摘要：Zoning and other land-use policies are a promising but controversial strategy to improve community food environments. To understand how these policies are debated, we searched existing databases and the Internet and analyzed news coverage and legal documentation of efforts to restrict fast-food restaurants in 77 US communities in 2001 to 2013. Policies intended to improve community health were most often proposed in urban, racially diverse communities; policies proposed in small towns or majority-White communities aimed to protect community aesthetics or local businesses. Health-focused policies were subject to more criticism than other policies and were generally less successful. Our findings could inform the work of advocates interested in employing land-use policies to improve the food environment in their own communities. In the face of rising obesity rates, public health advocates have suggested zoning and other land-use policies as a promising approach to fostering healthy food environments. 1–3 Local governments can employ land-use policies to limit the number or location of businesses that sell unhealthy food, such as fast-food restaurants, or to ban these businesses outright. Policies to restrict fast food have been implemented in cities and towns across the country. Some of these policies are public health measures intended to improve community nutrition, but many restrictions on fast food have been passed to protect community aesthetics or the economy. South Los Angeles, California, a low-income and racially diverse area of the city, implemented widely publicized restrictions on fast-food restaurants in 2008 and 2011. The area is home to a high concentration of fast-food restaurants, and the Los Angeles City Council made headlines when it banned new stand-alone fast-food restaurants in South Los Angeles as part of a health-motivated effort to encourage healthier food options. 4,5 Other communities have passed fast-food land-use regulations for reasons unrelated to health with much less public fanfare or controversy. For example, Wellfleet, Massachusetts, a Cape Cod vacation destination, used the same set of legal mechanisms to ban fast-food restaurants in 2011, but its ordinance was intended to protect the town's “unique character.” 6 Examining the range of ordinances to restrict fast food and how they are discussed in the news can provide important insights about the comparative success of land-use regulations intended to improve public health and regulations with other rationales. The news media play an important role in policy debates by setting the agenda for the public and policymakers, 7–10 as well as by framing the terms of debate. 11,12 Journalists' decisions about which of the many pressing issues of the day to cover can raise the profile of a social issue, whereas issues outside the media spotlight can be left out of the public conversation and policymakers' consideration. Regulatory proceedings recorded in public meeting minutes and agendas are also a significant source of information about policy debates, because they provide insights into the rationale for new proposals and the policy deliberations that occur outside of the mass media. 13,14 Public health is well equipped with resources on the underlying legal issues and model policy language supporting local zoning ordinances to improve food environments. 1,2,15–17 Researchers have not explored how efforts to pass fast-food land-use policies have been debated under real-world circumstances, however, and this could be a vital source of data to inform similar actions. Zoning and related policies govern the use of land in a community. 1,18 Among the most common types of land-use ordinances for fast-food restaurants are total bans on the construction of new fast-food outlets and partial bans that prohibit construction of new restaurants in specific areas. Land-use ordinances may also impose moratoriums that prohibit new fast-food restaurants for a limited time. Other land-use restrictions are quotas that limit the number of restaurants that can operate in a community and regulations that specify the distance required between fast-food restaurants or between fast-food outlets and specific land uses, such as schools. 1,16 Although some land-use regulations specifically restrict fast-food restaurants, policies that limit drive-throughs or formula businesses can also have the intended or unintended consequence of restricting fast-food outlets. 1 Formula, or chain, businesses (characterized by a shared brand and standardized decor and services) can be fast-food restaurants such as McDonald's, but also sit-down restaurants such as Applebee's and retail outlets such as the Gap. 19 We examined fast-food land-use policy debates since the advent of widespread concern about the obesity epidemic following the release of the Surgeon General's Call to Action to Prevent and Decrease Overweight and Obesity in 2001. 20–23 We analyzed news coverage, legislative histories, and demographic data to understand what types of policies have been proposed, which communities have proposed them, and why. We explored the arguments used for and against these policies and how these debates and their outcomes have differed.
