Collaborators: Nina Lemieux, Divya Jain, Nikhil Mahadevan, Ashlyn Anthony, Daphne Hancock
Project Overview
In the Fall of 2022, a team of five students in the Master of Design focused in Health program at The University of Texas at Austin joined together to better understand food insecurity in Austin. This project spanned one semester and progressed through design research, synthesis, system mapping, ideation, and prototyping. At the end of our project, we presented a design and possible future direction to our graduate program’s cohort and faculty.
The Problem
Food deserts are geographical areas in which residents don’t have easy access to grocery stores for fresh foods. Travis County, which encompasses Austin, is home to 33 food deserts [4]. Living in a food desert substantially increases one’s risk of experiencing food insecurity, also known as hunger, or the disruption of eating patterns because of lack of money or other resources. More than 13 million households are considered food insecure in the United States, and data from 2015 estimates that more than 200,000 of our Travis County neighbors experience food insecurity [3, 6].
Food insecurity is a critical health issue, as it is associated with obesity, type 2 diabetes, and high blood pressure, as well as increased emergency department visits [2, 5]. In 2016 alone, excess healthcare spending associated with food insecurity in the US was estimated at $52.9 billion [1].
To assist people facing food insecurity, the United States Department of Agriculture (USDA) administers a federal aid program, the Supplemental Nutrition Assistance Program (SNAP), which provides benefits distributed by individual states. SNAP benefits are often referred to as “food stamps.”
Phase 1 - Design Research
This project began in our Fieldwork in Design: Design Research course. Our first steps were to reflect on our patient population and conduct an assessment of potential harms that could be associated with our research process. We analyzed possible psychological, social, physical, and economic harms and developed plans to mitigate these, such as not requiring full patient name to assuage possible concerns about privacy, offering Zoom and phone interviews to address the risks of in-person interviews during a period of community COVID-19 spread, and offering financial incentives for participation.
From there, we developed questions and assumptions we wanted to learn more about through our interviews. We utilized a 2x2 grid to prioritize what we hoped to learn and generated specific interview questions intended to elicit relevant information.
A Few Interview Questions
What does a typical day look like for you?
Where do you get your food? How do you travel there?
What kinds of technology do you have access to? How does that impact your ability to get food and/or care for yourself?
What does health mean to you?
Tell me a story about the first time you [used a food bank, or other resource they have used]
How do you typically use your SNAP benefits? (if using SNAP)
Interview Process
We reached out to a number of organizations that provide food assistance for individuals experiencing food insecurity and asked to interview them about their organizations as well as for help connecting us to individuals who use their service. We were able to conduct two interviews with organization executives and three interviews with individuals who use Good Apple, an Austin-based produce delivery service that provides fresh produce from local farms to families and individuals who need help getting fresh produce. All of our interviewees happened to be single adults with one or more chronic health conditions. All were living in affordable housing communities and had relatively low food insecurity. Each had at least a moderate knowledge of the systems in place to help those who need help with rent, groceries, and other essentials. Acknowledging that our research focused on specific subset of individuals needing food assistance, we tailored our future insights and design to meet their unique needs.
In this time period, two of our team members actually volunteered with Good Apple doing produce deliveries. This gave us insight into the living situations of the individuals we were designing for, the types and quantity of produce Good Apple offered, and a deep appreciation for the financial and ecological sustainability of Good Apple’s business model.
After conducting our interviews, we synthesized the quantitative and qualitative data collected from both the surveys and interviews.
Synthesis and Sensemaking
First, we built a composite journey map and empathy map from the interviews we had conducted. With our data more organized and familiar, we placed key quotes from our interviews on a pseudo-journey map focused on three aspects of food insecurity:
1. Preparing, Budgeting, and Taking Inventory
2. Acquiring Groceries and Preparing Food
3. Eating
This process helped us highlight major insights and generate an outcome statement.
Insights and Outcome Statement
Once we were able to see our research at a higher level, a few clear needs began to emerge. Each of our interview participants had their own story, but affordable foods, accessible locations, and the ability to choose food that fit their unique needs were important factors to each of them.
Affordability
“Healthier meals tend to be more pricey.”
“I wish I could buy prepared foods like rotisserie chicken [with SNAP].”
Diet Choice
“They [Good Apple] gave me kale a few times… but I don’t really know what to do with kale so I gave it to my neighbor.”
