Food to the People:

Evaluating New York Citys Food Access Policies

Emily Apple Roosevelt House Public Policy Institute at Hunter College Public Policy Capstone May 7, 2013

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Contents
Executive Summary ........................................................................................................................ 3 Introduction ..................................................................................................................................... 5 What is a food desert? ................................................................................................................. 5 New York Citys Supermarket Need Index (SNI) ...................................................................... 7 Policy Interventions ........................................................................................................................ 7 Incentivizing New Providers: FRESH & FFFI ........................................................................... 8 Harnessing Entrepreneurship: Green Carts, Farmers Markets & Fresh Moves ........................ 9 Bringing Down the Cost: Health Bucks.................................................................................... 10 Out with the Old, In with the New: Healthy Bodegas .............................................................. 10 Green in the City: Agricultural Gardens and Farms ................................................................. 11 Weighing the Outcomes ................................................................................................................ 11 Incentivizing New Providers: FRESH & FFFI ......................................................................... 12 Harnessing Entrepreneurship: Green Carts, Stellar Farmers Markets & Fresh Moves ........... 13 Bringing Down the Cost: Health Bucks.................................................................................... 15 Out with the Old, In with the New: Healthy Bodegas .............................................................. 16 Green in the City: Urban Agriculture ....................................................................................... 17 Policy Recommendations.............................................................................................................. 18 Restructure FRESH ................................................................................................................... 19 Ramp Up Green Carts & Divest from Farmers Markets ......................................................... 19 Invest in Health Bucks .............................................................................................................. 19 Sustain Healthy Bodegas .......................................................................................................... 20 Create Spaces for Urban Agriculture ........................................................................................ 20 Conclusion .................................................................................................................................... 20 Bibliography ................................................................................................................................. 21 Acronyms ...................................................................................................................................... 23

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Executive Summary
According to the United States Department of Agricultures Economic Research Service, there are over 23.5 million Americans living in food desertsareas defined as urban neighborhoods and rural towns without ready access to fresh, healthy, and affordable food. Of those 23.5 million, it is estimated that over half of those individuals (13.5 million) are low-income.1 In New York City alone, City government estimates put the number of people living in food deserts at over 3 million.2 With nearly a third of city residents living in food deserts, New York City faces a crisis of food accessibility. The New York City Councils 2010 FoodWorks report identified the impetus for action on the issue of healthy food accessibility: New York Citys food system is not fully secure and faces a number of issues that compromise its long-term sustainability.3 With the sustainability of the food system at risk and millions of New Yorkers living in food insecure environments, this report will examine what the New York City government and other cities have done to increase access to healthy foods throughout New York as well as make recommendations for continued improvements in healthy food accessibility. This report examines five city programs which are currently underway: (1) Food Retail Expansion to Support Health (FRESH), (2) Green Carts, (3) Stellar Farmers Markets, (4) Health Bucks, and (5) Healthy Bodegas. It will also examine comparable programs in Pennsylvania and Chicago and explore the potential for urban agriculture in New York City. FRESH and Pennsylvanias Fresh Food Financing Initiative (FFFI) are programs that offer monetary incentives to open new supermarkets in areas of high need. Green Carts, farmers markets, and Chicagos Fresh Moves mobile market are public-private partnerships with entrepreneurs and nonprofit organizations to bring mobile food providers to areas with low-access to healthy foods. Health Bucks is a voucher program that distributes $2 vouchers redeemable at farmers markets, primarily for food stamp recipients. Healthy Bodegas is a program that increases the stock of healthy foods in small bodegas across the city. Finally, while the city does not currently have an urban agriculture policy, this report will examine the potential impact of urban agriculture on food security. Each of these programs was evaluated on three evaluative criteria: 1. Does the program increase the quantity of healthy foods available? 2. Does the program make the healthy foods more affordable? 3. Does the benefit outweigh the cost to the city and to local businesses?

United States Department of Agriculture, "Creating Access to Healthy, Affordable Foods," ed. Agricultural Marketing Service (Washington, DC2011). 2 New York City Food Policy Taskforce, "Going to Market: New York City's Neighborhood Grocerty Store and Supermarket Shortage," (New York: Office of the Mayor, 2008). 3 Sarah Brannen, "Foodworks: A Vision to Improve Nyc's Food System," (New York: New York City Council, 2010).

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Considering these evaluative criteria, the following policy changes are recommended: FRESH FRESH should be converted to the FFFI model of leveraging public dollars to create private investment. However, FRESH should maintain its current requirements to ensure that food retailers must continue to provide large quantities of healthy options. Green Carts New York City government must expedite the licensing process for Green Carts to move people off the waiting lists and onto the streets providing healthy foods in communities. The Green Cart licensing process should be altered so that each cart is assigned a location to prevent dense clusters to ensure that communities in need of food retailers are being equally served. Farmers Markets New York City should divest from directly running farmers markets and allow the nonprofit sector to continue operating markets. This allows investment in other areas of food access policies not otherwise served by nonprofits. Mobile Food Providers The Metropolitan Transit Authority (MTA) should donate decommissioned buses for use as a mobile food provider, similar to Chicagos Fresh Moves initiative. Health Bucks The Health Bucks program should be expanded to focus on other low-income populations besides SNAP beneficiaries through the assistance of community organizations working with populations in need. Healthy Bodegas The focus of the Healthy Bodegas program should be shifted with an eye toward sustaining existing changes through an expansion of the Adopt-a-Bodega and Farm to Bodega initiatives. Adopt-a-Bodega would allow community groups to encourage bodega owners to keep the changes already made with the assistance of Healthy Bodegas outreach workers and create new changes if desired. Farm to Bodega would increase the stock of fresh produce available in bodegas and utilize existing farmers markets and urban farms. Urban Agriculture The city should rezone vacant lands in areas of low-access to healthy foods for urban agricultural purposes and partner with community organizations to create agricultural gardens that could sell produce grown there to community members at low-cost. The New York City Housing Authority (NYCHA) should work to have an agricultural community garden on every NYCHA property that can then sell fresh produce to NYCHA residents at low-cost.

