Feeding Minds

An in-depth look at West Virginia's food access and obesity issues

In a state with the highest adult obesity rate in the nation, West Virginia continues to provide opportunities for its citizens through food access programs, nutrition education efforts and the help of friendly neighbors.

Bob Weaver, a Calhoun County resident of more than 70 years, said that he’s personally seen how obesity has affected his community over the years.

“I think [the obesity rate in West Virginia] probably doubled,” Weaver said. “I think people just look to food to bring them some kind of quick relief and comfort and I think it’s really linked into the deep psychology that’s in human beings. West Virginia is one of the leading states in America for the disease of addiction in general and I think it's tied into that to get the quick buzz fix in your mind of eating foods that bring you comfort and drinking more sugar water.”

About 39.2% of West Virginia adults consume a soda or sugar-added beverage on a daily basis, according to the West Virginia Department of Health and Human Resources (WV DHHR).

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Bob Weaver, Calhoun County resident

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In 2019, West Virginia tied with Mississippi for the highest adult obesity rate in the nation at 39.5%, according to the annual State of Obesity report released by the Trust for America’s Health.

West Virginia and Mississippi have also remained above a 35% obesity rate since 2013, according to the Centers for Disease Control and Prevention.

Alanna Higgins, Ph.D. candidate and Food Justice Lab worker studying nutrition and food access in the state of West Virginia, said that through her research she’s found that a lack of food access, low socioeconomic status and pollution all contribute to the high rate of obesity in the state.

“Things like behavior and cooking knowledge are often cited [as the reason for the state’s high obesity rate] without thinking about the larger, socioeconomic aspects, and access to food is such a big thing in a rural state where people may have to drive a really long time to access fresh produce and may not have the money to access foods besides what's offered at the Dollar General,” Higgins said. “I think those same factors of [the] lack of jobs, income, difficulties of accessing food and consequences of living in polluted areas affects everyone in the state.”

Thomson Gross, geographic information system (GIS) director of research at the Food Justice Lab, said that through his research he’s found that the biggest contributor to West Virginia’s high obesity rate is the lack of grocery stores that offer plentiful selections of healthy foods. In the absence of grocery stores, small box retailers and convenience stores begin to appear.

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"One of the biggest issues that I see is the lack of access to healthy food, so it’s not so much a behavior issue, but an environmental one that we face in West Virginia. In my opinion, that is the biggest contributor to why we’ve remained one of the more obese states, or the most obese state, in the nation."

Thomson Gross, GIS director of research at the Food Justice Lab

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West Virginia also ranks second in the nation for highest childhood obesity rate at 20.3% in youth ages 10-17, according to the State of Obesity report.

“Children are just as food insecure, if not more than adults,” Gross said. “I think that it has created just a reality in which it’s difficult to access healthy foods, let alone get that kind of one-on-one, individual experience of eating healthy foods and having healthy attitudes around food. They’re just reinforced by the stark economic reality.”

Food deserts, 'more than just boundaries on a map'

The presence of food deserts throughout the state and the closure of grocery stores that provide fresh produce, are just two factors that contribute to the state’s obesity problem.

Food deserts are geographic areas where access to grocery stores that sell fresh, nutritious and culturally appropriate food is difficult to find because of distance or lack of public transportation. Individuals who live in these areas must rely on less-healthy food options.

According to both Gross and Higgins, the term “food desert” is being moved away from because a lack of healthy food access encompasses more than just drawn boundaries on a map.

“I think that the shift away from just trying to draw these discrete boundaries of what a food desert is, is a recognition that research didn’t necessarily do anything to help mitigate the problem just by drawing some lines on a map and then trying to have that kind of tell the story for that geographic region,” Gross said. “They found that people within those areas in some households were eating well and people in some households were not and it wasn’t just a function of, people don't always necessarily shop at the closest grocery store.”

Gross said researchers, geographers and mappers are focusing instead on food access and food insecurity. He said the solution to the food access problem is to add a grocery store or food retailer within the food desert areas.

“I think the jury is out on what is the solution to it and in terms of West Virginia, we certainly have widespread food access issues in nearly every county [and] nearly every community,” Gross said. “I’ve personally moved away from trying to just figure out where the food deserts are in the state. We kind of take each community at their own level and we do a lot of participatory research and food access planning for communities at the community level.”

