Inspired by the concept I worked on during openIDEO, I decided to write about FreshMoves, a produce market on wheels for a uni assignment. Rather than let the essay gather digital dust, I’ve decided to publish it here. Because a market on a bus rocks. WANT!
On May 25, 2011, the Fresh Moves bus—a fruit and vegetable market on wheels—made its debut journey to the food deserts of Chicago. Their mission was primordial health promotion. The service was founded on the principles of equity, naturally healthy and active participation. By delivering healthy food to the residents of food deserts, they demonstrated that community, innovation and agility could help address health inequalities.
In 2006, a pioneering study identified that “communities with better average access to grocery stores have better average health.”
i It examined the city of Chicago and established the western and southern neighborhoods were “food deserts”. These were defined as geographic areas that had no or distant grocery stores but were served by fringe food stores—fast food restaurants, gas stations and convenience stores—destinations devoid of healthy food options. Around 500,000 residents faced barriers to buying fresh food, especially fruit and vegetables.
African-Americans almost exclusively populated the food deserts. It was much easier for them to access fast food than any other type of food. On average, they travelled the farthest distance to any type of grocery store with the nearest store being twice the distance as the nearest fast food restaurant. This was compounded by their overall low income. They tended to not own cars and so they relied on public transport, arranged lifts from friends or walked to travel to the shops. Single mothers, children, the disabled and the elderly were the most vulnerable. The African-Americans who lived in neighborhoods with the worst food balance had 7.55 diet-related deaths per thousand.
In response, a collective was formed to create community-based solutions to the food desert problem. They realized that opening a brick and mortar produce market wasn’t feasible; upfront capital, the risk of real estate investment and lack of speed were significant deterrents. In addition, a permanent location wasn’t flexible, as they wanted to meet the needs of several communities. Instead, they raised funds and refitted a decommissioned Chicago Transit Authority bus to create a mobile fruit and vegetable market. The bus was to make scheduled stops at multiple locations including schools, community centres and elderly care facilities. And thus, Fresh Moves was born.
Fresh Moves operates at the primordial prevention level. It addresses both the economic and environmental conditions that challenge residents to make healthy choices. When people face diminishing incomes, they first consume less expensive food to maintain energy at a lower cost; energy-dense fast food is relatively inexpensive compared to healthy food.
ii Fresh Moves counters this by providing healthy food at a competitive price. Chicagoan residents had to “travel farther to buy a fresh apple than they do to get a bag of potato chips or a greasy burger.”
iii In response, Fresh Moves brought fresh food directly to them. Yet whilst many prevention activities operate at a whole of population approach and policy level, Fresh Moves delivered a targeted, rapid—albeit temporary—response.
The Fresh Moves bus is a health intervention. The consumption of fruit and vegetables is a protective factor against obesity and the risk of a range of adverse health outcomes including type 2 diabetes, cardiovascular disease, osteoarthritis and some cancers. Food bought from fast-food outlets and restaurants are up to 65% energy dense than the average diet.
iv The bus not only sells fruit and vegetables but also gives away free recipe cards and seeds. By reducing the barriers to shopping for fruit and vegetables and inspiring people to create healthy meals, they increase their capacity for being healthy. Fresh Moves also collaborates with community organisations and schools to help them deliver programs. Tasteful Manners
v teaches students how to create meals and eat together. A nutritional program is conducted for pregnant, postpartum and breast-feeding women.
vi Wellness checks and diabetes screenings are also undertaken on the bus.
Equity is the core value of Fresh Moves. Low-income neighborhoods were more affected by the lack of healthy food as well as higher incidences of diet- related illnesses; predominantly African-American neighborhoods were the most disadvantaged. Fresh Moves aimed to reduce health inequalities by providing access to healthy food at an affordable price. To overcome the barrier of car ownership of low-income residents, they brought food directly to them. Instead of a whole of population approach, they focused on the marginalized groups to reduce the health gap.
