Municipal Land Use Planning Policies that Promote Equitable and Sustainable Food Systems

Ontario Dietitians in Public Health

Ontario Dietitians in Public Health (ODPH) represents Registered Dietitians working in Ontario’s Public Health System. Members work together for system approaches that promote health and equity across all populations based on the social, ecological, and commercial determinants of health.

Suggested citation:

Ontario Dietitians in Public Health. Rapid Review: Municipal Land Use Planning Policies that Promote Equitable and Sustainable Food Systems. Ontario: Ontario Dietitians in Public Health; 2024. Available from:

Authors:

Cyndie Pearson, MAEd, RD – Halton Region

Jennelle Arnew, RD, MSc – Chatham-Kent Public Health

Kendall Chambers, RD, MScFN – Southwestern Public Health

Lesley McMullin, RD, MScFN – Simcoe Muskoka District Health Unit

Acknowledgments:

The authors would like to acknowledge that this evidence review was completed with the help and ongoing support of many others. Thank you to Heather Kemp and Stephanie Hopkins from the Halton Region Health Department for assistance in conducting the literature search. Thank you to Robyn Traynor and Emily Clark from the National Collaborating Centre for Methods and Tools for their guidance and support throughout the evidence review process. Thank-you to Amanda Kratochvil, Dietetic Intern with University of Western Ontario for your support in reviewing the articles.

Executive Summary

Background

Registered Dietitians working in population-level health often encounter food system challenges that may negatively impact healthy eating behaviours. Diets are influenced by the same environmental factors that drive our food system, including physical, economic, and social factors (Waterlander et al., 2018). Public health can promote access to the local food system while preventing chronic disease through land use planning policies (e.g., farmland preservation) that promote healthy community design. This rapid review aims to provide Registered Dietitians in local public health agencies with evidence informed land use planning policy recommendations that promote access to nutritious foods within the local food system.

Key Messages

Top down land use planning policies (e.g., provincial and municipal) in combination with bottom up community food initiatives (e.g., local food movements and community food strategies) were associated with farmland preservation.
Top down land use planning policy (e.g., national) on its own was associated with farmland preservation.
A multi-functional land use planning approach, that reflects the various roles food plays (e.g., cultural heritage, aesthetic value, provision of food, economical, ecological, mental health benefits and social functions) was associated with farmland preservation and the promotion of more sustainable, dense urban development.
Government structure and interdepartmental collaboration was associated with influencing the integration of food system issues into land use planning policy. Improved collaboration and interaction between various levels of government (e.g., municipal, provincial, and federal) that encourages incorporation of agriculture and food system strategies (e.g., agricultural strategies and community food strategies) into urban planning policy, may increase support for farmland preservation.
Involvement of diverse community partners (e.g., local food advocates, agri-food sector) with local knowledge and expertise was associated with the development of land use planning policies that protected farmland.
Strong political will of local authorities (e.g., municipal elected officials) was associated with the development of land use planning policies that prioritized the protection of farmland from development.
Regional and municipal official plans and zoning ordinances (e.g., zoning by-laws) have limited content supporting local food systems.
Access to [short supply chain] farmers markets was associated with self-reported increased intake of fruit and vegetables.
Results on the density of favorable food stores’ (e.g., grocery store, fruit and vegetable market) impact on health outcomes was mixed. One study found it to be positively associated with having ideal cardiovascular health among men, but not women. While another study found the density of food outlets to have no association with the odds of higher weights in children.
Access to nutritious foods was associated with greater odds of having ideal cardiovascular health among women but not in men.
Access to lower priced nutritious food options in grocery and convenience stores was associated with lower body weights in children. Neither the distance to the closest food outlet nor the density of food outlets around children’s homes was associated with odds of having a higher body weight.
Results must be interpreted with caution due to the heterogeneity and low quality of the included studies. Nonetheless, there are various [interventions or land use planning policies] applicable to local food systems that can impact the preservation of farmland, food production, food access and diet.

