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State-Level Farmers Market Activities: A Review of CDC-Funded State Public Health Actions That Support Farmers Markets

Kahin, Sahra A. MA, MPH; Wright, Demia S. MPH; Pejavara, Anu MPH; Kim, Sonia A. PhD

Journal of Public Health Management & Practice: March/April 2017 - Volume 23 - Issue 2 - p 96–103
doi: 10.1097/PHH.0000000000000412
Research Articles

Context: Introducing farmers markets to underserved areas, or supporting existing farmers markets, can increase access and availability of fruits and vegetables and encourage healthy eating. Since 2003, the Centers for Disease Control and Prevention (CDC)'s Division of Nutrition, Physical Activity, and Obesity (DNPAO) has provided guidance and funding to state health departments (SHDs) to support the implementation of interventions, including activities around farmers markets, to address healthy eating, and improve the access to and availability of fruits and vegetables at state and community levels.

Objective: For this project, we identified state-level farmers market activities completed with CDC's DNPAO funding from 2003 to 2013. State-level was defined as actions taken by the state health department that influence or support farmers market work across the state.

Design and Participants: We completed an analysis of SHD farmers market activities of 3 DNPAO cooperative agreements from 2003 to 2013: State Nutrition and Physical Activity Programs to Prevent Obesity and Other Chronic Diseases; Nutrition, Physical Activity and Obesity Program; and Communities Putting Prevention to Work. To identify state farmers market activities, data sources for each cooperative agreement were searched using the key words “farm,” “market,” “produce market,” and “produce stand.” State data with at least one state-level farmers market action present were then coded for the presence of itemized activities.

Results: Across all cooperative agreements, the most common activities identified through analysis included the following: working on existing markets and nutrition assistance benefit programs, supporting community action, and providing training and technical assistance. Common partners were nutrition assistance benefit program offices and state or regional Department of Agriculture or agricultural extension offices.

Implications for Policy & Practice: Common farmers market practices and evidence-based activities, such as nutrition assistance benefits programs and land-use policies, can be adopted as methods for farmers market policy and practice work.

Conclusion: The activities identified in this study can inform future planning at the state and federal levels on environment, policy, and systems approaches that improve the food environment through farmers markets.

Division of Nutrition, Physical Activity and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia (Ms Kahin and Ms Pejavara and Dr Kim); and Worker Training Program, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina (Ms Wright).

Correspondence: Sahra A. Kahin, MA, MPH, Division of Nutrition, Physical Activity and Obesity, Centers for Disease Control and Prevention, 4770 Buford Hwy, NE, MS F-77, Atlanta, GA 30341 (

The authors thank Deborah Galuska for her thorough reviews and insightful feedback. The authors also acknowledge state health department staff for their efforts to increase access to and affordability and consumption of healthier foods.

All authors were full-time CDC staff during the writing of this article. The CDC funds authors' salaries to do this work.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

The authors declare no conflicts of interest.

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.