Ecological approaches to creating healthy local food environments in the United States: Push and pull forces

After more than a decade of research in the area of public health, there is evidence that, at least in the United States, disparities in access to food exist as a function of area wealth and racial composition. Although the measured impact of these disparities on dietary intake and health has limitations, some studies that have been conducted demonstrate the importance of equitable access to healthy foods. As we enter the next decade of research, investigators are challenged to conduct studies that will provide policy makers with evidence to support new legislation (e.g., city zoning requirement for food retailers, federal tax incentives for chain supermarkets to locate in restricted food environments, and/or policies that help small retailers carry perishable food products) that will improve public health nutrition and diet-related disease rates through the modification of local food environments. In spite of the limitation in current knowledge, many government, community-driven groups, and academics have used the precautionary principle to move forward and take action to improve many local food environments across the United States.