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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.

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