Preventing Chronic Disease | Associations Between County and Municipality Zoning Ordinances and Access to Fruit And Vegetable Outlets in Rural North Carolina, 2012 - CDC
Associations Between County and Municipality Zoning Ordinances and Access to Fruit And Vegetable Outlets in Rural North Carolina, 2012
Mariel Leah Mayo, MPH; Stephanie B. Jilcott Pitts, PhD; Jamie F. Chriqui, PhD, MHS
Suggested citation for this article: Mayo ML, Pitts SBJ, Chriqui JF. Associations Between County and Municipality Zoning Ordinances and Access to Fruit And Vegetable Outlets in Rural North Carolina, 2012. Prev Chronic Dis 2013;10:130196. DOI: http://dx.doi.org/10.5888/pcd10.130196.
Zoning ordinances and land-use plans may influence the community food environment by determining placement and access to food outlets, which subsequently support or hinder residents’ attempts to eat healthfully. The objective of this study was to examine associations between healthful food zoning scores as derived from information on local zoning ordinances, county demographics, and residents’ access to fruit and vegetable outlets in rural northeastern North Carolina.
From November 2012 through March 2013, county and municipality zoning ordinances were identified and double-coded by using the Bridging the Gap food code/policy audit form. A healthful food zoning score was derived by assigning points for the allowed use of fruit and vegetable outlets. Pearson coefficients were calculated to examine correlations between the healthful food zoning score, county demographics, and the number of fruit and vegetable outlets. In March and April 2013, qualitative interviews were conducted among county and municipal staff members knowledgeable about local zoning and planning to ascertain implementation and enforcement of zoning to support fruit and vegetable outlets.
We found a strong positive correlation between healthful food zoning scores and the number of fruit and vegetable outlets in 13 northeastern North Carolina counties (r = 0.66, P = .01). Major themes in implementation and enforcement of zoning to support fruit and vegetable outlets included strict enforcement versus lack of enforcement of zoning regulations.
Increasing the range of permitted uses in zoning districts to include fruit and vegetable outlets may increase access to healthful fruit and vegetable outlets in rural communities.
Author Affiliations: Mariel Leah Mayo, Albemarle Regional Health Services–North Carolina, Elizabeth City, North Carolina; Jamie F. Chriqui, University of Illinois at Chicago, Chicago, Illinois. At the time of the study, Ms Mayo was affiliated with East Carolina University, Greenville, North Carolina.
- Flegal KM, Carroll MD, Ogden CL, Curtin LR. Prevalence and trends in obesity among US adults, 1999–2008. JAMA 2010;303(3):235–41. CrossRefPubMed
- Centers for Disease Control and Prevention. County-level estimates of obesity — state maps (2009). Diabetes data and trends. http://apps.nccd.cdc.gov/DDT_STRS2/CountyPrevalenceData.aspx?mode=OBS. Accessed February 15, 2013.