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West Virginia Food Desert Areas copy.png

122 food deserts caused from low vehicle access, or more than 20 miles from nearest supermarket

111 food deserts caused from being more than 1/2 mile (urban) or 10 (rural) miles from nearest super market

73 food deserts caused from overlap between low vehicle access and 1/2 mile (urban) from nearest supermarket

Map courtesy of Thomson Gross

“We only have one grocery store in Calhoun County,” Gross said. “[In the past] it didn’t have fresh produce that often. It wasn’t reliably stocked anymore and there were talks of it shutting down.”

In Calhoun County, the only grocery store is the Grantsville Foodland. If residents want to get groceries elsewhere, the nearest Walmart from Grantsville is 30 to 40 minutes away.

“There probably have been times over the years where [Foodland] didn’t have a very wide menu of fresh foods and for about three or four years, more recently, the company that owned Foodland, they were bellying-up and often didn’t have much of any fresh fruit or vegetables or much of anything in the store,” Weaver said.

Weaver said that after Foodland switched ownership, it’s since had better options of fresh produce, but that there are healthier options for food in the area that people don’t take advantage of.

“I go to one of the local farmers markets here in Calhoun County,” Weaver said. “It’s been going on there for years and they have really great stuff. We have a couple of farmers markets here in the county and people just don’t use them. They like to get all the fat food they can get and drink a lot of the sweet water from the store.”

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The Grantsville Foodland is the only grocery store in Calhoun County that offers fresh foods to the community. After a change in management and a closing scare, the store now allows residents to find fresh produce as well as healthy food options that allow them to maintain healthy lifestyles.

'The number one barrier to accessing healthy food' and the programs that help

Many low-income households in West Virginia are forced to reduce the quality of foods purchased to ensure that fixed expenses are covered, according to WV Food Link. Unlike rent, utilities, childcare and transportation, food is a flexible part of the budget and for this reason, income is an important variable determining access to healthy food.

WV Food Link is a responsive research program designed to support a people-centered food network in the Appalachian region. The partnership includes a variety of participants such as the WV Food and Farm Coalition, Mountaineer Food Bank and the WVU Extension Family Nutrition Program.

“I think it is important to recognize that people who don't have a stable income, or are working multiple jobs or jobs that don't pay a living wage, that that's the number one barrier to accessing healthy food,” Higgins said. “Food is such a great lens for us to see so many other things in society along with it just being such a visceral thing for us to survive, but it is about a living wage. People need to be paid a living wage in order to access fresh and nutritious food.”

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According to the United States census, 17.8% of West Virginians were considered impoverished. This graph shows the percentage of poverty per county in West Virginia as of 2015.

Map courtesy of the Food Justice Lab

Programs like the Supplemental Nutrition Assistance Program (SNAP) and the Women, Infants and Children Program (WIC) provide food aid to low-income families in West Virginia.

Through the SNAP program, which is allocated out of the farm bill, each state is given a certain amount of money that it can then distribute through means testing to families and individuals who qualify. Eligibility to receive SNAP benefits is based on household size, income, assets and some household expenses. To qualify for the SNAP program, recipients must pass a gross income test and then a net income test.

For example, a one person household making a maximum of $2,082 or minimum of $1,041 a month can receive $194 per month from SNAP. A household of four earning a maximum of $4,292 or minimum of $2,146 a month can receive $646 per month, according to the WV DHHR.

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Graph courtesy of Fresh EBT

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“It is paid for through tax dollars,” Gross said. “It’s an entitlement program, but it is also a huge economic stimulus to states such as West Virginia. It is money that is distributed by the federal government, regardless of the tax base of the state. It’s based on need.”

Susan Shingleton, information & referral services specialist for the Eastern Panhandle and past SNAP recipient, said that she was part of the program when she was in college.

“I could only work part time and the student loans went toward classes, books, rent, car insurance [and other] essential things,” Shingleton said. “I had problems because you have to work at least 80 hours a month and I wanted to focus on school.”

SNAP recipients who qualify will receive an Electronic Benefits Transfer (EBT) card, which can be used to purchase selected food items at any participating store or farmers market.

Benefits are deposited electronically into a recipient's program account and the recipient can then use his or her EBT card to make purchases, which are subtracted from the account, according to the WV DHHR.

