Associations Between County and Municipality Zoning Ordinances and Access to Fruit And Vegetable Outlets in Rural North Carolina, 2012

Mayo, Mariel Leah; Pitts, Stephanie B. Jilcott; Chriqui, Jamie F.

doi:10.5888/pcd10.130196

Cited by 15 publications

(10 citation statements)

References 14 publications

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“…These findings suggest that neighborhood factors may influence the growth of additional food outlets, but not initial density (and vice-versa). Inconsistencies between probit and two-step models may be due to zoning ordinances and land-use policies that determine whether food outlets to locate in certain neighborhoods, 15 but do not necessarily influence the density of food outlets in areas that permit food retail.…”

Section: Discussionmentioning

confidence: 99%

Beyond Supermarkets: Food Outlet Location Selection in Four U.S. Cities Over Time

Rummo

Guilkey

et al. 2017

American Journal of Preventive Medicine

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Introduction Understanding what influences where food outlets locate is important for mitigating disparities in access to healthy food outlets. However, few studies have examined how neighborhood characteristics influence the neighborhood food environment over time, and whether these relationships differ by neighborhood-level income. Methods Neighborhood-level data from four U.S. cities (Birmingham, AL; Chicago, IL; Minneapolis, MN; Oakland, CA) from 1986, 1993, 1996, 2001, 2006, and 2011 were used with two-step econometric models to estimate longitudinal associations between neighborhood-level characteristics (z-scores) and the log-transformed count/km2 (density) of food outlets within real-estate-derived neighborhoods. We examined associations with lagged neighborhood-level sociodemographics and lagged density of food outlets, with interaction terms for neighborhood-level income. Data were analyzed in 2016. Results Neighborhood-level income at earlier years was negatively associated with the current density of convenience stores (β= −0.27; 95% CI: −0.16, −0.38; p<0.001). The percentage of neighborhood white population was negatively associated with fast food restaurant density in low income neighborhoods (10th percentile of income: β= −0.17; 95% CI: −0.34, −0.002; p=0.05), and the density of smaller grocery stores across all income levels (β= −0.27; 95% CI: −0.45, −0.09; p=0.003). There was a lack of policy-relevant associations between the pre-existing food environment and the current density of food outlet types, including supermarkets. Conclusions Socioeconomically-disadvantaged populations and minority populations may attract ‘unhealthy’ food outlets over time. To support equal access to healthy food outlets, the availability of ‘less healthy’ food outlets types may be relatively more important than the potential lack of supermarkets or full-service restaurants.

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Section: Discussionmentioning

confidence: 99%

Beyond Supermarkets: Food Outlet Location Selection in Four U.S. Cities Over Time

Rummo

Guilkey

et al. 2017

American Journal of Preventive Medicine

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“…Previous work by Dunn [ 26 ] and Blanchard and Lyson [ 43 ] documents significant county-level variations in access to fast food restaurants or grocery stores. Land-use and zoning policies are usually implemented at the county and city-level; therefore, our county-level assessment of this topic can potentially inform an identification strategy for municipalities that would most benefit from revising zoning policies related to the local food environment [ 44 ].…”

Section: Introductionmentioning

confidence: 99%

Food Swamps Predict Obesity Rates Better Than Food Deserts in the United States

Stowers

Schwartz

Brownell

2017

IJERPH

427

342

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This paper investigates the effect of food environments, characterized as food swamps, on adult obesity rates. Food swamps have been described as areas with a high-density of establishments selling high-calorie fast food and junk food, relative to healthier food options. This study examines multiple ways of categorizing food environments as food swamps and food deserts, including alternate versions of the Retail Food Environment Index. We merged food outlet, sociodemographic and obesity data from the United States Department of Agriculture (USDA) Food Environment Atlas, the American Community Survey, and a commercial street reference dataset. We employed an instrumental variables (IV) strategy to correct for the endogeneity of food environments (i.e., that individuals self-select into neighborhoods and may consider food availability in their decision). Our results suggest that the presence of a food swamp is a stronger predictor of obesity rates than the absence of full-service grocery stores. We found, even after controlling for food desert effects, food swamps have a positive, statistically significant effect on adult obesity rates. All three food swamp measures indicated the same positive association, but reflected different magnitudes of the food swamp effect on rates of adult obesity (p values ranged from 0.00 to 0.16). Our adjustment for reverse causality, using an IV approach, revealed a stronger effect of food swamps than would have been obtained by naïve ordinary least squares (OLS) estimates. The food swamp effect was stronger in counties with greater income inequality (p < 0.05) and where residents are less mobile (p < 0.01). Based on these findings, local government policies such as zoning laws simultaneously restricting access to unhealthy food outlets and incentivizing healthy food retailers to locate in underserved neighborhoods warrant consideration as strategies to increase health equity.

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“…Not all law that influences health falls within the traditional boundaries of “health law.” Most laws are proposed, enacted, and enforced with little or no thought to health, but many laws and policies can have a powerful health impact. For example, immigration policy influences health and access to health care among undocumented immigrants (53), drug laws and law enforcement practices can exacerbate HIV risk behavior among drug users (14), unemployment compensation laws may attenuate the effects of unemployment on adult and child health (46), and zoning may determine whether consumers can conveniently buy fresh fruits and vegetables (54). The realization that a wide range of laws and policies can have unintended and unexpected health effects was a primary impetus for Health Impact Assessment and Health in All Policies approaches (21, 45).…”

Section: “Legal Epidemiology”mentioning

confidence: 99%

A Transdisciplinary Approach to Public Health Law: The Emerging Practice of Legal Epidemiology

Burris

Ashe

Levin

et al. 2016

Annu. Rev. Public Health

120

153

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Public health law has roots in both law and science. For more than a century, lawyers have helped develop and implement health laws; over the past 50 years, scientific evaluation of the health effects of laws and legal practices has achieved high levels of rigor and influence. We describe an emerging model of public health law that unites these two traditions. This transdisciplinary model adds scientific practices to the lawyerly functions of normative and doctrinal research, counseling, and representation. These practices include policy surveillance and empirical public health law research on the efficacy of legal interventions and the impact of laws and legal practices on health and health system operation. A transdisciplinary model of public health law, melding its legal and scientific facets, can help break down enduring cultural, disciplinary, and resource barriers that have prevented the full recognition and optimal role of law in public health.

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Associations Between County and Municipality Zoning Ordinances and Access to Fruit And Vegetable Outlets in Rural North Carolina, 2012

Cited by 15 publications

References 14 publications

Beyond Supermarkets: Food Outlet Location Selection in Four U.S. Cities Over Time

Beyond Supermarkets: Food Outlet Location Selection in Four U.S. Cities Over Time

Food Swamps Predict Obesity Rates Better Than Food Deserts in the United States

A Transdisciplinary Approach to Public Health Law: The Emerging Practice of Legal Epidemiology

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