Believing that people were naturally healthy is another value. They acted upon the study that determined it was the environment that impaired peoples’ healthy food choices. When some residents had access to a grocery store they still had concerns in relation to product availability and the quality of food, especially fruit and vegetables. They also felt that junk food was strongly marketed to them in-store. Fresh Moves supported the notion that when people were enabled to make healthy food choices, they could.
Active participation of the people affected contributed to the intervention’s success. Community-wide dialogue and a collaborative design workshop ensured the participation of the people affected. “We wanted to empower the community and make sure the community wanted and needed this,” said Sheelah Muhammad, the Fresh Moves Board Secretary.
The innovative response of Fresh Moves has contributed to the reduction of the food desert population of 39% over the last five years, yet there are still 383,954 Chicagoans living in a food desert.
viii To achieve greater public health impact, Fresh Moves could extend their reach by becoming more convenient, increasing efficacy and achieving a level of permanence. They could add more days and stops to their route. They could place semi-permanent vending machines in various locations—for example, at train stations or pharmacies— to dispense fresh food. They could deliver fruit and vegetable boxes to workplaces, schools and community centres. To increase confidence and overcome barriers to buying fresh food, Fresh Moves could provide culinary tips and tools with goal setting, planning, budgeting, seasonality and recipes; behavioral approaches are found to be effective.
Nevertheless, these approaches for people in a lower socio-economic class is just the first step when the “heads of households have to work multiple jobs and have little time to cook at home, relying on eating out; and when families are targeted to eat unhealthy food on television and when they enter stores.” Community organisations could train the underemployed to undertake urban farming activities; the produce they grow could be sold on the bus. Social cooking clubs could use the produce to make healthy, seasonal meals. The meals would be made available for sale at local stores for others with less time and more money. Other underemployed persons could be trained to market or distribute the food. Any income generated would return to the workers and the programs.
Whilst improving access to and promoting healthy food should be viewed most positively, there should also be deterrents for buying unhealthy food. Ideally, the community would agree to limit the amount of fast food in their neighborhoods and zoning restrictions would comply. In the most ideal environment, however, and at a national level, there would be a ban of junk food marketing, regulation of formulation and a significant tax would be implemented.
The Fresh Moves innovation—working collaboratively with the community, businesses and organisations—delivers much more than fresh fruit and vegetables. It demonstrates a demand for healthy food in underserved neighborhoods. It shows that fast-paced innovation could be the first bold step where conventional programs could follow. Most of all, it delivers the message that the community itself has the capacity to make change.
i Gallagher, M. (2006). Examining the Impact of Food Deserts on Public Health in Chicago, Mari Gallagher Research and Consulting Group.
ii Drewnowski A and Specter SE. (2004). Poverty and obesity: the role of energy density and energy costs. The American Journal of Clinical Nutrition. 79(1)
iii Bowean L. (2011). Chicago’s food desert shrinking, report shows. Chicago Tribune, June 24, Retrieved April 27, 2012, from
iv Prentice M and Jebb A. (2003). Fast Foods, Energy Density and Obesity: A Possible Mechanistic Link. Obesity Reviews. 4(4)
v Tasteful Manners. Tasteful Manners. Retrieved April 25, 2012, from http://www.tastefulmanners.com
vi Fresh Moves. (2012). Facebook. Retrieved April 25, 2012, from http://www.facebook.com/freshmoves/posts/305604689467925?comment_id=4449513
vii Bloom H. (2011) Fresh Moves to launch in May. The Columbia Chronicle. Retrieved April 25, 2012, from http://columbiachronicle.com/fresh-moves-to-launch-in-may/
viii Gallagher M. (2011). The Chicago Food Desert Progress Report.
ix Pomerleau J, Lock K, Knai C and McKee M. (2005). Interventions Designed to Increase Adult Fruit and Vegetable Intake Can Be Effective: A Systematic Review of the Literature1-3. The Journal of Nutrition. 135(10)
x Illinois Advisory Committee to the U.S. Commission on Civil Rights. (2011) Food deserts in Chicago. Illinois: Illinois Advisory Committee to the U.S. Commission on Civil Rights.