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Introduction
According to the United States Department of Agriculture (USDA), there are over 23.5 million Americans living in food desertsareas defined as urban neighborhoods and rural towns without ready access to fresh, healthy, and affordable food. Of those 23.5 million, it is estimated that over half of those individuals (13.5 million) are low-income.4 In New York City alone, City government estimates put the number of people living in food deserts at over 3 million. 5 With nearly one third of city residents living in food deserts, New York City faces a crisis of food accessibility. The New York City Councils 2010 FoodWorks report identified the impetus for action on the issue of healthy food accessibility: New York Citys food system is not fully secure, and faces a number of issues that compromise its long-term sustainability.6 With the sustainability of the food system at risk and millions of New Yorkers living in food insecure environments, it is crucial to closely examine the issue of food insecurity, specifically regarding the healthfulness of the foods in communities across the city. This report will examine what the New York City government has done to increase access to healthy foods throughout New York as well as make recommendations for continued improvements in healthy food accessibility policies. What is a food desert? According to the USDA, a food desert is formally defined as, A census tract with a substantial share of residents who live in low-income areas that have low levels of access to a grocery store or healthy, affordable food retail outlet.7 Census tracts qualify as food deserts if they meet the following low-income and low-access thresholds: 1. They qualify as "low-income communities," based on having: a) a poverty rate of 20% or greater, OR b) a median family income at or below 80 percent of the area median family income; AND 2. They qualify as "low-access communities", based on the determination that at least 500 persons and/or at least 33% of the census tract's population live more than one mile from a supermarket or large grocery store (10 miles in the case of non-metropolitan census tracts).8 The USDA has done extensive work around food deserts and increasing access to healthy foods across the country, yet there is something lacking in its definition that excludes many areas of New York City from classification as a food desert. According to the USDA there are only three census tracts that qualify as food deserts in the five boroughs, all in Staten Island, totaling about 10,000 residents (see Figure 2). This is inconsistent with New York Citys own estimates that large swaths of Brooklyn, Manhattan, and the Bronx are food deserts, totaling over 3 million residents.9 The contrasts are stark when placed side by side, as seen in Figures 1 and 2.

4 5

United States Department of Agriculture, "Creating Access to Healthy, Affordable Foods." New York City Food Policy Taskforce, "Going to Market: New York City's Neighborhood Grocery Store and Supermarket Shortage." 6 Brannen, "Foodworks: A Vision to Improve NYC's Food System." 7 United States Department of Agriculture, "Creating Access to Healthy, Affordable Foods." 8 Ibid. 9 New York City Food Policy Taskforce, "Going to Market: New York City's Neighborhood Grocery Store and Supermarket Shortage."

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Figure 1: New York City Supermarket Need Index

Source: New York City Department of City Planning

Figure 2: USDA Food Desert Map

Source: United States Department of Agriculture

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So what makes the New York City estimates so vastly different from the federal governments? Some have speculated that bodegassmall corner or convenience storeshave been counted as grocery stores in the USDA estimates whereas they are usually excluded in New York Citys own calculations. Additionally, the USDAs one-mile specification might also be too much for New York City; one-mile in New York is about twenty city blockstoo much for many New Yorkers to travel for food, including the elderly and disabled.10 New York Citys Supermarket Need Index (SNI) Because the USDA definition excludes most parts of New York, local officials have been left to develop their own definition that works for New York City's food security policy. What New York City has developed is not a food desert locator, like the USDAs, but rather a Supermarket Need Index (SNI). SNI differs from the food desert measurements in that it reflects the geographic and economic barriers to purchasing healthy foods and the health status of communities.11 The index takes into account 9 different factors including household income, access to a car, consumption of fruits and vegetables, and the share of fresh food retailers. Based on this index, large areas of Northern Manhattan, Central Brooklyn, and the Bronx have been identified as areas of high supermarket need; however, areas of high need are not limited to those areas and exist across the five boroughs (see Figure 1). The SNI has allowed the city to target policy remedies to areas of the highest need and lowest access. The SNI also changed the general supermarket-to-person formula used throughout the United States. The normal ratio is about 50,000 to 100,000 square feet store per 10,000 people within an 8- to 10-minute drive. This formula is better suited to suburban areas with large shopping centers. First, there are few places in the five boroughs that could accommodate 50,000 to 100,000 square feet of retail space; second, New Yorkers are much more likely to walk to their local supermarket than to drive. Instead, under the new SNI the ratio is 15,000 square feet per 10,000 people, though the Department of City Planning (DCP) is hoping with targeted initiatives to raise the ratio to 30,000 square feet per 10,000 people.

Policy Interventions
Mayor Michael Bloomberg has been deemed by many the public health mayor, and has made improving the health of New York City residents a primary goal of his tenure. While recent reports may cast doubt on the link between food deserts and obesity, Bloomberg has nonetheless made increasing access to healthy foods across the city as a crucial part of any strategy to combat obesity.12 Bloomberg has been careful to define healthy foods not just as fruits and vegetables, but also includes low-fat milk, whole grains, and more generally non-processed foods that are low in carbohydrates, fat, calories, and cholesterol. As part of this strategy, Mayor Bloomberg created the New York City Food Policy Task Force and the Office of the Food Policy
10

Elizabeth Whalen and Michael Seserman, "Looking for an Oasis in a Food Desert: Low Income New Yorkers Lack Access to Healthy Foods," (New York October 2011). 11 Laura Smith et al., "Developing a Supermarket Need Index," in Geospatial Analysis of Environmental Health, ed. Juliana A. Maantay and Sara McLafferty, Geotechnologies and the Environment (Springer Netherlands, 2011). 12 A 2012 RAND Corporation study (see Am and Sturm, 2012) challenged common wisdom that the food environmentthe type of foods located in a given areawas closely linked with rates of obesity. Dr. Sturm, the studys main researcher, said that within a couple of miles of almost any urban area you can get basically any type of food.

