Planning for Healthy Neighborhoods

Including Healthy Food Infrastructure in the EIS/EA

Process

Environmental Impact Assessment

GEOG 5960

Alexandra Parvaz
April 27, 2010

GEOG 5963
University of Utah
 This paper seeks to explore and analyze a recommendation made on behalf of the
President of the Manhattan Borough that local governments, city planners and policy
makers should consider more proactive measures towards ensuring community health and
well-being through the lens of the city planning, zoning and the development permit
process (1. Stringer, 4th paragraph) . By carefully examining how our cities are designed
and how the built environment or proposed development projects can exacerbate
problems such as obesity/diabetes epidemics, we can better understand local
environmental factors and apply measures to manage and take a preventative medicine
approach.

Prevalence of Obesity and the influence of the Retail Food

Environment
Over the past two decades, the United States has followed a sobering trajectory
towards an unhealthy diet crisis. As shown below in the graph composed by the Centers
of Disease Control, one can see that the incidence of obesity has dramatically increased
in some states that have rapidly escalated from an initial 10% incidence to a startling near
25-30% prevalence in only 18 years (“Overweight and Obesity”). Nearly one third
of all US children and adolescents are considered overweight, having more than doubled
since the 1970s by enhancing morbidity and mortality in the U.S, obesity has become
the second leading preventable cause of disease and death in the United States, second
only to tobacco use (Wang, 22). Out of all 50 states, Mississippi has emerged by far as
the most obese state in the country (“Mississippi tops U.S. Obesity Ranking”). The map
below provides a shocking illustration of the expanse of the disease.
 Obesity Trends* Among U.S. Adults
BRFSS, 1990, 1999, 2008

1990 1999

2008

Figure 1. Source: CDC Behavioral Risk Surveillance System

No Data <10% 10%–14% 15%–19% 20%–24% 25%–29%
≥30%

Another alarming health trends is the increasing rates of diabetes, in particular

type 2 diabetes, a chronic version of the disease which for many people who suffer from
it, develop the disease due to lifestyle habits an. Excessive consumption of unhealthy,
highly processed sugary foods, inactivity and excess weight gain all enhance one’s risk
for developing the diseases as well as several other severe illnesses like coronary heart,
cancer, arthritis and hypertension. Nearly 23 million Americans, 7% of the entire
population suffers from the illness, and ranked the seventh leading cause of death in the
U.S in 2006 (“Diabetes Statistics”, Segal paragaph 3).

As one analyzes these disconcerting health profiles, one detects health disparities
among income, race and the incidence of the disease. Rates of disease prevalence have
been highest among people of color and low-income status. Between 2006-2008, African
Americans were more likely to develop obesity than any other race, with 51% higher
prevalence than Caucasians. Some of the contributing factors that have led to these
trends include cost of food items to the point where fresh produce is more expensive than
the less nutritious, highly processed food. In one instance, according to the US
Department of Agriculture, between the years of 1985 and 2000, the cost of fruits and
vegetables jumped to over 120 percent, while soft drinks, fats, sugars and sweets only
increased by less than 50 percent, hence creating a preference for the unhealthy. Cultural
factors also contributes to the trends, referring to what has been called an “obesogenic”
lifestyle in America given cultural and media pressure especially among youth to increase
their consumption and portion sizes of high energy, sugary foods, but minimal physical
exercise which fosters more sedentary behavior (Wung, 24; Davidow paragraph 20).
Still, other potentially more causal factors to the epidemic include the sheer
abundance and close proximity of fast food restaurants versus healthier food options from
grocery stores with respect to an individuals’ homes. Studies have shown disparities in
the availability of fruit and vegetable purveyors especially among minority and low
income populations, revealing 50 to 70% fewer chain supermarkets compared with White
and non-Hispanic neighborhoods, contributing to the higher instance of obesity and
diabetes rates (Wung 24, “Designed for Disease”). In contrast, researchers have
increasing found about the strong association between proximity to healthy food stores in
fostering more healthy diets, and thus higher vegetable intake (Wang 24).