“You can use it at any store that accepts the card,” Shingleton said. “You can buy vegetable plants and seeds. You can also use it at the main farmers market and they will double or triple what you want to spend.”

Brandi Sturdivant, SNAP recipient, said that she applied for the program about 11 years ago when she was pregnant with her son. She was also a recipient of the WIC program until her son turned 5.

“[It was] not hard [applying for SNAP], but time consuming having to go fill out a mountain of paperwork and then wait to be called, sometimes for hours like you're at the DMV,” Sturdivant said. “With kids in tow, that's a very hard task.”

Every year, recipients of SNAP must report to the WV DHHR things like income status, moving, marriage and change in the amount of utilities, which affects how much money is provided, according to Shingleton.

“You could become over income,” Shingleton said. “Job changes are not always reported and they get an alert if someone starts or applies for a job. They can also check DMV records and child support and social security.”

Sturdivant said that once she got a job, she received less money from SNAP.

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“I receive less than $20 a month since I work full time now. It’s bad for people who work, because you're suddenly outside of the bottom of the barrel income guidelines to qualify. I need that help now more than ever, but it gets taken the second you get a foot in somewhere.”

Brandi Sturdivant, SNAP recipient

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Shingleton said she can see both sides of the application process by first being a recipient herself, then by processing the SNAP applications. She said the computer calculates the eligibility based on provided information.

Gross said that WIC is a bit more restrictive than SNAP because individuals can only buy a limited number of items such as milk, bread, grains, rice and cans of beans. Whereas, with the SNAP program, individuals can buy anything that has a nutrition label at a grocery store, farmers market and convenience store.

WIC is a program established only for women and children, and its services include nutrition counseling and education, breastfeeding promotion and support, health screenings, medical and social service referrals and monthly food packages.

“[Through the WIC program] you have to have regular screenings where they do nutrition counseling [and] lactation counseling [and] they measure your child to make sure that they’re thriving,” Gross said. “It’s a very intensive program and that’s why they see a lot of drop-off, especially when infants faze out of needing baby formula anymore.”

“The kind of distribution of what you’re allocated changes so you receive less and less benefits the longer you’re in the program based on a perceived need, and also it becomes less viable and less worth it in many mothers’ eyes, or many families’ eyes, to continue to go back for these regular appointments in addition to the other appointments they’re doing with their regular pediatrician,” Gross said.

Gross said in addition to every emergency food agency or charitable food agency like a food pantry or a hot meal program, there are backpack programs for students. Children who qualify, and that are low-income, can receive free and reduced meals and many communities in West Virginia will have organizations that help organize backpacks of food.

Many United States households, regardless of socioeconomic differences, consume more than the recommended amounts of added fats, refined grains and added sugars, and below the recommended amounts of fruit, vegetables, whole grains and low-fat milk, according to the USDA.

“There’s kind of anecdotal evidence that people who are poor buy more unhealthy foods and they’re not as informed about nutrition, but the USDA released a study about the buying habits of those on SNAP versus those who aren’t,” Gross said. “Middle class and rich families [were] compared to poor families, and the differences and the number of unhealthy foods that were purchased was statistically insignificant, so it’s not just that poor people buy unhealthy food, it’s that Americans buy unhealthy food and some just happen to get some assistance in purchasing food.”

SNAP also runs the largest and only nutrition education program in the state called SNAP-Ed, which is also allocated out of the farm bill and includes nutrition education, social marketing and policy, systems and environmental change.

According to the U.S. Department of Agriculture, SNAP-Ed’s goal is to assure that people eligible for SNAP will make healthy food and lifestyle choices that prevent obesity.

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Thomson Gross, GIS director of research at the Food Justice Lab

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The Food Justice Lab is working with SNAP-Ed and the WV Bureau for Public Health, which work with part of the WV DHHR, to reduce obesity and increase food access throughout the state.

“Traditionally, I don't think they’ve worked together and this is kind of a new opportunity in which they’re trying to make sure that their programs aren’t redundant, but are supporting and reinforcing each other’s efforts,” Gross said.