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Coordinator to administer a number of programs to combat low access to healthy foods across a dozen agencies including the Department of Health and Mental Hygiene (DOHMH), Department of City Planning (DCP), and the Human Resources Administration (HRA).13 The task force has created a number of policies and programs to increase accessibility to healthy foods, which are discussed below. Incentivizing New Providers: FRESH & FFFI The Food Retail Expansion to Support Health (FRESH) programs goal is to promote the establishment and retention of grocery stores in underserved communities by providing zoning and financial incentives.14 Stores must open in areas pre-determined as FRESH zones (northern Manhattan, the South Bronx, central Brooklyn, areas of Queens) to be eligible for the incentives. Additionally, the stores must: (1) provide a minimum of 6,000 square feet of retail space for food and nonfood grocery products; (2) provide at least 50% of the space for consumable goods; (3) provide at least 30% for perishable goods (i.e. dairy, produce, fresh meats, etc.); and (4) provide at least 500 square feet for fresh produce.15 According to an analysis of food retailers across the city, FRESH neighborhoods the average square footage of grocery store per person in FRESH areas was 0.8 square feet, whereas in non-FRESH areas it was 1.5 square feet.16 FRESH incentives come in three forms: NYC Department of City Planning (DCP) zoning incentives, NYC Industrial Development Agency (IDA) incentives, and NYS Energy Research and Development Group (NYSERDA) benefits (see Table 1). These benefits are targeted toward developers to build new retail spaces for supermarkets so that neighborhoods with low access have a grocery store that carries produce in their neighborhood. Similarly, Pennsylvania, both in rural and urban areas, established a fund to incentivize the creation of new food retailers in areas of need. The fund is a public-private partnership with The Reinvestment Fund (TRF) and the Food Trust, forming the Pennsylvania Fresh Food Financing Initiative (FFFI). The goal of the program is similar to New York Citys FRESH program, to create new supermarkets in areas of low-access with high rates of obesity and obesity related diseases (i.e. heart disease, diabetes). The funding can simply be used to sustain or pay down debt for an existing market in an area of low-access or can be used to build entirely new markets in areas that need them most, though unlike FRESH, FFFI will give direct grants to supermarkets, not just tax breaks or zoning incentives. To qualify for direct grants supermarkets must be located in low- to moderate-income census tracts and in an area the government deems underserved. Grants range between $250,000 and $1 million, with no such cap for loans. The majority of the funding goes toward the New Markets Tax Credit (NMTC) to allow tax relief for new or struggling businesses in underserved communities.17

13

Office of the Mayor of the City of New York, "Office of the Food Policy Coordinator," http://www.nyc.gov/html/ceo/html/programs/food_policy.shtml. 14 New York City Food Policy Taskforce, "Fresh: Food Retail Expansion to Support Health," (New York: Office of the Mayor, 2012). 15 Ibid. 16 AECOM, "Final Project Report: Nyc Full Service Grocery Store Analysis," (New York New York City Department of Health and Mental Hygiene, May 27, 2010). 17 Pennsylvania House Appropriations Committee, "Pennsylvania Fresh Food Financing Initiative," (Harrisburg, PA Pennsylvania House of Representatives, March 4, 2010).

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Table 1: FRESH Incentives

NYCDIA Financial Incentives Real Estate Tax Reductions Land Taxes Building Taxes DCP Zoning Incentives Additional Development Rights One additional square foot of floor area in mixed residential development and commercial buildings for every square foot provided for a grocery store, up to a 20,000 square foot limit. Reduction in Required Parking Stores up to 40,000 square feet in commercial districts that permit residential buildings with ground floor retail will not be required to provide parking. Larger-As-Of-Right Stores in Light Manufacturing Districts Grocery stores up to 30,000 square feet permitted in M1 districts. NYSERDA Programs Existing Facilities Program Retrofitting existing facilities

Sales Tax Exemption Exemption from 8.875% sales tax on materials to construct or renovate

New Construction program Assistance and incentives to incorporate energy efficient measures into construction

Mortgage Recording Tax Deferral A deferral of mortgage recording tax relating to the project's financing

FlexTech/Technical Assistance Program 50-50 energy cost sharing program with NYSERDA

Source: FRESH: Food Retail Expansion to Support Health, New York City Food Policy Task Force (2012). Harnessing Entrepreneurship: Green Carts, Farmers Markets & Fresh Moves New York City has also partnered with individuals, foundations, and nonprofit organizations to bring healthy foods into neighborhoods that need it most. Instead of simply relying on large supermarkets to provide the bulk of the healthy food, the city has created partnerships to bring in healthy foods on a smaller scale, with smaller startup costs. The first of these programs is the NYC Green Carts, a partnership with individual entrepreneurs and the Laurie M. Tisch Illumination Fund. The fund granted DOHMH $1.5 million in 2008 to help increase access to healthy foods across New York City. The money is not to pay for the individual carts, but to subsidize the permitting process so that there is no cost to the city; the costs are instead passed on to entrepreneurs who want to operate Green Carts. David Borenstein, an author tracking social innovation, writes that, The idea is to harness the enterprise of small business people to mitigate a social problem in a sustainable way.18 By partnering with entrepreneurs the city reduces its own costs and can still provide fresh produce in areas of greatest need, not to mention encouraging entrepreneurship. Local Law 9 changed city code to allow the issuance of 1,000 new permits for street vendors, but to be eligible for the permit the cart must only sell fresh produce and must sell in an area of low access to produce. The vendors

18

David Borenstein, "Conquering Food Deserts with Green Carts," The New York Times April 18, 2012.

