As America gets fatter, policymakers are seeking creative approaches to legislating health. They may have entered the school cafeteria -- and now they're eyeing your neighborhood.
Amid worries of an obesity epidemic and its related illnesses, including high blood pressure, diabetes and heart disease, Los Angeles officials, among others around the country, are proposing to limit new fast-food restaurants -- a tactic that could be called health zoning.
The City Council will be asked this fall to consider an up to two-year moratorium on new fast-food restaurants in South L.A., a part of the city where fast food is at least as much a practicality as a preference.
"The people don't want them, but when they don't have any other options, they may gravitate to what's there," said Councilwoman Jan Perry, who proposed the ordinance in June, and whose district includes portions of South L.A. that would be affected by the plan.
In just one-quarter of a mile near USC on Figueroa Street, from Adams Boulevard south, there are about 20 fast-food outlets.
"To be honest, it's all we eat," Rey Merlan said one recent lunch hour at a Kentucky Fried Chicken. "Everywhere, it's fast food everywhere."
Merlan said it wasn't likely that a limit on new restaurants would change peoples' habits, even though he thinks it's a good idea.
A Times analysis of the city's roughly 8,200 restaurants found that South Los Angeles has the highest concentration of fast-food eateries. Per capita, the area has fewer eating establishments of any kind than the Westside, downtown or Hollywood, and about the same as the Valley. But a much higher percentage of those are fast-food chains. South L.A. also has far fewer grocery stores.
Thirty percent of adults in South L.A. are obese, compared with 20.9% in the county overall, according to a county Department of Public Health study released in April. For children, the obesity rate was 29% in South L.A., compared with 23.3% in the county.
And the figures are higher than a decade ago. In 1997, the adult rate was 25.3% in South L.A. and 14.3% in the county. South L.A. also has the highest diabetes levels in the county, at 11.7%, compared with 8.1% in the county.
"While limiting fast-food restaurants isn't a solution in itself, it's an important piece of the puzzle," said Mark Vallianatos, director of the Center for Food and Justice at Occidental College.
This is "bringing health policy and environmental policy together with land-use planning," he said. "I think that's smart, and it's the wave of the future."
Fast-food restaurants haven't missed the cue: From their menus, diners can choose salads over burgers, yogurts over shakes and grilled over fried these days. And many food manufacturers have reconfigured their recipes to eliminate trans fats, the most unhealthful unsaturated fats made of partially hydrogenated oils.
But especially for children, what's to eat is not completely a matter of choice. Legislators in California and elsewhere are giving closer scrutiny to school food. In 2002, the Los Angeles Unified School District was one of the first school districts in the country to ban soda, candy and other high-fat snack foods from school vending machines as of July 2004. The next year the school board decided to reduce sodium, sugar and fat in school lunches. At the federal level, there are proposals in the farm bill to spend an additional $3 billion over five years on fruits and vegetables for school programs.
A California law banning sugary drinks and limiting the fat and sugar content of foods sold in middle and high schools took effect in July. And the state enacted legislation last year to increase the purchase of fruits and vegetables to be sold in corner stores in lower-income communities.
Rep. Mary Bono (R-Palm Springs) introduced a bill in Congress in June that, among other things, would try to increase the availability of nutritious foods in economically depressed areas.
Regulations by cities
Some cities already regulate fast-food restaurants in certain areas, including Berkeley and Arcata, Calif.
Port Jefferson, N.Y.; Concord, Mass.; and Calistoga, Calif., ban fast-food restaurants in certain districts entirely, according to L.A. city planner Faisal Roble, who drafted Perry's ordinance.
But those earlier regulations are primarily tied to aesthetics or to the protection of smaller businesses, rather than to health concerns, said David Gay, L.A.'s principal city planner.
Perry's ordinance -- a moratorium intended to give the city time to come up with a long-term plan -- would, if passed, affect more than 700,000 residents of South Los Angeles, including West Adams, Baldwin Hills and Leimert Park.
Compared with the Westside, for example, that area has far fewer restaurants -- about 900 versus 2,200, according to The Times' analysis. And about 45% of the restaurants in South Los Angeles are fast-food chains or restaurants with minimal seating, compared with 16% on the Westside.
The analysis also highlights underlying issues that have plagued other lower-income urban areas around the country. Such concentrations of fast food have helped cultivate a reliance on their price and convenience, said Gwendolyn Flynn, policy director for the Community Health Councils, a Los Angeles health policy advocacy organization.
Catalina Ayala, 23, who grew up in South Los Angeles, lives three blocks from a McDonald's and a slew of other fast-food restaurants, and eats fast food about four times a week.
"By the time I go home, it's already too late to cook food," said Ayala, who works at LAX.
On a recent afternoon, Ayala and her husband were at a McDonald's. Their 3-year-old son played in the indoor playground, which for some families serves as their children's park.
But her husband, a 23-year-old construction worker in South L.A., said he avoids fast food.
"It's not for me," he said. "Later on sometimes, your son is too fat, he eats too much."
That was one reason Terrah Cephas, 32, left South L.A. for the Valley about two years ago.
"It's fast food on every corner, but it's not enough wholesome restaurants," she said. "You literally have to be willing to drive to Long Beach or Santa Monica, or Inglewood."
That's if you have a car.
Many South L.A. residents are "almost a captive audience for these restaurants, unfortunately," Flynn said.
In South Los Angeles, 28% of people live in poverty, compared with 16.2% of the county, according to county figures.
South L.A. has lots of fast-food restaurants because these restaurants do well in areas where people might not want to spend $15 on lunch, said Dennis Lombardi, executive vice president of Foodservice Strategies at WD Partners, a restaurant consulting firm that works with Red Lobster, Jamba Juice and Fatburger, among others.
But there also may be missed opportunities: According to a 2005 market study contracted by the city, South L.A. loses more than $400 million annually in general merchandise, grocery and restaurant sales to outside areas.
"The community has suffered for decades by an assumption that attracting business of any type is good, and it's not true," Perry said.
The city defines fast-food restaurants as those that sell food to eat there or to take out and have a limited menu, items prepared in advance or heated quickly, no table orders and disposable wrapping or containers.
"Part of the debate is even what is fast food, and it's a tricky thing," said city planner Gay. "Everybody has an impression, but when you try to write an ordinance, you have to be very legalistic about it."
The restaurant industry opposes such ordinances, in part because it's hard to define fast food, and although Perry's proposal allows for exceptions to the ban, some say that's not enough.
Restricting new restaurants to full-service, sit-down spots is "like saying we're not going to allow anybody to sell Chevrolets anymore because we want people to buy nothing but Mercedes-Benzes," consultant Lombardi said. "It's convoluted logic. If the objective is to get full-service, upscale casual dining restaurants in an area, I think the first step is finding out why they're not coming in an area, then start addressing those, and start by incentivizing."
The city already offers such incentives in South L.A., including speedier permit processing, Perry said.
And there's no way to ensure one result: getting people to change their eating habits.