State Indicator Report 

on 

Fruits and Vegetables 

2013 
	 	 	 	 	 	

	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	

	 	 	 	 	 	 	

	 	 	 	 	 	

	 	 	 	 	 	 	 	 	

	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	 	

	 	 	 	 	

	 	 	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	 	

	 	 	 	 	 	

	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	 	

The State Indicator Report on Fruits and Vegetables can be used to: 

•	 Illustrate	how	states	support	the	consumption	of	F&V

•	 Monitor	progress	and	celebrate		

state	successes

•	 Identify	opportunities	for		improvement	in	F&V	access	

	 	 	 	 	 	 	 	 	 	

	 	 	 	 	 	

	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	

 

Behavioral Risk Factor Surveillance System, 2011 

Introduction 


Median Daily Vegetable Intake
 

Among Adults in the United States 


Fruits and vegetables (F&V) contribute important

nutrients for the human body. Eating F&V lowers the

risk of developing many chronic diseases and can

also help with weight management.1 Creating greater

access to quality and affordable F&V nationwide is an

important step to increase F&V consumption. When state

leaders, health professionals, food retail owners, farmers,

education staff, and community members work together,

more Americans can live healthier lives.

The State Indicator Report on Fruits and Vegetables, 2013 

provides information for each state on fruit and vegetable

(F&V) consumption, and environmental and policy

indicators of support for consumption. The report, which

can be used to inform decision makers, shows that F&V

consumption is higher in some states than others, but

overall consumption of F&V in the United States is low.

Adults in the United States consume fruit about 1.1 times

per day and vegetables about 1.6 times per day. The

Dietary Guidelines for Americans, 2010 recommends

that Americans eat more F&V as part of a healthy diet.

The MyPlate food guidance system emphasizes the need

to “focus on fruits” and “vary your veggies” as building

blocks for a healthy diet (www. choosemyplate.gov).

Many states are attempting to increase F&V consumption

by improving access and establishing policies that make

it easier to get F&V in communities, schools, and child

The State Indicator Report on Fruits 

and Vegetables can be used to: 

• Illustrate how states support the 

consumption of F&V 

• Monitor progress and celebrate 

state successes 

• Identify opportunities for 

improvement in F&V access 

care. For example, 28 states now have a farm to school/

preschool policy. Twenty-seven states have created

state-level food policy councils--coalitions of private and

public partners working together to improve access to

healthy food.

2
 
	 	 	 	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	

	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 		

	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	

	 	 	 	 	 	 		

		

	 	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 		

There is still more work to be done to increase F&V

access and consumption. For example, only about 70%

of all census tracts in this country currently have at least

one store that offers a wide variety of affordable F&V.

This rate varies by state, with California, New York,

Florida, the District of Columbia, and Oregon having the

greatest access to one of these stores.

Farmers markets are an additional source of affordable

F&V in the community. Vermont, Wyoming, Iowa, and

New Hampshire have more than seven farmers markets

per 100,000 state residents. Nutrition assistance programs

improve access to F&V for individuals and families with

lower incomes. The percent of farmers markets that

accept Supplemental Nutrition Assistance Program

(SNAP) benefits varies among states; with the District of

Columbia, Vermont, New Mexico, and Oregon currently

leading all others. Additionally, 19 states now authorize

farmers to accept Special Supplemental Nutrition Program

for Women Infants and Children (WIC) Cash Value

Vouchers.

A number of states with the highest consumption of

fruits and vegetables have more environmental supports.

For example, adults in Oregon and California eat more

vegetables than adults in other states. They also are

among the highest in fruit consumption. Oregon and

California are also above the national score on access

to a healthier food retailer, farmers market density,

and farmers market acceptance of nutrition assistance

program benefits. However, many factors play a role

in improving consumption. Further monitoring and

evaluation may highlight those factors most supportive

of consumption.

Stories from the Field
 

Healthier Food Retail in Communities 

New York City 

Through its Health Bucks and Stellar Farmers Market programs, the

New York City Department of Health and Mental Hygiene is helping

customers learn about and buy fruits and vegetables.

z The Health Bucks program distributes $2 Health Bucks coupons to 

consumers for the purchase of fresh fruits and vegetables at farmers 

markets. SNAP participants who use their benefits at participating markets 

receive a $2 coupon for every $5 spent in SNAP benefits, effectively a 

40% increase in purchasing power. Since the program began in 2005, the 

number of participating markets has grown from about 5 in 2005 to 138 

in 2012. Coupon redemption rates have also increased every year; in 2011 

93% of the nearly 88,000 coupons distributed to SNAP recipients were 

redeemed. 

z The Stellar Farmers Market program provides free nutrition workshops 

and cooking demonstrations at farmers markets in low-income 

neighborhoods. It also offers tips on food safety and shopping on a 

budget. In 2011 the program sponsored over 1,300 workshops and 

provided Health Bucks coupons to more than 15,000 consumers. 

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Massachusetts 

The Massachusetts Department of Transitional Assistance

and the Department of Agricultural Resources partnered

in 2009 to increase SNAP recipients’ access to farmers

markets. They helped finance point-of-sale terminals and

transaction fees associated with SNAP purchases, increased

people’s purchasing power through incentives that matched

SNAP purchases at the farmers markets, and promoted

these benefits widely to SNAP recipients. In the first year,

these efforts increased the number of farmers markets that

accepted SNAP from 30 to 58 and boosted SNAP sales

at these markets by over 500%. On average, markets that

offered incentives had $1,700 more in SNAP sales than

markets that did not offer them.

Schools, Child Care, and Early Education 

Vermont 

Since its launch in January 2011, the Vermont Works for

Women FRESH Food Program has served more than 68,000

nutritious meals for 2 to 5-year-olds in early care and education

centers throughout the Greater Burlington area.  FRESH Food

creates healthy and delicious menu items that exceed USDA

nutritional standards and serves these meals home-style. As a

member of the Vermont Fresh Network, FRESH Food works

with more than 20 local and regional vendors and farmers to

acquire vegetables, fruits, dairy products, herbs, meats, and

honey.  FRESH Food grew out of Vermont Works for Women’s

Transitional Jobs program, which provides skills training and

work experience to help women find permanent employment.

