San Francisco is a city of haves and have-nots when it comes to nutrition
Antonia Williams is part of a slow, quiet food revolution. After battling obesity for much of her adult life, the 26-year-old lifelong Bayview resident did some research. "I realized it had a lot to do with the food I consumed," she told us. "As a result of growing up in the neighborhood, I suffer from obesity. I'm overweight because of the lack of options for good healthy food."
"It's what I grew up on, McDonald's and a lot of fried food for dinner," she recalls. "The grocery stores in the area were very limited in what they offered. I believe my parents weren't as educated or aware" about health and nutrition.
Williams managed to escape this bad foods trap, change her personal diet, and now works as a "food guardian" for the nonprofit Southeast Food Access (SEFA), helping to bring more nutritious fare to the Bayview.
The complex of challenges Williams faced simply to eat well—the fast food all around her, the dearth of grocery stores, and lack of awareness—reflects the array of systemic barriers to good food that keep tens of thousands of San Franciscans in chronically poor health.
Under the weight of recession and double-digit unemployment, San Francisco's chronic food divide has grown deeper and wider. From regions of the city like Bayview, Excelsior, and other Southeast neighborhoods, to seniors surviving on marginal fixed incomes, to the city's swelling unemployed and underemployed who rely on food pantries, access to fresh food is a daily geographic and economic battle.
Roughly one in five San Franciscans each day has no reliable source of adequate sustenance and must scramble for food from soup kitchens, food pantries, or other "emergency" supplies that have become a structural part of the city's food system, according to the San Francisco Food Bank.
Each month, more than 100,000 families rely on the Food Bank to help feed themselves — nearly double the amount from 2006. Economic recession has dramatically increased the number of city residents using food stamps (known as "CalFresh") each month, rising from 29,008 in 2008 to 44,185 in 2010.
Yet even that rise belies a far deeper need: only 47 percent of those qualifying for CalFresh are actually accessing benefits, according to a data analysis by California Food Policy Advocates; at minimum, more than 40,000 additional city residents are entitled to get this help, and thus eat better.
Across the city, parallel economic and food divides compound one another, spelling serious trouble for people's basic nutrition and health — in turn depleting their energy, cognition, and ability to do everything from succeeding in school to getting a job.
In Bayview, where poverty and unemployment run about double citywide averages, these geographic and economic food divides come to a head. District 10, encompassing Bayview/Hunters Point (BVHP), features some of the city's most grocery-impoverished neighborhoods, and has the highest rates of CalFresh usage.
This confluence of lack and need—compounded by a prevalence of fast food and liquor stores over fresh food offerings—has inspired Antonia Williams and other residents to fight for better food in their neighborhoods.
As one of four paid Food Guardians for SEFA, Williams spends about 20 hours a week examining grocery store shelves in Bayview, talking with consumers and food retailers, and educating both about the need for more fresh non-processed foods.
One recent victory: armed with customer survey data, she convinced the Bayview Foods Co. to stock low-sodium tomato paste. Next on Williams' food improvement list is getting more low-sodium products, less cholesterol, and more fiber on the shelves.
These may sound like small steps, but they're part of a larger effort to get healthier food in Bayview, where chronic diseases such as obesity, diabetes and heart disease are rampant. "I think a lot of people just don't know the link between the food we are eating and these chronic diseases," says Williams.
The Bayview is among the city's most food-deprived districts, with just 63 percent of residents living within a half-mile of a supermarket (in Excelsior, it's 57 percent), compared with 84 percent citywide. That ratio improved somewhat with the arrival this August of Fresh & Easy supermarket on Third Street, but access to fresh produce remains limited — a situation that numerous studies show contributes greatly to chronic undernourishment and disease.
Indeed, statistics show Bayview area residents suffer by far the city's "highest rates of everything negative," as former district supervisor Sophie Maxwell puts it: obesity, diabetes, heart disease, and cancer.
Ironically, the Bayview's Third Street is home to the city's bustling produce warehouses, which rattle early every morning with trucks and crates full of fruits and vegetable, "but you have to go out of the district to get it," says Maxwell, who helped spearhead a Food Security Task Force while in office. "I was very much aware of [the food access problem] because of what I had to do to get food myself."
Much of Third Street remains a boulevard of liquor stores and fried and fast food. According to Tia Shimada of California Food Policy Advocates, "A lot of what we see instead of food deserts is food swamps, where the amount of healthy nutritious food available is overwhelmed by all the fast food and junk food."
Despite a seemingly diverse landscape of food businesses, "There's a saturation in neighborhoods with unhealthy choices," SEFA's Tracey Patterson argues. "When the cheapest choice in front of you is fatty comfort food and fast food, that's what you get accustomed to eating. The easier options quickly become habit."
Kenny Hill, a 23-year-old food guardian and Bayview resident, puts it like this: "What we have in our community, that's what we eat." But he says history and culture play a role, too. "We need to change the culture of what's considered good...Growing up eating salad, people would say, 'Why are you eating that? That's white people's food.'"
In other words, it takes more than getting a grocery store—which itself involved a nearly 20-year struggle for Bayview residents and leaders. "Food access is just one part of the issue. Even if you get a grocery store, that doesn't solve the problem," says Patterson, whose group, SEFA, espouses "three pillars" to fix the area's food problems: more grocery stores; education and health literacy; and expanded urban agriculture. "None on their own is enough."
