Cross-sector analysis of socioeconomic, racial/ethnic, and urban/rural disparities in food policy enactment in the United States

We examined racial/ethnic, socioeconomic, and urban/rural disparities in food policy enactment across different sectors, as well as retail food access, throughout the United States. Policy and retail food store data were obtained from 443 communities as part of the Bridging the Gap Community Obesity Measures Project. Our results indicated that median household income was inversely associated with healthier retail food zoning policies in Hispanic communities, where competitive food policies for schools were also healthier and mean fruit/vegetable access in stores was higher. In contrast, income was positively associated with healthier retail food zoning in rural communities, where competitive food policies were weaker. Black communities had low scores across all policy domains. Overall, Hispanic communities had the strongest food policies across sectors. Barriers to policy adoption in both rural and Black communities must be explored further.