Gauging Geography as a Determinant of Health

For my first service project at the Bloomfield-Garfield Family Health Center, I am helping to implement a clinic food pantry to address food insecurity among the clinic’s patient population. I have previously volunteered with organizations that help to increase access to healthy foods for vulnerable populations and those in need. Common barriers to access that I observed while volunteering with these organizations often included transportation, financial, and health-related mobility issues. However, as I have begun to prepare for my project by performing research and engaging with community members to investigate barriers to food in Pittsburgh, I have become more conscious of a barrier that I have not previously given enough thought to. That barrier is geography.

The hilly topography of Pittsburgh alone presents a barrier to accessing good food. The incline of some of the streets of Pittsburgh make it difficult for an everyday person to navigate, let alone someone carrying heavy groceries, and possibly struggling with a health condition or other stressors. These difficulties can be worsened during winters due to snow and ice making steep roads inaccessible to public transit and even plow vehicles. For an urban location to be classified as a food desert, the USDA typically requires a community to be more than one mile from a supermarket or grocery store. However, in Pittsburgh, this distance is nearly halved due to inaccessibility related to the city’s topography.

The distinct neighborhood divisions of Pittsburgh also pose some challenges to food access. The city of Pittsburgh is split into 90 neighborhoods, each with their own unique identities and features. Many Pittsburghers closely associate with their respective neighborhoods, and stay within their neighborhoods as they go about their daily lives. This creates a need for affordable grocers and other food resources to be within each immediate neighborhood community. Despite an abundance of programs and organizations in Pittsburgh that help to address food insecurity, there are still neighborhoods left unreached. For example, I recently researched a produce distribution program at a local food bank to potentially recommend to patients at my clinic. The nearest distribution site for this program is multiple neighborhoods away, and inaccessible to many patients at my clinic without the means to reach the site and transport a large quantity of produce back home.

My clinic’s hope is that our food pantry will fill in some of the gaps in food accessibility related to geography. We are also developing this food pantry with mindfulness of other factors that influence food accessibility and diet, as well as the relationship that all of this has with health outcomes. With the link between geography, food, and health in mind, if I named one takeaway from my service thus far, it would be to never underestimate the potential significance of any single determinant of health, especially when considering a new environment.

This post was written by NPHC member Gabrielle Wasilewski.

Gabrielle serves at UPMC St. Margaret Family Health Center- Bloomfield/Garfield as a Patient Navigator.