The smart growth movement has changed the fabric and landscape of our cities and towns. Those changes have shaped communities that offer many potential health benefits to residents, including enhanced walkability, gathering places that promote social connection and good mental health, and improved air quality because of reduced auto dependency.

Evidence suggests that the built environment—the places we live, work, and play—has a profound influence on health. Some of these connections are more immediately evident than others, and some are easier to promote than others. For example, practitioners have acquired a sophisticated understanding of the health benefits of a walkable, bikeable environment and work to include these amenities in new development plans, whether infill or greenfield development.

An emerging issue in the smart growth field is the link between a healthy food environment and good land use planning. Although less obvious than walkability or bikeability, the connection between land use planning decisions and the food environment is profound. And while the problem is not one that is entirely framed within a land use context, there are important land use considerations to creating an optimal food environment. Studies have found that the issue is especially critical in low-income neighborhoods, which often suffer disproportionate impacts from disinvestment and poor land use planning. These policies—whether intentional or through neglect—have resulted in the creation of “food deserts”: residential neighborhoods that lack ready access to the components of a fresh and healthful diet.

Trading Fast Food for Grocery Stores

It is well-documented that supermarkets followed the middle-class migration to the suburbs in the postwar years. More recently, an increasingly competitive and multinational supermarket industry has caused supermarkets to increase their footprints to allow for a wider variety of goods and services. These larger stores require acres of land to accommodate parking and structures, land which is rarely available within existing “built-out” communities or even within walking distance of residential neighborhoods. Older, urban stores, smaller and more expensive to operate, are subject to closure. Small markets, which in another era offered a comprehensive array of goods, have been recast as “convenience” markets, and frequently rely on the sales of alcohol, tobacco, and packaged junk foods—high profit and low spoilage—to stay afloat, reducing the shelf space available for more traditional grocery items. In some communities, immigration has changed the cultural dietary preferences of the population as well.

In communities where grocery stores have become scarce, it is common to see fast-food restaurants filling the food retail void. For households with inadequate access to transportation and limited budgets, fast food can be a primary food source in these neighborhoods. A recent study in Chicago linked an “imbalanced food environment” (where the number and location of fast-food outlets was greater than the number and location of grocery stores) with increased body mass index (a measurement that can indicate obesity and overweight).

The cumulative impact of these environmental components—scarce grocery stores, plentiful fast food, and limited access to physical activity—is manifested in the obesity epidemic and its many corollary diet-related diseases, such as increased rates of high blood pressure, heart disease, diabetes, and premature deaths. Simply put, obesity is caused by a lack of physical activity and intake of too many calories. We know a great deal about how to improve opportunities for people to be more physically active; what can be done about the food environment?

Revising Code to Improve Food Access

In fact, cities and counties can do quite a lot. Communities have begun to explore land use strategies for limiting the number and density of fast food and other restaurants, for improving the nutritional content and variety of foods sold in small corner stores, and for supporting the establishment of farmers’ markets, community gardens, and full-service supermarkets. Jurisdictions have amended their comprehensive plans and zoning codes to reflect the importance of and to support the enhancement of healthy food access. Building on trip-generation data that concludes that most trips are non-work trips, communities have begun to recognize that providing an environment that supports accessible services that are essential for community health, like healthy food retail, not only promotes a smart growth agenda of reducing private vehicle trips but can improve public health.

The connections between zoning and a healthy food environment may seem tenuous, but in fact they can be direct and unambiguous. For example, the city of Fresno, California, has on its books a neighborhood commercial zoning designation which prohibits the sale of produce and meat or the siting of grocery stores, while allowing the sale of tobacco and candy. Sacramento, California, prohibits growing food in front yards. Communities seeking to maintain neighborhood character by managing scale within business districts may impose square foot limitations on retail businesses that are too small for the siting of grocery stores. Bans on sidewalk obstructions eliminate sidewalk displays of produce. Zoning may render infeasible or even prohibit the establishment of farmers’ markets, and restrictions on urban farming may disallow the creation of community gardens. Even where zoning does not explicitly ban a specific food retail activity, without clear zoning language that encourages or supports food retail, uses like community gardens and farmers’ markets may be seen as “informal” or nonofficial, providing less stability for these activities over the long term.