In an effort to examine the association between the location of food retail stores,
also known as “Food Environments” and the risks for obesity and diabetes, researchers
with the California Center for Public Health Advocacy have created an intriguing ration
called the Retail Food Environment Index, an indicator which compares the number of
fast food restaurants in addition to unhealthy convenient stores to the number of more
fresher food purveyors from either a grocery store, supermarket or farmers market. To
achieve a description number for a particular community, the number of these facilities is
counted relative to a 0.5 mile radius of a person’s home in the urban environment. If
measured in a small community, the value increases to 1 mile and if rural; a 5 mile
radius.
The equation is detailed below:

R.F.E.I. = # Fast-Food Restaurants + # Convenience Stores

#Grocery Stores + # Produce Vendors

A value of 2 would indicate that the number of fast food joints is twice as many
likely to be found nearby compared to grocery stores (Designed Disease ,2). An RFEI
below 3 is considered the low end of fast food to grocery ration, while 5 and above is
considered very high. The local R.F.E.I. for a Californian is 4.5, more than 4 times as
many fast food joints for every grocery store or produce vendor near a person’s
residence, therefore suggesting a fairly strong resource situation that explains
susceptibility to bad food choices. Studies have shown that higher RFEI are correlated
with higher prevalence of obesity and diabetes. Studies have also found had also been
conducted showing the relationship between income and the RFEI and health outcome,
revealing that low income communities, who are defined as having an income below
200% of the federal poverty level, are 20% higher compared to those in higher income
areas, showing a clear association (3, 4). To come full circle, another study testing the
relationship between prevalence of obesity and diabetes and adults with high local RFEIs
who also live in low income communities, and demonstrated a correlation. Obesity
prevalence had been found to be 17% higher for lower incomes communities with
R.F.E.Is of 5 or more relative to those whose R.F.E.I.s were less than 3 (5) .
In essence, this study has well demonstrated a strong association between the
proximity of food purveyors and the options that are readily available in the community
and the prevalence of dietary illnesses (6). Hence, these studies carry great import in
arguing that a good strategy for tackling and addressing the obesity/diabetes epidemic is
to embark in improving the retail food environment and thus the shape of one’s
community and urban design/planning. In addition to educational programs and reaching
out to people to change their eating habits, more aggressive measures must seriously be
implemented in strengthening health advocacy efforts by improving the food
environments which would more directly and easily create the conditions for the public to
make healthier food selections (8, Stringer, 2).

Strategies Improving the Retail Food Environment

Some of the suggested ways to improve the retail food environment include
engaging policy makers and city planners who need to recognize how the shape of our
cities and hence the prevalence of crucial building structures such as healthy foods stores
strongly impacts our communities food choices. In this way it is necessary that
environmental and policy interventions be implemented by increasing the availability of
grocery stores and produce vendors in the following ways:

1) Enhance access to healthy foods by providing incentives and new policies to be

made for stimulating the establishment of more local fruit and vegetable markets
particularly in communities in need, the so called “food deserts”. Establish more
farmers markets

2) Change zoning rules to dis-incentivize the fast food chains in favor of

businesses that make a deliberate attempt at improving community health (7).

The Manhattan Burough local government in New York City has taken these
studies very seriously and beginning in 2009, released a proposal for the city to tackle its
own alarming dietary healthy crises by taking proactive measures in looking at the built
environment’s influence on food choices. Under the promotion of the progressive
President of the Manhattan Burough Scot Stringer, the city has employed an similar tool
to the REIF called the FoodStat to help policy makers to assess the severity of their local
food crises.

The FoodStat= # of Bodegas + # Fast food restaurants

# of Supermarkets + Produce vendors
 Exactly like the REIF, the higher the FoodStat, “the worse the mix of retail food
options in a community” (Stringer 4). Among the key benefits Scott Stringer points out
of using these food climate indicators is that they help “institutionalize consideration of
the neighborhood food landscape in policies and programs developed by the City to
improve public health and the urban environment” (Stringer 5). Additionally, by
quantifying a well-known problem, FoodStat encourages the expansion of healthy food
options in neighborhoods where such options are in shortest supply and thus holds higher
standards the services and infrastructure located in any given community to promote
healthy food systems. Having comparative data across neighborhoods will help overall
raise more awareness of the defining local food landscape and help unify efforts through
policy to improve the diets of city residents (Stringer 5).