Issue and Context

Registered Dietitians working in public health aim to promote population health and reduce the burden of nutrition-related chronic diseases through community design or specifically land use planning policies that impact food access for our communities. In Ontario, dietary risk factors, such as inadequate vegetable and fruit intake, are a leading risk factor for chronic diseases such as ischemic heart disease, stroke, colorectal cancer and diabetes (CCO and Ontario Agency for Health Protection and Promotion, 2019). Chronic diseases associated with inadequate diets not only reduce the quality and length of people’s lives but are also associated with substantial financial costs (CCO and Ontario Agency for Health Protection and Promotion, 2019). A 2019 joint report by Public Health Ontario and Cancer Care Ontario estimated that inadequate diets results in $41 per person per year in direct healthcare costs, and $82 per person per year in indirect costs such as lost productivity due to disability and premature mortality (CCO and Ontario Agency for Health Protection and Promotion, 2019). In order to reduce the burden of disease, public health has recently focused efforts on addressing the complex and interconnected relationships between the food systems, health and well-being.

Food choices are a complex issue influenced by economic, social and physical factors alongside macro-level environments; many of which are impacted by the components of the food system (Waterlander et al., 2018). Food systems include the factors and outcomes related to food production, processing, distribution, preparation, consumption and waste (High Level Panel of Experts on Food Security and Nutrition, 2017). A community’s food security is dependent on having access to a food system that provides a sustainable supply of nutritious foods.

In Canada, the importance of a sustainable food system has been highlighted by both federal and provincial guiding documents. In 2019, the federal government launched the Food Policy for Canada, which aims to build and support a resilient, innovative, and sustainable food system with equitable access to safe, nutritious, and culturally diverse food (Government of Canada, 2010).

Provincially, a recent report, Ontario Provincial Climate Change Impact Assessment Adaptation Best Practices Report 2023, recommends adaptation best practices applicable to food systems and ultimately food security which include the following:

Protecting farmland and promoting sustainable growth through land use planning.
Promoting local and urban food production and circular economy principles (e.g., community gardens and edible landscaping) and by promoting sustainable dietary patterns.
Developing policies promoting Ontario’s food system (e.g., supporting demand for local food and short supply chains; taking action on food insecurity) (Ministry of the Environment, 2023).

The recommended best practices highlight the importance that land use planning policies play in promoting and sustaining access to a local food system. The need for public health (including Registered Dietitians), to address land use planning issues in preventing chronic disease through healthy community design has been highlighted in several key documents such as The Chief Public Health Officer’s Report on the State of Public Health in Canada: Designing Healthy Living (Public Health Agency of Canada, 2017), the Canadian Institute of Planners Policy on Healthy Communities Planning (Canadian Institute of Planners, 2018) and the Ontario Public Health Standard: Requirements for Programs, Services, and Accountability: Healthy Environments Standard (Ontario Ministry of Health and Long-term Care, 2018).

The guiding and key documents mentioned above, support public health taking action on land use planning policies to promote a sustainable food system which underpins community food security. To our knowledge, no reviews of the evidence of effective land use planning policies promoting a sustainable food system for local regions have been completed.

This evidence review will help inform how public health Registered Dietitians can address land use planning issues to prevent chronic disease through healthy community design. In addition, this evidence review aims to describe the state of peer-reviewed literature on effective land use planning policies at the municipal level that promote an equitable and sustainable food system.

Research Question

This research aims to answer the question ‘What are effective land use planning policies at the municipal level that promote an equitable and sustainable food system?’

Methods

Search

A literature search for articles published between 2013 and up to September 29, 2023 was conducted. The search included the following databases and academic search engines: Academic Search Premier, MEDLINE, Environment Complete, Cochrane Database of Systematic Reviews, GreenFILE, Health Evidence, and Google Scholar. A summary of the search terms and strings used during the search strategy can be found in Appendix 1.

