Modeling the dynamics of access to healthy food. The case of Cleveland, Ohio.

Food insecurity in Cleveland, Ohio, reflects structural inequities that shape urban food systems in the United States and beyond. Historical legacies of racial segregation, chronic underinvestment in marginalized neighborhoods, and persistent wage stagnation have contributed to uneven access to affordable, nutritious food. Understanding these disparities requires a systemic perspective that captures the dynamic interactions among economic, social, and market forces shaping food access and consumption. This study employs a system dynamics modeling approach, developed through a Group Model Building (GMB) process with low-income African American residents, to explore the drivers of access to healthy food and assess the long-term effects of policy scenarios. Simulation results suggest a substantial increase in households with limited access to nutritious food, driven primarily by declining affordability and rising food costs. Within the model, these trends are associated with greater availability of unhealthy food retailers, increased reliance on food banks and pantries, and continued closure of full-service grocery stores, contributing to a worsening food environment. The findings suggest that narrowly targeted interventions may have limited long-term effects unless combined with broader strategies addressing household purchasing power and local food retail conditions. Comprehensive, multisectoral policies that combine income-growth strategies, market incentives, and food-system interventions may yield greater improvements in modeled outcomes. These results should be interpreted as exploratory, model-based insights to inform policy discussions rather than predictions of actual policy effects.