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  • Writer's pictureChardá Bell, IBCLC, CBE, CD

Nourishing Equity: Tackling First Food Deserts and Food Justice in San Diego

Updated: May 11

I previously wrote a blog on this topic a few years ago, a lot has changed, but there is still work to be done. As we explore deeper into learning about first food desert, Southeast San Diego–my hometown, I want to share a little bit about my personal upbringing to better understand my connection to this issue and my passion behind it and why I won’t stop talking about it until inequities no longer exist. Warning this blog is long ass hell...stick with it, it makes sense I promise. 😊💯


(Me & my grandpa in 1989, at their house in Southeast, just 5 houses down from my house)


I have a deep love for my city and my community. As a child raised in SE, I truly think I was better prepared to deal with the world than one raised intentionally in an isolated environment. Children intentionally raised in all-white communities are going to perpetuate the world’s problems when they grow up. I’m definitely the opposite of that as I sit here trying to untangle and dismantle the systems that caused the inequities that lingers in a multitude of ways. 


Southeast is an area where four freeways — 5, 805, and 15, and the 94 — divide us the minority, from the majority and block logical traffic flow, and keep us in our little “box maze” that some of us refer to as “the trap”. 


Along those dividers we have three cemeteries — Mt. Hope, Greenwood, and Holy Cross —no where else in the county have I noticed so many graveyards in one area. I’ve traveled weekly for home visits county wide and spent my San Diego summers going to work with my dad as a handyman turned general contractor. Needless to say I’ve seen just about all of San Diego and would say I know it intimately. 


When I was out of school for break, and I didn’t go with my dad, I was at home with my sister while our parents went to work. Latch key kids like us were quite well versed in independent living skills and basic urban survival. I taught myself how to cook things like eggs, grilled cheese, Mac and cheese was my favorite and cup of noodles. However, most latch key kids were not allowed to turn on the stove while mom or dad were away. So, we ate what didn’t need to be cooked, but that often meant unhealthy and highly processed foods such as ramen noodles, I ate them raw crushed up in the bag with seasoning like chips, pickles with kool aid powder, and actual chips, and whatever we could get from the ice cream truck or the nearby liquor stores. I remember going through the couch and coin jar collecting quarters to walk a mile away to get some rolled tacos and use the leftover quarters to play street fighter on the video game machine as I waited for my food. Luckily, this wasn’t my main diet, my granny lived 5 houses down and that would be my second home. I could count on her to have fresh fruits to eat and cook me a hot meal until mom and dad got home. I knew nothing else, this was my life and my experience for the entire time of my existence up until…

I became a teenager, and my parents had thriving businesses and were in the position financially to provide more for our family. We moved to the suburbs of Spring Valley, Casa De Oro to be exact. It wasn’t until the tender age of 13, that I realized there were more food options, now we had a real grocery store. It was nothing like PayLow or Wrigleys, which were the two stores I grew up with in Southeast, where fresh produce was limited and expensive. My mom used to buy a giant red bucket of chitterlings aka “chitlins” which as I was older found out they were pig intestines. She’d cleaned them well, let ‘em stink up the house and then cook them for hours and for dinner, put them in a bowl smothered with hot sauce. I also ate alligator often, the other white meat as well as a lot of boxed dinners like hamburger helper, presumably because not only was it cheap but quick for parents who were working all day and had long commutes home. Gone were those days because, now at our “real” grocery store, we didn’t have any of that. We had lean chicken breast with broccoli, grilled fish, pasta, casseroles and other meals of suburbia. Fresh fruits and vegetables were ample at the store and looked like something out of a magazine, I couldn’t believe this was real. 


I was breastfed, which set me on a good health trajectory but with my childhood eating habits completely changed as a result of our move,my body was on the path to have a healthier longer lifespan than had I stayed eating the way I was eating with the limited food resources we had in my hometown. It was those childhood memories that I reflect on as I write this blog and discover just how bad things truly were and still are. I currently live only 5 mins away from my childhood home. I still notice big differences with food resources  in where I grew up vs. the suburbs where I spent my latter years. I still love stopping at a liquor store every now and again to grab a bag of chips, because that’s what I know and it brings me comfort, but I also know there are also better choices for regular everyday eating, and I want that for all of my community. 


