Certain neighborhoods in cities such as Jacksonville, Fla., lead the way in deaths from heart disease and diabetes -- the same geographic area also lags behind many other parts of town in the number of full-service grocery stores, reports The Florida Times-Union.

That's no coincidence, say experts and local health officials looking at geographic and economic conditions as major players in determining one's overall health.

Convenient access to healthy food options is near the top of that list, said Dana Fields-Johnson, director of the Healthy Jacksonville program for the Duval County Health Department.

There are plenty of neighborhood "food stores" and places with "grocery" in the title along Moncrief Road in Northwest Jacksonville. But of the nine the Times-Union visited last week, one had some potatoes and onions. The rest had no fruits or vegetables.

Shelves are lined with canned food, noodles and chips, though the top sellers are generally beer and cigarettes.

Judith Rodriguez sends her University of North Florida students out every year to see for themselves the differences of what's available in different parts of town.

The professor of nutrition assigns a ZIP code to each group of students and has them compile health statistics and demographic information for the area. Students are then asked to list assets in the neighborhood, including grocery stores.

In one urban ZIP code, students tracked one grocery store and three dozen fast-food restaurants. Grocery stores in Jacksonville are clustered on the Southside of town, where the housing started heading in recent years.

They're generally surprised by what they find. Rodriguez, though, isn't anymore.

And if the stores are there, people shop, according to a 2002 University of North Carolina study.

For every additional grocery store in their neighborhood, black Americans' fruit and vegetable consumption jumped 32 percent, compared with 11 percent for whites, the study showed.

Transportation is likely the difference, experts say.

Suburban, middle-class residents hop in their cars and go get what they want, so they're not as bound by what's right next to them, said Antronette Yancey, a professor and coordinator of the Center to Eliminate Health Disparities at the University of California-Los Angeles.

Residents can stock up on their big grocery trips every couple of weeks, but the produce is tough to keep around. If picking up some vegetables and fresh food for dinner means a long trip or a couple of bus transfers, people are more likely to choose fast food or whatever's close and cheap, Fields-Johnson said.

"The reality is people make the choices that are easiest for them," Fields-Johnson said.

Farmers Markets Can Help
Some cities on the West Coast will have traveling farmers markets that go into neighborhoods, but it has to be something that is made a priority, Rodriguez said.

Some market options are available locally, including the Jacksonville Farmers Market on Beaver Street with about 60 different vendors.

Margie Lamb picks up some of her produce at the farmers market because the items are fresh and there's often a variety she can't find at a grocery store.

The Northside resident has a grocery store nearby, but shops at the market for greens and will stop at roadside stands to pick up fresh fruit.

Farmers market customers range from local restaurants to middle-class to poorer people, vendor Glenette Clayton said. She says there is a noticeable bump in business when government assistance checks kick in.

Big Players Look for Payoff
The major grocery chains in Jacksonville wouldn't discuss specific criteria used in locating stores, citing proprietary information, but said they're businesses that need to make smart business decisions.

“We want to be everywhere, if it makes sense to make that investment,” Publix spokesman Dwaine Stevens said.

When Carlton Jones became part of the Gateway ownership group, the biggest thing residents wanted was a grocery store. The group recruited Publix, which Jones says is important for the neighborhood.

While he didn't have specific numbers, Stevens said the store, which opened in 2000, is doing well.

The late physician Robert Lewis Brown approached Winn-Dixie officials in the early 1990s about leasing land from him to open a store Soutel Drive. Brown wanted a store so residents had a place in the neighborhood and the store opened in 1996.

But most ribbon-cuttings and new stores are across town.

The Jacksonville Economic Development Commission helped pay for some water and sewer work at Gateway Town Center where a Publix is now, JEDC spokeswoman Ginny Walthour said. The commission has not directly offered incentives and has no plans to, Walthour said, though the city would work with a developer looking at a grocery store downtown.

Any tax incentive package would need the standard approval from the City Council, which continues to be in more of a cutting than adding mode because of a downturn in revenue.