What McDonalds Taught Us: Lessons learned from one community's efforts in shaping the local food environment

The healthy cities movement has made significant progress to integrate health criteria into city planning. In fact, there is increasing recognition of synergy between Public Health and Urban Planning. However, there appears to be a gap between the value of healthy food environments and the implementation of policies that would ensure optimal food environments. This case study presents a city that has been recognized internationally as the only “Blue Zone” in North America for its high life expectancy and how it has sought to go beyond its healthy city reputation to codify and ensure a purposeful approach to upholding its healthy nature. What started as a resistance to a proposed McDonald's restaurant in the city resulted in broader health policy efforts. Methods: citizens and public health professionals engaged local government leadership in dialogue to encourage healthy city by design decision-making; reviewed best practices; formed a coalition; and used media advocacy to impact the policies and design of the city's food environment. Findings: Lessons learned include: the importance of navigating political philosophies around choice and food regulation; the impact of media with its successes and challenges; the importance of partnering with a broad set of stakeholders to maximize results. Implications: The lessons learned discussed here can be applied to other communities, customizing existing best practices to a local context. More discussions should follow on how these efforts have been, and can be, implemented in communities with varying socio-economic realities who seek to take an active role in designing their food environment.