In one of the richest countries in the world, there are 23.5 million Americans, almost half of which are at or below the poverty line, who live in “food deserts”. These are usually communities where there is limited or no access to foods necessary to maintain a healthy diet. Food deserts occur mostly in low-income urban or rural areas where it’s either cheaper or easier to purchase a burger and fries combo than fresh produce.

While for some this may come as a surprise, this phenomenon has been around for decades. Just watch The Cosby Show’s 1992 episode, “The Price is Wrong.” In the episode, cousin Pam offers to drive a few elderly women to a cheaper and higher-quality supermarket in Brooklyn because their local grocer provided lower quality food at much higher prices.

Addressing this appalling trend has become incredibly important as the U.S. wages war against the obesity epidemic. It’s an epidemic that now affects 73 percent of adults and 43 percent of children, according to the Centers for Disease Control and Prevention. And minority populations fare far worse. Specifically, African-Americans are 1.4 times as likely to be obese as their whites counterparts, reports the Office of Minority Health’s website.

How deep does the rabbit hole go? Obesity could now be an even greater threat to Americans’ health than smoking. Congressman Joe Baca says that we’re raising the first ever generation of Americans that are expected to have a shorter life span than their parents. Baca, a supporter of federal programs to improve food accessibility and provide food education, also says that tipping the scales will cost taxpayers big-time. The United States spends almost $150 billion a year to treat obesity-related conditions. The costs are projected to almost double over the next decade and will account for a fifth of overall health care spending, according to White House budget director Peter Orszag.

“We’re dealing with a crisis around obesity in this country, and food retail has a big part to play in terms of how people are able to make choices in their community,” explained Heather Wooten, a Senior Planning and Policy Associate with Planning for Healthy Places at the Public Health Law & Policy. Today’s lack of choices in these food desert zones is attributable to the suburban housing boom following World War II. Wooten says, during the time when people began migrating to the suburbs, there was a major consolidation movement in the grocery industry that catered to this new demographic, creating a new retail model that required large stores with large parking lots. It was a model that would be hard to fit into the urban landscape, creating a window of opportunity for other businesses.

“The fast food restaurants, liquor stores and convenience stores on the other hand are small, can fit almost anywhere, they have a price point in terms of the products they are offering to communities that match with the purchasing power that people are able to spend on food in urban communities,” says Wooten. “So you have these two trends happening simultaneously, the proliferation of fast food restaurants in some of these communities and at the same time, the leaving of the full service grocery store.”

While land use, transportation and economic development decisions made by local municipalities have also played a role in creating what Wooten calls the “built environment” that sparked the food desert phenomenon, these same tools can be used to create opportunities to improve health within these communities. Her group, Planning for Healthy Places, does exactly that by forging partnerships between community organizations, businesses and local agencies to develop policies that aim to improve food accessibility in these desert zones (i.e. creating zoning policies that support community gardens, tax incentives for supermarket chains to return to urban areas, and providing residents access to farmer’s markets).

These grassroots efforts will only become more successful with the new national initiatives that are on the horizon. Major public policy initiatives that are already in the works are the Obama administration’s Healthy Food Financing Initiative, an over $400 million investment plan to bring grocery stores and other healthy food retailers to underserved urban and rural communities across America in 2011; restaurant chains with more than 20 locations must post calorie information starting in 2011; the inclusion of more farmer’s markets as acceptable vendors under the Supplemental Nutrition Assistance Program (formerly food stamps); and a focus on regional food systems and supply chains in the drafting of the 2012 Farm Bill, which could bring about more opportunities for small, local farmers.

Although these initiatives will likely provide more healthy food options to those living in food deserts, Rep. Baca believes it’ll take more than just access to effectively end our culture’s deadly addiction to processed food. “What we’ve got to do is have more education in our institutions [for our students] and then also educate the parents,” Baca asserts. “When we begin to repeat [what the risks are] over and over again, it finally begins to sink in. I’ve got to change my culture, my attitude, my behavior, and what I eat. If I don’t, I may not [live to] be with my family.”