January 2012 Fast Food Restaurant Report Promoting Healthy Dining in South Los Angeles Nicky Bassford, MPP Lark Galloway-Gilliam, MPA Gwendolyn Flynn Breanna Nicole Morrison, MPL ACKNOWLEDGMENTS Our thanks to the many organizations and individuals who contributed to this project. Their cumulative efforts made this publication possible. Los Angeles County Department of Public Health Principal Authors: Paul Simon, MD Lisa Nicky Bassford, MPP, Policy Analyst Jean Tremaine Lark Galloway-Gilliam, MPA, Executive Director Gwendolyn Flynn, Policy Director Breanna Nicole Morrison, MPL Public Health Law and Policy Manel Kappagoda, JD, MPH Design: Amy Ackerman, JD Aaron Makela, Print Media Collective Karen Kramer, JD [email protected] Heather Wooten, MCP www.printmediacollective.com Samantha Graff, JD Editor: Mabel Everette, RD Janice Taylor, Communications Director Community Health Councils is a non-profit, community-based health advocacy, policy and educational organization. Established in 1992, our mission is to improve health and increase access to quality healthcare for uninsured, under-resourced and underserved populations. This policy report is the second in a series of three on how policymakers, private industry and community members can change the South LA food resource environment by increasing access to healthy food outlets and preventing the proliferation of unhealthy food outlets. The first report FOR MORE INFORMATION, in this series, Food Desert to Food Oasis: Promoting Grocery Store Development in South Los CONTACT: Angeles, focused on food purchased for the home and proposed policy recommendations to Community Health Councils overcome barriers and encourage the establishment of new full-service grocery stores, healthy 3731 Stocker Street, Suite 201 corner stores, farmers’ markets and mobile produce vendors. The final report will address the Los Angeles, CA 90008 roles community members can play in advocating for policy changes, researching the needs Tel.: 323.295.9372 and strengths of their neighborhoods, and marketing their neighborhoods to potential healthy food retailers and developers. e-mail: [email protected] www.chc-inc.org This publication is part of the REACH US project supported with funding from the Centers for Disease Control and Prevention (CDC). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention. © Community Health Councils, 2011 TABLE OF CONTENTS Executive Summary 2 Background 4 South Los Angeles Restaurant Environment 7 Fast Food and Health 10 Manufacturing Fast Food Demand 13 Regulating Fast Food Restaurant Development 16 South LA Solution 20 Sit-Down Restaurant Incentives 25 Implementation & Monitoring Compliance 27 Preventing Unintended Consequences 29 Conclusion 30 Appendices 31 South LA Fast Food Restaurant Maps Watsonville Healthy Eating Ordinance Points System and National Fruit & Vegetable Program Potential Constitutional Challenges Land Use Planning Tools Encouraging Restaurants to Offer Healthy Meals Endnotes 39 Fast Food Restaurant Report Promoting Healthy Dining in South Los Angeles EXECUTIVE SUMMARY South Los Angeles is saturated with fast food restaurants that typically serve “unhealthy foods” — foods high in fat, sodium or sugar with few essential nutrients. Eating fast food has been associated with weight gain and lower intake of fruits, vegetables and other nutrient-rich foods that help prevent chronic diseases such as heart disease, cancer and diabetes. A growing body of evidence indicates a correlation between the proximity and density of fast food restaurants and greater fast food consumption. Americans’ growing dependence on dining out coupled with an abundance of fast food restaurants and lack of healthier alternatives in urban, lower-income and racial and ethnic communities like South Los Angeles (South LA) have disproportionately increased vulnerability to diet-related death and disease. The situation in South LA is critical as this community has the lowest life expectancy in the City of Los Angeles and the highest rates of obesity and several chronic diseases in LA County. The residents of South Los Angeles need policies that create equal opportunities for them to purchase a meal or food consistent with the Dietary Guidelines for Americans when dining out. The Dietary Guidelines are the Federal government’s authoritative advice about good dietary habits and are designed to promote health and reduce risk for major chronic diseases. The City of Los Angeles established the Grocery Store and Sit-Down Restaurant Incentive Package in 2006 to attract new healthy food retailers to South LA. The package promoted the available financial incentives and offered assistance to identify potential sites, navigate the