No Stupid Questions - 92. Is Poor Nutrition a Supply Problem or a Demand Problem?

Episode Date: March 27, 2022

Is evolution stacked against healthy eating? What policies could increase demand for nutritious food? And does Popeyes count as a cultural icon?

it's not my fault and it's not my problem and also it's not my responsibility i'm angela duckworth i'm stephen dubner and you're listening to no stupid questions today on the show is everything we thought we knew about food deserts wrong you mean for that two dollar burger i can get 600 calories give me two yeah more bang for your buck. Stephen, I read this paper from QJE. Economists call it the QGE. Wait, do they really call it QGE?

They do. All right, now I'm feeling slightly embarrassed. I didn't know that. Can I just say, not knowing that economists call the quarterly journal of economics, the QG should not be a source of embarrassment for anyone. It might be a badge of pride. Correct. Well, I was reading the QG and I was reading in particular this article about food deserts.

And I know we've talked a little bit about our affection mutual for Trader Joe's. And I'm so interested in this question of whether when you live in a food desert, so no Trader Joe's. And I'm so interested in this question of whether when you live in a food desert, so no Trader Joe's, no supermarkets that even sell decent fresh fruit and vegetables, does that make you into an unhealthy eater? And I think that's been the received wisdom for a long time. And this recent article done by one of my favorite economists, Hunt Alcott, is making the claim that food deserts do not cause people in low-income neighborhoods to eat worse. That, in fact, it is not a supply problem that people are eating junk food, fast food, but a demand problem. So, Stephen, what do you think about this argument? And do you think it's important?

So I did read this paper. There were, I believe, six authors, three of them economists, and then others are professors in marketing and data science and real estate. And yeah, after examining a lot of data, they found, I'm looking here, quote, that exposing low-income households to the same products and prices available to high-income households, in other words, ameliorating the food desert, reduces nutritional inequality by only about 10%, while the remaining 90% is driven by differences in demand, as you said. These findings counter the arguments that policies to increase the supply of healthy groceries could play an important role in reducing nutritional inequality. So look, whenever someone can bring data to the issue, I think that's a step in the right direction.

On the other hand, you can imagine a lot of people looking at these conclusions and saying, whoa, blaming the victims. You're basically saying that people around this country who are living in low-income communities because they are low-income families, they also eat worse. Right. Let's first talk about the paper itself, because this paper was amazing. And I know I'm a nerd, but I was reading this paper and I was like, holy smokes, how would you ever be able to make a causal conclusion about something which seems hopelessly correlational? And the correlation that had been well established long before these six scientists got together was that there is a

strong relationship between low income neighborhoods and the absence of food that's healthy, in particular supermarkets. So you find a lot of convenience stores, you find a lot of fast food joints, but if you go into a convenience store or a fast food joint, it's just like, where are you going to get a salad? Where are you going to get a fresh apple? So the correlation had been well established. So they replicate that. They combine the Nielsen home scan. It's like a nationally representative panel survey of grocery purchases of 61,000 households across the United States. And then they combine that with another national data set, which is sales data from 35,000 grocery stores covering like 40% of all U.S. grocery purchases. Then they match that to a third data set, which is surveys of nutrition knowledge and preferences. In addition to that,

they actually get hold of data for the entry dates and the exact geolocations of all 6,721 new supermarkets in the United States from 2004 to 2016 with the data on the other retail establishments in each zip code. I mean, just think about like getting the data together to paint a national portrait of the availability of food across the entire country, but also paired with how people are purchasing food, also paired with preferences and knowledge about food. When you look at this study, you have to say, look, everything that came before it is tiny in comparison to the monumental data set that they aggregated. I mean, when people talk about the big data revolution, I mean, when people talk about the big data revolution, this is the big data revolution.

