The study, published in SSM – Population Health by a research team led by John Pastor Ansah of Case Western Reserve University and University Hospitals Medical Center, is among the first to model urban food access as a dynamic system rather than a static snapshot. Using a technique known as system dynamics modeling, the researchers built a mathematical representation of how household income, food prices, grocery store viability, emergency food networks, and demographic change interact and reinforce one another over time. The model was calibrated with data from the U.S. Census Bureau, County Health Rankings and Roadmaps, the U.S. Department of Agriculture, and Ohio state sources, then run forward across a thirty-year horizon from 2015 to 2045.

Cleveland offers a stark testing ground for such an analysis. With a poverty rate exceeding 30 percent, more than double the national average, it ranks among the poorest large cities in the United States. Roughly 10.2 percent of U.S. households experienced food insecurity in 2021, but rates are substantially higher among Black and Hispanic households, and post-industrial cities like Cleveland concentrate the structural conditions—segregation, disinvestment, retail decline—that make nutritious food scarce where it is needed most. In many neighborhoods, residents depend on convenience stores, dollar stores, and fast-food outlets offering calorie-dense but nutrient-poor products, a pattern linked to elevated rates of obesity, diabetes, and cardiovascular disease.

The model’s architecture reflects this reality. It tracks the city’s population as two shifting stocks: people with adequate access to healthy food and people with limited access. Flows between these states are governed by birth and death rates, net migration, and transition rates modulated by the quality of the food environment, nutrition education, and support from food banks and pantries. Beneath this demographic layer sits an economic engine: food affordability is modeled as the proportion of households spending no more than 12 percent of income on food, a threshold reflecting typical expenditure shares in high-income countries. Healthy food costs, calibrated from USDA data for an average family of 2.4 people, rise with inflation, while household income grows through wages and Supplemental Nutrition Assistance Program benefits distributed across twelve income groups.

The most provocative insight lies in a feedback loop connecting charity to decline. As food becomes less affordable, demand for food banks and pantries rises. But the model proposes that expanding free food distribution can erode the customer base of grocery stores selling healthy food, straining their finances and pushing them toward closure. Each closure lengthens the average distance residents must travel to reach fresh produce, deepening food insecurity and driving yet more reliance on emergency food. The model’s authors are careful to stress that food banks play a vital, even life-sustaining role in the short term; the danger emerges when charity operates as a substitute for structural income and market interventions rather than a complement to them.

Under the business-as-usual scenario, the projections are grim. The share of households spending 12 percent or less of income on food falls from 27.4 percent in 2025 to just 15.6 percent by 2045, while the city’s food environment index collapses by roughly 53 percent. Limited access to healthy food climbs from 7.3 percent of residents to 17.7 percent. Meanwhile, the availability of unhealthy food outlets rises from 48.5 percent to 61.7 percent, full-service grocery stores dwindle from 21 to 8, and food banks and pantries multiply from 151 to 273 as the emergency system strains to absorb escalating need.

The intervention scenarios reveal a clear hierarchy of effectiveness. Simply doubling food bank funding cuts limited access modestly, to 14.6 percent, but leaves affordability untouched and even accelerates the underlying deterioration: in that scenario, grocery stores fall to just 5 and unhealthy outlets reach 64.1 percent. SNAP Double Up programs, which match benefits when spent on fresh produce, barely move the needle at all. Retail-focused incentives—grants and low-interest loans to keep grocery stores open—perform better, nearly tripling the number of stores by 2045 and trimming limited access to 13.4 percent. But the transformative results come from income. A substantial income increase, modeled as a shift toward higher earnings through federal and state economic and educational policies, lifts affordability to 46.1 percent—a 195 percent improvement over the baseline—cuts limited access to 6.1 percent, and reverses the retail exodus.

Most striking of all is the comprehensive scenario combining income growth, SNAP Double Up, grocery store incentives, and food bank funding. Together these policies cut limited access to healthy food by 82 percent relative to the status quo, raise the food environment index by 242 percent, and push affordability to 44.7 percent. Grocery stores recover to 20, unhealthy outlets recede to 37.5 percent, and even the emergency food network contracts back toward 170 pantries, a sign that fewer residents need the safety net at all. No single intervention achieves anything close to this; the model suggests the reinforcing feedback loops that drive food insecurity can only be broken by attacking income, retail viability, and assistance simultaneously.

The findings carry weight well beyond Ohio. Roughly half of Cleveland households earn $40,000 or less annually, and two-thirds earn under $60,000, meaning food consumes a disproportionate share of family budgets even before shocks like inflation. The researchers argue that policies strengthening household purchasing power—wage growth, workforce development, and income supports, including evidence from programs like the Alaska Permanent Fund dividend and municipal guaranteed-income pilots—may be as important to food security as anything that happens within the food sector itself. Unconditional transfers may be particularly effective, they note, because they reduce the financial uncertainty that leads households facing what psychologists call extrinsic mortality risk to prioritize immediate survival over long-term health investments.

The authors caution that their results are scenario-based insights rather than forecasts, and that the intervention scenarios are stylized policy experiments, not predictions of specific programs’ real-world feasibility. The model treats food access at an aggregate level and does not yet disaggregate by race, neighborhood, or household type, though community stakeholders—including residents of affected neighborhoods—helped shape its structure through group model-building workshops held in November 2023 and February 2024. Future work, the team suggests, could combine system dynamics with microsimulation to capture how policies affect different socioeconomic groups. For now, the message is unambiguous: food banks feed Cleveland today, but only incomes, supported by a stable retail landscape, can feed it tomorrow.

