Local government retail incentives for healthier food retailers in the USA, 2014.

Objective: National public health organizations recommend that local governments improve access to healthy foods. One way is by offering incentives for food retailer development and operation, but little is known about incentive use nationwide. We aimed to describe the national prevalence of local government reported incentives to increase access to healthy food options in three major food retail settings (farmers' markets, supermarkets, and convenience or corner (smaller) stores) overall and by municipality characteristics.
Design: Cross-sectional study using data from the 2014 National Survey of Community-Based Policy and Environmental Supports for Healthy Eating and Active Living.
Setting: USA, nationally representative survey of 2029 municipalities.
Participants: Municipal officials (e.g. city/town managers or planners; n 1853).
Results: Overall, 67 % of municipalities reported incentives to support farmers' markets, 34 % reported incentives to encourage opening new supermarkets, and 14 % reported incentives to help existing convenience or corner stores. Municipality characteristics significantly associated with incentive use were larger population size (all settings), location in Midwest v. West (supermarkets, smaller stores), higher poverty level (farmers' markets) and ≤50 % of the population non-Hispanic White (supermarkets, smaller stores). The most commonly reported individual incentives were permission of sales on city property for farmers' markets, tax credits for supermarkets and linkage to revitalization projects for smaller stores.
Conclusions: Most municipalities offered food retail incentives for farmers' markets, but fewer used incentives to open new supermarkets or assist existing smaller stores. National data can set benchmarks, provide relative comparisons for communities and identify areas for improvement.