- Patterson PD, Moore CG, Probst JC, Shinogle JA. Obesity and physical inactivity in rural America. J Rural Health 2004;20(2):151–9. CrossRefPubMed
- Hill JO, Peters JC. Environmental contributions to the obesity epidemic. Science 1998;280(5368):1371–4. CrossRefPubMed
- Jilcott SB, Wade S, McGuirt JT, Wu Q, Lazorick S, Moore JB. The association between the food environment and weight status among eastern North Carolina youth. Public Health Nutr 2011;14(9):1610–7. CrossRefPubMed
- Rundle A, Neckerman KM, Freeman L, Lovasi GS, Purciel M, Quinn J, et al. Neighborhood food environment and walkability predict obesity in New York City. Environ Health Perspect 2009;117(3):442–7. PubMed
- Leung CW, Laraia BA, Kelly M, Nickleach D, Adler NE, Kushi LH, et al. The influence of neighborhood food stores on change in young girls’ body mass index. Am J Prev Med 2011;41(1):43–51. CrossRefPubMed
- Glanz K, Sallis JF, Saelens BE, Frank LD. Healthy nutrition environments: concepts and measures. Am J Health Promot 2005;19(5):330–3. CrossRefPubMed
- Evans AE, Jennings R, Smiley AW, Medina JL, Sharma SV, Rutledge R, et al. Introduction of farm stands in low-income communities increases fruit and vegetable among community residents. Health Place 2012;18(5):1137–43. CrossRefPubMed
- Morland KB, Evenson KR. Obesity prevalence and the local food environment. Health Place 2009;15(2):491–5. CrossRefPubMed
- Morland K, Diez Roux AV, Wing S. Supermarkets, other food stores, and obesity: the Atherosclerosis Risk in Communities study. Am J Prev Med 2006;30(4):333–9. CrossRefPubMed
- Jilcott SB, Keyserling T, Crawford T, McGuirt JT, Ammerman AS. Examining associations among obesity and per capita farmers’ markets, grocery stores/supermarkets, and supercenters in US counties. J Am Diet Assoc 2011;111(4):567–72. CrossRefPubMed
- Morland K, Filomena S. Disparities in the availability of fruits and vegetables between racially segregated urban neighbourhoods. Public Health Nutr 2007;10(12):1481–9. CrossRefPubMed
- Ruelas V, Iverson E, Kiekel P, Peters A. The role of farmers’ markets in two low income, urban communities. J Community Health 2012;37(3):554–62. CrossRefPubMed
- The CDC guide to strategies to increase the consumption of fruits and vegetables. http://www.cdc.gov/obesity/downloads/FandV_2011_WEB_TAG508.pdf. Accessed September 12, 2012.
- Azagba S, Sharaf MF. Fruit and vegetable consumption and body mass index: a quantile regression approach. J Prim Care Community Health 2012;3(3):210–20. CrossRefPubMed
- Chriqui JF, Thrun E, Rimkus L, Barker DC, Chaloupka FJ. Zoning for healthy food access varies by community income — a BTG research brief. Chicago (IL): Bridging the Gap Program, Health Policy Center, Institute for Health Research and Policy, University of Illinois at Chicago; 2012.
- Centers for Disease Control and Prevention. Community Transformation Grants (CTG) states and communities programs description. http://www.cdc.gov/communitytransformation/funds/programs.htm. Accessed May 22, 2012.
- United States Department of Commerce. State and county quick facts, 2010. http://quickfacts.census.gov/qfd/states/37/37015.html. Accessed June 1, 2013.
- United States Department of Commerce. Small area income and poverty estimates. US and all state and counties [XLS]. State and county estimates for 2010. http://www.census.gov/did/www/saipe/data/statecounty/data/2010.html. Updated December 12, 2012. Accessed February 14, 2013.
- US Department of Agriculture Economic Research Service. Food desert locator: documentation. http://www.ers.usda.gov/data-products/food-desert-locator/documentation.aspx. Accessed November 21, 2012.
- United States Department of Commerce. Percent urban and rural in 2010 by state and county [XLS]. 2010 Census urban and rural classification and urban area criteria. http://www.census.gov/geo/reference/urban-rural-2010.html. Updated January 30, 2013. Accessed February 14, 2013.
- US Department of Commerce Economic and Statistical Administration. US Census Bureau. North Carolina — core based statistical areas, counties, and independent cities, November 2004. http://www2.census.gov/geo/maps/metroarea/stcbsa_pg/Nov2004/cbsa2004_NC.pdf.
- North Carolina Department of Commerce. 2011 County tier designations. http://www.nccommerce.com/research-publications/incentive-reports/2011-county-tier-designations. Accessed May 23, 2012.
- Bridging the Gap Community Obesity Measures Project: policy coding protocol. Chicago (IL): University of Illinois at Chicago, Institute for Health Research. Updated March 23, 2012.
- Cohen J. Statistical power analysis for the behavioral sciences, 2nd edition. Hillsdale (NJ): Lawrence Erlbaum Associates; 1988.
- Evenson KR, Aytur SA, Satinsky SB, Rodriguez DA. Barriers to municipal planning for pedestrians and bicyclists in North Carolina. N C Med J 2011;72(2):89–97. PubMed