Poor Diets are Not Just an “Education Problem”: The Role of Food Environment Studies in Creating Sustainable Behavior Change

Marisa NowickiLeland

Marisa Nowicki works with The Alliance of Bioversity International and CIAT in Nairobi, Kenya. The Alliance generates evidence and mainstreams innovations to create food systems that sustain the planet, drive prosperity, and nourish people. Marisa is part of the Food Environment and Consumer Behaviour Lever, which analyzes the relationship between local food environments and consumer behavior.

While I walked through streets of Lodwar—a small, rural town in Turkana County, Kenya—I was struck by the sheer number of Coca-Cola advertisements. The Coca-Cola logo was everywhere: on glossy, laminated posters, on dingy flags dangling from kiosks, and on humming, branded refrigerators. Not surprisingly, there was also an abundance of soda for sale there—from the massive pallets in wholesale shops to little refrigerators next to cashiers.

In sharp contrast to the glossy advertisements were the street vendors selling fruits and vegetables. They did not need advertising, as their produce was clearly visible in their open, street-side stalls. The few brick-and-mortar stores that sold unprocessed food (such as fruits, vegetables, pulses, and grains) signaled this to potential customers with paintings on their walls and doors.

Left: Coca-Cola sign on street vendor’s stand. Right: hand-painted images of fruits and vegetables.

My observations of these advertisements were not out of idle curiosity. Rather, I was collecting data for a food environment study. A “food environment” is the context in which people produce, sell/buy, prepare, and consume food. Its components include food availability, affordability, convenience, and promotion. Understanding this context provides a more wholistic picture of consumer behavior. For example, it can highlight potential barriers to eating a diverse, nutritious diet. This information can be used to better design nutrition programming, and craft more valuable policy recommendations.

Food environment studies in low- and middle-income countries (LMIC) are uncommon. Most food environment studies are conducted in formal, urban, and/or western markets. As a result, our team had the opportunity to adapt and create new tools for our study. My colleague developed the household survey, which identified where householders buy their food. I developed the vendor analysis tool, which analyzed the food/drinks for sale in the market. Our tools were used in Lodwar town, as well as in 10 rural community health units in Turkana County.

The vendor analysis tool comprises three parts. The first part provided a broad view of the food environment by geocoding (mapping with GPS) all of the food/drink vendors in town. In the second phase, a group of vendors was randomly selected for an in-depth follow-up. In the follow-up interview, we conducted a full vendor inventory, where we wrote down which food items were for sale, their price per unit, the quality, etc. Lastly, we completed an in-depth interview with the vendor to better understand their businesses. Topics covered in the interview include how they determined the price of their goods, their willingness to negotiate with customers, and their social role within the community.

My work on the food environment study closely ties into my background in behavioral science. Behavioral science analyzes the interaction between an organism’s behavior and its environment. Food environment studies are an example of how you could apply behavioral science to the issue of food insecurity, as they analyze the interaction between consumers, vendors, policymakers, and markets.

Food environment studies provide us with a more nuanced understanding of food insecurity by highlighting how our food-related behaviors are impacted by our environment. Food environments can be grouped into two types: obesogenic and healthy. Obesogenic food environments have an abundance of convenience stores, which tend to sell less nutritious, packaged items; these food environments are associated with higher rates of obesity. In contrast, healthy food environments have greater availability of healthy foods, and are associated with higher quality diets. Although we cannot say that the food environment causes these health outcomes, it’s apparent that the food environment influences consumers’ opportunities to eat more or less nutritious food. Therefore, those interested in improving nutrition outcomes must consider the food environment.

Often, NGOs approach nutrition as an education problem. They fall into the trap known as the G.I Joe Fallacy, which is the misconception that “knowing” what you should do is “half the battle.” Most of us can relate to this idea. We might know that we shouldn’t consume soda or processed foods, yet we continue to consume it anyway. Although we know that soda is bad for our health, the widespread availability, affordability, and promotion of soda makes it hard to resist.

Nutrition education is necessary, but not sufficient. By this, I mean that education is only one component in creating sustainable behavior change. In the case of Turkana County, education and personal “will power” alone cannot overcome an environment that facilitates poor dietary choices. Moreover, education campaigns alone do not address the systemic problems that make diverse, nutritious diets unattainable.

Food Environment Word Cloud for Turkana County, Kenya
Marisa Nowicki, Bioversity International

By studying the food environment, we can identify concrete issues that need to be addressed. For example, I used the data collected in the vendor inventory to better understand which food/drink items are more or less available to consumers in Turkana County, Kenya. I categorized the list of food items into food groups, and then put that new list into a word cloud. The more frequently the category appeared in the inventory, the bigger the word appears on the image. As you can see, Cereals, Sweets, Meat, and Sugary Drinks (aka soda) are prominent in Turkana County’s food environment. In contrast, fruits and vegetables, particularly vitamin-A rich fruits and vegetables, are relatively less available. A simple analysis like this can identify potential issues in the food environment, which can then be used to springboard conversations about local food availability.

If we take a closer look at this issue, we might conclude that one of the barriers to a diverse, nutritious diet in Turkana County is the limited availability of vitamin A-rich fruits and vegetables. A deeper conversation with vendors might reveal that the costs are prohibitive to most consumers, which limits the amount they keep in stock. Therefore, there is little value in NGOs educating locals on the importance of eating more vitamin-A rich fruits and vegetables, as little is available, and what is available is unaffordable. This type of analysis changes the conversation from “how we can educate people about the importance of consuming vitamin A-rich foods?” to “how can we make vitamin A-rich foods more accessible to consumers?”

It is vital that organizations begin taking a more wholistic approach to agri-nutrition programming. This includes acknowledging that poor health outcomes are, in part, a failure of the food environment. If NGOs take this approach, can move beyond treating community members as “beneficiaries,” and instead treat them as rational actors within a complex environment.

About the Authors

Marisa Nowicki is from McKinney, Texas. She has a Bachelor of Science in Applied Behavior Analysis and Bachelor of Arts in Psychology from the University of North Texas. In addition, Marisa has a Master’s in Public Policy and Management from Carnegie Mellon University. In graduate school, her capstone was a client project for 412 Food Rescue, which resulted in a comprehensive, replicable model to reduce food waste and improve food security in Pittsburgh, Pennsylvania. Outside of the classroom, Marisa has work experience with the U.S. House of Representatives, the George W. Bush Presidential Center, and the U.S. Department of State. Marisa aspires to have a career where she applies behavioral science to major global issues, such as food security, human trafficking, and poverty alleviation.

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