Exploring the intersectionality of food justice, breast/chestfeeding disparities, and systemic racism, this blog will bring to light the challenges faced by predominantly Black and brown communities in Southeast San Diego. From historical redlining to contemporary racial disparities, I’ll further unpack the complexities impacting infant nutrition and maternal health. If you’re curious to read my original writing on this topic visit here: First Food Deserts in San Diego County — SDBFC


Examining the concept of "first food deserts," coined by Kimberly Seals Allers, based on her research and community projects in Birmingham, AL,  Jackson, MS,  and New Orleans, LA, we uncover persistent barriers to breastfeeding success in Black communities. Consistently large obstacles to breastfeeding success in predominantly black and also low-income areas of the United States, these places are often classified as “first food deserts,” are defined as a geographical area where social and economic dynamics unequally constrain breastfeeding when compared with other locations.


“Where you live and work, then, unequally impacts what you feed and how you eat.”

— Seals-Allers


The healthiest first food is human milk, which is proven to have the best health and survival outcomes for humans. We must acknowledge that Black infants are more often limited, and at times stunted, and face systemic barriers by being born in a first food unfriendly habitat, born into an inequitable food system, where factors like inadequate public transit and workplace policies contribute to low breastfeeding rates amongst other factors such as generational historical trauma of acts of reproductive oppression such as forcing enslaved people to wet nurse their oppressors' children.  


High black populations = low breastfeeding rates due to:

  • No Baby-Friendly hospitals within a 30 minute commute by car and much longer by bus or trolley due to our inadequate public transit system; the nearest birthing hospital is Grossmont Sharp, in the illustrious and affluent town of La Mesa / Mt. Helix

  • 50% or more of employers have no breastfeeding policy or places to nurse/express milk

  • 50% or more of childcare facilities are untrained to handle expressed milk; childcare shortage in San Diego

  • 50% or more of the public reports feeling uncomfortable when seeing a woman breastfeed; reproductive justice issues around body shaming and control


Nationwide, the median white family has 7x the wealth of the median Hispanic family and 10x the wealth of the median Black family. The wealth gap and income gap is the result of years of public policy and private behavior designed to exclude families of color from opportunities to build wealth. Racism and racial inequity will continue to be perpetuated in our communities if we do not collectively commit to take targeted, consistent action. Though our laws are much less explicitly racist today than they have been in the past, our public and private institutions continue to discriminate against people of color. The impacts of these discriminatory practices block valuable members of our community from economic mobility and basic human decency. 


Racism is at the root of all evil and inequities. The history of systemic racism in America—and San Diego in particular—has created an economy in which people of color do not have access to the same opportunities as white San Diegans. Black San Diegans make approx. $10,500 less than their white peers. This is not just an accidental side effect of inadvertent discrimination, it is the intended outcome of over a century of public policy designed to give white workers an advantage over people of color. 


Police commonly arrest Black San Diegans for “loitering” when found outside of the Southeast neighborhood or even in front of their own homes! Police are constantly stopping taking down the names of unfamiliar faces. Today, data shows that San Diego County Sheriff's stop Black drivers at 2x the rate of white drivers, and San Diego Police stop Black drivers at 3x the rate. Both are 50% more likely to use force against Black San Diegans. San Diego Police search Black drivers nearly twice as often, even though they’re 57% more likely to find contraband when searching white drivers. 


Here is an example:

In January 2016, Genevieve Jones-Wright (Black mother, community champion, public defender, and non-profit executive director) was driving home from Mission Beach & got pulled over by police in front of Malcolm X Library in Valencia Park off Euclid Avenue--a road famous for entrapping SDSU students for alleged DUI's. She was handcuffed at gunpoint due to a “reported DMV error” that her license plates were stolen. Her license plates were proven to NOT be stolen and rather she was profiled by police officers for driving while Black (DWB). For her own safety, she recorded and published to her Facebook page. She is currently running for mayor of San Diego.