Minnesota 

With CDC funding, Minnesota’s Great TraysTM Partnership

worked to help schools serve healthier foods to students.

Formed in 2010 among eight state-level organizations—

including the State Departments of Agriculture, Education,

and Health and Human Services—Great TraysTM trained

school nutrition leaders, promoted time and cost savings to

allow schools to buy healthier foods, and supported farm-toschool programs. Over three-quarters of Minnesota public

schools participated in trainings and are now committed to

improving the foods they offer. Plus, farm-to-school efforts

are increasing access to local produce in at least 367 schools

and 22 school districts across the state, serving more than

200,000 students.

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Food System Support 

Rhode Island 

Market Mobile, which began in 2009 as a pilot project of the
 

non-profit organization Farm Fresh, is increasing Rhode Islanders’
 

access to healthy local foods. By facilitating relationships between
 

local food producers, institutions, and other buyers, Market Mobile
 

in 2012 generated over $1.5 million in sales from 60 local food
 

producers to more than 260 retail venues—including restaurants,
 

schools, hospitals, worksites, grocery stores, corner stores, and farm
 

stands. Through Market Mobile, about 50,000 families throughout
 

Rhode Island and neighboring areas like Boston now have access to
 

locally produced food, including fruits and vegetables.
 

Fruit and Vegetable Indicators 

In 2011‚ two updates occurred in the Behavioral Risk Factor Surveillance System (BRFSS) that will affect estimation of

fruit and vegetable intake. First, there was an overall change in the BRFSS methodology to adjust sample weighting

procedures and accommodate cell phone usage. Second, there were changes to the core questions used to assess fruit

and vegetable intake. Because of these changes, estimates of fruit and vegetable intake from 2011 forward cannot be

compared to estimates from previous years. Data from BRFSS collected in 2011 will provide a new baseline for fruit and

vegetable data collected in subsequent years. A number of policy and environmental indicators, which are not based on

BRFSS, may be comparable to findings from previous years.

There are eight behavioral indicators presented in Table

1 and 13 policy and environmental indicators presented

in Table 2. The indicators (described below) follow the

order of the columns in the tables. This report provides

data on behavioral, policy, and environmental indicators

for 50 states and the District of Columbia (hereafter

referred to as states).

Behavioral Indicators 

This report presents indicators of F&V consumption for

both US adults and adolescents from the Behavioral

Risk Factor Surveillance System* and Youth Risk Behavior

Surveillance System, respectively, both supported by CDC.

z Percentage of adults in the state who report 

consuming fruits less than one time daily and 

vegetables less than one time daily (new) 

z Median daily intake of fruits and median daily 

intake of vegetables for adults in the state (times 

per day) (new) 

z Percentage of adolescents in the state who report 

consuming fruits less than one time daily and 

vegetables less than one time daily (new) 

z Median daily intake of fruits and median daily intake 

of vegetables for adolescents in the state (times per 

day) (new) 

Tracking consumption of fruits and vegetables over time

will help states monitor progress towards increased F&V

consumption, a key recommendation of the Dietary 

Guidelines for Americans, 2010.1

Policy and Environmental 

Indicators 

Most indicators are the same as those introduced in the

2009 report, though two were dropped and two have

different definitions or data sources. In addition, there are

six new indicators. The strategies represented by these

indicators can occur or be supported at the state level

as well as in communities across the state. States may

focus on a few or many of the indicators based on their

existing capacity, partnerships, and resources.

* Due to changes in the Behavioral Risk Factor Surveillance System, these data cannot be compared to previous reports. See page 10 for more information. 

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Availability of Healthier Food Retail 

in Communities 

Having access to stores that sell F&V and other healthier

foods may increase F&V consumption among adults.2,3

Improving access to F&V and other healthier foods can

include expanding access to stores that typically stock an

affordable and wide selection of F&V (i.e. supermarkets,

larger grocery stores, F&V specialty stores), improving

availability of F&V in small stores including convenience

and corner stores, and utilizing farm-to-consumer

approaches such as markets at which farmers sell F&V

directly to consumers.2,4,5

z Percentage of census tracts in a state that have at 

least one healthier food retailer located within the 

tract or within 1/2-mile of tract boundaries (different 

definition or data source) 

One measure of access to F&V is the percentage of

census tracts in states that have a typical healthier food

retailer (at least one supermarket, supercenter, larger

grocery store, warehouse club, or F&V specialty store)

located within the tract or within a 1/2-mile of tract

boundaries. A census tract is a small and relatively

permanent subdivision of counties that is similar in

population and economic characteristics and living

conditions. On average supermarkets, supercenters,

larger grocery stores, warehouse clubs, and F&V specialty

stores stock a wide selection of affordable F&V. Other

types of retail venues in communities are often less

consistent in what they offer making it difficult to identify

whether they provide access to F&V. Residents may have

additional access to F&V in their neighborhoods through

seasonal farmers markets and farm stands, although

temporary venues may not be captured in this metric.

z State-level healthier food retail policy 

State-level policies that support healthier food retail

have the potential to increase F&V access and improve

nutrition among adults and children.5 Such policies

include support for: 1) the building and/or placement

of new food retail outlets (e.g. new supermarkets in

underserved areas); 2) renovation and equipment

upgrades of existing food retail outlets (e.g. purchasing

refrigerators for corner stores to allow for the sale of

fresh produce); 3) increases in and promotion of F&V at

food retail outlets (e.g., increased shelf space for F&V;

shelf-labeling).

z Number of farmers markets per 100,000 state 

residents 

z Percentage of farmers markets that accept SNAP 

benefits (new) 

z Percentage of farmers markets that accept WIC 

Farmers Market Nutrition Program coupons 

z States that authorize farmers to accept WIC Cash Value 

Vouchers (new) 

