Causes and Effects of Mothers Living Under Food Apartheid: A Spatial Data Analysis on the Impact of Food Insecurity and Access to Public Transportation on Maternal Health in New Jersey

Abstract

Maternal health outcomes in New Jersey are among the worst in the country. In 2018, New Jersey ranked 47th out of 50 states for Maternal Health outcomes. Moreover, among wealthy, economically developed nations in the Organization for Economic Cooperation and Development (OECD) the United States ranks last in maternal mortality. The most striking statistic, still, is that Black women in New Jersey experience seven times the rate of death from pregnancy, and pregnancy related causes as opposed to their white counterpart. Maternal mortality is defined as “Number of deaths related to or aggravated by pregnancy (excluding accidental or incidental causes) occurring within 42 days of the end of a pregnancy per 100,000 live births (5-year estimate)”. As of January 2026, 86.7% of pregnancy-related deaths in the state were determined to be preventable. This thesis argues that these disparities are not the result of individual choice or clinical care failure, but of food apartheid ,the racial, economic, and political structures that perpetuate food insecurity in marginalized communities. This thesis seeks to determine the specific underlying forces, such as the locations of NJ Transit bus routes and food retailers, that entrench structural racism and in turn maternal mortality in the state. Drawing on GIS spatial analysis of NJEDA-designated food desert communities, Full-Service Grocery store (FSGs) locations, SNAP/WIC approved retailers, and NJ Transit bus routes, this thesis finds 81% of SNAP/WIC retailers fall within a quarter mile of NJ Transit bus routes, compared to only 64% of FSGs, while in the highest ranked food desert communities like Camden and Newark, FSGs are virtually absent from the reach of public transit routes. These findings reveal that public transportation in New Jersey connects low-income mothers primarily to smaller, SNAP/WIC retailers, not to the FSGs that research identifies as essential for healthy maternal and fetal outcomes. This reflects the conditions mothers living under food apartheid face which have been created by decades of redlining, ultimately shaping their food environment. These findings demand policy interventions that create structural change to uproot food apartheid. In the short term, this thesis recommends rerouting and expanding NJ Transit bus routes towards FSGs in designated food desert communities, piloting a Demand Responsive Transit model for pregnant individuals modeled on programs already operating in Trenton, institutionalizing the Healthy Corner Store Initiative as a condition of SNAP/WIC certification, and scaling the Medically Indicated Meals Pilot to reach all pregnant individuals in designated food desert communities. In the long term, this thesis recommends investing in community-owned cooperative grocery stores through the NJEDA Food Desert Relief Act framework, replicating the publicly owned retail model piloted in Atlantic City, and exploring city-owned grocery stores in New Jersey’s highest-ranked food desert communities. Naming these conditions as food apartheid is a call for policymakers to address the racial and structural forces that have made nutritious food inaccessible to mothers and birthing people in New Jersey living in food desert communities, and that any long-lasting policy solution must operate at that level.