Roles of Cities in Creating Healthful Food Systems

Abstract

Over the past several decades, cities worldwide have attempted to reconfigure their food systems to improve public health, advance social justice, and promote environmental resilience using diverse municipal policies, often with the support of stakeholder-led governance mechanisms such as food policy councils. This article reviews the roles that cities have played in creating healthful urban food systems and the effects of those policies on public health. It explains that despite wide-ranging policy initiatives, disparities in food insecurity and malnourishment persist. It concludes by describing several promising pathways for urban food policy: engaging in food-focused urban planning to create equitable food environments; treating policies to address inequality and social justice as upstream food policies; considering the effects of new business models such as online food retail in urban food policy making; and using food procurement as a lever to influence regional, national, and global food systems. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Toward Heart-Healthy and Sustainable Cities: A Policy Statement From the American Heart Association

“…125 Many city food action plans focus on multilayered levers, some addressing the demand side through dietary interventions, others addressing food and nutrition insecurity and supply chain disruptions, and a third set of strategies addressing food supply through diverse mechanisms, including school lunch meals, procurement, food service guidelines, standards in workplaces, promotion of urban gardening, communitysupported agriculture, and farmers markets, which connect local-regional food producers with consumers living in urban areas. 37,[126][127][128][129][130][131][132][133] The evidence is clear that neighborhood racial and socioeconomic disparities are also associated with disparities in access to nutritious foods, the density of convenience stores selling unhealthy foods, and the extent of outdoor food product marketing. 134,135 Studies have been mixed, however, on how access to nutritious food may affect diet quality 136,137 and shape cardiometabolic and other health outcomes.…”

The Driving Role of Food and Cultivated Land Resource in Balancing the Complex Urban System of Socio-Economy and Environment: A Case Study of Shanghai City in China

“…Based on the simulation results, this paper attaches importance to agriculture and proposes the following suggestions for Shanghai city and other metropolises worldwide with tense cultivated land resources and food security capacity to improve sustainability. Food-focused urban planning has already been recommended in some countries [45].…”

Strategies to Assess and Enhance the Community Food Environment

“…CFEs support community FNS by strategically addressing opportunities for improvement in healthy food availability, affordability, accessibility, and acceptability. Local governments, nonprofits, and community organizations address this by improving food availability through food retail and markets, increasing enrollment in food benefit programs and incentives for healthy food, and implementing policies such as menu labeling, marketing restrictions, and ingredient bans and taxes (Cohen, 2022). Grassroots and community-based movements and interventions may inform meaningful policies that address community need, reinforcing the importance of community involvement in healthy food access projects (Dubowitz et al, 2015).…”

“…Through policies such as menu labeling, marketing restrictions, ingredient bans (e.g., trans fats or excess sodium), and sugar taxes, there may be a decrease in the availability of unhealthy foods in CFEs. However, the policies' effects on eating behavior are not well understood (Cohen, 2022).…”