Farmers markets are a mechanism for purchasing foods

from local farms and can augment access to F&V from

typical retail stores or provide a retail venue for F&V

in areas lacking such stores.5,6 The number of farmers

markets per 100,000 state residents provides a broad

estimate of the availability of F&V from farmers markets

adjusted for variation in state population. Farmers

markets that accept nutrition assistance program benefits,

such as Supplemental Nutrition Assistance Program

(SNAP), Special Supplemental Nutrition Program for

Women, Infants, and Children (WIC) Farmers Market

Nutrition Program (FMNP) coupons, and WIC Cash Value

Vouchers (CVV), improve access to F&V for individuals

and families with lower incomes.6

Availability of Fruits and Vegetables in Schools, 

Child Care, and Early Education Programs 

Schools, child care, and early education programs (e.g.,

child care centers, day care homes, Head Start programs,

preschool and pre-kindergarten) are uniquely positioned

to model and reinforce healthful eating behaviors by

including F&V at meals, activities and events, such as

celebrations, and incorporating nutrition education into

curricula.

z Percentage of middle and high schools that offer fruits 

or non-fried vegetables at school celebrations (new) 

The Institute of Medicine recommends that schools

limit opportunities for food and beverages obtained

outside the United States Department of Agriculture

(USDA) school meals programs.7 However, when these

opportunities arise, schools can encourage consumption

of healthier foods, including fruits and vegetables.7 Many

middle and high schools offer foods or beverages at

school celebrations and thus increasing the percentage

of schools that offer fruits and vegetables at these events

indicates schools’ support of a food environment that

aligns with current dietary guidance.7,8

z State child care regulations align with national 

standards for serving fruits (new) 

z State child care regulations align with national 

standards for serving vegetables (new) 

States can support increased fruit and vegetable

consumption by ensuring that their state child care

regulations related to nutrition closely align with

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evidence-based, best-practice standards.9 These

standards specify that children in early education and

child care facilities (both centers and family-homes) be

served a variety of fruits, especially whole fruits, and

vegetables, specifically dark green, orange, deep yellow

and root vegetables.

z State-level farm to school/preschool policy 

(different definition or data source) 

Farm to school and farm to preschool programs can

support increased fruit and vegetable intake among

children through the purchase of produce from local/

regional farms, implementation of salad bars, training

services for food providers, teachers, or parents, and

by providing experiential learning opportunities such

as school gardens programs and farm visits for youth

and staff.10,11 The existence of state-level farm to school/

preschool policies shows support for creation, expansion,

or maintenance of these programs.

Food System Support 

A systems approach to increasing access to F&V

considers the many factors involved in getting food from

farm to consumer, including aspects of food production,

processing, distribution, and retail.12 Also included in

such an approach are partnerships with the participants

in that system, including farmers, industries, workers,

governments, institutional purchasers, communities,

and consumers.

z Number of food hubs in each state (new) 

A food hub, as defined by the USDA, is a “business

or organization that actively manages the aggregation,

distribution, and marketing of source-identified food

products primarily from local and regional producers to

strengthen their ability to satisfy wholesale, retail, and

institutional demand.”13,14 For retailers and foodservice

buyers who would like to purchase larger volumes of

locally and regionally grown products, food hubs lower

the procurement costs by providing a single point of

purchase for consistent and reliable supplies of sourceidentified products from local and regional producers.

Moreover, food hubs have the potential to reach

populations who might otherwise lack access to healthier

foods. For example, some food hubs accept SNAP

benefits and have initiatives that support food banks and

hunger relief organizations. Additionally, food hubs may

provide services, such as quality control and processing,

that facilitate the purchase of F&V by schools, hospitals,

and small stores.13,14

z Percentage of cropland acreage harvested for fruits 

and vegetables 

Cropland acreage harvested for F&V is a broad indicator

of domestic F&V inputs to the food system. When

interpreting this measure, it may be important to consider

the types of crops harvested and their yields as well as

growing conditions across states. State-grown fruits and

vegetables can provide F&V for institutional buyers as

well as retail venues that source from local growers.

z State-level food policy council 

z Number of local food policy councils in each state 

Food policy councils (FPCs) and similar coalitions bring

together diverse stakeholders to examine and develop

recommendations for improvements to a regional,

state, and/or local food system.15 Members typically

represent a wide array of interests, including nutrition,

health, agriculture, education, community design,

and commerce.6 FPCs can support improved food

environments for healthy eating and aid community F&V

access by encouraging improvement of retail stores and

supporting farm to institution programs and practices by

schools, child care and early education, work sites, and

community organizations.

For more information or to provide feedback 

contact fvreport@cdc.gov. 

Additional materials for the State Indicator Report 

on Fruits and Vegetables, 2013 are available at

http://www.cdc.gov/nutrition/professionals/data.

7 
Table 1: State Indicator Report on Fruits and Vegetables, 2013: Behavioral Indicators 

Adults Adolescents 

Percentage who report 

consuming fruits and 

vegetables less than 

one time daily 

Median intake of 

fruits and vegetables 

(times per day) 

Percentage who report 

consuming fruits and 

vegetables less than 

one time daily 

Median intake of 

fruits and vegetables 

(times per day) 