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granted these permits are deemed Green Carts. In Brooklyn and the Bronx 350 permits were allocated in each borough, 150 for Manhattan, 100 for Queens, and 50 for Staten Island. The city has also partnered with nonprofit organizations like GreeNYC to open farmers markets across the five boroughs. At select markets across the city, DOHMH hosts workshops to educate the public about nutrition and how best to shop at the farmers market to get the most bang for the buck as part of their Stellar Farmers Markets initiative.19 The goal of the program is twofold: to bring healthy, locally sourced foods into neighborhoods that would not otherwise have access; and to educate the public about how to cook healthy foods and how to feed a family in a nutritious and cost-effective manner. Outside New York, other cities have also been partnering to bring new food providers into neighborhoods that need them most. In June 2012 Chicago Mayor Rahm Emmanuel announced a partnership with a local nonprofit organization, Fresh Moves, to bring food trucks into food deserts to sell fresh produce. The initiative repurposes decommissioned public buses and converts them into mobile farmers markets that move between Chicagos poorest neighborhoods with low levels of access to healthy foods or any supermarket at all. All the Fresh Moves buses also accept Electronic Benefit Transfer (EBT) cardsfood stamp benefits increasing the likelihood that they will be used by low-income residents. Funding was provided through the City of Chicago and the USDA Healthy Food Financing Initiative.20 Bringing Down the Cost: Health Bucks Farmers markets have become increasingly prevalent across the five boroughs, but to make them accessible to low-income families and individuals DOHMH has begun handing out vouchers to SNAP beneficiaries (more commonly referred to as food stamps) and community groups for use at farmers markets. These vouchersHealth Bucksare worth $2 each and are given to SNAP recipients or community groups for redemption at farmers markets. For every $5 spent on EBT cards, food stamp recipients receive one $2 voucher. The goal of the program is to increase the buying power of an individual on food stamps and to allow that increased budget to go toward the purchase of healthy, fresh foods. This program also has the added benefit of supporting farmers markets in low-income areas that might not otherwise flourish without Health Bucks. Out with the Old, In with the New: Healthy Bodegas Healthy Bodegas is an initiative of DOHMH working with local bodega owners to increase the availability of healthy foods in small convenience stores, usually full of processed and unhealthy food options. These bodegas are often the only form of grocery store in many neighborhoods; in areas of Central Brooklyn bodegas make up as much as 80% of food providers. 21 The program is small in scale relative to the number of bodegas across the city, only targeting neighborhoods
19

New York City Department of Health and Mental Hygiene, "Stellar Farmers' Markets," (New York: Office of the Mayor, 2009). 20 Mayor's Press Office, "Mayor Emanuel and Us Department of Agriculture Secretary Vilsack Announce Investment in Mobile Fresh Food Market in Chicago," ed. Office of the Mayor of the City of Chicago (Chicago June 8, 2012). 21 New York City Department of Health and Mental Hygiene, "New York City Healthy Bodegas Initiative 2010 Report," (New York: Office of the Mayor, 2010), 1.

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with the highest rates of diabetes and obesity: East and Central Harlem, the South Bronx, and North and Central Brooklyn. A bodega is defined as a store that: (1) has no more than two cash registers; (2) sells mostly food and does not specialize in any one item; and (3) sells milk. Stores that agree to work with the DOHMH agree to: (1) stock and sell a variety of healthy foods including, but not limited to, fresh fruits and vegetables, whole grain products, and low-fat and fat-free milk; (2) display nutritious foods prominently; and (3) label and promote healthful items.22 This program is designed not only to increase the availability of healthy foods, but also to replace unhealthy foods with healthy alternatives. As part of this initiative DOHMH also began a farm-to-bodega pilot program that linked bodegas with local farmers markets to stock shelves with local, fresh produce at a lower cost to consumers. There are no incentives offered to bodega owners for participating in the program, but they can receive technical assistance and training if requested. Green in the City: Agricultural Gardens and Farms When people hear New York City, most people do not think of farms or gardens. However, within the five boroughs there are currently 700 farms and gardens growing food. 23 These farms range from small rooftop gardens to large (at least by New York standards) plots of land for serious horticulture. Farms are run by individuals or nonprofit groups; they grow for personal consumption or for sale. The variation across the urban agricultural system is vast. However, the one common thread between them is that they are not funded by government dollars. The New York City government has a number of policies, as discussed in this section, to increase the availability of healthy foods in areas of need across the city. However, there has been little effort to tap into the urban agriculture community to date. There are a number of community gardens across the city, but not used for primarily agricultural purposes. The New York City Councils FoodWorks plan outlined the potential for urban agriculture, but it has not yet been integrated into city policy or programming.24

Weighing the Outcomes

With the host of programs throughout New York and the country, it can be difficult to know which programs are best at fulfilling their mission of increasing access to healthy foods. The main criterion for evaluating the success of any food access program obviously must be its ability to increase the quantity of healthy foods available in the targeted area. There is no point in discussing the viability of any program if it does not effectively meet this goal. Yet access is not only about the sheer quantity of food; there is a crucial second component that must be considered when evaluating programs: does the program increase the affordability of the healthy foods? There is little point in having a supermarket full of healthy foods that no one can afford to buy. Finally, like any policy, the program must be evaluated on its cost efficiency, measuring the relative costs and benefits to both the city and local businesses. In each of the initiatives outlined above, programs will be evaluated using the following criterion:
22 23

Ibid, 2. Nevin Cohen, et al., Five Borough Farm: Seeding the Future of Urban Agriculture in New York City (New York: Design Trust for Public Space, 2012). 24 New York City Council, FoodWorks: A Vision to Improve NYCs Food System, (New York: 2010), 26-30.

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Does the program increase the quantity of healthy foods available? Does the program make the healthy foods more affordable? Does the benefit outweigh the cost to the city and to local businesses?