Study Selection Criteria

Articles were eligible for inclusion if they: reported on primary studies¹; assessed municipal food system land use planning policies in urban or rural settings; assessed outcomes related to

agricultural land for food production, food access and availability, and food security; were based in OECD countries²; and were published in English. Articles were excluded if they assessed food systems interventions that were not related to land use policies and did not impact food security.

A summary of the eligibility criteria is included in Table 1.

All four authors were involved in screening articles at the title and abstract stage. Each article’s title and abstract were independently screened by two reviewers. Any conflicts were resolved through discussion. If consensus could not be reached between the two reviewers, a third reviewer was assigned. Full text articles were retrieved for all articles that passed title and abstract screening. Each article’s full text was screened by two reviewers. Where further discussion was needed, a second reviewer screened the article and consensus was reached through discussion among all reviewers. A summary of the literature search and screening process can be found in Table 2.

Table 2: Literature Search and Screening Process

Quality Appraisal

Each included article was independently appraised for quality by two reviewers using critical appraisal tools from the Joanna Briggs Institute (JBI). The specific tool used for each article was based on the reviewers’ assessment of the study design. Any discrepancies were resolved through discussion among the two reviewers. More information on quality appraisal is available upon request.

Data Extraction

Relevant information based on the inclusion criteria (Table 1) from each article was extracted independently by two reviewers. Consensus was achieved through discussion. A summary of the quality appraisal scores and data extraction can be found in Appendix 2.

Data Analysis

The data was analyzed by organizing the findings into conceptual descriptive categories of

recurring themes. Sub themes were created within the categories using the same process. The process was carried out by three reviewers. Consensus was achieved through discussion. The quality of the studies was considered when weighting the findings.

Main Findings

The search identified 126 articles, of which 9 met the inclusion criteria. Of the 9 included articles, 3 were rated as high quality (Perrin, 2013), (Newman et al., 2015), (Lam & Conway, 2018), 2 were rated as moderate quality, (Kassis et al., 2021), (Haines, 2018), and 4 rated as weak quality (Jilcott Pitts et al., 2013) (Polsky et al., 2016), (Unger et al., 2014), and (Le et al., 2016). See Appendix 1 for data extraction tables.

This rapid review aimed to provide detail on effective land use planning policies at the municipal level that promote equitable and sustainable food systems. Findings from this review have been organized into four overarching themes and seven sub themes that emerged from the literature.

Potential land use planning approaches that may enhance farmland protection.
B. Combining top-down policies with bottom-up initiatives may be more effective at preserving farmland.

Two strong-quality case reports by Newman et al. (2015) and Perrin (2013) demonstrated that protecting farmland from urbanization is more effectively achieved when top-down provincial and municipal government³ land use planning policies, are combined with bottom up community initiatives, such as local food movements and community food strategies. The combination of provincial and municipal policy with community interest and engagement in local food; may strengthen and support farmland protection by working towards a similar goal.

Perrin (2013) analyzed two European cities that, in the face of urbanization, were able to protect farmland through municipal planning policy and community mobilization supporting local food strategies. Perrin (2013) found that opportunities that connect farmland, agriculture and food and involving local administrators, civil society organizations and community members, may provide an opportunity for land valorization⁴ enhancing protection of farmland for food production. Perrin (2013) posits that collaborative community initiatives may create rural-urban linkages enhancing the cohesion of peri-urban communities and supporting farmland protection.

Newman et al. (2015) found that a provincial farmland preservation policy in British Columbia, combined with local food movements, were associated with agricultural land protection. Part of the preserved land was used for food systems engagement by urban food networks resulting in urban agricultural initiatives that integrated residential education, food production and environmental sustainability. An additional part of the land was maintained as open fields, wooded areas and ecologically sensitive wet and bog lands supporting ecological sustainability.

B. Top down policy on its own may be effective at preserving agricultural land.

One moderate-quality case series by Kassis et al. (2021) found that a national policy aimed at preserving farmland was effective in protecting the land in the long-term.

Kassis et al. (2021) examined two European communities and reported on the protective elements of a top-down national farmland preservation policy in isolation from other measures. This policy aimed to protect agricultural land areas in rural and peri-urban regions by law.