State Fruits Vegetables Fruits Vegetables Fruits Vegetables Fruits Vegetables 

U.S. National 37.7 22.6 1.1 1.6 36.0 37.7 1.0 1.3 

Alabama 43.8 24.3 1.0 1.6 44.4 45.7 1.0 1.0 

Alaska 38.7 19.7 1.1 1.7 39.1 34.1 1.0 1.3 

Arkansas 47.5 28.6 1.0 1.5 49.4 43.2 1.0 1.0 

Colorado 35.7 19.1 1.1 1.7 

Delaware 39.2 23.8 1.0 1.6 46.0 1.0 

Florida 37.7 22.6 1.1 1.6 37.2 42.1 1.0 1.1 

Hawaii 39.5 22.6 1.0 1.7 45.1 40.8 1.0 1.1 

Illinois 36.0 25.2 1.1 1.6 38.7 42.3 1.0 1.1 

Iowa 39.8 26.9 1.0 1.4 36.1 35.1 1.0 1.3 

Kentucky 45.9 25.2 1.0 1.5 49.7 43.2 1.0 1.1 

Maine 33.2 18.9 1.2 1.7 37.5 1.0 

Massachusetts 31.6 20.7 1.2 1.7 

Minnesota 36.2 23.6 1.1 1.5 

Missouri 43.9 25.2 1.0 1.5 

Nebraska 40.1 26.2 1.0 1.5 41.0 38.0 1.0 1.3 

New Hampshire 30.3 17.6 1.3 1.8 36.8 31.8 1.0 1.3 

New Mexico 38.0 21.9 1.1 1.7 40.8 37.1 1.0 1.3 

North Carolina 40.8 21.9 1.0 1.6 44.5 39.6 1.0 1.1 

Ohio 40.5 26.0 1.0 1.5 42.4 42.2 1.0 1.1 

Oregon 32.0 15.3 1.1 1.9 

Rhode Island 32.9 20.7 1.2 1.6 36.5 35.3 1.0 1.3 

South Dakota 39.6 26.3 1.0 1.4 41.2 38.8 1.0 1.1 

Texas 40.3 21.8 1.0 1.6 42.1 47.5 1.0 1.0 

Vermont 31.4 18.1 1.3 1.7 30.7 26.4 1.3 1.6 

Washington 35.0 18.8 1.1 1.7 

Wisconsin 35.6 26.0 1.1 1.5 34.1 35.7 1.0 1.3 

Arizona 38.0 20.6 1.1 1.7 

California 30.4 16.5 1.3 1.8 

Connecticut 32.0 20.6 1.3 1.7 34.6 35.3 1.3 1.3 

Dist of Columbia 31.7 20.1 1.3 1.8 

Georgia 41.9 23.2 1.0 1.6 42.9 43.1 1.0 1.0 

Idaho 38.1 20.1 1.1 1.6 33.9 32.2 1.0 1.3 

Indiana 41.6 27.3 1.0 1.5 44.7 42.0 1.0 1.1 

Kansas 41.4 22.2 1.0 1.6 40.4 35.7 1.0 1.3 

Louisiana 46.7 32.5 1.0 1.4 47.8 50.1 1.0 0.9 

Maryland 36.4 22.8 1.1 1.6 38.7 38.9 1.0 1.3 

Michigan 37.3 23.2 1.1 1.6 37.8 36.8 1.0 1.3 

Mississippi 50.8 32.3 0.9 1.4 39.8 42.4 1.0 1.1 

Montana 39.2 21.7 1.0 1.6 38.4 33.5 1.0 1.3 

Nevada 36.9 24.4 1.1 1.6 

New Jersey 33.9 22.2 1.1 1.6 39.1 34.9 1.0 1.3 

New York 33.9 23.0 1.2 1.6 34.7 1.3 

North Dakota 39.1 27.1 1.1 1.4 36.4 39.4 1.0 1.1 

Oklahoma 50.2 26.8 0.9 1.5 44.3 40.4 1.0 1.1 

Pennsylvania 36.1 23.9 1.1 1.5 

South Carolina 44.4 27.3 1.0 1.5 50.6 47.8 0.7 1.0 

Tennessee 46.3 25.4 1.0 1.6 44.9 41.4 1.0 1.1 

Utah 34.9 19.8 1.1 1.7 32.5 31.8 1.0 1.3 

Virginia 38.4 22.2 1.1 1.7 39.8 41.7 1.0 1.1 

West Virginia 47.2 26.2 1.0 1.5 37.8 34.9 1.0 1.3 

Wyoming 38.2 22.4 1.1 1.6 37.9 31.4 1.0 1.3 

Data sources: Behavioral Risk Factor Surveillance System, 2011. Youth Risk Behavior Surveillance System, 2011. Some states may not have estimates for F&V intake among 

adolescents which may be due to either not collecting survey data, not achieving a high enough overall response rate to receive weighted results, or omitting 1 or more 

questionnaire items during administration of the survey. 

8 
Table 2: State Indicator Report on Fruits and Vegetables, 2013: Policy and Environmental Indicators 

Healthier Food Retail in Communities Schools, Child Care, and Early 

Education Food System Support 

State Percentage of census 

tracts with at least one healthier food retailer within 1/2 mile of tract boundaryState-level healthier food retail policy Number of farmers markets per 100,000 residentsPercentage of farmers markets that accept SNAP benefitsPercentage of farmers markets that accept WIC Farmers Market Nutrition Program couponsStates that authorize farmers to accept WICCash Value VouchersPercentage of middle / high schools that off er fruits or vegetables at celebrations2State child care regulations align with national standards for serving fruits / vegetablesState-level farm to school / preschool policyNumber of food hubsPercentage of cropland acreage harvested for fruits and vegetablesState-level food policy councilNumber of local food policy councils 