“I’m diabetic, I don’t know how much food I can accept [from food pantries].”
“I am not inclined to sign up for food assistance like Keep Austin Fed because I’m not sure if it will meet my dietary needs.”
Accessibility
“Because of my surgery, I cannot take the bus to get food.”
“I have to set my paratransit ride a day before, I can’t just go to HEB whenever I want.”
Combining these insights, we stated the following desired outcome for our interviewees:
For me, a food service is successful when it reduces the time it takes to find and obtain food that lowers my burden of chronic disease and fits my budget.
So, how might we accomplish this?
Phase Two - Systems Design
The next steps in our projects occurred during our Introduction to Systems Design course. We began by mapping the food system in Austin, Texas.
Our system map embraced complexity and uncovered opportunities for positive change. We started with collecting key variables, grouping them by common themes, and clustering them together in the same color background. The five areas that we focused on in this system map were social determinants of health, food assistance, consumer traits, impact on health, and the food supply in Travis County. The direct and indirect connections between the variables emerged as we added arrows to the map.
Reviewing our map, we recognized that of all our demographic factors, geography was the most interconnected with other systems. We wondered, "Why can't an H-E-B just move into this area?" This question prompted us to look into possible laws, policies, and financial incentives shaping the current state of food supply and food assistance in Travis County.
Next, we examined our map and mapped symbols onto certain connections that indicated how hard or easy that connection would be to alter.
Ripple Effects: change would create a strong effect on the whole system
Frozen Areas: hard to change
Magnifying Glass: has potential for change
Star: positive changes already happening in community
Ideating
Next, our group brainstormed ideas based on our outcome statement. Our ideation focused on addressing the three main aspects of food insecurity uncovered during our research phase, namely: affordability, diet, and accessibility. We also wanted to make sure our ideas addressed gaps in current food services.
Gaps in current food services.
We generated a number of ideas, including a program that encourages and supports building at-home gardens. We also considered community gardens and how produce might be distributed to individuals who volunteered. We thought about a standalone store that would offer meal kits filled with only SNAP-eligible items and mobile delivery grocers that might offer tiered pricing or affordable produce alongside gourmet oils, spices, and other revenue-generating items for those who could afford them.
While these ideas each had fatal flaws (for example, there is no place to build a personal garden in our interviewees’ affordable housing complex), we took pieces of each idea and incorporated them into what we chose to prototype: a mobile farmer’s market food truck. We called our idea “The Roaming Grocer.”
Business Model
How would the Roaming Grocer be sustainable and affordable? The main program that we drew inspiration from was Double Up Food Bucks. Double Up Food Bucks is a program introduced by the USDA and private funder partners that allows people using SNAP to double their SNAP benefits when used at qualifying farmers’ markets. This program increases the accessibility of fresh, whole foods from local farmers and effectively doubles how many fruits and vegetables a family can bring home. We modeled The Roaming Grocer with this program in mind.
How would the Roaming Grocer be accessible? We planned to have the truck move to different locations throughout the week, stopping in neighborhoods, church parking lots, or local parks in zip codes categorized as food deserts. In each area, we would also offer delivery in a one mile radius of the stop at the end of the day. This feature was important as ⅔ of our interviewees cannot travel easily due to chronic and acute conditions. Here is a map of possible stops:
While the program would have a high start-up cost with the purchase of a refrigerated truck, our calculations confirmed low continued operating costs. Permits for parking the truck, gasoline, marketing, and staffing costs were also reasonable. We explored grant opportunities for initial start-up costs, which are detailed under “Future Directions.” Another source of income from the truck itself could be adding relevant advertisements to the back of the food truck, such as local businesses or job training programs.
We also wanted to center our business around the community. We were adamant that our employees be hired from areas that The Roaming Grocer would stop in and that employees would be included in business decisions. We proposed using the truck as a space for community events, such as screening an outdoor movie or hosting cooking classes. One feature we prototyped was recipe cards, where community members could submit a recipe featuring fresh produce and each week a winner would be selected. This winner would get $20 credit at The Roaming Grocer. We would then use that recipe for meal kits that contain all the necessary ingredients, with the fruits and vegetables specifically qualifying for Double Up Food Bucks.