Subject of Research: System dynamics modeling of urban access to healthy food in Cleveland, Ohio

Article Title: Modeling the Dynamics of Access to Healthy Food. The Case of Cleveland, Ohio

Article References: Ansah, J. P., Rua, R. S., Patki, A., Yamoah, O., & Rajagopalan, S. (2026). Modeling the Dynamics of Access to Healthy Food. The Case of Cleveland, Ohio. SSM – Population Health, Article 101964. https://doi.org/10.1016/j.ssmph.2026.101964

Image Credits: AI Generated

DOI: 10.1016/j.ssmph.2026.101964

Keywords: food insecurity, food deserts, system dynamics, Cleveland, food affordability, grocery stores, food banks, SNAP, health equity, simulation modeling, income policy, food environment

The food desert concept became popular because it offered a powerful way to visualize inequality. By comparing the locations of households with the locations of supermarkets and other food retailers, researchers and policymakers could identify areas that appeared underserved. The approach helped connect urban planning with public health, poverty, transportation and environmental justice. Yet the same map can conceal as much as it reveals. A neighborhood may appear to lack food outlets while residents rely on nearby markets, mobile vendors, community food programs or supermarkets just beyond an administrative boundary.

The central message of the research is that food access is not a universal condition that can be measured identically everywhere. It is shaped by place. Population density, income, car ownership, public transit, street design, housing patterns, local retail culture and the physical distribution of stores can all alter how residents obtain food. Two districts with the same distance to a supermarket may therefore experience very different levels of food security. For one community, a short bus trip may provide reliable access; for another, infrequent service, high fares or mobility limitations may make the same journey effectively impossible.

This distinction is technically important because many food desert assessments rely on geographic thresholds. Analysts may define an underserved area as a neighborhood located beyond a specific distance from a supermarket, often using straight-line measurements or fixed walking distances. Geographic information systems can then produce maps of apparent deprivation. But distance is only a proxy for accessibility. A road network, steep terrain, unsafe crossings or a lack of sidewalks can make a location much harder to reach than its map coordinates suggest. Conversely, dense transit connections may expand practical access beyond the boundaries shown by a simple radius.

The study’s contextual perspective also challenges the assumption that the presence of a supermarket automatically guarantees healthy food access. A store’s size, prices, product quality and operating hours may matter as much as its location. A retailer may be nearby but unaffordable for low-income households, or it may offer limited fresh produce. Food access is therefore multidimensional: it includes not only physical availability, but also economic affordability, cultural suitability, nutritional quality and the ability to shop safely and consistently. Measuring one dimension and treating it as the whole problem can produce misleading conclusions.

Researchers studying these patterns must also contend with the modifiable areal unit problem, a well-known issue in spatial analysis. Results can change depending on how researchers draw neighborhood boundaries or select the geographic units used for comparison. A community may be classified as adequately served when examined at one scale and underserved when examined at another. Administrative borders can further distort the picture, particularly when a store sits just outside a census tract but remains easily accessible to its residents. These technical choices are not neutral; they can influence which communities receive attention and public investment.

Time adds another layer of complexity. Food environments are constantly changing as stores open, close, relocate or alter their prices and product lines. A map based on outdated business data may describe a neighborhood that no longer exists. Residents’ routines also vary by season, work schedule and household responsibilities. A parent may shop during a commute rather than near home, while an older adult may depend on delivery services or a local convenience store. Static maps cannot easily capture these dynamic patterns, making longitudinal and behavior-sensitive research increasingly important.

The contextual approach could have major consequences for policy. If officials rely only on supermarket counts, they may respond by attracting a large retailer without addressing transportation costs, affordability or the needs of residents who cannot travel easily. More targeted strategies could include improving bus routes, supporting smaller independent grocers, expanding farmers’ markets, subsidizing fresh food, funding delivery programs or protecting existing community food networks. The most effective intervention may differ from one neighborhood to the next because the mechanisms producing food insecurity differ.

The research arrives as cities worldwide search for ways to reduce health inequality while adapting to rising food prices, urban growth and climate disruption. Extreme weather can interrupt supply chains and make food access more fragile, especially in communities already facing economic hardship. In this environment, the researchers’ argument is likely to resonate beyond academic geography: a food desert is not simply a place where a supermarket is absent. It is a condition produced by the interaction of space, money, mobility, infrastructure and social life.

By urging researchers to interpret food deserts in their local context, Park, Na, Jang and their colleagues could help shift the conversation from counting stores to understanding lived experience. The most useful question may no longer be “How far is the nearest supermarket?” but “Can people in this place obtain affordable, nutritious and culturally appropriate food reliably?” That change may sound subtle, but it could reshape the maps used by governments, the priorities of urban planners and the way the public understands one of the most visible forms of environmental inequality.

Subject of Research: Site-specific factors influencing the analysis and interpretation of food deserts, food accessibility, and urban sustainability.

Article Title: Food deserts in context: how site-specific factors reshape food deserts discussion

Article References: Park, Y., Na, J., Jang, K. et al. “Food deserts in context: how site-specific factors reshape food deserts discussion.” npj Urban Sustainability (2026). https://doi.org/10.1038/s42949-026-00458-2

Image Credits: AI Generated

DOI: 10.1038/s42949-026-00458-2

Keywords: Food deserts, food accessibility, urban sustainability, spatial analysis, public health, environmental justice, urban planning, food insecurity