Although a voluntary policy, once adopted by municipalities, the law created legal permanence making it difficult to change land use from agricultural to other uses (e.g. development), even when the government changed. This helped to ensure long-term preservation of farmland and resilience of local food systems.

C. Multifunctional land use approaches to planning may protect farmland directly or indirectly by promoting sustainable development.

Three strong-quality studies (two case reports and one case series) found that a multifunctional land-use approach may protect agricultural land from development, either directly or indirectly, by promoting increased intensification.

A case series by Lam and Conway (2018) examined the official plans⁵ of ten municipalities in Ontario to assess the inclusion of ecosystem services in urban land use planning policies.

Ecosystem services take a multifunctional approach and consist of nature’s provision of goods such as food and fresh water, as well as benefits, like aesthetic value, cultural heritage significance, mental health benefits and support for active and passive recreation, among others. An ecosystem services approach encourages increased intensification while also promoting environmental conservation and sustainable urban development.

The Lam and Conway (2018) study found that four municipalities had explicitly adopted an ecosystem services approach. All Thirteen official plans reviewed mentioned various ecosystem services, though each municipality had a different approach to incorporating them. The researchers concluded that using an ecosystem services approach in land use planning may help communicate the benefits to community members by linking land use planning, environmental protection and human well-being, indirectly protecting farmland.

Perrin (2013) highlights how shifting to a multifunctional land-use approach for agriculture, which includes cultural heritage, aesthetic value, provision of food, economical, ecological and social functions may strengthen farmland protection. The article details how olive oil and wine production exemplify this multifunctional approach by integrating connections to economic, social, and environmental aspects. These agricultural activities are tied to the region’s cultural heritage as they are key components of the traditional diet, and served a social function as they contributed to a sense of belonging and identification with the region. Furthermore, the markets for these products provided a unique consumer experience, attracting tourists and promoting the region’s agricultural heritage. Inactive protected farmland can also contribute to increased biodiversity and natural habitats. Perrin suggests that recognizing the multifunctionality of local food systems can help integrate farming into urban development planning, rather than viewing it as conflicting with urban development.

Newman et al. (2015) describes how a provincial farmland preservation policy and a local food movement’s urban agricultural initiatives work together to protect farmland. These initiatives use a multifunctional approach, linking land use with various benefits of local food systems. These benefits included social (e.g., community gathering), economic (e.g., low-rent farm parcels), aesthetic value, provision of food (e.g., community gardens and fruit free sharing project), cultural heritage (e.g., historical connection to local farming) and ecological sustainability (e.g., a low water use demonstration garden and the maintenance of ecologically sensitive wet and bog lands). Newman et al. (2015) also suggests how this interplay creates an “agriburbia”, where agriculture significantly shapes suburban landscapes and economies. Newman et al. (2015) suggests that promoting agriburbia may be crucial for the future of sustainable food systems for urban areas.

Notably, two studies found that the role of agriculture contributing to the local food supply is often overlooked. Perrin (2013) observed that other functions of agriculture, such as the cultural, economic, social, and ecological benefits were emphasized more than the food production aspect. Similarly, Lam and Conway (2018) found that while all ecosystem services were mentioned in the reviewed official plans, provisioning, including food production, received the fewest mentions in both municipal and regional official plans.

D. Government structure and policies can support or inhibit the integration of agriculture and food issues in urban planning policy.

One strong-quality case report and one moderate-quality case series found that government structures and interdepartmental collaboration can influence the integration of food system issues into land use planning policy.

A case series by Kassis et al. (2021) found a national farmland preservation procedure can promote local collaboration and coordination between municipal elected officials and agricultural professionals, referred to by the authors as organizational proximity. This collaboration can lead to the development of local food strategies which may further support the preservation of agricultural land.

