The Obesity Epidemic in Black America Has Nothing to Do With Food Deserts

Here is a number that should be spoken aloud in every Black household, every Black church, every community meeting, and every doctor’s office in America, spoken not as an abstraction but as an emergency, because that is precisely what it is: 49.9%. That is the obesity rate among Black adults in the United States, as measured by the CDC’s National Health and Nutrition Examination Survey for the period 2017–2020. Not overweight — obese. Nearly one in two Black adults in this country carries enough excess weight to significantly increase their risk of diabetes, heart disease, stroke, kidney failure, and early death. Among Black women, the number is 57%. Among Black children ages 2 to 19, it is 24.8%, compared to 16.1% for white children. These are not disparities. They are catastrophes, and they are killing Black people at rates that dwarf the police violence that dominates our public conversation about Black death.

The explanation you will hear most often, the one that has achieved the status of received wisdom in progressive policy circles, in public health departments, and in the academy, is the food desert. The argument is structurally elegant: Black neighborhoods lack grocery stores that sell fresh produce. Without access to healthy food, people eat unhealthy food. Unhealthy food causes obesity. Therefore, obesity in Black America is a structural problem — a consequence of disinvestment, redlining, and the systematic withdrawal of resources from Black communities. The solution, according to this framework, is to bring the grocery stores. Build the access. Fix the supply, and the demand will follow.

The research says otherwise. And this is the part of the conversation that almost nobody is willing to have.

The Food Desert Myth — and the Data That Demolished It

In 2019, economists Hunt Allcott, Rebecca Diamond, and Jean-Pierre Dubé published what remains the most rigorous study of food deserts and their relationship to dietary health in the economic literature. Using detailed consumer purchasing data from a nationwide panel of households, they tracked what happened when new supermarkets opened in food deserts. The finding was unambiguous: the entry of a new grocery store into a food desert changed the nutritional quality of local purchases by approximately 9%. Nine percent. The vast majority of the dietary gap between residents of food deserts and residents of food-rich neighborhoods persisted even after access was equalized.

The study’s central finding is worth repeating because it demolishes the foundational premise of two decades of food desert policy: when low-income households gained access to the same stores as higher-income households, they did not make the same purchasing decisions. The gap was not primarily about supply. It was about demand — about preferences, habits, nutritional knowledge, and what the researchers carefully termed “demand-side factors.”

Jessie Handbury, Ilya Rahkovsky, and Molly Schnell, in a complementary study published in the Quarterly Journal of Economics, decomposed the nutritional gap between wealthy and poor households and found that approximately 90% of the difference was attributable to demand-side factors — what people chose to buy — and only about 10% was attributable to supply-side factors like store availability. Ninety percent. When the full weight of the evidence is assembled, the food desert explanation does not survive. It explains a fraction of the crisis and has been permitted, by a political and academic establishment that finds structural explanations more comfortable than behavioral ones, to stand in for the whole.

“We find that exposing low-income households to the same products and prices available to high-income households would reduce the nutritional gap by only about 10 percent.”
— Allcott, Diamond, & Dubé, 2019

What Black America Is Eating — and What It Costs

The NHANES dietary recall data, which asks participants to report everything they have eaten in the previous 24 hours, reveals patterns that the food desert explanation cannot account for. Black Americans consume sugar-sweetened beverages at significantly higher rates than any other demographic group. The average intake of added sugars among Black adults exceeds the American Heart Association’s recommended limit by a factor of two. Fried food consumption, processed meat consumption, and sodium intake are all elevated relative to white and Hispanic Americans at equivalent income levels. These are not the dietary patterns of people who cannot find a vegetable. They are the dietary patterns of people who have not been taught, or have not been culturally reinforced, to choose differently.

The arithmetic of obesity is merciless in its simplicity. An excess of 150 calories per day — roughly one can of soda or one small bag of chips — produces approximately 15 pounds of weight gain per year. Over five years, that single daily excess produces 75 pounds. The caloric difference between an obese dietary pattern and a healthy one is not vast. It is incremental, habitual, and cumulative, and it operates according to the laws of thermodynamics with a precision that no amount of sociological explanation can override. You cannot be in sustained caloric surplus and not gain weight. This is not a political position. It is physics.

The Cultural Factor Nobody Will Name

Let me say the thing that the public health establishment will not say, the thing that will get this article forwarded with outrage rather than reflection, the thing that is nonetheless true and documented and measurable: there is a cultural relationship to food in Black America that is contributing to the death of Black people, and pretending that this relationship is entirely the product of structural forces is a lie that is killing us.

The soul food tradition — which is a magnificent culinary achievement born of the ingenuity of enslaved people making something extraordinary from the scraps they were given — was a survival cuisine. It was designed to maximize calories in conditions of extreme deprivation. Fried chicken, collard greens cooked in fatback, macaroni and cheese, cornbread, sweet potato pie — these foods were developed when the challenge was getting enough calories, not avoiding too many. The cuisine was adaptive. It kept people alive. But the conditions it was adapted to no longer exist, and the continuation of those dietary patterns in an era of caloric abundance is not cultural preservation. It is cultural inertia, and the consequences are documented in the mortality tables of every major health organization in the country.

This is not an argument against soul food. It is an argument for the evolution of soul food — for the same ingenuity that created something delicious from almost nothing to now create something both delicious and life-sustaining. That evolution has already begun, in the work of chefs and nutritionists who are reimagining the tradition. But the cultural conversation around food in many Black communities still treats any suggestion of dietary change as an attack on identity, as though choosing to grill instead of fry is an act of racial betrayal.