Nourishing Networks is another program that the Food Justice Lab hosts. The program brings together state and county agencies, extension agents, market actors, charitable agencies, social workers, farmers, gardeners and other community food workers to learn how to understand the effects of food policy, develop evidence-based plans and put them into action, according to the Food Justice Lab.

“We bring expert based knowledge,” Gross said. “We bring maps. We bring data that describes their community and we ask them, ‘What about these figures do you resonate with? What’s surprising? What do you know that we don’t see and hear and that experts will never see in the data about the food landscape in your community?’”

Gross said that through that process, they can identify assets and strengths within communities such as lots of gardens and strong faith-based organizations that are in the communities, as well as barriers. The Food Justice Lab will then provide accelerator funding to get new projects off of the ground and support fundraising to sustain those healthy food access initiatives.

It’s also important to take into account that for generations, people in West Virginia have been hunting, fishing and gardening to feed their households. The state currently classifies these people as self-provisioning.

“Outside of these government subsidy programs, which are critical, there are a lot of options and kind of informal social networks in which people share food from gardens and I think you’ll really see a lot of that happening right now, especially as we get into the peak of growing season and people are isolated from their conventional food ways,” Gross said.

Accessing resources

A common issue for many people in West Virginia, especially those living in the more rural areas of the state, lack reliable internet access. This limits people from finding available resources such as nutrition and food assistance programs nearby, online maps that show where people can access healthy food in the state or simple workout routines that can be found online.

Higgins said a few ways people can access the internet to locate these resources, is to find a local library with a computer or go to a restaurant that has free Wi-Fi.

She said a useful website to visit for anyone struggling with obesity and food access, is foodlink.wvu.edu, which provides users with interactive food maps that list everywhere in the state free food and food assistance programs are available. The site also has other maps that show county profiles, which display each county’s socioeconomic factors, SNAP and WIC retailers and food charities in West Virginia.

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“Internet access is an issue especially in certain parts of the state, so if people were able to access a library or somewhere else where they can access the internet, the food link website is updated every year and so it is a continuing resource about where people can access those programs or organizations who can further get them access to healthy food."

Alanna Higgins, Ph.D. candidate and Food Justice Lab worker

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Reducing the obesity rate together

Nutrition education and exercise are some other important components in reducing obesity in the state.

Micki Pauley, Warrior Body founder and fitness coach in Morgantown, said fitness and nutrition are key to improving your mind and body.

“For us, it's removing what people think exercise is and replacing it with what it should be, which is fun and something they can look forward to doing and sustain,” Pauley said. “That's why exercise is so important. It keeps people healthy without feeling like a chore.”

Pauley said she also helps people at her gym create nutrition plans.

“Food based, we really work on helping them learn how to make healthy choices,” she said. “It's really important to take a look and see where they are in life right now and try and incorporate things as it fits for them, so that they don't become overwhelmed. For the nutrition part, it can be to eat more veggies or if they have a really high carb diet, let's reduce some of those and teach you why it's good to have more proteins.”

However, Pauley said it can be hard to find fresh foods, and offers solutions to those struggling with these healthy options.

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Micki Pauley, Warrior Body founder and fitness coach

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Pauley said she worked with individuals in California who are low-income and feel they couldn't purchase higher quality foods. She said it becomes about educating people on what they can use instead, and said the more they are educated, the more they will see the relevance in obtaining healthier foods.

“They may hate it at first, but the better they start to feel, the more they want to keep going with it,” Pauley said.

West Virginia also has a variety of different food assistance and education programs that provide aid and resources for those struggling with food insecurity and obesity.

Together, WV Food Link, the WV Food and Farm Coalition, Mountaineer Food Bank and the WVU Extension Family Nutrition Program work to provide a map of available food sources throughout West Virginia.

From this map, you can find local farmers markets, SNAP accepting retailers, charitable food organizations and more that can serve as healthy, accessible food sources.

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Map courtesy of WV Food Link

Communities throughout West Virginia are making efforts to increase healthy food access and encourage nutrition education. Even elementary school children are supporting their local community by raising food.

“The Arnoldsburg Elementary School, this has really been a great project for them," Weaver said. "They’ve built a big greenhouse and they raise food. The students and faculty members do a food project at the school and they supply a lot of stuff to local people, including myself. My daughter, Tracy, that’s one of her projects.”