Perrin (2013) concluded that the way a community’s economic activities and planning responsibilities are organized by sectors can hinder the integration of agriculture and food issues in urban planning. This division of power creates a problem with policy implementation across different levels of government. However, this issue could be overcome by new institutional arrangements that encourage greater interaction between various levels of government (e.g., municipal, regional, provincial and federal) to better incorporate agriculture and food issues into urban planning policy.

Kassis et al. (2021) and Perrin (2013) also found that better integration across government (municipal, provincial, and federal) policies and strategies may increase support for farmland preservation. Kassis et al. (2021) highlighted a lack of integration between agri-food strategies and land use planning policies, suggesting that integrating these could strengthen commitments to farmland preservation and sustainable development. Kassis et al. (2021) also found that a coordinated approach between agri-food strategies and land use planning policies, as urbanization increases, may help mitigate conflicts between land preservation and housing development, ensuring agricultural land is prioritized. Whereas Perrin (2013) found that while agricultural strategies were incorporated into municipal land use planning policies, community food strategies were not integrated into these policies.

E. Representation from diverse community partners may strengthen a collective voice for farmland preservation.

Two strong-quality case reports and one moderate-quality case series collectively demonstrate that involving diverse community partners with local knowledge and expertise strengthens land use planning policies and supports effective farmland preservation.

These studies found that land use planning policies are more effective when a variety of community partners with local knowledge and expertise are involved in their development. This diverse input helps ensure that land use planning policies are tailored to the specific interests, priorities and values of the local community.

In the Newman et al. (2015) case report, local public mobilization by urban residents and local food advocates successfully prevented housing development on land protected under the provincial farmland preservation policy. The protected land became a municipally managed park where local food movement organizations introduced agricultural initiatives such as community gardens, a community gathering barn, provision of low-rent farm parcels and a fruit tree sharing project.

The Kassis et al. (2021) case series found that the national farmland preservation procedure encouraged local coordination among actors in the agri-food sector. This coordination facilitated collective action and long-term preservation of agricultural land. Similarly, the Perrin (2013) case study found both the political commitment of local government (e.g., municipal council, mayor) combined with community involvement (e.g., residents, farmers), resulted in effective preservation of agricultural land.

F. Strong political will may enhance farmland preservation.

One strong-quality case report and one moderate-quality case series found that strong political will of local authorities preserved agricultural land from development.

Kassis et al. (2021) found the political will of local authorities, including members of the Chambers of Agriculture and municipal elected officials, effectively limited peri-urban development and supported agricultural land preservation. Similarly, the Perrin (2013) case report found that the strong political will of both elected officials and the community led to strict land use planning policies that prioritized the preservation of agricultural land. Municipal authorities implemented specific measures in their urban development plans to protect agricultural land. Additionally, the mobilization of civil society fostered collaborative arrangements and community initiatives that further supported farmland protection.

2. Land use planning policies that support local food systems and related uses are underutilized in municipal and regional official plans.

Two studies, one strong-quality case series and one moderate-quality cross sectional study, found that regional and municipal official plans and zoning ordinances have limited content supporting local food systems.

The Lam and Conway (2018) case series reviewed official plans for the inclusion of ecosystem services and found that provisioning, which includes food, is the least mentioned aspect in both municipal and regional official plans. In addition, green infrastructure such as community gardens or rooftop gardens was rarely referenced. The authors noted that a definition for green infrastructure was only added to the Provincial Policy Statement (PPS) in 2014, and municipalities may not have updated their official plans to include it. Lam et al. proposes that a clear definition in the PPS⁶ is needed to help urban planners incorporate ecosystem services into land use plans effectively.

Similarly, a cross sectional study by Haines (2018) examined whether zoning ordinances⁷ (called zoning by-laws in Ontario) in Wisconsin, US, support local food systems. The results showed that elements of food systems (e.g., production, processing) and their associated land uses (e.g., community gardens, food processing) are uncommon in zoning ordinances. When land uses are absent from zoning ordinances, they are effectively prohibited. The author concludes that inadequate zoning ordinances may be a barrier to local food systems.