U.S. National 69.5 10 2.5 21.0 25.8 19 33.63 10 / 4 28 213 2.5 27 150 

Alabama 64.8 No 3.1 4.7 6.7 No 34.9 No / No No 3 1.2 Yes 2 

Alaska 48.5 No 4.4 18.8 37.5 Yes 40.9 No / No Yes 0 4.0 Yes 0 

Arizona 71.1 No 1.3 30.5 41.5 Yes 44.0 No / No No 2 18.9 No 2 

Arkansas 58.9 No 2.7 8.8 18.8 No 22.2 No / No No 4 0.2 Yes 0 

California 82.4 Yes 2.2 27.4 39.3 Yes 36.9 Yes / No Yes 10 34.4 Yes 22 

Colorado 69.9 No 3.2 21.7 NA1 Yes 33.8 No / No Yes 3 1.7 Yes 6 

Connecticut 66.7 No 4.3 10.3 21.3 Yes 44.5 No / No Yes 2 10.8 Yes 3 

Delaware 76.2 No 3.5 6.3 NA No 35.4 Yes / No No 0 8.7 No 0 

Dist of Columbia 77.7 Yes 5.7 60.0 71.4 Yes 30.6 No / No Yes 2 NA 1 

Florida 78.5 No 1.1 15.7 5.4 No 35.3 Yes / Yes Yes 5 42.9 Yes 7 

Georgia 70.9 No 1.2 21.5 10.7 No 31.5 No / No Yes 2 4.3 Yes 2 

Hawaii 73.5 No 6.4 30.7 NA No 39.4 No / No No 0 27.6 Yes 0 

Idaho 67.1 No 4.2 9.0 NA No 34.1 No / No No 2 9.1 No 1 

Illinois 71.4 Yes 2.3 10.6 10.6 No Yes / No Yes 8 0.3 Yes 7 

Indiana 62.3 No 2.5 11.7 35.0 No 23.5 No / No No 1 0.3 No 1 

Iowa 55.5 No 7.5 12.2 24.9 No 23.1 No / No Yes 5 0.1 Yes 3 

Kansas 57.3 No 3.4 18.6 NA No 17.6 No / No No 2 0.1 No 1 

Kentucky 59.6 No 3.7 9.3 20.4 No 24.0 No / No Yes 4 0.2 No 2 

Louisiana 67.1 Yes 1.4 12.9 16.1 No 30.3 Yes / No No 2 0.6 No 1 

Maine 55.3 No 6.3 31.0 35.7 Yes 48.6 No / No Yes 3 29.3 Yes 3 

Maryland 74.0 Yes 2.6 16.3 66.0 Yes 41.6 No / No Yes 3 3.0 No 3 

Massachusetts 68.6 No 4.4 29.8 45.0 Yes 44.4 No / No Yes 13 23.2 Yes 5 

Michigan 63.9 Yes 3.2 29.5 32.1 Yes 28.3 No / No Yes 5 4.5 Yes 6 

Minnesota 57.6 No 3.2 20.1 21.3 Yes 29.5 No / No No 3 1.3 No 6 

Mississippi 61.5 No 2.5 26.7 13.3 No 33.3 Yes / Yes No 2 0.8 Yes 0 

Missouri 65.9 No 2.6 14.8 NA No 24.4 Yes / No No 3 0.3 No 4 

Montana 52.0 No 6.5 21.5 18.5 Yes 30.6 No / No Yes 4 0.1 Yes 1 

Nebraska 60.2 No 4.6 8.2 7.1 No 16.4 No / No No 1 0.1 No 1 

Nevada 71.9 Yes 1.5 17.5 NA No 39.1 No / No No 0 2.2 No 2 

New Hampshire 54.5 No 7.3 16.7 NA No 44.7 No / No No 0 6.6 No 0 

New Jersey 76.9 No 1.5 13.4 32.1 Yes 41.0 No / No Yes 1 17.9 No 5 

New Mexico 56.4 No 3.3 47.8 76.8 No 44.4 Yes / No Yes 4 3.6 Yes 4 

New York 78.9 Yes 3.3 29.5 42.7 Yes 41.7 No / No Yes 15 7.2 Yes 3 

North Carolina 69.9 No 2.2 12.6 11.7 No 27.3 No / No No 13 3.3 Yes 5 

North Dakota 49.8 No 9.5 1.5 NA No 28.9 No / No No 0 0.4 No 1 

Ohio 63.7 No 2.3 21.5 22.6 Yes 27.6 No / No No 7 0.6 Yes 9 

Oklahoma 51.1 Yes 1.9 14.1 NA Yes 23.7 No / No Yes 2 0.3 Yes 1 

Oregon 77.1 No 4.2 45.4 47.2 Yes 42.3 No / No Yes 8 7.7 No 4 

Pennsylvania 69.1 Yes 2.0 20.7 22.7 No 41.6 Yes / Yes Yes 10 2.6 No 5 

Rhode Island 67.6 No 5.8 27.9 39.3 Yes 47.8 No / No Yes 2 17.1 Yes 0 

South Carolina 66.4 No 2.7 13.6 15.2 Yes 37.4 No / No No 2 2.9 Yes 1 

South Dakota 45.5 No 4.6 31.6 NA No 12.5 Yes / Yes No 0 0.0 No 0 

Tennessee 63.1 No 1.5 11.8 2.2 No 29.4 No / No Yes 2 0.8 Yes 3 

Texas 66.4 No 0.7 18.5 11.3 No 27.1 No / No Yes 6 0.9 No 6 

Utah 66.0 No 1.3 10.8 NA No 31.6 No / No No 0 1.4 No 1 

Vermont 43.7 No 15.0 50.0 25.5 No 52.4 No / No Yes 12 1.6 No 3 

Virginia 70.3 No 2.8 14.5 NA No 37.9 No / No Yes 18 1.8 Yes 1 

Washington 71.6 No 2.1 35.6 58.2 No 29.8 No / No Yes 8 14.9 No 3 

West Virginia 59.3 No 4.4 19.8 34.6 No 43.2 No / No No 1 1.4 Yes 0 

Wisconsin 61.1 No 5.2 13.1 36.9 No 25.6 No / No Yes 8 3.6 Yes 3 

Wyoming 60.3 No 7.6 7.0 NA No 30.1 No / No No 0 0.1 No 0 

1 Indicates states that did not receive WIC FMNP grants in FY2012. 

2 Among schools that offer foods or beverages at school celebrations. 

3 Median across states. 

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Indicator Definitions and Data Sources 


Behavioral Indicators 

Percentage of adults in the state consuming fruits 

less than one time daily and vegetables less than 

one time daily 

Median daily intake of fruits and vegetables among 

adults in the state (times per day) 

Behavioral Risk Factor Surveillance System (BRFSS)

(adults aged ≥ 18 years), 2011. Weighted data.

The BRFSS included 6 questions about F&V intake

asked via a telephone survey, preceded by the following

statement: “These next questions are about the fruits

and vegetables you ate or drank during the past 30 days.

Please think about all forms of fruits and vegetables

including cooked or raw, fresh, frozen or canned. Please

think about all meals, snacks, and food consumed at

home and away from home.” Respondents were asked to

report consumption of the following beverages and foods

during the past month as times per day, week, or month:

1) 100% PURE fruit juices; 2) fruit, including fresh,

frozen, or canned fruit (not counting juice); 3) cooked or

canned beans (not including long green beans); 4) dark

green vegetables; 5) orange-colored vegetables; 6) other

vegetables (not counting what was reported already).

Total daily fruit consumption was calculated based on

responses to questions 1 and 2, and total daily vegetable

consumption was based on questions 3-6.

Survey questions and data are available at: 

http://www.cdc.gov/brfss/questionnaires/pdfques/2011brfss.pdf and http://www.cdc.gov/brfss/ 

technical_infodata/surveydata/2011.htm.

Percentage of adolescents in the state consuming 

fruits less than one time daily and vegetables less 

than one time daily 

Median daily intake of fruits and vegetables among 

adolescents in the state (times per day) 

Youth Risk Behavior Surveillance System (adolescents in

grades 9–12), 2011. Weighted data.