The growth of food access resources, nutrition education programs and West Virginians' evergreen willingness to help one another, all contribute to the state’s efforts in creating healthier communities.

“I’m 80 years old,” Weaver said. “I love living here, and most of the people are the kind of people that will help you. If you’re in trouble, they’ll help you anytime, anywhere.”

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Feeding Minds

In a state with the highest adult obesity rate in the nation, West Virginia continues to provide opportunities for its citizens through food access programs, nutrition education efforts and the help of friendly neighbors.

Bob Weaver, a Calhoun County resident of more than 70 years, said that he’s personally seen how obesity has affected his community over the years.

About 39.2% of West Virginia adults consume a soda or sugar-added beverage on a daily basis, according to the West Virginia Department of Health and Human Resources (WV DHHR).

In 2019, West Virginia tied with Mississippi for the highest adult obesity rate in the nation at 39.5%, according to the annual State of Obesity report released by the Trust for America’s Health.

West Virginia and Mississippi have also remained above a 35% obesity rate since 2013, according to the Centers for Disease Control and Prevention.

Alanna Higgins, Ph.D. candidate and Food Justice Lab worker studying nutrition and food access in the state of West Virginia, said that through her research she’s found that a lack of food access, low socioeconomic status and pollution all contribute to the high rate of obesity in the state.

Thomson Gross, GIS director of research at the Food Justice Lab

West Virginia also ranks second in the nation for highest childhood obesity rate at 20.3% in youth ages 10-17, according to the State of Obesity report.

Food deserts, 'more than just boundaries on a map'

The presence of food deserts throughout the state and the closure of grocery stores that provide fresh produce, are just two factors that contribute to the state’s obesity problem.

Food deserts are geographic areas where access to grocery stores that sell fresh, nutritious and culturally appropriate food is difficult to find because of distance or lack of public transportation. Individuals who live in these areas must rely on less-healthy food options.

According to both Gross and Higgins, the term “food desert” is being moved away from because a lack of healthy food access encompasses more than just drawn boundaries on a map.

Gross said researchers, geographers and mappers are focusing instead on food access and food insecurity. He said the solution to the food access problem is to add a grocery store or food retailer within the food desert areas.

Map courtesy of Thomson Gross

“We only have one grocery store in Calhoun County,” Gross said. “[In the past] it didn’t have fresh produce that often. It wasn’t reliably stocked anymore and there were talks of it shutting down.”

In Calhoun County, the only grocery store is the Grantsville Foodland. If residents want to get groceries elsewhere, the nearest Walmart from Grantsville is 30 to 40 minutes away.

Weaver said that after Foodland switched ownership, it’s since had better options of fresh produce, but that there are healthier options for food in the area that people don’t take advantage of.

The Grantsville Foodland is the only grocery store in Calhoun County that offers fresh foods to the community. After a change in management and a closing scare, the store now allows residents to find fresh produce as well as healthy food options that allow them to maintain healthy lifestyles.

'The number one barrier to accessing healthy food' and the programs that help

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WV Food Link is a responsive research program designed to support a people-centered food network in the Appalachian region. The partnership includes a variety of participants such as the WV Food and Farm Coalition, Mountaineer Food Bank and the WVU Extension Family Nutrition Program.

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Programs like the Supplemental Nutrition Assistance Program (SNAP) and the Women, Infants and Children Program (WIC) provide food aid to low-income families in West Virginia.

For example, a one person household making a maximum of $2,082 or minimum of $1,041 a month can receive $194 per month from SNAP. A household of four earning a maximum of $4,292 or minimum of $2,146 a month can receive $646 per month, according to the WV DHHR.

“It is paid for through tax dollars,” Gross said. “It’s an entitlement program, but it is also a huge economic stimulus to states such as West Virginia. It is money that is distributed by the federal government, regardless of the tax base of the state. It’s based on need.”

Susan Shingleton, information & referral services specialist for the Eastern Panhandle and past SNAP recipient, said that she was part of the program when she was in college.

“I could only work part time and the student loans went toward classes, books, rent, car insurance [and other] essential things,” Shingleton said. “I had problems because you have to work at least 80 hours a month and I wanted to focus on school.”

SNAP recipients who qualify will receive an Electronic Benefits Transfer (EBT) card, which can be used to purchase selected food items at any participating store or farmers market.