Prototyping
At this point, we had put a lot of thought and care into our ideas for a solution. We knew that we had to take this idea back to the community that gave it to us, but we were far from building partnerships with farmers or being able to afford a truck. We decided to solicit feedback with a low-fidelity paper and cardboard prototype of the service we wanted to implement.
Even with the most simplified version of our service concept, we received meaningful feedback from community members we had the opportunity to share with.
Experience 1:
Our first interviewee and his son resonated with the need for more access to farmers market food that qualifies for Double Up Food Bucks. They also commented that they enjoy going to the farmer’s market, but there is never any parking or the parking is unaffordable ($10+), so a neighborhood truck would be better.
Experience 2:
Our second interviewee was most excited about the community aspect. They wanted the truck to stand out as something the community would be excited to see come down their block. He also commented that visual appeal would be very important; the van should make you want to post on Instagram.
Experience 3:
Our third interviewee commented that he would like the option to walk to the farmer’s market truck. However, if it was across town he would still go if he could access fresh, local produce on weekdays because all the farmer’s markets are on the weekend and he often works Saturday and Sunday.
Additional Insights:
With all our interviewees, the meal kit option was a hit. Even with an emphasis on individual choice, our interviews helped clarify that sometimes the best option is not having to think too much about what you’ll be making for dinner. This is a unique opportunity for our food truck as most pre-made meals are not SNAP-eligible. Our proposed meal kit addresses this insight while maintaining SNAP-eligibility by providing ingredients intended for home preparation.
Future Directions
If we chose to continue this project, we would propose two possible directions. The first would rely on grant funding from organizations and institutions such as The Cullen Foundation, Glimmer Austin, Wells Fargo, or The Moody Foundation. These organizations have grant programs that could apply to a mobile, double up grocery truck. One option for securing the truck itself would be to purchase one directly from an organization specializing in mobile grocery trucks, such as The Farmer’s Truck.
The second option we would propose focuses more on building upon the work of a previous Design in Health cohort. One of last year’s (2020-2021 cohort) capstone projects was in partnership with Equidad ATX and the Central Texas Food Bank to build a grocery store out of a retired CapMetro bus. The program, called “Live Well/Vive Bien,” is now functional in Austin’s Eastern Crescent. Our hope would be to take some of the ideas from our prototype and business model and integrate them into their model. For example, applying for and utilizing Double Up Food Bucks through local farm partnerships and building out SNAP-eligible meal kits utilizing fresh produce. With either approach, we would be taking steps towards helping Travis County residents find and obtain food that lowers their burden of chronic disease and fits their budget.
References:
[1]. Berkowitz SA, Basu S, Gundersen C, Seligman HK. State-Level and County-Level Estimates of Health Care Costs Associated with Food Insecurity. Prev Chronic Dis 2019;16:180549. DOI: http://dx.doi.org/10.5888/pcd16.180549
[2]. Berkowitz SA, Seligman HK, Meigs JB, Basu S. Food insecurity, healthcare utilization, and high cost: a longitudinal cohort study. Am J Manag Care. 2018 Sep;24(9):399-404. PMID: 30222918; PMCID: PMC6426124.
[3]. Lyndon B. Johnson School of Public Affairs. Food for All: Inclusive Neighborhood Food Planning in North Austin. 2016; https://www.austintexas.gov/sites/default/files/files/Sustainability/Food_For_All_FINAL_070616.compressed.pdf
[4]. Schleede, Sara. “Travis County Has 33 Food Deserts. After 10 Years of Activism, One Might Finally Get an H-E-B.” Medium, 23 Oct. 2020, https://saraschleede.medium.com/travis-county-has-33-food-deserts-after-10-years-of-activism-one-might-finally-get-an-h-e-b-7ed6050993d1.
[5]. Sun Y, Liu B, Rong S, Du Y, Xu G, Snetselaar LG, Wallace RB, Bao W. Food Insecurity Is Associated With Cardiovascular and All-Cause Mortality Among Adults in the United States. J Am Heart Assoc. 2020 Oct 20;9(19):e014629. doi: 10.1161/JAHA.119.014629. Epub 2020 Sep 25. PMID: 32975173; PMCID: PMC7792411.
[6]. USDA. Household Food Security in the United States in 2019. 2020 Sept; https://www.ers.usda.gov/webdocs/publications/99282/err-275.pdf?v=228.1
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