The Youth Risk Behavior Survey questionnaire includes 6

questions about F&V intake asked via classroom survey,

preceded by the following statement: “The next questions

ask about food you ate or drank during the past 7 days.

Think about all the meals and snacks you had from

the time you got up until you went to bed. Be sure to

include food you ate at home, at school, at restaurants, or

anywhere else.” Respondents were asked about intake of

the following: 1) 100% fruit juices; 2) fruit; 3) green salad;

4) potatoes; 5) carrots; 6) other vegetables. Total daily

fruit consumption was calculated based on responses to

questions 1 and 2, and total daily vegetable consumption

was based on responses to questions 3-6.

The national estimate was derived from the national

Youth Risk Behavior Survey, conducted among a

nationally representative sample of students in grades

9–12. The state estimates were derived from Youth Risk

Behavior Surveys conducted among representative

samples of students in grades 9–12 in each state. Some

states may not have estimates for F&V intake among

adolescents. This may be due to either not collecting

survey data, not achieving a high enough overall

response rate to receive weighted results, or omitting

1 or more questionnaire items during administration of

the survey.

Survey questions and data are available at: 

http://www.cdc.gov/healthyyouth/yrbs/pdf/ 

questionnaire/2011_hs_questionnaire.pdf and http:// 

www.cdc.gov/healthyyouth/yrbs/data/index.htm.

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Policy and Environmental 

Indicators 

Percentage of census tracts in a state that have at 

least one healthier food retailer located within the 

tract or within 1/2-mile of tract boundaries* 

Numerator: Number of census tracts that have at least

one healthier food retailer within the tract or within

one-half mile of the tract boundary. Two separate

national-level directories on retail food stores were

used to develop a comprehensive list of healthier food

retailers in the U.S.:3,16 InfoUSA, a proprietary source of

individual store listings, current as of June 2011, and a

list of stores authorized to accept Supplemental Nutrition

Assistance Program (SNAP) benefits as of January 2012.

The following types of stores were defined as healthier

food retailers: larger grocery stores, supermarkets,

supercenters, warehouse clubs, and fruit and vegetable

specialty food stores. General descriptions of these Food

and Beverage and General Merchandise Stores (North

American Industry Classification System (NAICS) codes

445 and 452, respectively) can be found at http://www. 

census.gov/eos/www/naics. Date accessed June 1, 2012.

Further details on methodology for identifying healthier

food retailers are available upon request.

Denominator: Total number of census tracts in the state.

Census Tract Boundaries, 2010 U.S. Census Bureau.

Available at http://www.census.gov/geo/www/tiger/ 

tgrshp2010/tgrshp2010.html. Date accessed June 1, 2012.

State-level healthier food retail policy 

State-level healthier food retail policies include state

legislation enacted between January 1, 2001, and

December 31, 2011 that supported any of the following

goals: a) the building and/or placement of new food

retail outlets (e.g. new supermarkets in underserved

areas, loan financing program for small business

development); b) renovation and equipment upgrades of

existing food retail outlets (e.g. purchasing refrigerators

for corner stores to allow for the sale of fresh produce);

c) increases in and promotion of foods encouraged by

the Dietary Guidelines for Americans, 2010 stocked or

available at food retail outlets (e.g. increase shelf space

for F&V; assistance in marketing of these foods such as

through point of decision information).

1.	 Chronic Disease State Policy Tracking System. Date

accessed June 1, 2012. Available at

http://apps.nccd.cdc.gov/CDPHPPolicySearch.

2.	 National Conference of State Legislatures Healthy

Community Design and Access to Healthy Food

Legislation Database. Date accessed August 11, 2009.

Available at http://www.ncsl.org/?tabid=13227. 

3.	 The Food Trust. Date accessed August 11, 2009.

Available at http://www.thefoodtrust.org/php/ 

programs/super.market.campaign.php#FFFIcreation.

4.	 Patricia L. Smith, The Reinvestment Fund, personal

communication, May 21, 2009.

5.	 Nguyen, L., Kong, J., Barnhart, K., Eyler, A., &

Brownson, R. (2011). State Legislative Search

Guide. Available at http://prcstl.wustl.edu/ 

Documents/2011%20State%20Legislative%20

Search%20Guide.pdf. (Source of state legislative

websites; used to find state bills.)

Number of farmers markets per 100,000 

state residents 

Numerator: Total farmers markets per state. United
 

States Department of Agriculture, Agricultural Marketing
 

Service. USDA National Farmers Market Directory.
 

Released August 2012. Date accessed August 23, 2012.
 

Available at http://apps.ams.usda.gov/FarmersMarkets.
 

Denominator: Population Estimates United States
 

Census Bureau. July 1, 2011. Date accessed July 23, 2012.
 

Available at http://www.census.gov/popest/.
 

Percentage of farmers markets that accept 

SNAP benefits 

Numerator: Number of farmers markets that accept

SNAP benefits. United States Department of Agriculture,

Agricultural Marketing Service. USDA National Farmers

Market Directory. Released August 2012. Date accessed

August 23, 2012. Available at http://apps.ams.usda.gov/ 

FarmersMarkets.

(Note: This is the number of farmers markets with

one or more vendor accepting SNAP benefits based

on survey responses received by USDA’s Agricultural

Marketing Service (AMS). This number will differ

from the official number used by USDA’s Food and

Nutrition Service (FNS), which is based on the number

of organizations and vendors who are authorized to

accept SNAP benefits.)

11 
	 	 	 	 	 	 	

	 	 	 	 	

	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	

	 	 	 	 	 	

	 	 	 	 	 	 	

	 	 	 	 		

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	

	 	 	 	 	 	

	 	 	 	 	 	 	

	 	 	 	 	 	 	

	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	

	 	 	 	 	 	 	

	 	 	 	 	

	 	 	 	 	 	 	

	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	

	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	

	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	 	 	 	

	 	 	 	

	 	 	 	 	 	 	 	 	

	 	 	 	 		 		 	 	

	 	 	 	 	 		 	 	

	 	 	

	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	

	 	 	 	 	 	

	 	 	 	 	

	 	

	 	 	 	 	 	 	

	 	 	 	 	 	

	 	 	 	 	 	

	 	 	 	 	 	 	

	 	 	 	 	 	 	

	 	

Denominator: Total number of farmers markets. United

States Department of Agriculture, Agricultural Marketing

Service. USDA National Farmers Market Directory.

