Zoning regulations can be used to limit or ban fast food outlets in certain areas of a city, restrict the number of fast food outlets in a city overall, restrict the density of fast food outlets in a given area, or regulate the distance between fast food outlets and other sites such as schools or hospitals1. Frequent consumption of food from fast food chain restaurants may contribute to cardiovascular disease, type 2 diabetes, and obesity2.
Expected Beneficial Outcomes (Rated)
Improved food environment
Other Potential Beneficial Outcomes
Improved dietary choices
Evidence of Effectiveness
Zoning regulations that limit fast food outlets are a suggested strategy to improve the food environment and encourage healthy eating1, 3. In some cases, living in areas with many fast food outlets is associated with higher body mass index (BMI) for adults4 and among African-Americans, especially those with lower incomes5. Living in neighborhoods with a high density of fast food and unhealthy food options is associated with greater fast food consumption, especially among individuals with low incomes and adolescent males6, 7 and increased obesity rates8. Fast food restaurant density is also associated with increased prevalence of Type 2 diabetes, cardiovascular disease, and stroke, although the effects of individual fast food restaurants are small9. In other studies, however, fast food outlet density has not been associated with overweight and obesity10 and availability is not associated with consumption frequency or body mass index11, 12. Additional evidence is needed to confirm effects.
Available evidence suggests fast food restaurants near schools is associated with higher obesity risk among urban schoolchildren13 and in general, proximity to schools is associated with increased fast food purchases and obesity rates among adolescents14, 15, 16, 17.
Zoning regulations that only alter geographic access to food outlets may promote equitable access to healthy food and improve nutrition, however, such policies may not be the most effective way to address high rates of adult obesity18. One model suggests zoning regulations to reduce fast food availability may not change unhealthy eating behaviors, rather interventions to address healthy eating norms and increase visibility of healthy options may be more effective19. Zoning regulations in South Los Angeles have not been associated with improvements in the overall food environment, residents’ diet, or obesity rates20. Experts suggest the South Los Angeles regulation is too narrow to reduce availability of unhealthy foods or increase access to affordable healthy foods, and a more comprehensive policy may be more effective20, 21.
Reports suggest predominantly black neighborhoods have more access to fast food restaurants, especially in neighborhoods with higher levels of poverty22. Fast food restaurants are more prevalent in low income areas than in middle to higher income areas4.
Impact on Disparities
One 2015 report found 77 US communities with 100 proposed policies and zoning regulations for fast food. Roughly 80% of those policies focus on protecting community aesthetics, while 20% aim to improve community nutrition and the food environment. The report suggests that policies to address the food environment and to improve community nutrition face more opposition and are generally less successful than policies proposed to protect community aesthetics23.
Some cities have passed zoning regulations to change the food environment. For example, Arden Hills, Minnesota24 and Detroit, Michigan have regulations that require a minimum distance of 500 feet between fast food outlets and schools25. In 2008, Los Angeles passed a one year moratorium on opening or expanding fast food establishments in South Los Angeles26.
Other smaller municipalities have additional zoning regulations, including prohibiting fast food restaurants to preserve the character of a downtown district. For example, Concord, Massachusetts; Carlsbad, California; and Newport, Rhode Island have bans on fast food and drive-through outlets, and Calistoga, California bans formula restaurants. Some cities have also passed zoning ordinances to regulate the density of fast food restaurants as in Bainbridge Island, Washington; the Westwood Village area of Los Angeles, California; and the Town of Warner, New Hampshire24.
The Association of State and Territorial Health Officials (ASTHO), a national nonprofit representing public health agencies across the country, supports the use of zoning regulations to limit unhealthy food availability through fast food and other retail outlets, especially near schools27.
In Canada, as of 2016, 27 municipalities have adopted fast food zoning regulations that prohibit fast food drive-throughs; 22 municipalities have partial bans and 5 have adopted full bans28.
ChangeLab-Healthy school food zone - ChangeLab Solutions. Creating a healthy food zone around schools: A fact sheet about supporting schools’ nutrition efforts.
ChangeLab-Model HFZ - ChangeLab Solutions. Model healthy food zone (HFZ) ordinance: Enacting zoning measures to ensure healthier food options near schools.
ChangeLab-Licensing & Zoning - ChangeLab Solutions. Licensing & Zoning Guide: Tools for public health.
PAS-Zoning 2016 - Planning Advisory Service (PAS). Planning & zoning for health in the built environment. American Planning Association (APA); 2016.
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1 CDC-Healthy places zoning - Centers for Disease Control and Prevention (CDC). Healthy places: Zoning.
2 Jaworowska 2013 - Jaworowska A, Blackham T, Davies IG, Stevenson L. Nutritional challenges and health implications of takeaway and fast food. Nutrition Reviews. 2013;71(5):310–8.
3 Mair 2005 - Mair JS, Pierce MW, Teret SP. The use of zoning to restrict fast food outlets: A potential strategy to combat obesity. Baltimore: Center for Law and the Public’s Health, Johns Hopkins University, Georgetown University; 2005.
4 Fleischhacker 2010 - Fleischhacker SE, Evenson KR, Rodriguez DA, Ammerman A. A systematic review of fast food access studies. Obesity Reviews. 2011;12(5):e460–71.