3. Farmland preservation policies may shape housing forms.

Two studies, one strong-quality case report and one moderate-quality case series, found policies protecting agricultural land shaped housing forms by encouraging increased intensification.

The Kassis et al. (2021) case series found that implementation of a national farmland preservation procedure influenced housing forms in peri-urban areas. By protecting agricultural land, development shifted towards compact forms that supported higher density, resulting in an increase in multi-unit dwellings versus single family homes. This approach reduced urban sprawl and promoted sustainability. Similarly, Perrin (2013) found that implementing strict zoning codes in development plans prioritizing agricultural lands helped to avoid urban sprawl, and encouraged dense urban development.

4. Land use planning policies encouraging access to nutritious food outlets (farmers markets, grocery stores) in all neighborhoods may impact fruit and vegetable consumption and health.

Three weak-quality cross sectional studies explored the association between access to healthy food outlets on various health parameters, including fresh fruit and vegetable intake.

Jilcott Pitts et al. (2013) reviewed associations between access to food venues (farmers markets and supermarkets), shopping patterns, fruit and vegetable consumption (self-reported daily consumption) and health indicators (BMI and blood pressure by clinical measurement) among low-income women of reproductive age (18-44 years) in eastern North Carolina, US. The study, conducted in a university town, stratified its analyses by student status due to potentially different shopping habits between students and non-students. The study found that among non-students, those who shopped at farmers’ markets were more likely to consume five or more servings of fruits and vegetables daily compared to those who did not shop at farmers’ markets. There were no other statistically significant associations between daily fruit and vegetable consumption and shopping patterns or access to food venues.

Unger et al. (2014) assessed the association between levels of cardiovascular health (CVH) and characteristics of the neighborhood environment including the density of favorable food stores and healthy food availability amongst other health indicators. Data from the Multi-Ethnic Study of Atherosclerosis (MESA) which included participants (45 to 84 years old) from six communities across the US were analyzed. For the purposes of this review only the results related to favorable food stores and healthy food availability will be included. Favorable food stores were defined as supermarkets that provided fresh fruits and vegetables and fruit and vegetable markets. The density of favorable food stores was defined as the number of food stores within a 1-mile radius around the participants primary residential address. Healthy food availability was measure by a 120-item food frequency questionnaire (FFQ) defined by five components of a healthy diet (high intake of fruit and vegetables, fish, whole grains; low intake of sodium and sugar sweetened beverages). The density of favorable food stores was found to be positively associated with having ideal CVH among men but not women, even after adjusting for individual sociodemographic factors. In contrast, healthy food availability was significantly associated with greater odds of having ideal CVH among women but not in men.

Le et al. (2016) examined whether proximity to or density (number of retail or food services outlets within a given geographic area) of grocery, convenience stores or fast food restaurants, or the prices of nutritious food options were more strongly associated with higher body weight risk in children (aged 10-14 years) in Saskatoon, SK. For the purposes of this review only the results related to grocery and convenience stores will be included. They found that children who had access to lower priced nutritious food options in grocery and convenience stores within walking distance (800 meters) of home had lower body weights. Neither the distance to the closest food outlet nor the density of food outlets around children’s homes was associated with odds of overweight/obesity and they did not find it statistically significant.

Conclusion

Implications for practice

The following implications for practice are based on low certainty of evidence, due to the nature of the study designs, in the evidence available. The evidence was limited to observational studies that are not designed to establish causation. Case reports and case series are particularly prone to bias. However, this is the best available evidence we have at this time and therefore the findings should be considered as part of the evidence informed decision making framework.

Registered Dietitians in public health, and other professionals, are encouraged to consider the main findings of this review, as well as the following implications for practice, to help inform how effective land use planning policies can promote an equitable and sustainable food system.

