Food access is health access — especially for celiac patients

Every May, Celiac Disease Awareness Month urges us to confront persistent problems: many people still do not know what celiac disease is, or they confuse it with a preference or trend. “Gluten-free” has become a marketing category, a lifestyle label, a shorthand for being “healthy.” Meanwhile, for people with celiac disease, gluten is not an indulgence or a guilty pleasure. It is a trigger for an autoimmune reaction that damages the small intestine, interferes with nutrient absorption and can unravel a person’s health in ways that are slow, cumulative and not always immediately obvious. Complications can include anemia, osteoporosis, infertility, neurological problems and increased risk of certain cancers if left untreated.

In Riverdale, this reality is intensified by an issue many residents already know too well: food access. When grocery stores close, when prices rise and when local shelves carry limited gluten-free options, managing celiac disease becomes far more than a matter of willpower or careful eating. City data shows 22.6 percent of Bronx residents struggle to access enough affordable food, and a Hunter College New York City Food Policy Center analysis in 2022 revealed more than 14 percent of Riverdale-Fieldston area residents struggle with food insecurity. For those with celiac disease, challenges with food access can hit even harder.

While inconsistent and sometimes quiet symptoms can make identifying celiac disease a challenge, the battle does not end with a diagnosis. The only current treatment for celiac disease is a strict, lifelong gluten-free diet. Even trace exposure to gluten can cause symptoms and intestinal damage in celiac patients. Obtaining the gluten-free food necessary to live a normal, pain-free life can pose a challenge to many suffering from the disease. Not only does cultural framing often reduce the seriousness with which the disease is treated in some dining settings, but the simple act of shopping for groceries each week can become a challenge. Gluten-free staples are more expensive than their gluten-filled counterparts, and they can also be harder to find. In fact, The Celiac Disease Foundation reported in 2024 that gluten-free products can cost up to 139 percent more than gluten-containing alternatives. When patients are impacted by food insecurity, or when grocery shopping options disappear, like with the closing of Riverdale’s Key Food, obtaining necessary gluten-free foods becomes all the more difficult.

This is not a rare problem. Estimates suggest celiac disease affects about one percent of the global population, and in the United States, it is often cited as affecting about one in 33 Americans. By these numbers, a significant portion of greater Riverdale’s community likely suffers from the disease — whether they know it or not. NYU Langone Health reported in 2015 that an estimated 83 percent of people who suffer from celiac disease are misdiagnosed or undiagnosed. These facts make awareness of the disease and ensuring food access to celiac patients in every corner of our community incredibly important.

For individuals with celiac disease, this month of awareness is not about trendy recipes or cheerful social media posts. It is about urging others to take the disease seriously enough to recognize its weight. It is necessary that we all understand that undiagnosed celiac disease is not just discomfort, but risk, and that people with persistent unexplained symptoms should get tested before invisible damage has the chance to set in. Above all, it is important to remind schools, restaurants, workplaces and communities at large that this is a medical condition, not a preference. In our community discussions about food security and access — as advocates rally to fill vacant storefronts and neighbors keep an eye on the anticipated arrival of a Fine Fare Supermarket — it is important to maintain medically necessary dietary restrictions as a prominent part of the conversation.