1999; Kantor, 2001; Conrey et al., 2003). Others are promoting community gardens (Kantor, 2001; Twiss et al., 2003), school gardens (Edible Schoolyard, 2004; see Chapter 7), and farm-to-school and farm-to-cafeteria programs (Kantor, 2001; Bellows et al., 2003; Center for Food and Justice, 2004; Sanger and Zenz, 2004; see Chapter 7).

Recent research has demonstrated that children who grow some of their own food in school gardens have an increased preference for certain vegetables (Morris and Zidenberg-Cherr, 2002). Recent federal legislation (Public Law 108-265) includes provisions designed to strengthen partnerships between local agriculture and schools to ensure that fresh local produce can go from farms directly to schools.

These initiatives to enhance the community food environment and promote household and community food security are promising to expand healthful food choices, especially for neighborhoods that are now limited in their ability to obtain healthful and affordable food on a regular basis. However, evaluations will be required to determine the programs’ effectiveness in meeting these goals.

Local governments should work with community groups, nonprofit organizations, local farmers and food processors, and local businesses to support multisectoral partnerships and networks that expand the availability of healthful foods within walking distance, particularly in low-income and underserved neighborhoods. Such efforts will expand healthful food choices at local grocery stores, supermarkets, and fast food restaurants, and they will encourage a broad range of community food-security initiatives that improve access to highly nutritional foods.

Health Impact Assessments and Community Health Evaluations

Evaluation of community-wide efforts can be a challenge, given the typically wide age range among members of the population; their ethnic, racial, and social diversities; the differences in settings of various community interventions; and the numerous barriers involved.

Nevertheless, it is important to assess the potential impact of proposed programs and changes as well as to conduct evaluations of recent and ongoing efforts. A prospective approach to community evaluation efforts involves a “health impact assessment” that gauges the potential effects of a proposed policy or intervention on the health of the population (WHO, 1999). Much as environmental impact assessments examine the potential effects of a new construction project on such indicators as an area’s air and water quality, health impact assessments are used to evaluate and then modify a proposed action—that is, to remove or minimize that action’s negative public health impacts, and to help enhance its positive effects (Taylor and Quigley, 2002). The health impact assessment may also be



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