What big data means to a lot of people is that I, as an individual, am having my data fed into a big pool where some other people serve me ads based on my preferences, which is not the most delicious use of big data for most people, but it takes a real blend of art and science to do it the way that these scholars did. These are people who are really well-equipped to manage huge sets of data, and they know how to ask really good questions of those data. And here, they're using the introduction of a new local supermarket after it opens to look at how the existing population changes their dietary habits. Is that about right? That's exactly right. So the assumption, I think it's a very reasonable one, is that when a supermarket opens in your neighborhood, we can look to see how that influences your purchases.

Do you start buying fruits and vegetables and other healthy foods? Because now there's a more convenient place. The food desert is no longer such a food desert. And the prediction would be if it's a supply problem, then when one of these supermarkets opens and finally you have somewhere other than CVS or Popeyes to get food, you flock there and you start eating differently. And in fact, they found that that did not happen much. And here's the big thing. What people are doing is they're shifting from one supermarket to a different supermarket, and they will go to the closer supermarket. But what they found in this study was that people are already driving something like five miles on average to go to the supermarket in the first place. In other words,

to some extent, the food desert problem isn't as grave as it might seem only because people are in the habit of commuting relatively long distances, certainly not walking distance, to where they were going to buy their groceries in the first place. So you might switch from grocery A to grocery B, but it's not exactly changing your personal landscape all that much. I was talking about this topic with my daughter, Anya, who is in college. You know her a little bit. She's interested in food. She's interested in psychology and so on. And she made what I felt was a really good point that I felt ridiculous for not having thought of. She said the fundamental question really here is how and where and when do people or better

a given person learn to eat nutritiously? And when I think back to my life, but also a lot of the research I've read, the obvious answer is the family into which you were born and the community into which you were born. Your habits. Right. So I happen to have been raised in an aggressively free range organic type family. Farm, literally, right? Not that I would have chosen it. I'll be honest with you. Like all the other kids would come to school with Wonder Bread and bologna sandwiches. And I've got other kids would come to school with Wonder Bread and bologna sandwiches, and I've got homemade whole wheat bread with bean sprouts and some funky protein-ish spread created from some indeterminate animal who may have died in the last month or maybe a little bit longer ago than that. I can't say it was necessarily to my liking, but we were

essentially organic before that was a big trend. So homemade everything, bread, yogurt, grew most of our own veg, our own eggs from chickens, some of the meat, local fruit, milk, no refined sugar at all, except what you could sneak somehow. In retrospect, I feel I was very lucky having been conditioned with a palette for generally nutritious food. So imagine that you've been raised in a family or a community or a culture even where you're not eating nutritious food. And that's your habit. And habits, as we know, are so deep. They're sticky. And then you get a really nice, fresh supermarket next door. You have to think, how much should we expect that to actually change your buying and eating habits, especially when fresh fruit and veg particularly, but also healthier food overall

is more expensive than the other processed stuff? It's more expensive. It's a pain in the ass to prepare, relatively speaking. You know, I think the fact that healthy food, which of course can be delicious, of course we can learn to prepare it, is at a disadvantage to junk food in that it is relatively less convenient. It is relatively less caloric, which by the way, is one of the reasons why we crave unhealthy food, right? reasons why we crave unhealthy food, right? Our evolutionary past has said salt, fat, sugar,

carbs, go for it. So I think there's a lot stacked against healthy food. So when you open a supermarket, it's not just that you're not changing culture and you're not automatically changing habits. I mean, it's not exactly a fair fight. I think for me, what this study reveals, though, is that there is a geographic physical food desert, but there's also cultural circumstances. I'm sure our childhood eating habits do influence our adult eating habits. But honestly, Stephen, when I grew up trying to assimilate as a Chinese girl in a nearly all white suburban neighborhood, I absolutely made my mom get Wonder Bread, Oscar Mayer, bologna, bright yellow mustard. I think it's like French's. French's, yeah. Fritos, Twinkies or Tasty Cakes because, you know, I'm from Philadelphia. I drank tons of soda. I ate tons

of candy, probably why I have so many cavities. So I don't eat like that today. And it's partly, I think, maybe largely because my current cultural context, all the people I hang out with, nobody's eating that way. So I don't know that we have to be completely bound to... Programmed from birth, you're saying? Yeah, there's obviously some flexibility. Sure. I think that does suggest that all of us can evolve as we go and break habits that are less good and embrace habits that are somewhat better. But it's really interesting to me, I come back to this notion that the paper really points to of thinking that something is a supply problem when in fact it's a demand problem and why that is a big problem.

