Introduction
“Food deserts,” areas characterized by poor access to healthy and affordable food, may contribute to social and spatial disparities in diet and diet-related health outcomes. However, the extent to which food deserts exist is debated. We review the evidence for the existence of food deserts in socioeconomically disadvantaged areas.

Methods
We conducted a systematic review of primary, quantitative, observational studies, published in English or French, that used geographic or market-basket approaches in high-income countries. The literature search included electronic and hand searches and peer-reviewed and grey literature from 1966 through 2007. We also contacted key researchers to identify other studies. We analyzed the findings and quality of the studies qualitatively.

Results
Forty-nine studies in 5 countries met inclusion criteria; the amount and consistency of the evidence varied by country. These studies were a mix of geographic and market-basket approaches, but the methodologic quality of studies and completeness of reported findings were mixed. We found clear evidence for disparities in food access in the United States by income and race. Findings from other high-income countries were sparse and equivocal.

Conclusions
This review suggests that food deserts exist in the United States, where area-level deprivation compounds individual disadvantage. Evidence for the existence of food deserts in other high-income nations is weak.