Incentivizing New Providers: FRESH & FFFI As of April 10, 2013, there were 13 supermarkets taking advantage of FRESH incentives. While this may appear to be a small number relative to the thousands of grocery stores across the city, it is three above the citys own goal, as set by their grant.25 The supermarkets are spread throughout the city with the majority concentrated in Brooklyn and the Bronx.26 Of these 13 supermarkets, all took advantage of FRESH financial incentives, but only one claimed the zoning incentives. 27 Started in 2004, Pennsylvanias Fresh Food Financing Initiative (FFFI) is more robust than its NYC counterpart. It is structured as a public-private partnership fund with an initial $30 million investment from the Pennsylvania State government that was then leveraged by The Reinvestment Fund (TRF) to create a pool of $120 million from 2004 to 2009. Of the $120 million, $40.5 million is for supermarket financing loans, with unspecified allocations for grants and the New Markets Tax Credit. The program attracted 203 applications from across the State of Pennsylvania and 88 have been approved, totaling $72.9 million in loans and $11.3 million in grants given directly to supermarkets to support continued operations and entirely new markets. Pennsylvania estimates this funding has created over 5,000 jobs and 1.6 million square feet of retail space.28 Both FRESH and FFFI are ambitious programs to support existing food providers and encourage the development of new businesses in areas of highest need. Both programs have been successful in increasing the quantity of foods available in an area, though FRESH goes much further to ensure that healthy options must be included to receive benefits. However, FFFI has had much larger success than FRESH in the sheer retail space created. This is due in part to the amount of space available in the entire state of Pennsylvania compared with the small amounts of retail space available in a densely populated city like New York. The great success of FFFI is not in the numbers alone, but in its conception as a public-private partnership that leverages a relatively small amount of public money to encourage private investment in the creation of food retailers. In this way, the cost to government is minimal and still supports local businesses. Neither of these programs aims to make healthy foods more affordable, but simple economic laws of supply and demand suggest when there are more retailers in a given area the price must come down because of competition between retailers. More retailers will ultimately make healthy foods more affordable; the challenge is making sure that new retailers dedicate substantial space to healthy foods, which FRESH ensures.

25

Sabrina Baronberg (Director, Food Access and Community Health Programs, NYC DOHMH) in discussion with the author, April 2013. 26 New York City Department of Health and Mental Hygiene, FRESH Projects, 2013. 27 New York City Department of Health and Mental Hygiene. "Fresh Projects," 2013. 28 Committee, "Pennsylvania Fresh Food Financing Initiative."

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Harnessing Entrepreneurship: Green Carts, Stellar Farmers Markets & Fresh Moves Between 2008 and 2011 the city received 1,954 applications for Green Cart permits, nearly double the number of permits available. Yet as of September 2011the most recently available public dataonly half (501) of the total permits for Green Carts had been issued. Table 2 demonstrates the citys slow progress to issue permits for Green Carts despite the high demand.29 Table 2: Green Cart Permits (data as of September 9, 2011) Bronx Brooklyn Manhattan Queens Staten Island 50 Citywide Total 1,000

Permits Available Applications Submitted

350

350

150

100

618

752

343

195

46

1,954

Current Permits 197 Issued Percentage Available Permits Allocated of 56.3%

171

90

39

501

48.9%

60%

39%

8%

50.1%

People on Wait 133 List at FY2011 End

160

1,770

830

N/A*

Source: New York City Department of Health and Mental Hygiene, Report to the New York City Council on Green Carts FY2011 *Not applicable for Citywide Total; a person may be on the wait list for multiple boroughs In addition to the lack of permits issued, it is unclear if the Green Cart permits that have been issued are truly covering the areas of highest need for healthy foods. DOHMH has not conducted a full scale evaluation of the Green Carts program, but there have been independent evaluations of Green Cart areas. One such evaluation found that in the Bronx, Green Carts were clustered close to areas of high pedestrian traffic in a very small swath of the Bronx.30 While this maximized the amount of customers, the high concentration of Green Carts in a small area was antithetical to the programs goal to widely expand access to fresh produce across the city. The

29

New York City Department of Health and Mental Hygiene, "Report to the New York City Council on Green Carts Fy2011," (New York2011). 30 Andrew Maroko Sean C. Lucan, Renee Shanker, and William B. Jordan, "Green Carts (Mobile Produce Vendors in the Bronx)Optimally Positioned to Meet Neighborhood Fruit-and-Vegetable Needs? ," Journal of Urban Health 88, no. 5 (October 2011).

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study concluded that based on the high concentration of Green Carts in small areas, the program was only covering approximately 57% of the needy areas the city had previously identified. 31 Stellar Farmers Markets is a relatively small program focusing primarily on education. In 2011, the Health Department conducted 1,300 nutrition workshops and cooking demonstrations at 18 markets, reaching more than 37,000 people.32 Workshops were only held at 18 farmers markets with GrowNYC, but there are many more markets than only the citys Stellar markets. GrowNYC alone hosts 54 farmers markets across the five boroughs,33 and there are a number of other organizations that also host markets. As can be seen in Figure 3, the majority of the city's markets are concentrated in Manhattan, the Bronx, and Brooklyn.

Figure 3: New York City Farmers Markets

Source: New York City Department of Health and Mental Hygiene

31 32

Ibid. New York City Department of Health and Mental Hygiene, "New York City Health Department Farmers' Market Programs," (New York June 2012). 33 GrowNYC, "Greenmarket Farmers Markets," http://www.grownyc.org/greenmarket.

