Zoning as a tool for increasing the availability of healthy food outlets

Background: Zoning and land use laws have been identified as tools for increasing availability of healthy foods including fresh fruits and vegetables (F&V). This study examined whether communities that permit certain “healthy” food outlets (HFOs) through zoning have a higher density of such outlets.

Methods: Zoning ordinances for 676 local jurisdictions overlapping 314 secondary school catchments were compiled in 2011 and 2012. A dichotomous measure of any permitted use zoning for supermarkets and F&V markets was weighted by the proportion of the catchment population in that jurisdiction, then aggregated to the catchment level to measure the proportion of the population exposed to HFO zoning. The number of HFOs in each catchment was compiled from direct observation of supermarkets and F&V markets and divided by the catchment size to estimate density of HFOs per square mile. GLM regressions, controlling for income, race/ethnicity, region, urbanicity, and year were estimated.

Results: On average, 52.6% of a catchment’s population was exposed to HFO zoning and mean density of HFOs per square mile averaged 0.21. Catchments with 100% exposure to HFO permitted use zoning (6.9%) had a mean healthy outlet density twice that of catchments with no permitted uses (27.0%). A 10% increase in population exposure to HFO permitted use zoning was associated with 7.3% higher mean density of HFOs.

Discussion: Explicitly permitting HFOs through zoning codes is associated with a higher availability of such outlets. Public health officials should work with planning and zoning officials to ensure that community zoning codes allow for HFOs.