Because if you try to solve policy, assuming that the problem is on one side of the equation, but it's on the other, you're probably not going to address that. You know, in the food realm, I think back to this line of research about calorie count posting, which began maybe 10 years ago or so now. And the research shows that it really doesn't work in the way that it was intended. For instance, if a chain fast food store in a place like New York City is required to post the calories on every, let's say, hamburger, it found that people didn't consume less often. And in fact, sometimes they would consume more for the very simple reason that, oh, calories. Yeah, more bang for your buck. Yeah, those are valuable. You mean for that $2 burger, I can get 600 calories?

Give me two. That's a lot of calories for the penny. 600 calories is really kind of an That's a lot of calories for the penny. 600 calories is really kind of an amazingly good deal in some ways. There was a paper recently looking at voluntary disclosure information from firms, and they found that calorie posting at Starbucks would sometimes drive people away from Starbucks over time, especially men, and that a place where they were often likely to go instead was Dunkin' Donuts. Out of the frying pan into the fire. So I think it's instructive, jumping off from this paper, to look at other examples of where we think it's a supply problem, but in reality, it's a demand problem.

I asked our Freakonomics Twitter feed for examples along these lines. Can I read you a few? Yeah. I said, does anyone have a good example of a problem that we typically talk about as a low supply problem, but in fact is often a low demand problem. We got many, many, many replies. Here are a few. Fact-based news. That's so interesting because people are always blaming the lack of supply and maybe as a populace, we're not asking for it as much as we should. Yeah. And truth be told, there's a lot of fact-based news out there. There's a lot of writing by academics and analysts of different sorts who are really, really evidence-based, but those don't get 5 million views. Here's another one. Bipartisan politicians. This person wrote,

everyone complains there are none, but no one wants their politicians to compromise. Oh, that's a good one. Here's another. Trade schools. I don't know how true this is, but I like the idea of this example. This person wrote, people have been told that working in trades doesn't pay well and is unstable, so it isn't in high demand from consumers despite crazy high supply shortages in just about every skilled trade. Right. Electricians, plumbers, and people who know how to do stuff. And here's another example on Twitter from a fellow named David Johnson. He wrote, sleep. It's common to complain about not getting enough sleep. However, most people simply are

choosing other activities instead of sleeping, sometimes out of necessity. So I wonder what you and your field and your psychology cohort say about this notion, about the way that we might find it more comforting to think of a problem as a problem caused by the supply people out there as opposed to being the internal demand from ourselves? I mean, this gets back to Anya's question, where do our preferences come from? And I do think that all of us human beings may have some bias to things that are not our preferences and habits and choices, but are external to us. As we've talked about before, Stephen, this is sometimes considered external locus of control, that all of us human beings, you and me included, would have some motivation to think, well, it's not my fault and it's not my

problem. And also, it's not my responsibility, therefore, to do something about it. At the same time, because it's very complicated, all human beings are somewhat rational in the sense that they're reacting to their incentives, their perceived costs and benefits. For example, if you look at the soda tax, right, the soda tax has been suggested by the authors of the paper that we're talking about, as well as many, many other economists, as a very helpful assistance to all of us human beings, because we all love sugar. And when you say you can have 64 ounces of sugar with a straw in a cup with a nice lid for a dollar, it's really hard to resist that because we are reacting to our benefits and costs. And they say, here's a solution for everyone, not just for people who are in food