Analyzing nationwide wealth gaps and historical discriminatory practices, we confront the stark reality that racism continues to have our communities in a chokehold both literally and figuratively. Racial profiling incidents and disparities in law enforcement interactions, emphasize the urgent need for targeted, consistent action to dismantle systemic racism.


Historical context of Southeast San Diego for better understanding of barriers:


Tracing back SD redlining in Southeast and zoning rights has shown years of oppressive finding, we uncover how the construction of the 94 freeway which physically separated Southeast San Diego,  a Black neighborhood, from surrounding white communities, perpetuates racial and economic disparities. Restricting the ability to have easy access to first foods and resources for chest/breastfeeding support.


Southeast San Diego is a mid-size area of the county made up of low income to upper middle class, and some military. Solola apartments, where I started my life as an infant, in the community of Logan Heights. My family moved there in 1985 at the height of white flight / white exodus which was white folks moving to the north and east, as far away from us Black folks as possible. In 1987, we moved to Skyline. So you have the “four corners of life” to Skyline and Paradise Hills, both beautiful hilly urban neighborhoods, bordered by Encanto to the west, Jamacha-Lomita to the North East, and Bay Terraces to the South. None of these communities have easy access to chest/breastfeeding support or easy access to quality affordable foods.


In these areas, we tell parents to breastfeed and expect them to be successful, but we don’t even have the basic infrastructure in place to make that support possible. Not to mention, everything is hyper-local–meaning you have to travel a far distance to get decent quality food and support. A person shouldn’t have to go far and wide to have access to nutrition that is most optimal to support a growing child in their first year of life. Especially when Black infants are 2x more likely to die in their first year of life than white infants, lack of access to human milk makes those mortality rates jump up astronomically. Infant mortality refers to the death of a child under the age of one—death before a first birthday.


This geographical impact on access is huge, and we don’t talk about it enough. Southeast is an ethnic island, an isolated borough. Unlike they do in other “minority islands” like on east coast cities like in NYC, few non-resident whites have to pass through Southeast on surface streets to get to the shopping mall, the baseball game at Petco, or the movie theater. Don’t even get me started on how the high rises around Petco surround the homeless folks on the streets, making their living conditions even more dark and dreary. I remember driving to a lactation home visit downtown in a high rise condo and noticing how dark it was from the buildings blocking the sunlight making the downtown San Diego scene more grim and depressing, not because of the homeless but because of the way they simply developed millions of dollars around the homeless like they weren’t there and invested nothing in helping the people living on the streets, I digress. 


First foods desert map of Southeast San Diego & South Bay - Chardá Bell, IBCLC 

I created this map as I was helping to write a grant to bring a breastfeeding support group and clinic to Southeast.

This 1936 map of San Diego from the agency shows much of southeastern San Diego in red, compared to La Jolla and Coronado in blue. That color coding is what led to the term, “redlining.” San Diego Home Owners' Loan Corporation, marking which neighborhoods it believed were at highest risk of mortgage default. Those determinations were heavily influenced by a neighborhoods' racial demographics and led to the term "redlining." 


–Richard Rothstein, a research associate at the Economic Policy Institute and author - The Color of Law: A Forgotten History of How Our Government Segregated America

Previous maps are nearly identical to socio-economic maps of San Diego today, with a few exceptions. San Diego is a majority-minority region, meaning no single race or ethnic group makes up more than 50% of the total population. It is a more diverse region than it was 80 or 90 years ago, but we are still very segregated. The result is a legacy of deliberate investment in some parts of our county, and deliberate disinvestment in others. We must address the ways in which communities of color are most impacted. It’s no coincidence the above map mirrors that of COVID-19 impacts map below. 



By exploring the impact of historical redlining on Southeast San Diego, we analyze modern day disparities. 


Southeast has a population of approx. 222,338 - including zip codes 92114, 92113, 92102, 91945, 92139 and if you add the 453,901 in South Bay that’s 676,239 total populations combined. We have about 3.26 million San Diego residents in the county. That means over 25% of the San Diego County population is underserved and faces challenges accessing healthy food and breastfeeding resources. 


By bringing attention to the disparity in community spaces, we see the lack of resources, culturally relevant healthcare, and accessible grocery stores. There is an undeniable correlation between these deficiencies and poor health outcomes for Black families.


