CBS-HEAL Publications

At a glance

The published papers listed here use data from the 2014 National Survey of Community-Based Policy and Environmental Supports for Healthy Eating and Active Living (CBS-HEAL). They are sorted by topic and include a summary of the main findings.

Stack of reports

Healthy eating

Nutrition Standards for Food Service Guidelines for Foods Served or Sold in Municipal Government Buildings or Worksites, 2014

  • 3% of U.S. municipalities reported having nutrition standards.
  • Prevalence was higher in municipalities with larger populations:
    • 13% for those with 50,000 residents or more.
    • 2% for those with fewer than 2,500 residents.

Nationally representative survey‎

CBS-HEAL is a CDC survey of a nationally representative sample of U.S. municipalities. Survey results can help researchers and public understand existing community-level policies and practices that support healthy eating and active living.

Community-Based Policies and Support for Free Drinking Water Access in Outdoor Areas and Building Standards in U.S. Municipalities

  • More than half (56%) of local governments had a community plan to include free drinking water in outdoor areas.
  • Municipalities in the Northeast and South were less likely to have a plan.
  • Municipalities with fewer non-Hispanic White residents (50% or less) were less likely to have a plan.
  • Municipalities with larger populations were more likely to have a plan.

Local Government Retail Incentives for Healthier Food Retailers in the United States, 2014

  • About two-thirds (67%) of municipalities reported incentives to support farmers' markets.
  • Common incentives included:
    • Tax credits for supermarkets.
    • Permission for farmers' markets to sell products on city property.
    • Links to revitalization projects for smaller stores.
  • Municipalities with larger populations were more likely to use incentives.

Associations Between Food Policy Councils and Policies That Support Healthy Food Access: A National Survey of Community Policy Supports

  • 8% of municipalities reported having a local or regional food policy council.
  • Food policy councils were more common in:
    • Municipalities with 50,000 or more residents.
    • Municipalities in the West.

Prevalence of Municipal-Level Policies Dedicated to Transportation That Consider Food Access

  • About one-third (34%) of municipalities reported no public transit.
  • Public transit and demand-responsive transit were less common in:
    • Municipalities with fewer than 2,500 residents.
    • Municipalities in the South.

Active living

Shared Use Agreements Between Municipalities and Public Schools in the United States, 2014

  • About 4 in 10 municipal officials reported a shared use agreement.
  • Municipalities with fewer than 2,500 residents were less likely to have a shared use agreement.

Prevalence of Complete Streets Policies in U.S. Municipalities

  • 25% of municipalities had a Complete Streets policy.
  • Prevalence was lower in:
    • Municipalities with fewer than 2,500 residents.
    • Municipalities with a lower median education level.
    • Municipalities located in the South.

Prevalence of Master Plans Supportive of Active Living in U.S. Municipalities

  • 89% of municipalities reported having a master plan supportive of active living.
  • Nearly half of municipalities had a transportation plan (46%) or a bicycle or pedestrian plan (48%).
  • Prevalence of a master plan was lower in rural municipalities.

Supporting Active Living Through Community Plans: The Association of Planning Documents With Design Standards and Features

  • Prevalence of activity-friendly design standards in community plans ranged from 19% for dedicated right-of-way for bicycles to 50% for traffic-calming in places with high pedestrian and bicycle volume.
  • Features required in development policies ranged from 14% for short or medium block sizes to 44% for minimum sidewalk widths of 5 feet.

Public Health Representation on Active Transportation Bodies Across U.S. Municipalities

  • About 9 in 10 U.S. municipalities have a planning or zoning commission.
  • Only 1 in 6 municipalities has an active transportation advisory committee.
  • Public health representation on active transportation bodies across U.S. municipalities is low.
  • Active transportation bodies are less common in:
    • Municipalities with fewer than 2,500 residents.
    • Municipalities with a lower median education level.
    • Rural municipalities.
    • Municipalities in the South.

Differences in Park Plans and Policies Across U.S. Municipalities

  • About 7 in 10 municipalities with at least 1,000 residents reported having a parks and recreation plan.
  • Prevalence of a parks and recreation plan and of park or outdoor recreation policies was lower in smaller communities.

Methods: 2012 pilot

Development and Implementation of a Local Government Survey to Measure Community Supports for Healthy Eating and Active Living

CDC developed a 38-item, web-based, self-administered survey and sampling frame. The frame helped assess the prevalence of 22 types of healthy eating and active living policies in a representative sample of local governments.

A majority of respondents reported that the survey required minimal effort to complete. Half said they took the survey in less than 20 minutes.