining markets agreed to pay for new menu boards that highlight those options with a green leaf icon. Eventually, the managers also will help defray the cost of new menu items offered by merchants.
So far the managers have pledged $50,000, some of which was used to hire interpreters to pitch the program to the business owners, most of whom are Korean, said Casper Genco, Lexington Market's general manager.
When the city suggested the program, Genco said, "it was evident that it was something we needed to work on."
He expects the vendors to discover which items make money through trial and error, and eventually be weaned off subsidies. Other merchants likely will add items that are popular.
"I'm not suggesting people will completely alter their diet," he said. "But I am saying that when you give a person a visual indication of an item that would be healthier than other items, at least a portion of the time people are going to choose the healthier option."
Ki Joeng, owner of the Healthy Choice stand, said he thought the new icons would influence regular customers and draw in new ones.
"I think it will help sales," he said. "At least I hope it does."
Lunchtime customers on a recent day didn't seem to notice them, but many said they already were trying to eat healthier and appreciated the effort.
Troy Briscoe, who works in pest control in Baltimore, looked at the menu at Blue Island Malaysian Cuisine. He chose a somewhat greasy pile of noodles and shrimp. But when the icons were pointed out, he said they would influence his next order.
"I like beef with broccoli and, if it's healthier, I'll order it next time," he said. "I don't know if other people will. They serve greasy foods because they know what people like."
Then there was Charon Franklin, who said she didn't need to be steered away from fried chicken and fatty side dishes. She went right to the produce stand for some mixed fruit bowls for her, her husband and granddaughter. The Odenton woman said she's been eating healthier since she was diagnosed with diabetes and high blood pressure.
Her granddaughter Sahmia Brown was initially distracted by a nearby glass case filled with Berger cookies and cakes, but was lured back by watermelon and grapes.
"You don't have to look that hard to find the healthy stuff," Franklin said.
The city got the idea for the market program from studies by another Hopkins researcher. Joel Gittelsohn, a professor in the international health department, began working with corner stores and carryout restaurants nearly a decade ago.
He showed that small shops that carried low-calorie milk, low-salt pretzels and whole wheat bread were able to sell them. The same was true in carryout restaurants that sold grilled foods, healthy side dishes and lower calorie drinks.
The shops and restaurants Gittelsohn studied also were given subsidies to buy healthier food initially. The restaurants got new menu boards highlighting the healthy foods, and in some cases, a small grill to use in addition to deep fryers.
"No one would have paid attention if we said, 'Don't sell chips,' " he said. "We said, 'You can also sell healthier alternatives to chips.' …To a large degree people bought them just because they were there."
The city's Freishtat said she'll continue working with other planning, health and development officials, as well as with the mayor's office, to make sure every neighborhood has options.
The city has succeeded in luring some supermarkets, including a new ShopRite under construction in Howard Park, using funds from the Healthy Food Financing Initiative, a federal program to eliminate food deserts. However, most of the other new or planned grocery stores are not in food deserts.
Officials also will continue to look to nonprofit groups such as Maryland Hunger Solutions, which works to improve participation in school meal programs, and to bring credit and debit card readers to area farmers' markets for electronic "food stamps" and other federal benefits.
Seven markets already have the machines, and an eighth will be added in April at the large Sunday market under the Jones Falls Expressway downtown. Customers surveyed at the markets said they had few other options for fresh produce in their neighborhoods.
Sales last year from the reader program topped $37,000 from those with federal benefits. Another $40,000 in sales came from consumers using credit and debit cards.
"We'll continue to look for new ways for people to access healthy foods," said Cathy Demeroto, Maryland Hunger's executive director.