Involving public health in the consultation and development process of municipal official plans may help municipal decision makers understand the impact of land use planning decisions on health and wellbeing. In Ontario, where agriculture is often looked at as a commodity rather than a contributor to the regional food supply, linking land use planning policy and food in official plans is important for public understanding. Public health consultation helps provide an opportunity for land valorization and may further promote protection of farmland for local food production.
To protect farmland from urbanization, public health can advocate for land-use planning that aligns bottom up initiatives (e.g., agricultural strategies and community food strategies) with existing provincial and municipal land use policies. Public health can support connections between existing community food system initiatives and land-use policies, which may further protect agricultural land from urbanization.
It may be beneficial for public health to liaise with urban planners to encourage using a multifunctional land use approach to planning. A multifunctional land use approach integrates consideration for different elements which may include food production, health, cultural, ecological and social functions. This type of approach may help communicate the benefits to community members by conveying a rationale of the link between land use planning, environmental protection and human well-being and therefore indirectly protect farmland.
Public health professionals can encourage the integration of agriculture and food systems as a consideration within different departmental policies (e.g., planning, transportation, climate change, parks and recreation, health etc..) and across various levels of government (e.g., municipal, regional, provincial and federal) through collaboration. By advocating for a coordinated approach to land-use planning, public health may help mitigate conflicts between the need for farmland preservation and the demand for housing development.
Public health may help leverage and enhance the community engagement phase of the official planning process by providing knowledge translation to community residents and organizations about the linkages between land use planning decisions and health and wellbeing to promote their participation in the consultation process.
Food systems planning may be more readily advanced when elected officials understand and prioritize food system issues, and then support and develop relevant policies. Where political will is lacking, it may be beneficial for public health and planners to engage advocacy and education activities to build broader support.
Public health can continue to support advocacy efforts at the provincial level protecting agricultural lands (e.g., The Greenbelt Plan) which promotes a sustainable food system. By supporting legal frameworks that make it challenging to convert agricultural land to other uses, practitioners can contribute to maintaining local food systems. Advocating for effective national and/or provincial land-use policy can ensure long-term land protection. In addition, protecting agricultural land, even when not in use, preserves natural ecosystems and the land can be used in future for agriculture, as it will not be lost to development or other competing priorities⁸.
It may be beneficial for public health to promote the inclusion of land use planning policies supportive of local food systems elements (e.g., production, processing) and associated uses (e.g., community gardens, rooftop gardens, edible landscaping) in the development of official plans, as many plans may have limited references to these aspects.
It may be beneficial for public health to promote policies protecting agricultural land as also promoting development occurring in a compact form supportive of higher density. This form of development reduces urban sprawl, is more sustainable and supports the planning principles of complete communities⁹.
Increased access to nutritious food outlets may impact health. Strategies such as increasing the density of nutritious food outlets and lowering prices of nutritious foods should be considered. Public health can continue to advocate for nutritious food access, as it may be associated with an increase in the purchase and consumption of these foods.Some of the studies reviewed focused on local or regional efforts (e.g., European cities, British Columbia) and findings might not be generalizable to other contexts with different

Limitations

The studies included in this rapid review do not provide evidence for the experiences of populations who live with social and structural inequities, such as Indigenous or racialized communities. Further research is required to ensure representation of these populations for decision making.
The review findings are shaped by colonial systems and perspectives, which may overlook valuable insights from Indigenous knowledge systems about effective sustainable land-use practices. Incorporation of Indigenous-led land use planning and food system initiatives can help inform effective and equitable land use planning.
The nature of a rapid review involves a quicker, potentially less thorough, search and cannot report the same level of detail as a systematic review.
Many included studies were single studies that were observational in nature, such as case reports and case series, which are prone to bias and cannot establish causation. This limits the strength and reliability of the conclusions, however, this is the best available evidence we have at this time and therefore the findings should be considered as part of the evidenced informed decision making framework.
The variability in the quality of the included studies (3 high quality, 2 moderate quality, and 4 weak quality) may affect the robustness of the review’s findings.
Some of the studies reviewed focused on local or regional efforts (e.g., European cities, British Columbia) and findings might not be generalizable to other contexts with different land use planning policies and political environments.

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