In Minneapolis, Minn., the health inspection checklist for corner stores has a box not found anywhere else in the country: are you selling fresh, affordable produce—and is it prominently displayed?
Many cities have experimented with incentives to encourage neighborhood corner stores to sell healthier foods. But Minneapolis was the first city to make it a condition for doing business. The city council passed an ordinance in 2008 that required corner stores to sell five varieties of perishable produce. The health department expanded the regulation in 2009 to require that stores that are certified by the Women, Infants and Children program (a federal program that gives those populations support to purchase food) carry seven varieties and 30 pounds of fresh produce.
And in the last three years, the statute has changed the face of corner stores in Minneapolis. When the rule took effect, the health department estimated that only 25 percent of stores were compliant. But by 2011, the city issued only three citations (for 364 stores) for non-compliance over the entire year. Those numbers would seem to indicate wholesale buy-in from the business community.
“Most of our stores understand the requirement, embrace it and can meet it,” says Linda Roberts, the city’s licensing inspector. “I think that people understand the interest and the purpose and the goal is one that will benefit us all. I don’t see a big concern, and I don’t think it’s particularly onerous.”
That is, of course, the potential problem. The political argument against requiring (as opposed to incentivizing) selling healthy produce is easy to imagine. Another government regulation that makes it harder for the private sector to stay in business.
But city officials say they haven’t heard those complaints, and they’ve taken proactive steps to make it easier for corner stores to comply. The city has distributed $400 worth of displays and signage to individual stores to meet those requirements. Businesses also get a leg up on purchasing the produce through a $200 initial stipend from the city. Health department officials have conducted consultations with store owners to give them a sense of what they need to do to comply and what the customers in their neighborhoods are looking for. They’ve held kick-off events, complete with taste testing demonstrations, so the community is aware of their new healthy food options—and will hopefully patronize the businesses that sell them, making it a win-win for both sides.
"The policy was a good first step, but it certainly wasn't everything that needed to happen,” says Kristen Klinger, who heads the Minneapolis Healthy Living initiative. “The store owners needed some support from the city."
Now, city officials are waiting to see what kind of long-term impact the regulations could have. Only one in three Minneapolis adults eats the recommended number of fruits and vegetables, according to city estimates, one of the central motivators for passing the statute. A less healthy diet is routinely linked to chronic health problems and higher health costs—it’s a problem that’s been recognized across the country, particularly in urban areas with greater health disparities.
It will likely take years for something like increased healthy food access to have a tangible effect on the health of a population. But early indicators are promising, Klinger says. Initial data from compliant stores suggest that produce sales are making up a bigger chunk of their revenue.
"Health outcomes are always long-term measurements,” she says. “Right now, we're really just focused on making sure people have access to healthy foods. That's the first step."
And other cities may soon be following that path. The Minneapolis statute caught the eye of ChangeLab Solutions, a California think tank that advocates using public policy to improve the nation’s health. The group has had preliminary conversations this year with other cities—particularly those considered more “progressive” and therefore potentially more receptive to the idea—about putting similar regulations into place elsewhere.
Given the various health crises facing the nation (obesity, diabetes, heart disease, etc.), more direct action like that taken in Minneapolis might be needed, says Ian McLaughlin, senior staff attorney at ChangeLab Solutions.
“I think we're at the point in dealing with a public health crisis that we need to do something. Rather than focusing on individuals, we need to focus on the systems in which individual behavior occurs,” he says. “But we're still trying to figure out what's the mix of incentives, regulations and community education that's going to make a difference."