deserts, but for everyone, there's going to be a tax. And I actually experienced this the other day. I went into a corner bakery. I was trying to buy a Diet Coke. And I don't do this very often because I don't even drink diet soda much anymore. But they were like, yeah, it's $4.29. And I was like, what? And I'll tell you, I'm not going to go buy another one because that soda tax works. It worked on me. And we should say that was one of the most successful components of driving down cigarette demand in this country and other countries, too. Arguably, the single biggest difference was made by taxes. I mean, not to say that we shouldn't have warnings, not to say that those commercials with the Marlboro man smoking a cigarette out of his trachea, I mean, not to say that those didn't have any effect, but many people would argue that taxes had the single biggest effect. And it is not a gigantic leap, both psychologically and physiologically, to suggest that there is a parallel between the addiction to nicotine and the addiction to sugar. The appetite for sugar can be based on an addictive taste the way that

the appetite for nicotine can be. Oh, yeah, I completely agree. I mean, if you could remove one thing from the American diet and just solve 80% of the problem overnight, it would be sugar. I don't think that's really any more in question, although it was questioned by research, some of which was funded by sugar producers. There's a rather grotesque history in this and many countries of academic research that looks to be objective and it turns out to be industry funded. And that's been the case with nicotine and with sugar. We should also say nicotine itself is not a bad drug. And in fact,

it's being used in many different ways, many different applications. But smoking cigarettes is a terrible delivery system for nicotine because smoking is so bad. Well, look, when we understand that by human nature, all of us human beings like sugar, we crave it. All of us are vulnerable to really cheap, easy ways to get things that by evolution we of course want. But I do think that policies that encourage us to do what's good for us in the long run by levying short-term costs on the things that we're all easily addicted to

or attracted to, I think that's great. I mean, tax the hell out of soda, in my view. Charge me over $4, even if I'm trying to get a Diet Coke, fine, good. And then also, maybe if you could make fruits, vegetables somewhat more likely to get eaten because they're subsidized in some way. And that has happened. Right, SNAP programs. And I think with good effect.

And there has been good research done on that, which showed that if you decrease the price of the goods, I mean, look, this is basic Economics 101 with a little bit of Psych 101. But if you increase the availability and decrease the price of the goods. I mean, look, this is basic economics 101 with a little bit of psych 101. But if you increase the availability and decrease the price of the things that are better, then people are going to consume some more of it. Still to come on No Stupid Questions, Stephen and Angela discuss initiatives that effectively encourage healthier habits. I have to say that habits are hard to break, but not impossible. Before we return to Stephen and Angela's conversation about the demand for healthy food, let's hear some of your thoughts on the topic. We asked listeners to send us voice memos, letting us know what's standing between them and healthier eating habits. Here's what you said.

I grew up in a sort of poor household, and veggies meant canned ones and maybe like iceberg lettuce salads. And busting onto the scene in adulthood, I didn't know what chard was, let alone how to cook it. One of my many jobs in college was as a cashier and a customer told me how to steam green beans. So I went home and I tried it. And when they came out bright green, I thought I'd done something wrong because I was used to them being brown from a can. The second sort of odd obstacle is that a lot of vegetables go bad pretty quickly, right? So if I go to the farmer's market to pick out veggies for the week, anything with leaves is wilted after a couple days in the fridge.

This is Eric from Stillwater, Oklahoma. And I got to say, one of the biggest difficulties in eating healthy has to be social influences. A lot of my friends and family don't always eat the most healthy, and I'm usually just going to have what they're eating. And when we're going to go someplace to have fun or if we're going to go out, no one's going to pick a healthy option

because no one ever said, hey man, come on, let's go out and have some glasses of water and salads. Hi, Steven and Angela. This is Lauren Grunsfeld from Brooklyn. For me, there are two obstacles to eating healthy. One is accessibility and readiness. When I'm hungry and I'm busy, it's so much easier just to grab a piece of bread and