5 Reitzel 2014 - Reitzel LR, Regan SD, Nguyen N, et al. Density and proximity of fast food restaurants and body mass index among African Americans. American Journal of Public Health. 2014;104(1):110-116.
6 Boone-Heinonen 2011 - Boone-Heinonen J, Gordon-Larsen P, Kiefe CI, et al. Fast food restaurants and food stores: Longitudinal associations with diet in young to middle-aged adults: The CARDIA study. Archives of Internal Medicine. 2011;171(13):1162–70.
7 Forsyth 2012 - Forsyth A, Wall M, Larson N, Story M, Neumark-Sztainer D. Do adolescents who live or go to school near fast-food restaurants eat more frequently from fast-food restaurants? Health & Place. 2012;18(6):1261–9.
8 Cooksey-Stowers 2017 - Cooksey-Stowers K, Schwartz MB, Brownell KD. Food swamps predict obesity rates better than food deserts in the United States. International Journal of Environmental Research and Public Health. 2017;14(11).
9 Mazidi 2018 - Mazidi M, Speakman JR. Association of fast-food and full-service restaurant densities with mortality from cardiovascular disease and stroke, and the prevalence of diabetes mellitus. Journal of the American Heart Association. 2018;7(11).
10 Viola 2013 - Viola D, Arno PS, Maroko AR, et al. Overweight and obesity: Can we reconcile evidence about supermarkets and fast food retailers for public health policy? Journal of Public Health Policy. 2013;34(3):424–38.
11 Richardson 2011 - Richardson AS, Boone-Heinonen J, Popkin BM, Gordon-Larsen P. Neighborhood fast food restaurants and fast food consumption: A national study. BMC Public Health. 2011;11(1):543.
12 Hickson 2011 - Hickson DA, Diez Roux AV, Smith AE, et al. Associations of fast food restaurant availability with dietary intake and weight among African Americans in the Jackson Heart Study, 2000-2004. American Journal of Public Health. 2011;101(Suppl 1):S301–9.
13 Jia 2019 - Jia P, Xue H, Cheng X, Wang Y. Effects of school neighborhood food environments on childhood obesity at multiple scales: A longitudinal kindergarten cohort study in the USA. BMC Medicine. 2019;17(1).
14 Alviola 2014 - Alviola PA, Nayga RM, Thomsen MR, Danforth D, Smartt J. The effect of fast-food restaurants on childhood obesity: A school level analysis. Economics & Human Biology. 2014;12:110-9.
15 Davis 2009a - Davis B, Carpenter C. Proximity of fast-food restaurants to schools and adolescent obesity. American Journal of Public Health. 2009;99(3):505–10.
16 Currie 2010 - Currie J, Vigna SD, Moretti E, Pathania V. The effect of fast food restaurants on obesity and weight gain. American Economic Journal: Economic Policy. 2010;2(3):32–63.
17 Babey 2011 - Babey SH, Wolstein J, Diamant AL. Food environments near home and school related to consumption of soda and fast food. Los Angeles: UCLA Center for Health Policy Research, University of California, Los Angeles (UCLA); 2011.
18 Zenk 2017 - Zenk SN, Tarlov E, Wing C, et al. Geographic accessibility of food outlets not associated with body mass index change among veterans, 2009-14. Health Affairs. 2017;36(8):1433-1442.
19 Zhang 2014a - Zhang D, Giabbanelli PJ, Arah OA, Zimmerman FJ. Impact of different policies on unhealthy dietary behaviors in an urban adult population: An agent-based simulation model. American Journal of Public Health. 2014;104(7):1217-1222.
20 Sturm 2015 - Sturm R, Hattori A. Diet and obesity in Los Angeles County 2007-2012: Is there a measurable effect of the 2008 “Fast-Food Ban”? Social Science and Medicine. 2015;133:205-211.
21 Brown 2015c - Brown DR, Brewster LG. The food environment is a complex social network. Social Science and Medicine. 2015;133:202-204.
22 James 2014 - James P, Arcaya MC, Parker DM, Tucker-Seeley RD, Subramanian S V. Do minority and poor neighborhoods have higher access to fast-food restaurants in the United States? Health and Place. 2014;29:10-17.
23 Nixon 2015 - Nixon L, Mejia P, Dorfman L, et al. Fast-food fights: News coverage of local efforts to improve food environments through land-use regulations, 2000-2013. American Journal of Public Health. 2015;105(3):490-496.
24 Mair 2005a - Mair JS, Pierce MW, Teret SP. The city planner’s guide to the obesity epidemic: Zoning and fast food. 2005.
25 Detroit-Zoning - City of Detroit, Michigan. Ordinance No. 9-98 §1, 4-1-98.
26 LA-Ordinance - Los Angeles Department of City Planning. Ordinance 180103: Proposed fast food interim control ordinance (ICO) boundary. Los Angeles: Los Angeles Department of City Planning; 2007.
27 ASTHO-Healthy eating - Association of State and Territorial Health Officials (ASTHO). Healthy eating position statement: ASTHO supports state efforts to increase the availability of healthy foods and supports the following recommendations for state and territorial public health agencies.
28 Nykiforuk 2018 - Nykiforuk CIJ, Campbell EJ, Macridis S, et al. Adoption and diffusion of zoning bylaws banning fast food drive-through services across Canadian municipalities. BMC Public Health. 2018;18(1).
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