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While New York City has struggled somewhat to effectively and efficiently create mobile food providers, Chicago has had resounding success with its Fresh Moves mobile supermarket. Fresh Moves was a nonprofit launched in 2006 after a report estimated that 600,000 Chicago residents lived in food deserts, more than 20% of the citys population. In five years, the number of people living in food deserts has decreased by 40% to less than 400,000. 34 There has been no formal evaluation to determine the true impact of the Fresh Moves buses on these results, but the program has been effective enough to receive national attention and funding from the likes of the City of Chicago, the United States Department of Agriculture, and Oprah Winfrey. 35 The operation currently costs $275,000 per year and brings in about $50,000 in sales revenue.36 While it is not a profitable venture, the City of Chicago sees it as worthy of investment and has committed more money and more buses to its continued operation.37 All three of these public-private partnerships have been extremely successful in increasing the quantity of healthy foods available in communities across the city. Green Carts has had some problems covering the areas of need and preventing small clusters of carts. The city has also been moving slowly to distribute the licenses, despite long waiting lists of entrepreneurs looking to make the leap and open a Green Cart. Farmers Markets also have little presence in Northern Manhattan and Queens, but have been successful in expanding to most of the areas of need in Brooklyn and the Bronx.38 All have also been successful in efforts to make healthy foods more accessible to low-income populations by providing EBT machines at vendors. While this does not bring down the actual price of the food, it makes it more feasible for SNAP beneficiaries to spend their benefits on healthy foods rather than only processed foods. This, paired with Health Bucks (discussed below) makes it feasible for an individual or family on food stamps to afford fresh produce. These public-private partnerships harness the power of entrepreneurs and nonprofits to create their own businesses. Initiatives like Fresh Moves, Farmers Markets and Green Carts both represent little cost to the city and a good opportunity for entrepreneurs to make a relatively low startup investment in a cart or farmers market stand and start a business venture. Bringing Down the Cost: Health Bucks Health Bucks was launched in 2005 by the NYC Human Resources Administration and has been largely successful in increasing farmers market sales among low-income populations. Health Bucks has grown to the largest SNAP incentive program in the nation, totaling $180,000 worth of Health Bucks distributed. Health Bucks increase SNAP purchasing power by 40%, allowing beneficiaries to stretch their dollar further, and healthier. Redemption rates among SNAP beneficiaries was 93% in 2011; among community organizations it was 71%. While the

34 35

Sandra Guy, "Report: Chicago Food Desert Shrinks 40 Percent," Chicago Sun-Times October 24, 2011. Office, "Mayor Emanuel and Us Department of Agriculture Secretary Vilsack Announce Investment in Mobile Fresh Food Market in Chicago." 36 Angie Schmitt, "'Fresh Moves' Produce Market: Greening the (Food) Desert," AIArchitect November 16, 2012. 37 Mayors Press Office, "Mayor Emanuel and Us Department of Agriculture Secretary Vilsack Announce Investment in Mobile Fresh Food Market in Chicago." 38 New York City Department of Health and Mental Hygiene, "Farmers' Market Map," http://www.nyc.gov/html/doh/downloads/pdf/cdp/farmers-market-map.pdf.

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redemption rate among community organizations is not as high, it has increased 18% since 2008.39 Health Bucks for SNAP beneficiaries are dependent on EBT spending, and since the introduction of Health Bucks average EBT sales at farmers markets have more than doubled from $237 to $597. Farmers Markets that accepted Health Bucks received an average of $170 more in daily EBT sales than non-Health Bucks markets. DOHMH estimates that EBT sales coupled with Health Bucks yielded more than $640,000 in additional revenue for local farmers.40 Health Bucks, more than any other city policy, has worked the hardest to make healthy foods more affordable to low-income individuals and families. Farmers markets were long thought to be the territory of the citys yuppies and wealthy families, but Health Bucks shatters this assumption and makes it possible for those on a tight budget to stretch their benefits and afford the quality, healthy foods available at farmers markets. Vendors and individuals have clearly taken to the vouchers, demonstrated by high redemption rates and increased revenues. The cost to city government in 2011 was approximately $217,000: $180,000 worth of vouchers, $22,500 in administrative processing costs ($0.25 per voucher), and $15,000 for printing and postage costs.41 Out with the Old, In with the New: Healthy Bodegas The Healthy Bodegas program has been one of DOHMHs most labor intensive programs, but it has yielded positive results in nearly all areas. While the program initially began as a small pilot, since the programs inception in 2006 DOHMH outreach workers have worked with over 1,000 bodegas in the identified areas in Brooklyn, Manhattan and the Bronx.42 DOHMH outreach workers conducted a program evaluation in 2011 with 60 bodegas, visiting each store 10 times over five months to assess progress and success. Outreach workers evaluated success based on 16 health-promoting criteria relating to the availability of fruits and vegetables, low-sodium products, multigrain products, no-sugar-added products, and low-fat milk.43 Stores stocking at least four types of fresh fruits increased from 36% to 47%; stores with refrigerated waternot soda or other sugary drinksat eye level increased from 35% to 64%; 78% of store owners reported that after the intervention, sales of healthy products increased. 44 While the percentage change may not be overwhelming, the trend is a positive step toward the goal of healthier food providers. However, evaluators noted that, Our findings indicate that although improving the inventory of healthy foods in corner stores is feasible, changing customer purchases is more difficult.45 Sabrina Baronberg, Director of Food Access and Community Programs for DOHMH, conceded the difficulty of changing customer attitudes and sustaining change in these

39

New York City Department of Health and Mental HygieneHygiene, "New York City Health Department Farmers' Market Programs," 2-3. 40 Ibid., 4. 41 National Association of County & City Health Officials, "Model Practices Program Details: Health Bucks," http://www.naccho.org/topics/modelpractices/database/practice.cfm?practiceID=523. 42 Rachel Dannefer et al., "Healthy Bodegas: Increasing and Promoting Healthy Foods at Corner Stores in New York City," American Journal of Public Health 102, no. 10 (2012): e27. 43 Ibid., e28. 44 Ibid., e29. 45 Ibid., e30.