smear some peanut butter on it or have cereal and milk rather than start to wash the lettuce and cut vegetables and find a protein to add to it or have all of that prepared in advance. And the other obstacle is really believing that there's a long-term benefit to rather eating the salad than the peanut butter sandwich. Sometimes it just feels like the work is not worth it. That was, respectively, Sarah Johnson, Eric Natvold, and Lauren Grunsfeld. Thanks to them and to everyone who sent us their thoughts. Now, back to Stephen and Angela's

conversation about the behavioral economics of food deserts. I think the tricky part, or maybe the difficult part, is that if the problem of generally poor nutrition were caused by low supply, that would be amazing because supply is pretty fixable. But what they find instead is that most people who eat generally well nutritionally, there are a couple of big commonalities in that population, and those are higher income and higher education. Which, by the way, are correlates, not necessarily causes. Exactly. But here's the thing, especially because those are correlated, it makes me think of how hard this problem is. I remember a paper from 2015 by Jesse Hanbury, Ilya Rakovsky, and Molly Schnell.

Jesse Hanbury, Ilya Rakovsky, and Molly Schnell. It was very similar. It was called, Is the Focus on Food Deserts Fruitless? Retail Access and Food Purchases Across the Socio-Economic Spectrum. And they argued, similarly, that access to food is a relatively minor driver to nutritious eating, and a much more powerful driver is education, how educated you are about nutrition. So if it's education, which correlates with income, which lead to better nutrition, it also suggests that the arrow may be going in the other direction and maybe even more

aggressively, which is to say that low nutrition can lead to lower education and correspondingly lower income. And that's a vicious cycle. Well, first of all, these are all correlations, but you're right that there could be causality going in both directions. And whenever there's causality in both directions, X driving Y and Y driving X, that is the very definition of a vicious or, by the way, a virtuous cycle, depending how things go. I think we have some other avenues, though, other than making people wealthier and getting people all the way through college, both of which are noble and urgent policy imperatives. There is cultural change. Like,

we can say that cigarette taxes are maybe the primary driver for why people don't smoke today. But I do think that in many, many communities, smoking is looked at with some amount of shame, some amount of embarrassment, some amount of like, yeah, I probably shouldn't be doing this. I mean, just from watching Mad Men, I don't think that was always true for the United States. So cultural change is possible. And I have to say this. If you look at the cultural icons really across the board, you know, people that you might admire from movies, from music. Oh, when you said cultural icons, I was thinking McDonald's and Popeyes. That's not the cultural icons you meant?

No, no. I was thinking about human cultural icons. And guess what? I think that people who are famous and very successful in all these different walks of life tend, by the way, to eat very well. I mean, healthy eating and exercise and self-care are kind of a thing among the elite of every cultural category that I can think of. For the most part, you can point to exceptions. That suggests to me that maybe with some creativity, we can think about how to make these role models a little more salient without being judgy. I think

one thing to keep in mind with all of this is that another thing that is universal to human nature is to not want to feel bad about yourself. And so if there is a way to increase demand for healthy food without making people feel bad, that's going to be the trick. The one last thing I want to ask you about is we know that culture and cultural influence is strong and we know that habit formation is really strong. Is there anything you can pull from your bag of tricks as to how to form a better habit in this realm? Anything maybe you've learned from the Behavior Change for Good project? Well, habit was exactly where my mind was going as I concluded my reading of this extremely

long but excellent article. So in that analysis, they said, hey, supermarket opens up. We're going to look and see what happens. What happens to people's buying patterns and so forth. Oh, it turns out they don't change all that much. But I did wonder what happens in the long term. What happens when you live in a neighborhood where not just one supermarket pops up and we look at your behavior in the short term. But what if you live in a neighborhood where there are more and more of these grocery stores, where we now start to look at shifts in behavior that happen over much longer time scales, where there's a number of things hopefully happening? Maybe there's some pressure on fast food outlets to make a dollar menu that doesn't have quite as fatal food on it. I have to say that habits are hard to break, but not impossible. And if a kid like me who grew up with RC Cola, Doritos,

bologna sandwiches on Wonder Bread, and tasty cakes is like 80% of her calories, can eat a pretty healthy diet these days, it just suggests to me that hope is not lost. That demand really is dynamic. Demand can change. And it's not easy, but it's possible. And look, I think if you look around a place like New York City, at least, it's been a dramatic change over the past 20 or 30 years.