The Implications for City Planners, governmental

agencies, and augmenting the E.I.S.
With these recommendations in place, a key question to consider now is what,
then are the implications for developers and city planners? Understanding that a healthy
food infrastructure is crucial to ensure the health and quality of life of fellow residents,
Stringer has now called forth for the establishment of more proactive city planning
measures to be implemented to ensure local food systems are protected from any zoning
or development projects that could put them at risk. In this light, Stringer via his 2009
proposal entitled, Planning for Healthy Neighborhoods: Include Food
Infrastructure in the City’s Environmental Review, has announced the
need to ensure that decision-makers like the City Planning
Commission, before approving a development project in a particular
neighborhood, “should be well informed about the impacts of any
development proposal on the local food system” (Stringer, 5).
In an effort to leverage the city’s commitment to enhance food
security and access to healthy produce to particularly at risk, low
income communities, he has suggested that a category called the
“Healthy Food Infrastructure” be incorporated into the City’s
Environmental Quality Review (CEQR) (“Proposal to Include Healthy Food
Infrastructure in Environmental Impact Review”). The CEQR is a process which
measures the negatives impact that proposed developments would have on the
surrounding neighborhood’s resources such as water and air quality and which requires
mitigation measures to be addressed. However under his recommendation, the same
consideration should be given to local food resources which should be considered as an
impact category. Inherent in this proposal is an understanding of the inextricable
linkages between the shape of any given neighborhood and the public health. Before a
permit can be granted to a proposed project in a neighborhood, here must an assessment
of whether this project will affect the communities capacity to access fresh, healthy
produce and where appropriate, identify methods to either mitigate or minimize these
effects.
As part of this assessment, prior to the developer and associated agency in
studying impacts is the first prepare either an Environmental Assessment Statement, to an
Environmental Impact Statement if the proposed development has a direct significant
impact on healthy food infrastructure. When considering where a category regarding
Local Food System impacts in the EIS, the traditional EIS structure already holds offers
several good categories to host it under, either as a subsection to the Community
Facilities, Socio-economic or public Health Sections. However, a local food system
could be even its own section alone, and thus as Stringer says, provide “the technical and
legal basis for questioning food infrastructure during the review of new development
proprosals (2).
Some of the impacts that agencies should consider would relate to direct and
indirect effects, as detailed below (2):

• Direct effects refer to those impacts which would directly harm existing
food resources essential for healthy communities, this couls be int eh
form of displacement of food retailers or for that matter the entities
responsible for provisioning the retailers with food, such as a community
garden, urban agricultural project.
 • Indirect effects relate mores o to local demand on the supply of food. If a
porejct proposes that he population increase which results in more
resource consumers, it is essential to assess whether the local food supply
can even accommodate the food pressures.

The CEQR mandates that the agency first consider thresholds to determine
whether an EA or EIS is warranted. Those projects that would be located within food
insecure neighborhoods would demand stricter scrutiny compared to that of a more
wealthy, ample food community. In addition to using the REIF indicator to determine the
type of community one would be working with and thus get an idea of the type of
analysis to do, agencies are requested to consider the total square footage of supermarket
space to total population. On average, 15,000 sq ft of supermarket space is afforded per
10,000 people. A key goal in trying to enhance local fresh food systems is the enhance
this ratio to 30,000 sq.ft/10,000 residents. In this light, agencies should identify to the
following categories (3):

1) Healthy Food Deficient Neighborhoods-areas also known as “food deserts”

where the market sq. ft. to resident ratio is well below the average. Any
population increase of at least 1% within 0.25 miles of the site would create
enormous strains, hence an EIS required.
2) Healthy Food Undersupplied Neighborhoods-lack adequate healthy food
infrastructure since their citywide average of supermarkets to residents is
below the ideal of 30,000 sq ft/10,000 residents. A population increase of at
least 5% would within 0.25 mile of the site would result in significant impact
and thus warrant an EIS.
3) Healthy Food Sufficient Neighborhoods: Hence, if a neighborhood’s sq
footage to resident ratio is less than the average,

Upon identifying the type of locale to work with next steps would need to consider
factors such as the number, type and location of the food retail stores in vicinity of the
area, as well as looking into the degree of farmers markets, urban agricultural sites and
other sources of fresh food availability (3-4). Once again, critical questions to assess are
the following:
1) Will this project cause direct or indirect barriers to social interaction?
2) Impede access to neighborhoods and services?
3) Will it invoke any Loss of services?

If sever impact is detected, then mitigation measures must be addressed such as the
creation of a new healthy food supplier in the region, enhancing the fresh food supply by
implementing more farmers markets, or reserving retail space for food providers that
would be able to connect with recipients of food stamps.