Released August 2012. Date accessed August 23, 2012.

Available at http://apps.ams.usda.gov/FarmersMarkets.

Percentage of farmers markets that accept WIC 

Farmers Market Nutrition Program coupons 

Numerator: Number of farmers markets that accept WIC

FMNP coupons. United States Department of Agriculture,

Agricultural Marketing Service. USDA National Farmers

Market Directory. Released August 2012. Date accessed

August 23, 2012. Available at http://apps.ams.usda.gov/ 

FarmersMarkets.

Denominator: Total number of farmers markets in states

that receive WIC FMNP grants. United States Department

of Agriculture, Agricultural Marketing Service. USDA

National Farmers Market Directory. Released August 2012.

Date accessed August 23, 2012. Available at http://apps. 

ams.usda.gov/FarmersMarkets.

WIC Farmers Market Nutrition Program. Grant Levels

by State FY 2008-2012. Date accessed August 30,

2012. Available at http://www.fns.usda.gov/wic/FMNP/ 

FMNPgrantlevels.htm.

States that authorize farmers to accept WIC Cash 

Value Vouchers 

United States Department of Agriculture, Food and

Nutrition Service. SFMNP/FMNP map. Released

September 2012. Date accessed September 27, 2012.

Available at http://www.fns.usda.gov/wic/SFMNP-FMNPMap.pdf.

Percentage of middle and high schools 

that offer fruits or non-fried vegetables at 

school celebrations 

Numerator: Number of middle and high schools that

responded (via principal survey) “(e) always or almost

always” to Q. 33 “When foods or beverages are offered

at school celebrations, how often are fruits or non-fried

vegetables offered?” States with estimates are those

with weighted data (at least 70% of the principals in

the sampled schools completed the survey). CDC 2010

School Health Profiles, School Principal Survey. Available

at http://www.cdc.gov/healthyYouth/profiles/2010/ 

QuestionnaireP.rtf.

Denominator: Total number of middle and all high

schools surveyed with the exception of schools that

responded “(a) foods or beverages are not offered at

school celebrations” to Q.33 “When foods or beverages

are offered at school celebrations, how often are fruits or

non-fried vegetables offered?”. CDC 2010 School Health

Profiles, School Principal Survey. Available at http://www. 

cdc.gov/healthyYouth/profiles/2010/QuestionnaireP.rtf.

State child care regulations align with national 

standards for serving fruits / vegetables 

Data were derived from the National Resource Center

for Health and Safety in Child Care and Early Education’s

(NRC) analysis of the degree to which state child care

regulations (for licensed child care centers, large or

group family child care homes, and small family child

care homes) reflected national nutrition standards

for serving fruits and vegetables as described in 3rd 

Caring for Our Children: National Health and Safety 

Performance Standards for Early Care and Education 

Programs. The standards specify that children be served

a variety of fruits, especially whole fruits and vegetables,

specifically dark green, orange, deep yellow and root

vegetables. States whose regulations were given a score

of 4 (regulation fully addresses standard) across all 3

childcare types were designated as “yes” whereas states

that received a score of less than 4 in any childcare type

were designated as “no.”

National Resource Center for Health and Safety in Child

Care and Early Education (NRC). 2012. Achieving a

State of Healthy Weight: 2011 update. Aurora, CO:

NRC. Available at: http://nrckids.org/ASHW/ASHW%20 

2011-Final-8-1.pdf.

State-level farm to school/preschool policy* 

State-level farm to school/preschool policies include

state legislation enacted between January 1, 2001, and

December 31, 2011 that supported any component of a

farm to school program or initiative and targeted grades

K-12 or child care and early care and education.10

Components can include: serving F&V purchased from

local/regional farms; providing agriculture and nutrition

education opportunities; and supporting local and

regional farmers.

1.	 Chronic Disease State Policy Tracking System. Date

accessed June 1, 2012. Available at http://apps.nccd. 

cdc.gov/CDPHPPolicySearch.

2.	 National Conference of State Legislatures Healthy

Community Design and Access to Healthy Food

Legislation Database. Date accessed August 11, 2009.

Available at http://www.ncsl.org/?tabid=13227. 

12 
	 	 	 	 	 	 	

	 	 	 	 	 	 	

	 	 	 	 	

	 	 	 	 	 	 	 	 	

	 	 	 	 	 	

	 	 	

	 	 	 	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	

	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	

	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	

	 	 	 	 	

	 	 	 	 	 	 	

	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	

	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	

	 	 	 	 	 	 	

	 	

	 	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	 	

	 	 	 	 	 	

	 	 	 	 	 	

	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	 	

	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	 	

	 	 	 	 	 	 	

3.	 National Farm to School Network and Community

Food Security Coalition. State Farm to School

Legislation, Updated 8/17/11. Available at http://www. 

farmtoschool.org/files/policies_114.pdf.

4.	 Nguyen, L., Kong, J., Barnhart, K., Eyler, A., &

Brownson, R. (2011). State Legislative Search

Guide. Available at http://prcstl.wustl.edu/ 

Documents/2011%20State%20Legislative%20

Search%20Guide.pdf. (Source of state legislative 

websites; used to find state bills.) 

Number of food hubs in each state 

The number of food hubs by state was based on the list

available on the USDA, Agricultural Marketing Service

website as of the accessed date. Multiple models of food

hubs are included in the list: farm to consumer, farm to

business/institution, and a combination of the two. Food

hubs may be cooperative, nonprofit, publicly held, or

privately held business.

United States Department of Agriculture, Agricultural

Marketing Service. Working List of Food Hubs. Updated

September 1, 2012. Date accessed September 1, 2012.

Available at http://www.ams.usda.gov/AMSv1.0/foodhubs.

Percentage of cropland acreage harvested for fruits 

and vegetables 

Every five years the Census of Agriculture collects

comprehensive agricultural data from U.S. farms and

ranches producing $1000 or more of agricultural

products. Crop production is measured for the calendar

year, except for avocados, citrus, and olives for which the

production year overlaps the calendar year. Harvested

cropland includes land from which crops were harvested,

land used to grow short-rotation woody crops, and

land in orchards, citrus groves, vineyards, nurseries, and

greenhouses. Land from which two or more crops were

harvested was counted only once.