We're not a typical place to eat because we've never had as many chains and franchises as other cities or other places, especially more suburban or exurban areas. Although that has also changed too. There are a lot more chains even in Manhattan than there used to be. But among those chains and franchises, there are so many more healthier places now. All these places that have a generally nutritious option, at least. And so I would say that is very much a reflection of what you are saying you would hope for, which is a real holistic overall change in demand, at least to some degree. It may not be a 60% shift in demand, but a 12% shift in demand is still really large and I think encouraging. I would also suggest if it's so hard to wean oneself from eating a lot of food that one

feels they'll suffer from later, that rather than listening to podcasts, people should just start making them, maybe several, because it's just hard to eat when you're constantly talking is what I've found. Maybe people should start hosting their own podcast. That's what you're saying. Exactly. Everyone should probably have eight or 10 podcasts. Such a great idea, Stephen. That's a really actionable policy idea. You're welcome. I have a related suggestion. You could also take a walk

while you're listening to this podcast. Yeah, but it's really easy walking and eating. It's one of my favorite combinations. And also don't walk to get a dollar cheeseburger. So, you know, there's nuance here. But yes, I think there's hope. No Stupid Questions is produced by me, Rebecca Lee Douglas. And now here's a fact check of today's conversation. Rebecca Lee Douglas. And now, here's a fact check of today's conversation. Angela and Stephen discuss why New York City's 2008 calorie posting requirement backfired. They say that paying $2 for a 600-calorie burger might be perceived as a great deal. They're presumably thinking of McDonald's. According to the McDonald's website,

a Big Mac is about 550 calories. But it will likely cost you more than $2. As of January 2022, the sandwich cost an average of $5.81 in the United States. However, according to The Economist's Big Mac Index, if you were in Turkey, you could nab one for just under two U.S. dollars. Later, Stephen was unsure about a claim in a listener's tweet about trade schools. According to a report from the National Center for Education Statistics, trade school enrollment has actually been on the rise since 1999. However, this is after a decline in the 80s and 90s that created a shortage of tradespeople. Also, demand for specific trades is certainly on the rise. A 2020 report from the Bureau of Labor Statistics

lists wind turbine service technicians, physical therapist assistants, and home and health personal care aides among the fastest-growing occupations. That's next to white-collar jobs like statisticians and data scientists. Also, Stephen cites a 2015 paper from the National Bureau of Economic Research titled, Is the Focus on Food Deserts Fruitless?

And notes that it's similar to the article that is the focus of today's question. That makes sense because the co-authors of the 2015 paper are actually three of the authors of the quarterly Journal of Economics article. Finally, Angela references, quote, those commercials with the Marlboro man smoking a cigarette out of his trachea. In this case, I'm pretty sure she's misremembering a 1996 California public service advertisement featuring a woman named Debbie Austin. In the piece, Austin explains to viewers that she began smoking at age 13 and could never quit. She tells the camera they say nicotine isn't addictive before inhaling a

cigarette from a stoma in her throat, a hole that allowed her to breathe after her larynx was removed at age 42. Austin died in 2013 of cancer at the age of 62. That's it for the Fact Check. 2013 of cancer at the age of 62. That's it for the Fact Check. Coming up next week on No Stupid Questions, does the early bird really get the worm? I usually do wake up quite early, between 5 and 5.30. But to me, that's just normal. This is the thing. You think it's normal. It is not normal. That's next week on No Stupid Questions. For that episode, we want to know which is better, being an early riser or a night owl, and why? To share your thoughts, send a voice memo to nsq at Freakonomics.com with the subject line early bird.

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