As a pediatrician working with Children’s Health Fund to provide health care for underserved populations, I have seen how poverty leads to increased rates of obesity in children. Once, while I was working in a clinic at a homeless daycare center, a donor left bags of pasta and jars of gourmet red sauce for the parents to take. At the end of the clinic, I was surprised to see that the food was still there. I learned that it wasn’t that the food was unwanted, it was that the parents didn’t know what to do with it. To me, spaghetti and tomato sauce is an easy meal after a long day, but to the families at the daycare center, it was totally foreign.

The difficulty in understanding how to cook this food reflected the families’ environments and upbringing. Many indigent families live in food deserts — places where stores do not sell fresh fruits and vegetables. And when people grow up without seeing healthy food, they usually don’t eat it.

There is no simple answer in how to combat food deserts.

But food deserts are only one of the factors that lead to obesity in impoverished communities, and bringing in groceries is only a first step in addressing the problem. Studies show, for example, that a baby who rejects spinach at first will ultimately eat it happily — after 10 days of spitting it out. Families living in poverty often cannot spend money on food that’s not being eaten by children. Plus, fresh food is more expensive, spoils quickly and isn’t as filling as processed food. In my work, I have also heard parents say to their children, “If you are good, we can go to McDonald’s.” For poor families, junk food is not only ubiquitous and filling, it is also used as a relatively low-priced reward. In stark contrast, wealthier households can separate food from rewards, making stickers or a trip to the park adequate for good behavior at the doctor’s office and carrots a reasonable midday snack.

There is no simple answer in how to combat food deserts. Building more grocery stores in these areas is just a first step.