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stores.46 The Adopt-a-Bodega program has become an offshoot of the Healthy Bodegas program to engage community groups, nonprofits, elected officials, and everyday individuals to sustain the healthy changes made in their bodegas and help influence community members to make the healthier choices in these bodegas.47 Healthy Bodegas is labor intensive, and therefore expensive for the city, costing about $180,000 per year with no guarantee of any direct benefit to consumers or business owners. 48 Food retailers take risks when they change their inventory and are not paid by the city to do so. It is a gamble for bodega owners, but one that many have undertaken in some small way. When bodega owners do opt to make changes, it becomes much easier for neighborhood residents to have access to healthy foods. In many neighborhoods the bodega is the primary food retailer, and their stock dictates what is in residents refrigerators and kitchen cabinets. The goal of Healthy Bodegas is not to decrease the price of healthy foods, but to provide healthy alternatives to the standard processed choices available, which are hopefully within the price range of the average consumer. The growth of the farm-to-bodega initiative can help decrease costs of produce and establish partnerships between farmers markets and bodegas. Green in the City: Urban Agriculture Even advocates of urban agriculture concede that it cannot provide enough food to feed the city, but nonetheless it still provides some food for city residents. In 2010 there were 87,690 pounds of vegetables grown on 71,950 square feet in 67 gardens, averaging 1.2 pounds of produce per square foot. Based on crop yield capabilities calculated by the USDA and the vacant space in New York City, there is potential to supply the produce needs of as many as 174,000 people, far from the citys population, but a substantial number nonetheless considering how little space is available in New York City. 49 This calculation did not include the potential of rooftop gardens or repurposing already occupied spaces, such as schoolyards or space in New York City Housing Authority complexes. Urban farms that are not solely for personal consumption currently sell their produce through Community Supported Agriculture (CSA) programs, farmers markets, or give their produce to local food banks. Yet these efforts still have not made large contributions to the food security of many New Yorkers. Figure 4 demonstrates that there are high concentrations of vacant lands and community gardens in areas identified as being of the highest need. Much of this vacant land could be utilized as a community agricultural garden or farm and provide at least some form of support to the existing food environment to provide more fresh produce.

46

Sabrina Baronberg (Director, Food Access and Community Health Programs, NYC DOHMH) in discussion with the author, April 2013. 47 New York City Department of Health and Mental Hygiene, "New York City Healthy Bodegas Initiative 2010 Report." 48 New York City Center for Economic Opportunity, "Ceo Internal Program Review Summary: Healthy Bodegas, a Program of the New York City Department of Health and Mental Hygiene," (New York 2009). 49 Kubi Ackerman, "The Potential for Urban Agriculture in New York City," ed. The Earth Institute at Columbia University (New York Urban Design Lab 2012), 20.

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Figure 4: Public Vacant Lands in NYC

Source: The Potential for Urban Agriculture in New York City, 2012

Urban farming can bring new produce into neighborhoods without traditional retailers. Because there are no transport costs the cost to consumers would also be lower than at most retailers. The maintenance of an urban farm would not be a great cost in dollars, but in time. However, if there was community buy-in and partnerships with nonprofit community organizations, small community farms could not only provide healthy options for neighborhoods, but also a neighborhood institution that have great community value.

Policy Recommendations
New York City has been exemplary in its food access policies and has set a solid foundation that cities across the globe can build on. With a new mayor coming into office next year, it is important not to solely rest on the progress of the Bloomberg Administration and say the work is done. There are still millions of New Yorkers living without sufficient access to a healthy food retailer, or unable to afford the healthy foods available to them. These programs represent an excellent beginning to what is sure to be a decades-long effort to ensure that all New Yorkers have equal access to healthy foods.

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Restructure FRESH FRESH has gone above and beyond its grant requirement, but that does not mean it should not be pushed even further. Getting new, large retailers into neighborhoods is a crucial part of any food access strategy. The FFFI model may provide a way to scale the program upusing a small public investment to encourage private investorsespecially given the programs grant will be expiring next year.50 FRESH should restructure itself as a general fund that supermarkets could take advantage of, rather than just a tax break or zoning incentive program. Store owners might be keener to take advantage of a cash-based grant program rather than only incentives. However, to improve upon the FFFI model the FRESH program should keep current requirements to receive funding to ensure that food retailers are providing ample healthy options in their stores and that the retailers are going where they are most needed. Ramp Up Green Carts & Divest from Farmers Markets The city has only released about half of the licenses available for Green Carts. The licensing process must be expedited to get Green Carts out on the streets. With wait lists in the hundreds, there is no reason to delay this process any further. The city should also monitor cart location to ensure that there are not large clusters in small areas, but rather that the carts are spread out over areas of need. This could be done by including a specific location for the Green Cart in the license, determined by the city government and not by the retailer. The city should also ensure that every Green Cart has an EBT machine so that SNAP beneficiaries can take advantage of these healthy retailers. While the Stellar Farmers Market has done an excellent job conducting workshops and lessons for consumers, it is likely that this duty could be handled by nonprofit organizations, and it is at many farmers markets. To ensure city resources are being used most efficiently, the city should consider divesting from farmers market initiatives since this niche seems to be well served by a number of nonprofit organizations. The city should also seek to create a program like Chicagos Fresh Moves, with mobile supermarkets converted from decommissioned city buses. A program like this could provide healthy food options beyond just fruits and vegetables. It also ensures that residents of different neighborhoods are ensured the same quality of healthy foods. Invest in Health Bucks Health Bucks has primarily been targeted toward SNAP beneficiaries, with lower emphasis on community organizations. While it is crucial to continue handing out vouchers to SNAP beneficiaries, there should be increased focus on community organizations helping needy populations, but that might not always be receiving SNAP benefits. There are plenty of lowincome New Yorkers who could benefit from this program, and the city should seek to aggressively expand this crucial program. There is little point in having healthy food available in a neighborhood if no one can afford it. The city should also explore expanding these vouchers beyond only farmers markets to retailers like Green Carts or bodegas that have participated in the Healthy Bodegas program.

50

Sabrina Baronberg (Director, Food Access and Community Health Programs, NYC DOHMH) in discussion with the author, April 2013.

