摘要：Poor diet is the leading risk factor for chronic disease and early death in Canada. (1) This trend is due, in part, to the widespread availability of processed foods in settings outside of the home. (2, 3) The development of healthy food and beverage (HFB) policy is an important strategy for addressing this issue by increasing availability of and access to healthier options. (4, 5) HFB policy refers to laws, regulations, guidelines, strategies, or policy-making actions aimed at facilitating healthier dietary behaviours. (6)
Municipalities are important laboratories for policy innovation related to nutrition and chronic disease prevention. (7) Considering the large number of employees and individuals who access public settings, the development of municipal HFB policy has the potential to result in significant health benefits at the population level. (8) Further, development of public policy in one municipal setting can influence policy learning in another, helping to shift public and decision-maker understanding of an issue and contributing to the development of more comprehensive policies over time. (7)
Despite the potential of municipal action to improve diets, the majority of Canadian municipalities have yet to implement HFB policies. (9) Reasons for this may include a lack of priority given to healthy eating environments, barriers to implementation, and limited support for policy learning across jurisdictions. In the United States context, the cities of New York and Los Angeles have had nutrition policy in place since 2007 and 2010 respectively. (5, 8, 10) In the literature, key lessons from the New York experience include the importance of high-level support and technical assistance in facilitating policy development. (8) Further, a published case study on the Los Angeles experience highlights potential facilitators (e.g., examining institutional authority to adopt policies and practice, educating key stakeholders, and recruiting champions) and barriers (e.g., complex administrative processes and variable levels of consumer acceptance) to policy change. (5, 10) In Canada, a small number of municipalities have developed HFB policy and initiatives. However, there is a gap in the peer-reviewed literature documenting these changes and subsequent policy learnings. To help address this gap, this article explores the City of Hamilton's story of municipal HFB policy development, as well as key lessons learned throughout this process.