Numerator: Total cropland harvested for fruits and

vegetables includes: Table 29 Vegetables, page 508;

Table 32 Fruits (excluding nuts), page 543; Table 33

Berries, page 560. National Agricultural Statistics Service,

United States Department of Agriculture. 2007. Census of

Agriculture. Available at http://www.agcensus.usda.gov/ 

Publications/2007/Full_Report/usv1.pdf.

Denominator: Total cropland harvested in the state

found in: Table 1, State Summary Highlights: 2007, page

276. National Agricultural Statistics Service, United States

Department of Agriculture. 2007. Census of Agriculture.

Available at http://www.agcensus.usda.gov/ 

Publications/2007/Full_Report/usv1.pdf.

State-level food policy council 

States with state-level councils listed in this report have a

named point of contact on the Community Food Security

Coalition website as of the accessed date. Recognized

state food policy councils exist to influence state food

policy and to coordinate the work of the area food

system stakeholders. Those listed include councils of

various types at different stages of development.

Community Food Security Coalition. 2012. Food Policy

Council Program. Date accessed July 16, 2012. Available

at http://www.foodsecurity.org/FPC/council.html.

Number of local food policy councils in each state 

Local councils enumerated in this report have a named

point of contact on the Community Food Security

Coalition website as of the accessed date. Recognized

local food policy councils exist to influence local,

county or regional food policy and to coordinate the

work of the area food system stakeholders. Those listed

include councils of various types at different stages of

development.

Community Food Security Coalition. 2012. Food Policy

Council Program. Date accessed July 16, 2012. Available

at http://www.foodsecurity.org/FPC/council.html.

* Indicator definition or data source varies from

2009 indicator, therefore direct comparisons are not

recommended.

Links to non-Federal organizations are provided solely as a service to our users. These links do not constitute an 

endorsement of these organizations or their programs by CDC or the Federal Government, and none should be inferred. 

CDC is not responsible for the content of the individual organization Web pages found at these links. 

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References 


1.	 U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for 

Americans, 2010. 7th Edition, Washington, DC: U.S. Government Printing Office, December 2010. http://health.gov/ 

dietaryguidelines/dga2010/DietaryGuidelines2010.pdf. Accessed May 1, 2012.

2.	 Larson MI, Story M, Nelson MC. Neighborhood environments disparities in access to healthy foods in the U.S.

American Journal of Preventive Medicine 2009;36(1):74–81.

3.	 United States Department of Agriculture Economic Research Service. Access to Affordable and Nutritious Food:

Measuring and Understanding Food Deserts and Their Consequences. 2009. http://www.ers.usda.gov/Publications/ 

AP/AP036/AP036.pdf. Accessed July 2, 2012.

4.	 Seymour JD, Fenley MA, Yaroch AL, Khan LK, Serdula M. Fruit and vegetable environment, policy, and pricing

workshop: introduction to the conference proceedings. Prev Med 2004;39(2)S71–4.

5.	 Story M, Kaphingst KM, Robinson-O’Brien R, Glanz K. Creating healthy food and eating environments: policy and

environmental approaches. Annu Rev Public Health 2008;29:253–72.

6.	 Centers for Disease Control and Prevention. Strategies to Prevent Obesity and Other Chwvronic Diseases: The CDC

Guide to Strategies to Increase the Consumption of Fruits and Vegetables. Atlanta: U.S. Department of Health and

Human Services; 2011. http://www.cdc.gov/obesity/resources/recommendations.html.

7.	 IOM (Institute of Medicine). 2007. Nutrition Standards for Foods in Schools: Leading the Way Toward Healthier

Youth. Washington, DC: The National Academies Press. http://www.iom.edu/CMS/3788/30181/42502.aspx.

8.	 Centers for Disease Control and Prevention. School Health Guidelines to Promote Healthy Eating and Physical

Activity. MMWR 2011;60(5):1-76.

9.	 National Resource Center for Health and Safety in Child Care and Early Education (NRC). 2011. Achieving a State of

Healthy Weight: A National Assessment of Obesity Prevention Terminology in Child Care Regulations 2010. Aurora,

CO: NRC. Data updated for 2011 by NRC June, 2012; update available upon request.

10. Joshi A, Azuma AM, Feenstra G. Do Farm-to-School Programs Make a Difference? Findings and Future Research

Need. Journal of Hunger & Environmental Nutrition 2008;3:(2)229–246.

11. Joshi A, Azuma AM. Bearing fruit: Farm to School Program evaluation resources and recommendations. Los

Angeles: Center for Food and Justice, Occidental College; 2008.

12. Sobal J, Khan LK, Bisogni C. A conceptual model of the food and nutrition system. Soc Sci Med 1998;47(7):853–63.

13. Barham, James, Debra Tropp, Kathleen Enterline, Jeff Farbman, John Fisk, and Stacia Kiraly. Regional Food Hub

Resource Guide. U.S. Department of Agriculture, Agricultural Marketing Service. Washington, DC. April 2012.

14. U.S. Department of Agriculture, Agricultural Marketing Service. Food Hubs: Building Stronger Infrastructure for

Small and Mid-Size Producers. Date accessed July 16, 2012. www.ams.usda.gov/foodhubs.

15. Community Food Security Coalition. North American Food Policy Council. Date accessed July 16. 2012. http://www. 

foodsecurity.org/FPC.

16. Auchincloss AH, Moore KAB, Moore LV, Diez Roux AV. Improving characterization of the food environment for a

large region in the United States during a historic time period. Health & Place, In Press.

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Centers for Disease Control and Prevention. State Indicator Report on Fruits and Vegetables, 2013. Atlanta, GA:
 

Centers for Disease Control and Prevention, U.S. Department of Health and Human Services; 2013.
 
For more information please contact 

Centers for Disease Control and Prevention
 

1600 Clifton Road NE, Atlanta, GA 30333
 

Telephone: 1-800-CDC-INO (232-4636/TTY: 1-888-232-6348
 

www.cdc.gov/info 


http://www.cdc.gov/nutrition/professionals/data/
 

Publication date: May 2013