Promoting Healthy Communities and Preventing Childhood Obesity: Trends in Recent Legislation

This report documents the increasing interest in adopting policies designed to promote healthy communities and prevent childhood obesity that the National Conference of State Legislatures (NCSL) has witnessed among state legislatures.  It follows the trends that NCSL reported in its 2009 publication, Promoting Healthy Communities and Reducing Childhood Obesity:  Legislative Options,1 which summarized proposed and enacted state legislation in 17 topic areas during the 2007 and 2008 legislative sessions.  This report focuses on enacted legislation only—the emphasis is on policy results—for just one year—2009.   

The report summarizes state legislation enacted in two broad policy categories—healthy eating and physical activity, and healthy community design and access to healthy food—divided into 16 topic areas.  The first category focuses on nutrition and physical activity/physical education issues, primarily in schools.  It is divided into nine specific topics:

• School Nutrition
• Nutrition Education
• Body Mass Index Measurement for Students
• Diabetes Screening at School
• Insurance Coverage for Obesity Prevention 
• School Wellness
• Physical Activity or Physical Education in School
• Taxes and Tax Credits
• Task Forces, Commissions, Studies and Other Special Programs

The second category—healthy community design and access to healthy food—deals with changes in the built environment—including land use, transportation and agricultural topics—that can create more walkable/bikeable communities and increase access to healthy food through changes in infrastructure and procurement policies.  It is comprised of seven issue areas:

• Bicycling and Walking/Complete Streets
• Transit-Oriented Development
• Safe Routes to School/School Siting
• Farm-to-School
• Farmers’ Markets
• Food Deserts/Access to Healthy Food
• Local Food/Direct Marketing

Although some bills may fall into more than one category—for example, school nutrition and nutrition education—the summary appears only once, in the category that contains the most relevant issues addressed by the legislation.  Proposed and pending legislation that has not been enacted often is referenced in the narrative description of each legislation category—although those bills are not summarized—to illustrate trends in legislation that may serve as precursors to eventual laws.

The report documents continuing interest in—and increasing action on—healthy eating and active living policies by state legislatures, with more legislation passed in some categories in 2009 than in any single year of the previous two-year period (and in some cases, more than in the two previous years combined).  In the broad policy category of healthy eating and physical activity, for example, nine states enacted laws addressing school nutrition and nutrition education in 2009 alone, compared to 17 states during the two-year period 2007-2008.  Four states passed body mass index bills in 2009, compared to six in the previous two years; three states adopted insurance coverage for obesity prevention, compared to zero in 2007-2008; and two states enacted tax or tax credit legislation last year, although none did so in the prior two sessions.

The trends are even more apparent in the broad policy category of healthy community design and access to healthy food.  Transit-oriented development legislation was particularly noteworthy; 10 states passed bills last year compared to eight in 2007-2008.  Local food/direct marketing laws saw the largest number of states take policy action; 11 states enacted laws in 2009, compared to 16 in the prior two sessions.  (A complete listing of states that enacted legislation in each policy category during the 2007-2008 sessions can be found in NCSL’s 2009 publication Promoting Healthy Communities and Reducing Childhood Obesity:  Legislative Options, cited earlier in this report.)  Although not every topic area experienced increased activity, the number of states moving forward suggests that legislatures have maintained or enhanced their awareness of the important role they can play in developing policies that promote healthy communities and prevent childhood obesity.  The availability of federal funds in 2009 under the American Recovery and Reinvestment Act spurred additional action among state legislatures in adopting healthy eating and active living policies, primarily to support school nutrition and safe routes to school programs.