To: Board of Supervisors
From: Dr. Grant Colfax, Health Services Director
Report Title: Report on Healthy Retail and Options at the Point of Sale
☒Recommendation of the County Administrator ☐ Recommendation of Board Committee
RECOMMENDATIONS:
ACCEPT a report from Contra Costa Health (CCH) with updates on CCH staff activities related to retailer survey and development of an ordinance that promotes the placement of healthy food options at the point of sale in certain stores, since the last report at the November 5, 2024, Board of Supervisors meeting; and
INTRODUCE Ordinance No. 2025-04, requiring large retail stores, over 2,000 square feet, within unincorporated Contra Costa County to stock healthy foods and beverages in checkout areas, WAIVE reading, and FIX October 7, 2025, for adoption.
FISCAL IMPACT:
The fees for inspections will be covered by the permit fees for the subject retailers, resulting in no impact to the County’s general fund. Potential fiscal impact could include re-inspection fees applied by Contra Costa Environmental Health for retailers who violate the ordinance.
BACKGROUND:
According to the Centers for Disease Control (CDC), children's and adults’ consumption of added sugar and sodium has increased the population’s risk of developing type 2 diabetes, heart disease, and other chronic health conditions. Grocery and convenience stores are the top sources of foods and beverages, and they generally stock snacks high in sodium, saturated fat, and added sugars in their checkout areas. Studies have shown an association between living in a neighborhood near healthy food options and better dietary quality, higher fruit/vegetable intake, and a lower risk of having a higher body weight, even after controlling for individual-level characteristics. Accordingly, changing the retail environment to include more nutritious food and beverage standards at the points of sale can contribute to better health and well-being of children and families in Contra Costa County.
In Contra Costa County, the 2019 Kidsdata.org analyzed the FitnessGram Report and revealed that 24.5% of 5th and 27.2% of 7th-grade students are obese, with its highest obesity rates among children of color. Rates are highest among communities of color, with over 40% for African Americans, close to 50% for Hispanic and Latinos, and 60% for Native Hawaiian/ Pacific Islanders.
With the above in mind, in May 2022, CCH staff and youth from Bay Area Community Resources (BACR) presented a report to the Board of Supervisors on the potential health benefits of enacting a policy which required that healthy snack options shall be stocked at the point-of-sale. Specifically, the policy would require the placement of healthy food options at the point of sale or checkout queues within stores over 2,000 square feet. The Board of Supervisors accepted the report, and CCH staff was directed to conduct additional research on this matter and to present their findings to the Family and Human Services (FHS) Committee.
In February 2023, CCH and BACR reported on the above directives to the FHS (FHS) Committee. After accepting the report, the FHS Committee directed CCH staff to solicit feedback from the 32 retailers within unincorporated Contra Costa County, who would be subject to the proposed policy, and thereafter, present their findings to the Board of Supervisors.
In the Summer and Fall of 2023, CCH staff conducted two surveys of retailers and held two town hall meetings to garner retailer input on the proposed ordinance and to allow their questions and concerns to be heard. Findings from the surveys and town halls were presented to the Board of Supervisors on November 5, 2024, at which time the Board of Supervisors directed CCH staff to develop an Ordinance promoting the placement of healthy food options at the point of sale in retail stores greater than 2,000 square feet in unincorporated Contra Costa County.
The attached Ordinance No. 2025-04 would require large retail stores, over 2,000 square feet, within unincorporated Contra Costa County, to stock healthy foods and beverages in their checkout areas. Specifically, the Ordinance requires the subject stores to only sell the following within their checkout areas: (1) foods with no more than five grams of added sugar and no more than 200 milligrams of sodium per labeled serving; (2) gum and mints with no added sugars; and (3) beverages with no added sugar and no artificial sweetener.
To promote this Ordinance and assist the subject retailers in complying with the Ordinance, an “implementation period” of twelve (12) months will be in effect from the effective date of the Ordinance. During this period, no fines or administrative penalties will be imposed against the subject retailers. During the implementation period, subject retailers will be educated about the new Ordinance and receive technical assistance, including guidance on nutrition standards and no penalty inspections. After the implementation period ends, the County will enforce the ordinance as permitted under the County Ordinance Code.
CONSEQUENCE OF NEGATIVE ACTION:
A lack of healthy food options at a retailer checkout can contribute to higher consumption of unhealthy foods and drinks that lead to poor diets, higher rates of obesity, and other health concerns. This could also impact governmental costs associated with treating diseases resulting from poor nutrition.