Deprivation amplification refers to the tendency of poverty to complicate and worsen situations that could be more readily handled by those in a relatively stable economic situation. For instance, when someone is evicted, their economic class makes it either more likely or less likely that they will have a relative who owns a rental apartment, or who has an empty guest house, or a vacation cottage that may not be ideal, but does at least provide a roof. Those options are not open to an inner-city single parent who was raised in the foster care system.

Another example of how being poor makes things worse is in the current news. Payday lenders located in strip malls are positioned and enabled to soak their captive customers even worse than banks do their middle-class clients. This ties to the previous post, which covered deprivation amplification.

Sally Macintyre, one of the authors of the paper that deals with this subject, has more to say about it. She draws a distinction between individual determinants, like the particulars of the person’s dilemma in our first example; and the factors that affect large groups of people, and that have become institutionalized.

There are features of the physical and social environment that either promote health, or damage health. Macintyre says,

Such environmental features may be modifiable, and environmental changes may help promote healthier behaviors.

But here’s the thing. Even when conditions are amenable to modification, how much evidence should be demanded before society takes extreme steps like making new laws? Will the change actually create change? Is it possible that we sometimes single out the wrong targets for reform? Specifically, are we getting our shirt in a knot over the Food desert concept, when we should be looking elsewhere for the villain?

According to Macintyre, research into the distribution of facilities and resources shows that “location does not always disadvantage poorer neighborhoods.” She says,

It may not always be true that poorer neighborhoods are more likely to lack health promoting resources, and to be exposed to more health damaging resources. It may also be that the presence or absence of resources is less important than their quality, their social meaning, or local perceptions of their accessibility and relevance.

The point being, what that evictee in the example above needs is a generous aunt with a second home that just happens to be available, which is not in our societal power to give. What we can do, collectively, is make it harder to evict tenants without good cause; and force our city to relax zoning regulations so that more affordable housing can be built. We can legislate against allowing lenders to charge exorbitant interest.

The point of all this is, even though the activities of retail food outlets do come under the heading of things that can be modified, Macintyre and others are in doubt. While we can offer incentives for grocery stores to open in Food Deserts, the effort might be futile, and even counterproductive, because it costs the taxpayers something to offer those incentives. Some studies showed that better food availability did not improve a neighborhood’s health to any appreciable extent.

In 2007, Macintyre threw a wet blanket over the whole food desert idea:

Even at the time at which this term was receiving wide currency, there was very little empirical evidence about the existence of food deserts. Three studies in the UK often cited as proving the existence of food deserts mainly concentrated on the price of healthy compared with unhealthy food, and did not examine the location of food outlets.

Another study in the UK found that despite government beliefs that low income groups have difficulties in accessing and affording fruit and vegetables, few low income participants said that they experienced any difficulty visiting supermarkets, or perceived any problems in the choice of shops, or of fruit and vegetables, in their local area.

Your responses and feedback are welcome!

Source: “Deprivation amplification revisited; or, is it always true that poorer places have poorer access to resources for healthy diets and physical activity?,” BiomedCentral.com, 07/26/07
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