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In South L.A., Food Deserts Impact Health of HIV/AIDS Patients

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Los Angeles Wave

May 14, 2012

[updated March 4, 2020]

Residents living in South Los Angeles neighborhoods are grappling with an outsize presence of fast-food outlets, making access to healthy foods particularly challenging for those who need it most.

For people living with HIV or AIDS, nutrition is a key component of any treatment plan. With a weakened immune system, it is vital that they maintain optimum health by way of exercise and following the basics set forth in widely-accepted dietary guidelines.

But according to a 2010 report called "Food Desert to Food Oasis: Promoting Grocery Store Development in South Los Angeles,” they and others in the community have fewer opportunities to make healthy food choices than people in other parts of the county.

"As in many inner-city communities where lower-income and racial or ethnic minority individuals reside, South L.A. has suffered from a dearth of private investment and the inequitable distribution of public resources," the report said. "Home to over 1.3 million people, the area's 60 full-service grocery stores equate to one for every 22,156 residents in contrast to the 57 stores in West L.A. that equate to one for every 11,150 residents.

“Limited access to supermarkets with affordable, nutritious food creates a 'food desert' and significant barriers to healthful eating that are too high for many individuals and families to overcome," the report continued.

Nutritionist Talks about the Battle to Help HIV/AIDS Patients Living in Food Deserts

AIDS Project Los Angeles (APLA) nutritionist Janelle L'Heureux’s has always held the mantra that nutrition is a life-sustaining treatment for everybody, whether they have an illness or not. Yet, she has struggled for more than a decade to get patients to adopt her slogan.

When it comes to choosing between the dollar menu at a fast-food outlet or spending significantly more on fruits, vegetables, grains and lean meats, people on tight budgets see the cheaper option as an acceptable bargain for making ends meet.

Budget aside, there are customary and mobile barriers as well. L’Heureaux and many food-conscious advocates in South L.A. note that many have not been trained to eat healthily, with poor eating habits passed down sometimes for generations. Or, they may have limited transportation to get to the often long-distance markets that offer fresh foods.

Then, there are the problems of food overconsumption and getting people with HIV or AIDS to care about their health, especially in the first few years of receiving the diagnosis.

Three HIV Patients Living in South L.A. Describe The Fight to Eat Healthy

Darryl Hendrix, who has been HIV positive for 22 years, said that in the beginning, he did not pay attention to the foods he consumed because doctors told him he only had six months to live.

At the onset of the disease, he dropped to 160 pounds. "I didn't do the right things or eat the right foods. I just thought I was going to die," he said.

LaVera Anom, who has been HIV positive for nearly a decade, deals with severe depression brought on after finding out about her status and consequently gaining mass amounts of weight from the HIV and hypothyroid medication she’s been taking.

With the mental imbalance and lack of self-esteem, she said choosing to take care of herself by eating healthy is hard. She admittedly struggles to meet her nutritionist in the middle and instead finds comfort in sweets and fried foods. When she’s compliant, however, she befriends fruits, dairy, vegetables and lean baked meats.

Precious Jackson, who has been HIV positive for 14 years, went on junk food binges early on, until she was scared straight. "I love fried chicken," she said. "I ate whatever I wanted to. But when I went back to the doctor and she told me that my cholesterol had doubled, it scared me. I told myself then that I needed to get it together" due to constant fatigue, opportunistic infections, and overall body strain.

Combining nutrition—vegetables, lean meats, fruits, water—and exercise has since lowered her cholesterol, drastically increased her T-cell count, and made her viral load undetectable.

For Hendrix, the breakthrough came after medicine advanced and he realized he was going to be around for his grandkids and kids.

Today, “I am able to have a life because I started eating right," he said.

Since taking nutritional classes, Hendrix, who carries 210 pounds on a tall frame, has taken off 10 pounds.

"In the last five years, I have changed my whole diet. I have one burger a month and pizza every now and then," he said, adding that he also does a lot of walking. "I have more energy than when I buy junk food."

Instead, he eats more fruits and vegetables and purchases sugar-free chocolates and candy.

Three patients mirroring different mental, emotional, and physical stages. All started out eating poorly after discovering they had HIV because they had become accustomed to their diets and felt hopeless amidst the news. Two finally realized there was life to be lived and if they maintained their habits they wouldn’t be physically able to live life to the fullest. One is stuck in the middle with hope for a better future.

Barriers to Healthy Eating in South Los Angeles: A Look at Structure and Institution

In 2009, community organizations and retail developers gathered to discuss barriers to attracting grocery and health food stores to the region.

Matthew Dodson, director of government relations for the California Grocers Association, told The Wave then that conversations on the matter have been held over the years.

He explained that the community, grocery stores, local governments, and redevelopment agencies were trying to address the matter independently instead of collaboratively.

Dodson also detailed several larger barriers, including land assembly, time-consuming and money-draining city permitting processes and the belief of grocery operators that other areas, such as the westside, are more profitable.

These have aided in communities in South Los Angeles being overrun by fast-food chains, which has an effect on the health of those infected and uninfected with HIV and AIDS.

How HIV/AIDS Organizations are Using Creativity to Get Around South L.A.’s Food Hurdles

Organizations like APLA — which operates nine food banks specifically designed for AIDS or HIV patients living in poverty-ridden areas — are jumping over structural and institutional hurdles by finding creative ways to improve nutrition for their clients.

Take for instance the Aid for AIDS Keep it Fresh food program, which encourages healthy eating habits and offers need-based vouchers for groceries from either Ralphs or Food 4 Less.

And L'Heureux and her team are constantly trying to find approaches for those who insist on eating out.

Burger and fries, she said, are not the best choices, but people may ask for wheat bread, additional vegetables or even supplement the beef patty with turkey or a veggie burger. To cut costs as well as calories, they can cut the burger in half and save the other portion for a future meal.

APLA has also developed a program called Eating on a Budget, in which clients and nutritionists figure out ways to get the needed vitamins and minerals. One way clients do so is by shopping at deep discount stores that offer food items, L'Heureux said.

While some food studies contend that the quality of foods at 99 cent stores and other similar chain markets are not suitable because in order to offer such inexpensive prices they must get the tail-end of the batches, which is often on it’s way to spoiling and therefore has less nutritional value, L’Heureux said that when it comes down to it they offer more nutrition than fatty foods found at fast-food restaurants.

The point is to offer healthier alternatives in an arena where money matters and resources are low.

By re-using left-overs, L'Heureux said clients can get the biggest bang for their buck by creating entirely different meals. Ground meat, for example, can be used in a variety of fares — including tacos, salads, and vegan spaghetti.

And if food preparation is not a person's strong suit, L’Heureux, who matches up clients’ dietary plans with what they are getting from APLA’s food pantries, said he or she can be guided by way of food demonstrations.

"The pantry was initially conceived of as a supplemental source of food for clients," APLA Communications Director Gabriel McGowan said. “They would do whatever shopping they could on the budget they had. Then the purpose of coming to our pantry was to supplement that with some of the grains, dairy and other stuff that maybe they couldn't afford as part of their weekly shopping budget. What we are seeing more of now are clients” whose food comes almost exclusively from the pantry.

Now with better fare, clients are presenting with healthier outcomes, L'Heureux and McGowan contend. They’ve even seen some taken off of insulin and medications that were being distributed in order to manage such conditions as diabetes or high blood pressure.

*This reporting was undertaken as part of The California Endowment Health Journalism Fellowships, a program of USC's Annenberg School for Communications & Journalism.