Larimer is a neighborhood of opposites: Sitting on the southern border is the booming Bakery Square development, filled with shops, restaurants and Pittsburgh’s Google offices, a glowing symbol of the city’s economic rebound. But less than a mile north, hundreds of low-income residents lack access to affordable, fresh and healthy food.

The stretch of Larimer is one of many pockets of hunger in Pittsburgh, a city in which 47 percent of residents live in what are known as food deserts, according to a 2012 Department of Treasury report. In fact, among mid-sized cities, Pittsburgh has one of the highest percentages of people experiencing food insecurity.

This may seem surprising, with the dizzying number of restaurants opening in the area. But restaurants don’t improve access to food, nor do they make it easier to feed families. Restaurants are usually not an affordable option for healthy meals.

Food insecurity isn't just a citywide problem, it's nationwide. Despite improvements over the past few years, the latest data show that 15 million children in the U.S. live in households struggling with hunger. In response, the American Academy of Pediatrics announced on Friday a recommendation that pediatricians screen all children for food insecurity.

Despite the city's economic rebound, many Pittsburghers are being left behind.

In Pittsburgh, various groups have mobilized to address the challenges that come with hunger. They've created urban farms, food pantries and produce distributions. In some places, they've equipped hungry school kids with backpacks of food for the weekend. Yet the problems remain too significant to ignore.

According to the U.S.Department of Agriculture, food deserts are city neighborhoods or tracts that are more than a mile from a grocery store or rural areas that are more than 10 miles from a supermarket. Some nonprofits look at the percentage of residents who live a half-mile from a grocery store, especially elderly people without cars, who would have difficulty walking that distance.

“Both the experience and measurement of living in a food desert is complicated,” said Tamara Dubowitz, senior policy researcher for Rand Corp., a public policy nonprofit. “The concept of ‘food desert’ seems easy to understand. But when we talk about it from a public health and public policy perspective, we are talking about access to healthy food options. That might take form in terms of geographic distance, but it could also take form in understanding in-store marketing of healthy and unhealthy options and how that influences choice.”

Here’s the breakdown of the local picture on food insecurity:

▪ At least 20,000 low-income city residents live a mile or more from a grocery store, and 85,000 live more than a half-mile from one.

▪ Countywide, the numbers are greater, with 87,000 low-income residents a mile from a store, and 244,000 living more than a half-mile from one.

There are many reasons why so many Pittsburgh residents live in food deserts. It starts with topography.

“With all of Pittsburgh’s hills, valleys, rivers and bridges, there’s more isolation and it’s more difficult to get from here to there,” said Ken Regal, executive director of Just Harvest, an advocacy group based on the South Side. “It’s both a physical issue and a psychological issue in that those barriers can make a market seem far away and outside of a person’s comfort zone."

At a time when Pittsburgh’s economy was in a free fall in the 1980s and people started moving away, stores such as A&P and Thorofare left the Pittsburgh market because of high labor costs here. Then Cincinnati-based Kroger closed all of its 45 stores in the Pittsburgh region, prompted by a labor dispute.

In response to competition from big-box stores such as Walmart opening in the suburbs, Giant Eagle, following a trend around the country, expanded its holdings in the region and closed smaller stores in favor of fewer superstore destinations. By 2007, Giant Eagle owned 54 percent of the region’s market share, according to an industry tracking report by Market Scope. More recently, Progressive Grocer, a different tracking group, found that as of October 2014, Giant Eagle held 28 percent of the market, with Walmart at 26 percent.

“The fact that this consolidation was happening in conjunction with all of the city’s other economic problems, it made the effects more severe and longer lasting,” Mr. Regal said.

Despite the city’s economic rebound, many Pittsburghers are being left behind.

Traci Weatherford-Brown, director of development for the Greater Pittsburgh Community Food Bank, said that more people need meals this year compared with last year in Allegheny County and across the 10 other counties the food bank serves. Currently, the organization needs to provide 28 million meals in Allegheny County per year and 60 million meals in its full service area. Right now, it can cover only half of them. The goal is to meet the full need in 10 years.

When people are hungry, the city suffers. Productivity slides. Public school and health care costs increase. It’s simple: When you’re hungry, you can’t focus, function or fight illness. Charities have more to do. A national study on Hunger in America last year cited that Pennsylvania is one of 12 states with an increase between 2007 and 2010 of more than $1 billion in expenses related to poverty and hunger.

Who is affected?

Jeanette Coleman has lived on the Garfield side of Penn Avenue for more than 10 years. From her house, it takes a half-hour to walk to the Giant Eagle on Shakespeare Street in Shadyside and 15 minutes to ride the bus the 1½-mile route. If she wanted to go to the Market District on Centre Avenue a little over a mile away, there is no direct bus.

Without a car, Ms. Coleman can carry only so much. “That cuts down on the amounts of fruits and vegetables, because we have to carry those things,” she said. “Carrying a bag of apples takes up a lot of space.”

Aldi is scheduled to open in her neighborhood before Thanksgiving, taking the place of a Bottom Dollar store that closed in January. It will make things better, but it won’t solve problems.