Advocates and policy makers have begun to address zoning impediments to healthy food access. In San Francisco, when rezoning threatened neighborhood food access, a special use district was created that expressly encouraged the siting of a supermarket. A supermarket anchors what is today a successful shopping center that is readily accessible by foot, bike, or transit, as well as by automobile.

In Sacramento, advocates are working to overturn the prohibition against growing food in front yards. In other jurisdictions, legislation has been enacted that bans or restricts fast-food restaurants, usually structured as a restriction on formula restaurants or formula retail to protect community character. However, New York City Councilman Joel Rivera, who chairs the New York City Council Health Committee, has proposed zoning changes to limit the number of fast-food establishments in that city to fight chronic obesity, especially in poor neighborhoods.1

Comprehensive Planning in California

Two northern California jurisdictions offer good examples of how smart growth principles can be linked with food access in guidance documents such as comprehensive plans. Marin County and the city of Benicia both undertook comprehensive plan updates that address public health and food access.

Marin County’s freshly minted plan takes a radical new approach to land use policy. Instead of the traditional California elements such as “Land Use” and “Housing,” Marin’s plan is organized under headings that include “Natural Systems and Agriculture,” “Built Environment,” and “Socioeconomic.” The introduction to the plan explains that its scope “has been revised to reflect the theme of planning sustainable communities.” Throughout the plan, this theme is expressed through language and policies that promote denser development that is accessible by transit, and protection of agricultural and open space resources.

The Socioeconomic Element takes these multifaceted smart growth issues and links them to the specific needs of the population of the county, including food access issues. In this element, the county “focuses on the people of Marin County and seeks to reinforce the complex connections between individual well-being, economic prosperity, community involvement, and cultural richness.” This focus includes a Public Health section, which reports that “Marin shares in the national obesity epidemic” and states that “factors contributing to obesity include…community environments that make it difficult to access healthy foods….”

The county has an implementation goal that includes supporting “neighborhood-oriented, specific sources of healthful foods such as farmers’ markets and local outlets.” This action plan takes the issue of food access and addresses it in a neighborhood-oriented, smart growth manner.

When the c ity of Benicia undertook its plan update a few years ago, the citizens’ advisory committee that was appointed by the city council included individuals with backgrounds in planning as well as in health. Sustainability became a guiding principle. One member advocated for a strong focus on walkability, while others worked for a stronger health focus. The result included a section called “Dimensions of Optimal Health” which identified hunger as a component of the social environment. The city seeks to address the issue of hunger with a policy that “Promotes the establishment of demonstration gardens at schools, churches, fire stations, and other sites” and instructs the city leadership to “consider utilizing vacant city property for gardening of fruits and vegetables.”

Communities that have enhanced walkability/bikeability by implementing smart growth principles have focused on the “Three D’s”: Density, Diversity, and Design (and perhaps even a “fourth D”: Destinations). The underlying principles of good design, safety, and mixed-use also apply to creating an environment that supports healthy food retail. For example, allowing for mixed-use could potentially increase the number of locations available for food retail in a community. However, the emphasis in this context rests less on design and more on ensuring that land use regulations support and encourage the kinds of healthy food retail activities that communities need to make balanced food choices.

As with any land use strategy, it is important to undertake an effort to improve the food access environment with the understanding that land use change is prospective and happens over a long time period. A comprehensive plan update or zoning amendment may take several years to complete, and change “on the ground” may not be seen for years or decades beyond. Over the long term, however, local government leadership who incorporate healthy food access into their smart growth agendas can anticipate an improved food environment in which people have the opportunity to make more nourishing food choices.


1. At this writing, the author is not aware of any jurisdictions that have enacted fast-food restrictions for nutritional reasons. While research out of John Hopkins University advocates such a strategy, there is reason to proceed with caution in enacting a restriction based on nutritional findings. Many restaurants that do not meet the definition of a fast-food restaurant serve food that does not offer nutritional advantages over the offerings of traditional fast food. It may be more defensible to impose restrictions on all restaurant food that does not meet an established nutritional standard.

Lisa Feldstein is the Public Health Law Program’s Senior Policy Director and Director of the Land Use and Health Program. She is the author of General Plans & Zoning: A Toolkit on Land Use and Health, and is coauthor of the forthcoming Redevelopment & Economic Development: A Toolkit on Land Use and Health. Lisa may be reached at [email protected].