The contrast between the commanding views of startling green hills in Skyline, views of the beautiful SD skyline from Encanto to grungy lots and strip centers along nearby Imperial Avenue is somewhat unsettling. 


We don’t have nice spaces to congregate or provide services and resources. Churches are a psychological aid for many in the Black community, we need more access to real therapy but we’re working on that too. Anecdotally speaking and to be blunt, if you’re well to do, you can afford to go to a therapist, if you ain’t got it, you go to church for therapy. Many of our churches also occupy storefronts in failed strip mall shopping centers, along with pawn shops, check cash advance places, liquor stores. 


Residential areas can have an auto body shop squeezed in between two homes with another liquor store next to that, advertising its acceptance of food stamps. We mostly have fast food and convenience stores selling a lot of fat, salt and sugar but not full service grocery stores with fresh wholesome food. More taco shops cooking with cheap oil like lard (I love a good taco shop but they aren’t all equal, IYKYK) & greasy fast food, large full service grocery stores are few and far between, and those stores often lock up basic living items that should be easily accessible such as hygiene items like soap, toothpaste, deodorant, tampons, pregnancy tests, covid tests, condoms and infant formula which may be suggested for supplementation if medically recommended by an IBCLC or pediatrician, temporarily due to ineffective or inefficient breastfeeding. There is a persistent and widespread lack of culturally relevant healthcare support, peer support, and public spaces that facilitate breastfeeding.


Southeast San Diego is also disadvantaged when it comes to chest/breastfeeding promotion factors, such as the lack of chest/breastfeeding support groups and Baby Friendly hospitals within reach. What we do have is a disturbing trend of chest/breastfeeding sabotaging factors, such formula advertisements on bus stops and health offices passing out formula to Black women at a disproportionate rate when it is not medically needed. 


All of these revelations correlate to poor infant and mother health outcomes, specifically for Black families and it’s by system design, which means it’s 100% preventable. Every infant has the right to fair and equitable access to the first food of human milk.  Every family deserves the support of their community if they choose to chest/breastfeed. We must also have an understanding of how the racial and social inequities around chest/breastfeeding and first foods adversely affect vulnerable populations. Human milk is proven to be the most efficient and nutritious first food available. It also happens to be the food that has all the components needed to reduce the risks for many diseases that disproportionately affect black children more often such as Type 2 diabetes, asthma, SIDS and childhood obesity. 


Something has to be done to rectify the wrongdoing of the ancestors and descendents of enslaved Black diverse communities and begin to shape a healthier future for disadvantaged communities and foster resilience in these communities for health equity through better food for better health. We must empower and uplift marginalized communities and better serve our community regardless of race, class, or gender. We must improve the living conditions of Southeast. The long-term impact of disinvestment is death, disease and disadvantages. We must invest in our communities. Newsom, we are still waiting on our reparations here in California. 


Unpacking the root cause of inequities, which is racism in its many ugly forms, we address systemic racism's role in creating an economy that excludes people of color from opportunities. The impact of racism on income disparities via the wealth gap highlights  the importance of fair access to human milk as a fundamental right for every infant.


We need the community to be engaged in promoting food justice. Proposed actionable steps can look like advocating for healthy food options in isolated boroughs like Southeast to developing a diverse perinatal workforce, and everything in between and around.  These are simple ways we can all encourage involvement in local initiatives for a more equitable food system.


We can follow the framework of Listen, Learn, Act by digging deep to understand and name the policies and practices inherent in the systems where we work and to radically shift the tide. Recognizing ongoing efforts to improve food security such as farmers markets provided by Project New Village, providing locally sourced produce & contribute to community well-being. We can advocate for more healthy food options and stores like Whole Foods, which accepts EBT for low income folks. We can create programs that focus on ensuring access to nutritious meals for all. Other things to advocate for:


  • Increasing access to breastfeeding support through more culturally congruent care and providing spaces in the community for group/peer support as well as individual support


  • Developing a more diverse perinatal workforce


  • Programs that support healthy living and access to culturally sensitive health education that doesn’t place shame or blame on the community, acknowledging that these health disparities are caused not by our poor habits or lack of knowing how to take care of ourselves but rather the systems in place the prevent us from having better habits and the ability to take care of ourselves, the absence of racism would be helpful to eliminating the daily and generational stressors that cause these diseases and disparities. We urge people to take care of themselves as prevention is key, but there are no places or resources within reach to do so. 