Getting a job isn't enough either, statistics show. A recent study by the USDA cited by the Food Security Task Force shows that 70 percent of families nationwide with "food insecure" children have at least one member working full-time. And in San Francisco, the task force found, "39 percent of the households that receive weekly groceries through the SF Food Bank include at least one working adult. Only 18 percent of clients are homeless."
At least by federal definitions of poverty, food insecurity isn't just for poor people anymore — particularly in San Francisco, where exorbitant housing and other costs compound people's struggles to meet their food needs. "If you just look at the poverty level, you're missing a lot of people who are struggling to make ends meet," says Colleen Rivecca, advocacy coordinator with St. Anthony's Foundation. "Hunger and health and housing are so interconnected."
Indeed, while the Federal Poverty Level for a family of three is $18,310, cost-of-living research by the INSIGHT Center for Community Economic Development found that in San Francisco, this family would need almost $40,000 more than that to make ends meet.
Rivecca says the ongoing recession is simultaneously deepening the food divides and undermining efforts to address it. For instance, SSI recipients must make do with $77 a month less than they got in 2009, while California is the only state where SSI cannot be supplemented by food stamps.
According to the Food Security Task Force, San Francisco "has an inordinately high number of residents who are elderly, low-income and/or blind and disabled — over 47,000 residents receive SSI." Many are homebound, socially isolated, and living in SRO units without kitchens, and no means of preparing their own food. So it's no surprise that these same people, who need help the most, often get it the least.
Due to "misconceptions about what qualifies," says CFPA's Kerry Birnbach, only 5 percent of Californians eligible for Social Security participate in CalFresh. "Senior citizens are more isolated, and the more isolated you are, the less likely you are to know about it." Birnbach says that leads to lower nutrition, less energy, and greater hospitalization rates. "It's not having food on the table — choosing between food and medicine."
A 2006 study by the San Francisco Department of Aging and Adult Services found that while the city's elders "received approximately 12.2 million free meals through all of the programs in the City including food pantries, free dining rooms, and home delivered meals, the gap between the number of meals served and the number of meals needed was somewhere between 6 [million] and 9 million meals annually."
As television cameras made clear on Thanksgiving, there's no shortage of food and meal giveaway programs, soup kitchens run by churches and nonprofits — a whole constellation of ad hoc benevolence spread across the city. But this kind of "emergency food assistance" has become a structural part of the city's dietary landscape.
Another main ingredient in the city's food infrastructure is seemingly cheap fast food, which for many poor people becomes the diet of first and last resort. Sup. Eric Mar recalls meeting with teenage mothers and hearing one parent speak about dumpster diving at McDonald's for what she called "fancy dinner."
"The cheapest possible food like McDonald's is seen as a luxury," says Mar, who last year passed legislation preventing fast food chains from selling kids meals with toys unless they improved their nutrition content. "Poor people rely on whatever's out there, and when McDonald's or Burger King sells cheap, it undercuts families' efforts to get healthy."
District 10 Sup. Malia Cohen sees the impacts of fast food and junk food every day in Bayview. "There is no infrastructure out there to de-program people" from long-standing fast food habits. "I don't fault people for eating fast food, but I do want them to think twice and know they have a choice."
So what is the choice, and how will the city address its deep food divides, which cut across geographic and demographic lines?
So far, it's a patchwork project. As one step, the supervisors in April passed a new zoning ordinance designed to encourage more urban food production. In Bayview, Cohen says, "We're looking at urban agriculture as something that's viable" to feed low-income residents.
Despite the arrival of Fresh & Easy, BVHP remains a critical flashpoint for the food security fight. Markets for fresh produce are few and far between. In 2006 the Department of the Environment teamed with Girls 2000 and Literacy for Environmental Justice to create the Bayview Hunters' Point Farmers Market, but for a variety of reasons, the customer base wasn't sufficient for farmers to keep selling there, and the project stalled. Now there is talk of reviving a farmers market in the area.
But for larger, more structural change to take hold, Mar argues, the food gap "has to be a citywide goal and priority." And, he notes, bigger forces — notably agribusiness lobbies and congressional agriculture committees — make local progress more difficult. "It's hard because the Farm Bill allows these food companies and commodity groups to keep their prices lower, and small businesses and producers have a hard time keeping their prices low," encouraging more fast food and obesity and other diet-related diseases.
On a chilly gray late afternoon the day before Thanksgiving, we met with Patterson, Williams, and two other food guardians at Bridgeview Community Garden on the corner of Newhall and Revere in Bayview. Perched on a small chunk of slope overlooking houses and freeway traffic, the plot offers a thriving little harvest of tomatoes, kale, leeks, basil, and other vegetables and herbs. It's not a lot of food, but along with other nearby agriculture, such as Quesada Gardens and the larger Alemany Farm, it helps bolster residents' weekly dose of fresh produce.
Equally important, it gives budding food activists like Antonia Williams and Kenny Hill reason to believe things can change. After yanking a healthy crop of leeks from the soil, fellow food guardian Jazz Vassar, 25, notes, "There are a lot of community organizations doing good work here. We have high hopes to change things."
Even as they work to nourish a different food future, the food guardians are acutely aware of the jagged rocks and stubborn old roots that need to be cleared. Asked what the city should do about Bayview's many-layered food struggles, Hill responds: "Realize there is a problem in Bayview, and allocate resources here. There are statistics that this is a food desert, there are high rates of crime—people have to wake up and see that people here have been disenfranchised."
It's not about having the city do it for them, says Hill. "Give us something to latch on to so we can help ourselves."
Former Bay Guardian city editor Christopher D. Cook  is the author of Diet for a Dead Planet: Big Business and the Coming Food Crisis.