Case Example:

In the city of Detroit, a region crippled by the economic downtown and suffering from
soaring unemployment rates and social despair, a former stockbroker John Hantz has
sought to help his community. Hantz has invested over $30 million to transform an
urban blighted abandoned area in the heart of the city into a thriving for-profit 50 acre
urban agricultural farm, turning the lot into the largest urban farm in the world. Among
the main goals of this project is to rejuvenate the decaying Detroit into a biologically
productive area where community members can work the land, grow fresh, local
produdc, and all the while “create a viable, beautiful environment that will enhance the
City, attract tourism, increase the tax base, create jobs and greatly improve the quality of
life in Detroit” (Hantz Farms.org). Through the creation of green jobs for Detroit citizens
to grow food year round, he envisions this project enhancing the access to fresh, healthy
produce all the while stimulating the local economy and providing jobs that offer a
livable and meaningful wage to the farmers. Although Hantz has already bought the land
and immediately seeks to hire locally full time positions for planning the area, he also
seeks to receive a free tax –delinquent land, change the zoning adjustment from
residential or commercial property to agriculture, and zoning rules to create a lower tax
rate for agriculture. (Berman paragraph 30, Whitford paragraph 32).
 This case lends itself very well as a good example of a project that may need to
compose an Environmental Assessment in order to get a permit from the City of Detroit
to begin breaking ground. Since it directly relates to urban local food systems, his
agency partners would assess impacts as related to the Healthy Food Infrastructure
resource category.

Conclusion
Overall, the incorporation of a Healthy Food Infrastructure in the City Environmental
Review and for that matter an Environmental Impact Statement would offer a series of
cascading benefits in the form of creating amore holistic and comprehensive assessment
of a project’s impacts on issues which deserve attention. With increasing research
demonstrating the impacts of retail food environments on people’s food choices, we have
come to recognize the need for better designing our cities to make fresh produce more
readily accessible to communities in need. By taking more proactive measures in the
way that a City grants permits for development projects, communities can more easily
achieve the goal of more sustainable, multi-functional, elegant cities that take an
integrated approach to addressing critical social issues.
References:

Berman, Laura. John Hantz envisions vacant Detroit land as a working farm. The Detroit
News: http://www.detnews.com/article/20090723/OPINION03/907230340/1008/John-
Hantz-envisions-vacant-Detroit-land-as-a-working-farm#ixzz0mP3I2nFj, retrieved April
26, 2010.

California's Food Landscape Encourages Obesity: New Research Tools Monitors Retail
Food Environment. http://www.collectiveroots.org/node/761, retrieved April 20, 2010

Davidow, Julie. “The Obesity Crisis: A healthy diet often beyond the means of poor,
hungry” Seattle Post Intelligencer. 2004

Diabetes Statistics. American Diabetes Assocation, http://www.diabetes.org/diabetes-

basics/diabetes-statistics/, retrieved April 23, 2010.

Designed for Disease: The Link Between Local Food Environments and Obesity and
Diabetes. California Center for Public Health Advocacy, Policy Link, and the UCLA
Center for Health Policy Research. April 2008.

“Mississippi tops U.S. obesity rankings” CNNHealth.com.

http://www.cnn.com/2009/HEALTH/07/01/obesity.rankings/index.html, retrieved
April 20, 2010

“Overweight and Obesity: Trends by State 1985-2008”. Centers for Disease Control and
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“Proposal to Include Healthy Food Infrastructure in Environmental Impact Review.” The

Manhattan Minute: Blogging about the Borough. http://mbpo.org/blog_details.asp?
id=178&page=1, retrieved April 20, 2010.

Segal, Laura. “America’s Obesity Epidemic Getting Worse. New Report Finds
Adult Obesity Rates Up in 31 States; The South is the ‘Biggest Belt’”. Trust for
America’s Health. August 29, 2006

Stringer, Scott M. FoodStat: Measuring the Retail Food Environment in NYC

Neighborhoods. Manhattan Borough President Proposal. May 2009

Stringer, Scott. M, Planning for Healthy Neighborhoods: Include Food

Infrastructure in the City’s Environmental Review. President of the Borough of
Manhattan Proposal. June 2009
 Stringer, Scott. “Putting Food Policy on the City’s From Burner.” Huffington Post.
http://www.huffingtonpost.com/scott-stringer/putting-food-policy-on-
th_b_233880.html. July 16, 2009, retrieved April 21, 2010

Wang, Youfa and May A. Beydoun. The Obesity Epidemic in the United States—
Gender, Age, Socioeconomic, Racial/Ethnic, and Geographic Characteristics: A
Systematic Review and Meta-Regression Analysis. Epidemiologic Reviews. Vol. 29,
2007.

Whitford, David. “Can Farming Save Detroit?” CNNMoney.com.

http://money.cnn.com/fdcp?1271662956308. December 29, 2009. Retrieved April 20,
2010.