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Sustain Healthy Bodegas With over 1,000 bodegas participating in the Healthy Bodegas program, the city should shift its efforts toward sustaining changes already made by shifting focus to its Adopt-a-Bodega program, which trains community organizers, nonprofits, and individuals to work with bodega owners to make new healthy changes and to sustain old changes. The program should also focus more on its Farm to Bodega initiative, which could be boosted by an increase in urban farms and agricultural gardens in the city. This could also be bolstered by foods directly from farmers markets across the city. This will increase stock of healthy produce and hopefully lower the costs because of the low transport costs. Create Spaces for Urban Agriculture Urban agriculture is currently the most lacking in the citys food policy toolkit. Agricultural gardens and farms have been the purview of nonprofit organizations and individuals and have been successful on a small scale. While the city should refrain from directly operating farms, a time and labor intensive process, the city should instead devote a portion of vacant, city owned land in areas of low access to healthy foods to community organizations committed to creating and sustaining urban agricultural space. The city should also rezone those vacant lots to allow gardens and farms to be developed with minimal bureaucratic interference. The city can also explore creating agricultural gardens on New York City Housing Authority (NYCHA) properties, many of which are in areas lacking sufficient access to healthy food. There is already a well-established NYCHA program, Garden and Greening, began in 1962, that establishes community gardens on NYCHA properties.51 However, this is mostly for beautification purposes. This program should be expanded, with the help of community partners, to eventually create an agricultural garden on every NYCHA property. According to an independent evaluation, there are currently 1,199 acres of NYCHA green space that could be used for potential agricultural farms or gardens.52

Conclusion
These numerous programs created by the Bloomberg Administration can be altered and expanded beyond their current parameters to make healthy foods accessible both geographically and economically. The economic component is especially important as the city moves forward. Mayor Bloomberg and the Food Policy Task Force have created a solid set of programs that increase geographic access to healthy foods. The next mayor, whoever that may be, can put his or her unique mark on this issue by focusing on economic accessibility. The next Administration must continue to build upon this foundation so that a zip code is not a determinant of someones diet or their access to healthy food options.

51

New York City Housing Authority, "Community Programs & Services: Garden Program," http://www.nyc.gov/html/nycha/html/community/garden.shtml. 52 Ackerman, "The Potential for Urban Agriculture in New York City."

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Bibliography
Ackerman, Kubi. "The Potential for Urban Agriculture in New York City." edited by The Earth Institute at Columbia University. New York Urban Design Lab 2012. AECOM. "Final Project Report: NYC Full Service Grocery Store Analysis." New York New York City Department of Health and Mental Hygiene, May 27, 2010. An, Ruopeng, and Roland Sturm. "School and Residential Neighborhood Food Environment and Diet among California Youth." American Journal of Preventive Medicine 42, no. 2 (2012): 12935. Borenstein, David. "Conquering Food Deserts with Green Carts." The New York Times, April 18, 2012. Brannen, Sarah. "FoodWorks: A Vision to Improve NYC's Food System." New York: New York City Council, 2010. Center for Economic Opportunity. "CEO Internal Program Review Summary: Healthy Bodegas, a Program of the New York City Department of Health and Mental Hygiene." New York 2009. Dannefer, Rachel, Williams, Donya A., Baronberg, Sabrina, and Silver, Lynn. "Healthy Bodegas: Increasing and Promoting Healthy Foods at Corner Stores in New York City." American Journal of Public Health 102, no. 10 (2012): e27-e31. GrowNYC. "Greenmarket Farmers Markets." http://www.grownyc.org/greenmarket. Guy, Sandra. "Report: Chicago Food Desert Shrinks 40 Percent." Chicago Sun-Times, October 24, 2011. Lucan, Sean C., Maroko, Andrew, Shanker, Renee and Jordan, William B.. "Green Carts (Mobile Produce Vendors in the Bronx)Optimally Positioned to Meet Neighborhood Fruit-andVegetable Needs? ." Journal of Urban Health 88, no. 5 (October 2011): 977-81. National Association of County & City Health Officials. "Model Practices Program Details: Health Bucks." http://www.naccho.org/topics/modelpractices/database/practice.cfm?practiceID=523. New York City Department of Health and Mental http://www.nyc.gov/html/misc/html/2009/fresh_projects.shtml. . "Stellar Farmers' Markets." New York: 2009. . "New York City Health Department Farmers' Market Programs." New York: 2011. . "Report to the New York City Council on Green Carts FY2011." New York: 2011. Hygiene. "Fresh Projects."

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. "Farmers' Market Map." http://www.nyc.gov/html/doh/downloads/pdf/cdp/farmers-marketmap.pdf. New York City Food Policy Taskforce. "Going to Market: New York City's Neighborhood Grocery Store and Supermarket Shortage." New York: Office of the Mayor, 2008. . "FRESH: Food Retail Expansion to Support Health." New York: Office of the Mayor, 2012. New York City Housing Authority. "Community Programs & Services: Garden Program." http://www.nyc.gov/html/nycha/html/community/garden.shtml. Office of the Mayor of the City of New York. "Office of the Food Policy Coordinator." http://www.nyc.gov/html/ceo/html/programs/food_policy.shtml. Pennsylvania House Appropriations Committee. "Pennsylvania Fresh Food Financing Initiative." Harrisburg, PA Pennsylvania House of Representatives, March 4, 2010. Schmitt, Angie. "'Fresh Moves' Produce Market: Greening the (Food) Desert." AIArchitect, November 16, 2012. Seserman, Michael and Whalen, Elizabeth. "Looking for an Oasis in a Food Desert: Low Income New Yorkers Lack Access to Healthy Foods." American Cancer Society October 2011. Smith, Laura, Goranson, Chris, Bryon, Jodi, Kerker, Bonnie, and Nonas, Cathy. "Developing a Supermarket Need Index." In Geospatial Analysis of Environmental Health, edited by Juliana A. Maantay and Sara McLafferty, 205-21: Springer Netherlands, 2011. United States Department of Agriculture. "Creating Access to Healthy, Affordable Foods." edited by Agricultural Marketing Service. Washington, DC, 2011. United States Department of Agriculture. "Food Desert Locator." edited by Economic Research Service, 2012.

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Acronyms
CSA EBT DCP DOHMH FFFI FRESH HRA IDA NMTC NYCHA NYSERDA SNAP SNI TRF USDA Community Supported Agriculture Electronic Benefit Transfer Department of City Planning Department of Health and Mental Hygiene Fresh Food Financing Initiative Food Retail Expansion to Support Health Human Resources Administration Industrial Development Agency New Market Tax Credit New York City Housing Authority New York State Energy Research and Development Association Supplemental Nutrition Assistance Program Supermarket Need Index The Reinvestment Fund United States Department of Agriculture