  • Providing people with more food banks, transportation vouchers and carts for carrying food home on public transportation, transportation to peer support groups and health related appointments, like the new Live Well bus, and more mobile options to bring these things into the community.


  • Making it easier for us to get out, creating new roads and pathways out of the community to the larger community so that we are not put in a box maze, “the trap”.


  • More preventative care including lactation consults and education prenatally and incorporating it in family life class. 


  • We also can’t allow the targeted and predatory marketing of formula to Black families—so aggressive that we don’t know we even have a choice when we are not equally marketed breastfeeding support—and expect them to also have high breastfeeding rates, we should be calling these companies out in accordance with the WHO code of marketing breastmilk substitutes in order to stop them before they even get a chance to start. 



We have to acknowledge, listen, learn, and act to see change and make the public’s health better as a whole.


In a white dominated world of lactation professionals and medical providers, we also have to stop telling people in areas we know are first food deserts to just chest/breastfeed and expect it all to work out for them when they try. We tell Black moms that chest/breast is best, but those same people saying it don’t host support groups or provide lactation support that make Black or BIPOC moms feel comfortable, secure and most of all heard without bias or judgments.


For this reason, I started a few breastfeeding support groups in partnerships with local non-profit organizations, using Kimberly Seals Allers’ blue-print for a community-driven model for achieving first food justice in order to combat some of the issues we face with food deserts throughout San Diego. Photo is of our first group started right at the beginning of our post pandemic life.

By increasing access to first foods, including human milk, we can have a resounding impact on infant nutrition and maternal health. When we look at the big picture in real time and take all things into account, we can better provide the needs of the community. We all deserve a more equitable future and access to quality food, including breastmilk or human milk is a basic human right.

I’d like to end this with a call to action. We must all emphasize the need for systemic change beyond capitalist perspectives. I invite you to think about ways you can begin to help create systemic change for our community, not just once but every day until positive change is seen in all spaces and we live in a truly equitable city for all.


This work isn’t easy and may feel uncomfortable to you, but we know that together we can create change. While we can’t erase the past, we CAN change the future.


Consider supporting initiatives like the San Diego Breastfeeding Center Foundation, which aims to eliminate disparities in chest/breastfeeding through reduced cost and free visits for Black, BIPOC and low income families. www.sdbfcfoundation.org


TLDR, and you'll read the full blog later 😉:


Personal Background:

- Raised in Southeast San Diego, impacted by its unique challenges.

- Experienced both the struggles and benefits of the community.

Geographical Challenges:

- Divided by freeways, creating a "trap" with limited logical traffic flow & limited access to resources

Childhood Nutrition:

- Latchkey kid experience, relying on easily accessible, unhealthy foods.

- Limited access to affordable fresh produce

Impact of Moving:

- Transitioned to the suburbs, noticed a significant improvement in food options.

- Shift from processed foods to healthier choices due to improved grocery store access.

Introduction of "First Food Deserts":

- Examining the concept, focusing on Southeast San Diego's challenges.

- Highlighting barriers to breastfeeding success in Black communities.

Health Disparities and Systemic Racism:

- Connecting wealth gaps to racism and historical discriminatory practices.

- Addressing law enforcement disparities and racial profiling.

Historical Context and Urban Planning:

- Tracing back redlining and zoning, linking to racial and economic disparities.

- Impact of freeway construction on accessibility to first foods and breastfeeding resources.

Current Challenges in Southeast San Diego:

- Limited access to breastfeeding support, culturally relevant healthcare, and grocery stores.

- Lack of spaces for community support

Proposed Actionable Steps:

- Advocacy for healthy food options, diverse perinatal workforce, and accessible support.

- Encouraging community involvement and addressing systemic issues.

Call to Action:

- Emphasizing the need for systemic change beyond capitalist perspectives.

- Supporting initiatives like the San Diego Breastfeeding Center Foundation.


References:










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