State Legislation Encourages Healthy Food Choices

September 04, 2019 | ASTHO Staff

The environment in which we live, work, and play contributes to our eating habits making "you are where you eat" just as important as the more familiar adage. Our surroundings can make healthy eating choices difficult, especially when nutritious foods are costly and unavailable and unhealthy foods are abundant and accessible. Over 23 million people in the United States live in "food deserts," or low-income neighborhoods that are more than one mile from a supermarket or large grocery store and often home to less nutritious, inexpensive food choices such as fast-food restaurants. 

To remedy the negative impacts of our food environment, state policymakers have encouraged healthier eating and drinking habits by incentivizing behavior change, making healthy choices more available, and discouraging unhealthy choices. Two areas of in which policymakers have tended to focus these efforts are farmers markets and sugar-sweetened beverages.

Recent legislative trends related to farmers markets include:

• Shifting public subsidy support from highly processed foods and beverages to healthier foods, especially fruits and vegetables.
• Increasing access to affordable fresh fruits, vegetables, and other natural food products through commodity programs.
• Supporting healthy foods in food assistance programs.

Meanwhile, many states are incentivizing healthy beverage choices by:

• Limiting consumption of sugar-sweetened beverages by children at restaurants.
• Requiring warning labels on sugar-sweetened beverages.
• Using cost deterrents at the point of purchase of sugar-sweetened beverages.

Farmers Markets

This year, several states enacted legislation to increase access to healthy foods incentives linked to state and/or federal food assistance programs. Colorado's governor signed legislation updating the purpose and duties of the Colorado Food Systems Advisory Council to include growing local, regional, and statewide food economies within which low-income populations have access to fresh, affordable, and healthy food. One way in which the council is directed to do this is by connecting agricultural producers to federal food assistance programs.

In Hawaii, a new law establishes a local healthy food incentive program for  supplemental nutrition assistance program (SNAP) recipients. SNAP recipients participating in the program receive a dollar-for-dollar match of up to 20 dollars per visit to be used for the purchase of Hawaii-grown fresh fruits and vegetables at specified locations including farmers' markets and farm stands. Maine's governor signed a bill providing additional funding to the Maine Center for Disease Control and Prevention to expand the use of the Women, Infants, Children Supplemental Food Program (WIC) at farmers' markets.

In Maryland, a new law (SB 483 and HB 84) directs the Maryland Farms and Families Fund to provide grants to nonprofit organizations and nonprofit farmers markets. Nonprofits that receive grants are required to distribute 70 percent of the grant money directly to participating famers markets as matching dollars for purchases made with SNAP, WIC, or federal Farmers Market Nutrition Program (FMNP). The legislative intent of these bills is to increase the purchasing power of food-insecure residents with limited access to fresh fruits and vegetables and increase revenue for farmers through redemption of federal nutrition benefits at farmers markets.

New Jersey's governor signed a bil establishing a program to provide residents of food desert communities with access to fresh and affordable produce. The department of agriculture is required to select partnering providers to establish weekly markets in three food desert communities, one of which must be in a rural area. The partnering providers must accept cash, credit, debit, and food vouchers for produce and offer reduced price produce packages.

Finally, while not enacted, Pennsylvania's legislature considered a bill authorizing the department of agriculture to award grants for the purpose of developing or expanding farmers’ markets. Grants may be used to conduct outreach to increase participation in existing food assistance programs and establishing satellite locations of existing farmers’ markets designed to increase sales in underserved areas. 

Sugar-Sweetened Beverages

Four states introduced legislation regulating the inclusion of sugar-sweetened beverages in children’s meals at restaurants. Delaware enacted a new law requiring state food safety standards for restaurants that include a system for offering healthy beverages as the default in children’s meal. Hawaii adopted a bill to require restaurants serving children’s meals to offer as a default beverage the following: water, sparkling water, or flavored water with no added natural or artificial sweeteners; unflavored milk; or nondairy milk. New Jersey considered a bill with similar language. Customers may choose, and restaurants may sell a substitute to the default beverage.

Massachusetts introduced similar bills (H 1947, H 2858, and S 1291) allowing the sale of children’s meals at restaurants only if the default beverage is one of the following: water, sparkling water, or flavored water with no added natural or artificial sweeteners; nonfat, one percent, or nondairy milk; or 100 percent juice with no added sweeteners. The bills would also require sugary drink advertisement to include a warning label about the health risks of added sugar. Containers or packages, menus, displays, and logos on vehicles would be exempt from the warning label requirement.

California's legislature is considering legislation to prohibit a person from distributing, selling, or offering for sale a sugar-sweetened beverage in a sealed beverage container, a multipack of sugar-sweetened beverages, or a concentrate unless they bear a consumer warning. The bill would also require every person who owns, leases, or legally controls the premises where a vending machine or beverage dispensing machine is located, or where a sugar-sweetened beverage is sold in an unsealed container, to place a specified consumer warning in certain locations.

Finally, companion bills in Massachusetts (H 2529 and S 1709) would impose an excise tax on every distributor of bottles sugary drinks, syrups, or powders. Beverages, including those made from syrup or powder, with 7.5 grams of sugars or less per 12 fluid ounces would not be taxed. Beverages with more than 7.5 grams but less than 30 grams of sugars per 12 fluid ounces would be taxed at $0.01 per ounce. Beverages with 30 grams of sugar or more per 12 fluid ounces would be taxed at $0.02 per ounce.

State and territorial health agencies have an opportunity to promote healthier eating and lifestyles, reduce healthy food disparities by increasing availability and access, and make the healthy choice a possible or easier choice for everyone. Health agencies can also foster partnerships with agricultural departments, consumers, the food and beverage industry, local producers, and the restaurant industry and support efforts to improve overall nutrition among their populations.