City’s permitting process and find qualified employees. The City passed an interim control ordinance (ICO) placing a moratorium on permits for new stand-alone establishments in South LA in 2008 to address the overconcentration of fast food restaurants. It then replaced the temporary policy in 2010 with an amendment to the City’s General Plan requiring that new restaurants locate at least a half mile from existing ones. The City continues to work on a comprehensive policy for fast food restaurant development in South LA. This report builds upon these efforts and provides recommendations for strengthening the City’s fast food restaurant development policy and Sit-Down Restaurant Incentive Program to create a healthier environment in South LA. The recommendations are specific to the restaurant environment in South LA, which is in the jurisdiction of the City of Los Angeles. They are based on community knowledge, community-based research, and an extensive literature review that indicate the need to extend the scope of the policy to all fast food restaurants, not just stand-alone establishments, and target populations that are most dependent on their neighborhood food environment, particularly children and individuals who lack private transportation. 2 The recommendations also acknowledge that fast food restaurants are defined broadly in the Los Angeles Municipal Code based on characteristics unrelated to the nutritional quality of the food provided. A fast food restaurant is “any establishment which dispenses food for consumption on or off the premises, and which has the following characteristics: a limited menu, items prepared in advance or prepared or heated quickly, no table orders, and food served in disposable wrapping and containers.”1 The recommendations propose a strategy for limiting the density of unhealthy fast food restaurants while encouraging new healthy restaurants of all types including healthy limited-service restaurants. The report recommends that the City of Los Angeles adopt the following policies: 1. Extend the criteria to obtain a construction permit to all fast food restaurants in South LA, not just stand- alone establishments. 2. Add an additional criteria requiring new fast food restaurants in South LA to locate at least a half mile away from schools, parks, playgrounds, child care centers, recreation facilities, and other children-oriented facilities. 3. Add an additional criteria requiring new fast food restaurants in South LA to locate at least 750 feet from bus, rail and other transit stops. 4. Define a healthy restaurant using criteria based on the Dietary Guidelines for Americans. 5. Provide an exemption from distance requirements for fast food restaurants meeting the healthy restaurant definition. 6. Strengthen the City’s Grocery Store and Sit-Down Restaurant Incentive Program and extend incentives to healthy fast food restaurants. 7. Monitor healthy restaurants that receive zoning and/or financial incentives for continued compliance with the healthy restaurant criteria and establish penalties for non-compliance. 3 Fast Food Restaurant Report Promoting Healthy Dining in South Los Angeles BACKGROUND Community Health Councils (CHC), a nonprofit health policy and advocacy organization located in South LA, and the CHC-led African Americans Building a Legacy of Health (AABLH) coalition are among several community organizations working in partnership with policymakers, institutions and the private sector to increase investment in South LA and ensure all residents have access to healthy foods and opportunities for healthy living. CHC’s role in addressing the South LA food retail environment began in 1999 with a cooperative agreement from the Centers for Disease Control and Prevention’s REACH (Racial and Ethnic Approaches to Community Health) 2010 Initiative. This award allowed CHC to establish AABLH and bring together organizations and individuals in the community to address the social determinants of racial/ethnic disparities in diabetes, cardiovascular disease and other diseases. AABLH developed a model for community change founded on a community-based participatory approach for assessing community needs, identifying policy and systems solutions and advocating in support of them. With the help of research- ers at the University of Southern California, AABLH trained community-based organizations and residents to survey restaurants, food markets and physical activity facilities in South LA and, as a comparison area, West LA. These community assessments found that South LA neighborhoods have much less diversity in dining options and more fast food restaurants than West LA neighborhoods. Diners in South LA also have fewer healthy options