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

      research-article
      , MPH, , PhD , , PhD, MHS
      Preventing Chronic Disease
      Centers for Disease Control and Prevention

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          Abstract

          Introduction

          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.

          Methods

          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.

          Results

          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.

          Conclusion

          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.

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          Most cited references13

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          Environmental contributions to the obesity epidemic.

          The current epidemic of obesity is caused largely by an environment that promotes excessive food intake and discourages physical activity. Although humans have evolved excellent physiological mechanisms to defend against body weight loss, they have only weak physiological mechanisms to defend against body weight gain when food is abundant. Control of portion size, consumption of a diet low in fat and energy density, and regular physical activity are behaviors that protect against obesity, but it is becoming difficult to adopt and maintain these behaviors in the current environment. Because obesity is difficult to treat, public health efforts need to be directed toward prevention.
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            Supermarkets, other food stores, and obesity: the atherosclerosis risk in communities study.

            Obesity is a leading public health concern, and although environmental factors have been hypothesized to play a role in the prevention of obesity, little empirical data exist to document their effects. The purpose of this study was to examine whether characteristics of the local food environment are associated with the prevalence of cardiovascular disease risk factors. A cross-sectional study of men and women participating in the third visit (1993-1995) of the Atherosclerosis Risk in Communities (ARIC) Study was conducted in 2004. The analyses included 10,763 ARIC participants residing in one of the 207 eligible census tracts located in the four ARIC-defined geographic areas. Names and addresses of food stores located in Mississippi, North Carolina, Maryland, and Minnesota were obtained from departments of agriculture. Multilevel modeling was used to calculate prevalence ratios of the associations between the presence of specific types of food stores and cardiovascular disease risk factors. The presence of supermarkets was associated with a lower prevalence of obesity and overweight (obesity prevalence ratio [PR] = 0.83, 95% confidence interval [CI] = 0.75-0.92; overweight PR = 0.94, 95% CI = 0.90-0.98), and the presence of convenience stores was associated with a higher prevalence of obesity and overweight (obesity PR = 1.16, 95% CI = 1.05-1.27; overweight PR = 1.06, 95% CI = 1.02-1.10). Associations for diabetes, high serum cholesterol, and hypertension were not consistently observed. Results from this study suggest that characteristics of local food environments may play a role in the prevention of overweight and obesity.
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              Obesity prevalence and the local food environment.

              Disparities in access to healthy foods have been identified particularly in the United States. Fewer studies have measured the effects these disparities have on diet-related health outcomes. This study measured the association between the presence of food establishments and obesity among 1295 adults living in the southern region of the United States. The prevalence of obesity was lower in areas that had supermarkets and higher in area with small grocery stores or fast food restaurants. Our findings are consistent with other studies showing that types of food stores and restaurants influence food choices and, subsequently, diet-related health outcomes.
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                Author and article information

                Journal
                Prev Chronic Dis
                Prev Chronic Dis
                PCD
                Preventing Chronic Disease
                Centers for Disease Control and Prevention
                1545-1151
                2013
                5 December 2013
                : 10
                : E203
                Affiliations
                [1]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.
                Author notes
                Corresponding Author: Stephanie B. Jilcott Pitts, PhD, Associate Professor, Department of Public Health, Brody School of Medicine, East Carolina University, 600 Moye Blvd, MS 660, Greenville, NC 27834. Telephone: 252-744-5572. E-mail: jilcotts@ 123456ecu.edu .
                Article
                13_0196
                10.5888/pcd10.130196
                3854873
                24309091
                cea6fad0-801f-4f62-be02-7fc24d9104cb
                History
                Categories
                Original Research
                Peer Reviewed

                Health & Social care
                Health & Social care

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