Disparities in Healthy Food Zoning, Farmers\u27 Market Availability, and Fruit and Vegetable Consumption Among North Carolina Residents

Background: Context and purpose of the study. To examine (1) associations between county-level zoning to support farmers\u27 market placement and county-level farmers\u27 market availability, rural/urban designation, percent African American residents, and percent of residents living below poverty and (2) individual-level associations between zoning to support farmers\u27 markets; fruit and vegetable consumption and body mass index (BMI) among a random sample of residents of six North Carolina (NC) counties. Methods: Zoning ordinances were scored to indicate supportiveness for healthy food outlets. Number of farmers\u27 markets (per capita) was obtained from the NC-Community Transformation Grant Project Fruit and Vegetable Outlet Inventory (2013). County-level census data on rural/urban status, percent African American, and percent poverty were obtained. For data on farmers\u27 market shopping, fruit and vegetable consumption, and BMI, trained interviewers conducted a random digit dial telephone survey of residents of six NC counties (3 urban and 3 rural). Pearson correlation coefficients and multilevel linear regression models were used to examine county-level and individual-level associations between zoning supportiveness, farmers\u27 market availability, and fruit and vegetable consumption and BMI. Results: At the county-level, healthier food zoning was greater in more urban areas and areas with less poverty. At the individual-level, self-reported fruit and vegetable consumption was associated with healthier food zoning. Conclusions: Disparities in zoning to promote healthy eating should be further examined, and future studies should assess whether amending zoning ordinances will lead to greater availability of healthy foods and changes in dietary behavior and health outcomes

Disparities in healthy food zoning, farmers' market availability, and fruit and vegetable consumption among North Carolina residents

Background: Context and purpose of the study. To examine (1) associations between county-level zoning to supportfarmers" market placement and county-level farmers" market availability, rural/urban designation, percent AfricanAmerican residents, and percent of residents living below poverty and (2) individual-level associations between zoningto support farmers" markets; fruit and vegetable consumption and body mass index (BMI) among a random sample ofresidents of six North Carolina (NC) counties.Methods: Zoning ordinances were scored to indicate supportiveness for healthy food outlets. Number of farmers"markets (per capita) was obtained from the NC-Community Transformation Grant Project Fruit and Vegetable OutletInventory (2013). County-level census data on rural/urban status, percent African American, and percent poverty wereobtained. For data on farmers" market shopping, fruit and vegetable consumption, and BMI, trained interviewersconducted a random digit dial telephone survey of residents of six NC counties (3 urban and 3 rural). Pearsoncorrelation coefficients and multilevel linear regression models were used to examine county-level and individual-levelassociations between zoning supportiveness, farmers" market availability, and fruit and vegetable consumptionand BMI.Results: At the county-level, healthier food zoning was greater in more urban areas and areas with less poverty.At the individual-level, self-reported fruit and vegetable consumption was associated with healthier food zoning.Conclusions: Disparities in zoning to promote healthy eating should be further examined, and future studiesshould assess whether amending zoning ordinances will lead to greater availability of healthy foods and changesin dietary behavior and health outcomes

Availability of Farmers’ Markets and Supplemental Nutrition Assistance Program/Electronic Benefit Transfer Systems and Associations With Rurality, Poverty, Race/Ethnicity, and Obesity Among North Carolina Counties

Increasing the number of farmers’ markets and implementing Electronic Benefit Transfer (EBT) systems for the Supplemental Nutrition Assistance Program (SNAP) at more farmers’ markets have been suggested as strategies to overcome food access issues, but little is known about their availability in the rural South. This study examines differences in availability of farmers’ markets and SNAP/EBT at markets by county-level rural/urban classification, percentage poverty, percentage racial/ethnic minority, and percentage obese residents in North Carolina counties. Data were collected using a cross-sectional survey. Though results related to rurality and economic status are mixed, regression analyses indicate that the percentage of African American residents is inversely associated with the number of markets and number of markets that accept EBT. Results suggest that access to farmers’ markets varies in North Carolina, and additional research is needed to determine whether this impacts obesity