Benefits are deposited electronically into a recipient's program account and the recipient can then use his or her EBT card to make purchases, which are subtracted from the account, according to the WV DHHR.

“You can use it at any store that accepts the card,” Shingleton said. “You can buy vegetable plants and seeds. You can also use it at the main farmers market and they will double or triple what you want to spend.”

Brandi Sturdivant, SNAP recipient, said that she applied for the program about 11 years ago when she was pregnant with her son. She was also a recipient of the WIC program until her son turned 5.

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“[It was] not hard [applying for SNAP], but time consuming having to go fill out a mountain of paperwork and then wait to be called, sometimes for hours like you're at the DMV,” Sturdivant said. “With kids in tow, that's a very hard task.”

Every year, recipients of SNAP must report to the WV DHHR things like income status, moving, marriage and change in the amount of utilities, which affects how much money is provided, according to Shingleton.

“You could become over income,” Shingleton said. “Job changes are not always reported and they get an alert if someone starts or applies for a job. They can also check DMV records and child support and social security.”

Sturdivant said that once she got a job, she received less money from SNAP.

Brandi Sturdivant, SNAP recipient

Shingleton said she can see both sides of the application process by first being a recipient herself, then by processing the SNAP applications. She said the computer calculates the eligibility based on provided information.

​

WIC is a program established only for women and children, and its services include nutrition counseling and education, breastfeeding promotion and support, health screenings, medical and social service referrals and monthly food packages.

Many United States households, regardless of socioeconomic differences, consume more than the recommended amounts of added fats, refined grains and added sugars, and below the recommended amounts of fruit, vegetables, whole grains and low-fat milk, according to the USDA.

SNAP also runs the largest and only nutrition education program in the state called SNAP-Ed, which is also allocated out of the farm bill and includes nutrition education, social marketing and policy, systems and environmental change.

According to the U.S. Department of Agriculture, SNAP-Ed’s goal is to assure that people eligible for SNAP will make healthy food and lifestyle choices that prevent obesity.

Thomson Gross, GIS director of research at the Food Justice Lab

The Food Justice Lab is working with SNAP-Ed and the WV Bureau for Public Health, which work with part of the WV DHHR, to reduce obesity and increase food access throughout the state.

“Traditionally, I don't think they’ve worked together and this is kind of a new opportunity in which they’re trying to make sure that their programs aren’t redundant, but are supporting and reinforcing each other’s efforts,” Gross said.

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It’s also important to take into account that for generations, people in West Virginia have been hunting, fishing and gardening to feed their households. The state currently classifies these people as self-provisioning.

​

Accessing resources

Higgins said a few ways people can access the internet to locate these resources, is to find a local library with a computer or go to a restaurant that has free Wi-Fi.

Alanna Higgins, Ph.D. candidate and Food Justice Lab worker

Reducing the obesity rate together

​

Nutrition education and exercise are some other important components in reducing obesity in the state.

​

Micki Pauley, Warrior Body founder and fitness coach in Morgantown, said fitness and nutrition are key to improving your mind and body.

“For us, it's removing what people think exercise is and replacing it with what it should be, which is fun and something they can look forward to doing and sustain,” Pauley said. “That's why exercise is so important. It keeps people healthy without feeling like a chore.”

​

Pauley said she also helps people at her gym create nutrition plans.

​

However, Pauley said it can be hard to find fresh foods, and offers solutions to those struggling with these healthy options.

Micki Pauley, Warrior Body founder and fitness coach

“They may hate it at first, but the better they start to feel, the more they want to keep going with it,” Pauley said.

West Virginia also has a variety of different food assistance and education programs that provide aid and resources for those struggling with food insecurity and obesity.

Together, WV Food Link, the WV Food and Farm Coalition, Mountaineer Food Bank and the WVU Extension Family Nutrition Program work to provide a map of available food sources throughout West Virginia.

From this map, you can find local farmers markets, SNAP accepting retailers, charitable food organizations and more that can serve as healthy, accessible food sources.

Communities throughout West Virginia are making efforts to increase healthy food access and encourage nutrition education. Even elementary school children are supporting their local community by raising food.

The growth of food access resources, nutrition education programs and West Virginians' evergreen willingness to help one another, all contribute to the state’s efforts in creating healthier communities.