Changes in the food environment surrounding schools in four New Jersey school districts between school years 2012-13 and 2019-20.

Objective: While public health policies have mostly targeted the food environment within schools, recent research shows that the food environment surrounding schools is also related to children's diet and health outcomes. The goal of this paper was to examine changes in the food environment around schools from school year 2012-13 to 2019-20 in four New Jersey school districts.

Methods: We analyzed data from 152 kindergarten - 12th grade public schools in Camden, Newark, New Brunswick, and Trenton for 2012-13 to 2019-20. Food outlets within 0.25-mile buffers around schools were classified into convenience stores, limited-service restaurants, small grocery stores, and upgraded convenience stores. Multivariable Poisson and negative binomial regression models were used to evaluate trends in food outlet prevalence over the study period.

Results: The number of convenience stores decreased by 6 % annually (exp(βi) = 0.94, 95 % CI: 0.91; 0.96), while the number of upgraded convenience stores (carrying a selection of healthier items) increased by 30 % annually (exp(βi) = 1.30, 95 % CI: 1.17; 1.44). Other outlet types, such as small grocery stores and limited-service restaurants, remained stable.

Conclusions: Although unhealthy outlets remained the most prevalent, there were improvements in the food environment around schools over the study period. Notably, these changes coincided with local policy initiatives aimed at improving healthy food offerings in convenience stores. Local policies can improve the food environment around schools by increasing access to healthier options. Policies aimed at improving the food environment around schools are crucial for supporting children's health and enhancing the effectiveness of school nutrition programs.