“What becomes crippling is the winter time,” said Rick Swartz, executive director of the Bloomfield-Garfield Corp., “when you’re lugging groceries back to the community and then you’ve got a long walk up the hill if you live in the Garfield Commons development. So it’s not a very pleasant prospect if you do not have a car. And that’s the issue for hundreds of residents of Garfield.”

Carrying groceries and packages on crowded buses makes shopping without a car more difficult. Larry Roberts/Post-Gazette

The trek has also been a factor in Hazelwood. Many people go through a routine like Elaine Price did when she moved to the neighborhood without a car 20 years ago. To get to the grocery store, she took two buses then walked to the South Side Giant Eagle on Wharton Street. She took a jitney home. The round-trip took three hours, a journey she repeated every two weeks.

Ms. Price had to learn how to shop more economically and how to prevent food from spoiling between trips, part of what she called “food desert living.”

Other stretches of neighborhoods that are food-insecure include East Hills, Homewood, Oakland, Lincoln-Lemington-Belmar, Spring Garden, Arlington, Knoxville and Allentown. Both Just Harvest and the food bank focus efforts on 14 neighborhoods with census tracts that have high percentages of low-income residents.

Some neighborhoods that had been labeled food deserts in 2010 and 2012 are turning around. Others defy the “desert” connotation in that they’re bustling with restaurants, but there is nowhere to buy groceries.

Take Oakland, where University of Pittsburgh students have access to plenty of bar and restaurant food, but no traditional grocery store. One place where students used to shop, the Giant Eagle on Centre Avenue, closed in the 2000s. And in what had been a food mart at Atwood and Bennett streets, the windows are papered and a sign announces the arrival of a new frozen yogurt shop. Some people shop at Las Palmas market on Atwood, IGA on Forbes Avenue or other smaller groceries in the neighborhood.

College-age patrons crowd Hemingway's Cafe last July in Oakland. Bill Wade/Post-Gazette

In March 2015, Pitt students in the group PittServes partnered with Bellefield Presbyterian Church on Fifth Avenue to create Pitt Pantry. Twice a month, students can pick up food staples at the church. About 60 students used it the first month.

“The Pitt Pantry’s goal is to fill the gaps in the college diet to ensure that our students are properly nourished and can function at their full capacity for their work,” said Holly Giovengo, pantry coordinator and AmeriCorps/VISTA worker.

A group effort

The biggest challenges today for organizations that address food insecurity “are related to the growing political polarization of Americans and the social isolation of both the wealthy and of people living in poverty,” Mr. Regal said.

“There has been a breakdown in what had been a long-standing social consensus that fighting hunger with a strong safety net was a public good, not an overspending, left-wing boondoggle.”

Education is part of the struggle. Just Harvest has been working with anti-hunger, food policy and food sustainability groups at the local, state and national levels.

Mr. Regal is especially optimistic about Mayor Bill Peduto’s administration; he’s the sixth mayor that Just Harvest has worked with.

“We're doing our best to address food insecurity,” Mr. Peduto wrote in an email. He pointed to the Citiparks-administered GrubUp, the free breakfast, lunch and snack program for children and teens that expanded this summer, along with new urban agriculture rules to let people grow and raise more of their own food.

“But there is so much more to do,” Mr. Peduto wrote. “We’ll be working more with partners [like Just Harvest and the Pittsburgh Food Policy Council] to come up with more ways to make sure all city residents have access to quality, healthy food.”

Closing the gap

Pittsburgh groups have been ramping up their efforts to address food insecurity, with varying degrees of success.

The food bank has been reorganizing how it now distributes food. This switch is related to manufacturers’ producing just enough for demand, starting in 2011, which resulted in less product donated to food banks. Now, farmers and retail stores donate the most to food banks.

In the meantime, the food bank has expanded several shopping pantries, including Squirrel Hill Community Food Pantry, which provides 850 clients a year a shopping list based on household size. The idea is to help people buy more nutritious items, yet this type of pantry is more expensive to run.

Just Harvest implemented Fresh Access food bucks in 2013, a program in which people who purchase $5 worth of products using their Electronic Benefit Transfer, or EBT, card get another $2 to spend on produce at certain farmers markets. The program has expanded from two farmers markets within the city in June 2013 to 15 farmers markets in the region. Sales have increased 282 percent since the first season. The group is also working on its Fresh Corners initiative with the goal of improving access to healthy food in targeted neighborhoods around Allegheny County.

Grow Pittsburgh has helped spearhead community garden projects in food deserts such as Lawrenceville, in conjunction with Lawrenceville United. Other gardens are independent, serving food-insecure neighborhoods such as Garfield Community Farms in Garfield.

Youth Places helps at-risk youth, ages 16 to 25, land jobs in restaurants, where they learn how to cook and improve their food literacy through a program called Back of the House.

“We believe that the restaurant industry can actually help alleviate food insecurity,” said board member Christina French, publisher of Table magazine.

“Access to food and the role it can play in a person’s life is an absolute vehicle for transformation and integration,” she said. “Food is the great equalizer.”

Melissa McCart: 412-263-1198 or on Twitter @melissamccart. Former interns Gabe Rosenberg, Amaka Uchegbu, Caelin Miltko, Hannah Schwarz, Jewell Porter, Katerina Sarandou and Amy Brooks contributed.