State legislative efforts to improve access to fruits and vegetables: A systematic examination of policies

Background

Despite their benefits, few American's consume recommended levels of fruits and vegetables (F&V). To improve consumption, nutrition education is being augmented with environmental and policy approaches. This study sought to systematically examine state legislative efforts for F&V.

Methods

Key word searches were used to identify state legislation that intended to increase access to and production and consumption of F&V. Multiple databases were used: CDC's Division of Nutrition, Physical Activity and Obesity State Legislative database, the National Conference of State Legislatures database and Lexis-Nexis. Bills related to schools were excluded. Legislation was examined for multiple content areas (not mutually exclusive). Descriptive statistics were used to estimate the proportion of bills introduced and enacted.

Results

Our systematic review of bills introduced during 2001-2008 identified 315 relevant bills of which 109 (35%) were enacted and 37 (12%) were pending action. Bills related to farmers' markets were the most common: 109 introduced; 50 enacted. Other common topics included: direct marketing/access (95 introduced; 30 enacted), local procurement/farm to institution (67; 21), agriculture/farming (39; 8), and food policy councils (31; 12). 43 states introduced legislation, with New York having the most bills introduced (58) and New Mexico having the most enacted (13). Legislation increased over time, with 14 bills introduced in the 2001-02 session (64% enacted), and 149 bills introduced in 2007-08 (35% enacted).

Conclusions

Standardized cataloging of legislation may enhance evaluation of policy-based nutrition strategies. Public health practitioners can use this information to educate decision makers about legislation related to F&V within state governments.