The Health Consequences — in Numbers

The cost of the obesity epidemic in Black America is not measured in pounds. It is measured in years. Black Americans have twice the rate of type 2 diabetes as white Americans — 12.1% versus 7.4%, according to the CDC. Black Americans have 1.5 times the rate of hypertension. Black women have the highest rate of cardiovascular mortality of any demographic group in the country. Kidney disease, which is heavily correlated with both diabetes and hypertension, is 3.5 times more common in Black Americans. And the American Heart Association has documented that the excess cardiovascular mortality attributable to obesity in Black America accounts for tens of thousands of preventable deaths every year.

These numbers mean something specific. They mean that a Black woman who is obese at age 40 will, on average, die seven to ten years earlier than a Black woman of healthy weight with otherwise similar characteristics. They mean that a Black man with uncontrolled type 2 diabetes will spend his fifties managing a chronic disease that progressively destroys his kidneys, his eyesight, his circulation, and his cognitive function. They mean that Black children who are obese by age 10 have a 75% chance of being obese as adults, with all the cascading health consequences that follow. This is not a health disparity. It is a health emergency, and it has been dressed up as a policy problem to avoid the discomfort of discussing it as a behavioral one.

The Economics Are Not an Excuse

The objection will come immediately: healthy food is more expensive. And this is partially true. Fresh produce costs more per calorie than processed food. Lean protein costs more than processed meat. The USDA’s own data confirms a price differential. But the same USDA that documents the price differential also publishes the Thrifty Food Plan — a detailed, week-by-week meal plan designed to provide a nutritionally adequate diet at the cost level of SNAP benefits. The plan is not luxurious. It requires cooking from scratch. It requires planning. It requires the same discipline that our grandmothers exercised when they fed families of six on a fraction of what we spend today, without the benefit of a supermarket on every corner.

The documented reality is that rice, dried beans, frozen vegetables, oatmeal, eggs, and whole chickens — the staples of healthy, affordable cooking around the world — are available in virtually every neighborhood in America, including those classified as food deserts. The Dollar Tree sells frozen broccoli. The corner store sells eggs. The question is not whether healthy food exists in Black neighborhoods. The question is whether the knowledge, the habit, and the cultural expectation of cooking with these ingredients exists in Black households. And the honest answer, the one that the data supports, is that in too many cases, it does not — not because Black people are incapable of cooking healthy food, but because the cultural transmission of those skills has been disrupted, and the institutions that might restore it have been replaced by a fast-food industry that spends $5 billion per year marketing processed food to communities that can least afford the health consequences.

What Actually Works

The programs that have produced measurable dietary change in Black communities share a common characteristic: they are community-based, culturally specific, and they address behavior rather than access. The Body & Soul program, funded by the National Cancer Institute and developed in partnership with Black churches, used the institutional structure of the church — its social networks, its moral authority, its weekly gathering of congregants — to deliver nutrition education and promote dietary change. Randomized controlled trials showed that participants in the program significantly increased their fruit and vegetable consumption and reduced their fat intake compared to control groups.

The Black Women’s Health Imperative, founded in 1983, has spent four decades addressing the specific health challenges facing Black women through education, advocacy, and community programming. Community cooking programs in cities from Detroit to Atlanta have demonstrated that when Black families are taught to cook healthy meals that respect their culinary traditions while modifying the most damaging elements — less frying, less sodium, less sugar, more vegetables, more whole grains — they adopt and sustain those changes. The evidence is clear: the intervention that works is not a grocery store. It is education, cultural engagement, and the restoration of cooking as a household practice rather than a convenience outsourced to corporations whose profits depend on your addiction to salt, sugar, and fat.

“The question is not whether healthy food exists in Black neighborhoods. The question is whether the knowledge, the habit, and the cultural expectation of preparing it exists in Black households.”

The Surrender

Let me say this as plainly as it can be said, because the euphemisms have cost too many lives and the politeness has buried too many people: if you are eating yourself into diabetes, heart disease, and an early grave while waiting for a grocery store to open in your neighborhood, you are not engaged in a political act. You are engaged in a slow form of surrender. And the people who have told you that your diet is not your responsibility — that it is the food desert, the systemic racism, the lack of access, the historical trauma — have given you an explanation that is flattering and incomplete, and the incompleteness is the part that kills you.

The food desert is real. It should be fixed. The predatory marketing of fast food to Black communities is real. It should be regulated. The historical patterns that created these conditions are real. They should be understood. But none of these truths, individually or collectively, change the fact that the fork is in your hand. The grocery store two miles away sells produce. The internet contains ten thousand free recipes for meals that cost less than a combo meal at a drive-through and do not contribute to the chronic diseases that are the leading killers of Black Americans. The choice — and it is a choice, not a structural inevitability — to eat in a way that preserves your life is available to you right now, today, regardless of what the USDA classifies your neighborhood as.

Our grandmothers cooked. They cooked with less money, less access, less education, and less convenience than we have today, and they did it because they understood that feeding your family well was not a luxury that depended on the proximity of a Whole Foods. It was a responsibility that depended on knowledge, discipline, and love. The obesity epidemic in Black America will not be solved by policy alone, any more than it was caused by policy alone. It will be solved when Black families reclaim the kitchen, when Black communities reclaim the conversation about food and health from the people who have made it an ideological battleground, and when we decide — collectively, culturally, without apology — that 49.9% is not a statistic we are willing to accept, and that the first step toward changing it is admitting that the fork, at least, is within our reach.