Education And Debate

“Food deserts”—evidence and assumption in health policy making

BMJ 2002; 325 doi: http://dx.doi.org/10.1136/bmj.325.7361.436 (Published 24 August 2002) Cite this as: BMJ 2002;325:436
  1. Steven Cummins, research associate (steven@msoc.mrc.gla.ac.uk),
  2. Sally Macintyre, director
  1. MRC Social and Public Health Sciences Unit, Glasgow G12 8RZ
  1. Correspondence to: S Cummins
  • Accepted 11 April 2002

Assertions can be reported so often that they are considered true (“factoids”). They may sometimes even be used to determine health policy when empirical information is lacking. Steven Cummins and Sally Macintyre use the claimed existence of “food deserts”—poor urban areas where residents cannot buy affordable, healthy food—to illustrate why policy makers need to look more critically at the facts

In December 2001 a cross party motion on food poverty signed by 198 UK MPs gained its first reading in parliament. The Food Poverty (Eradication) Bill is now waiting to be read for a second time.1 Though this bill is a laudable attempt to introduce a policy designed to improve the nutrition of those with the lowest incomes and in the poorest places, it is an example of how some ideas become accepted as fact though they may not be true. They become “factoids”: assumptions or speculations reported and repeated so often that they are popularly considered true; they are simulated or imagined facts.2 This paper illustrates how, if the social climate is right, facts about the social world can be assumed and hence used as the basis for health policy in the absence of much empirical information.

Summary points

Factoids are assumptions or speculations reported and repeated until they are considered true

They are sometimes used to determine health policy when empirical information is lacking

The assumption that in the United Kingdom there are poor urban areas where residents cannot buy affordable, healthy food (“food deserts”) is a factoid

Policy strategies to combat the existence of food deserts exemplify how factoids can influence health and social policy

The burden of proof, or demand for evidence, may vary according to a policy's perceived fit within current collective world views

Policy makers need to move away from unquestioning acceptance and should …

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