2018 State Indicator Report On Fruits And Vegetables

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2018STATE INDICATOR REPORT ONFRUITS ANDVEGETABLES

Centers for Disease Control and Prevention. State Indicator Report on Fruits and Vegetables, 2018. Atlanta, GA:Centers for Disease Control and Prevention, U.S. Department of Health and Human Services; 2018.

2 01 8State Indicator Report on Fruits and Vegetables3Executive SummaryWhat is This Report?Despite the health benefits of fruits and vegetables, Americans are notconsuming enough in their daily diet. States and communities can help citizensconsume more fruits and vegetables by making them convenient and affordablein the places where children and adults live, work, learn, and play. This isparticularly important for individuals and families that face food insecurity orlack access to stores selling quality produce at reasonable prices.The State Indicator Report on Fruits and Vegetables, 2018, shows the status of10 indicators of fruit and vegetable access and production by state.Key findings from this report include:The 2018 State IndicatorReport on Fruits andVegetables can be used to: Describe how states cansupport a strong foodsystem and promote fruitand vegetable access Highlight state successes Identify opportunitiesfor improvementyy 10 states adopted a policy onfood service guidelines thatensures healthy foods be soldor served in government-ownedor -controlled facilities. Foodservice guidelines increaseaccess to healthy food options(e.g., fruits and vegetables, leanproteins, and whole grains) inwork sites, state agencies, parksand recreation centers, and otherinstitutional settings.yy 47 states adopted a policy thatsupports either farm to school orfarm to Early Care and Education(ECE) and increases studentaccess to locally grown foods,including fruits and vegetables;school gardening; or othereducational activities related tonutrition and agriculture.yy 32 states have an active statefood policy council. Food policycouncils bring together diversestakeholders to support a strongregional food system and oftenwork to increase access tonutritious foods, including fruitsand vegetables.

2 01 8State Indicator Report on Fruits and VegetablesTHE PROBLEMONLY 12.2%of adults meet thedaily fruit intakerecommendation. [4]ONLY 9.3%of adults meet thedaily vegetable intakerecommendation. [4]Poor diet quality is a leading riskfactor associated with death anddisability in the United States.1,2Eating a diet rich in fruits andvegetables as part of an overallhealthy diet can help protect againsta number of serious and costlychronic diseases, including heartdisease, type 2 diabetes, somecancers, and obesity. Fruits andvegetables also provide importantvitamins and minerals that help thehuman body work as it should andfight off illness and disease.3The 2015–2020 Dietary Guidelinesfor Americans recommendsthat adults consume 1.5–2cups of fruits and 2–3 cups ofvegetables per day.3 Despite theserecommendations, recent data showlow consumption.4,5 Only 1 in 10US adults eat the recommendedamount of fruits or vegetableseach day.4 Fruit and vegetableconsumption among Americanyouth is also low; just 9% of highschool students meet the fruitrecommendation, and only 2% meetthe vegetable recommendation.5Income-related disparities exist, aswell, with 7% of adults who live at orbelow the poverty level meeting thedaily vegetable recommendation,compared to 11.4% of adults withthe highest household incomes.4SOLUTIONSAs part of a healthy foodenvironment, fruits andvegetables need to beaccessible and affordablein the places wherechildren and familiesspend time3,6Educating individuals on the benefitsof a diet rich in fruits and vegetablesis important; but alone, theseefforts are not enough.3 To changebehavior and improve populationlevel dietary habits, expertsrecommend a collective approachthat improves the availability andaffordability of healthy foods whereAmericans live, work, learn, andplay. In addition to community foodretailers, institutions, such as state4and local governments, work sites,schools, ECE centers, and hospitals,are important partners in improvingaccess to healthy foods.3,6-9 Theseinstitutions provide frontline accessto foods for millions of Americanseach day. States can work with thesediverse stakeholders to increaseaccess to fruits and vegetables andstrengthen the regional food system.For example, government agenciesand work sites can adopt nutritionstandards that make healthy foods(e.g., fruits and vegetables, wholegrains, lean proteins) available infood service operations; schools canestablish farm to school programsthat support buying locally grownfruits and vegetables and provideeducational gardening experiences;and state and local food policycouncils can work to guide policiesand programs that improve theproduction, distribution, andaffordability of fruits and vegetablesin underserved communities.6,10

2 01 8State Indicator Report on Fruits and Vegetables5State Indicator Report on Fruits and VegetablesThis state indicator report provides national and state data on 10 indicators of fruitand vegetable access and production for all 50 states and the District of Columbia(Table 1). These data augment recently releasedstate-specific fruit and vegetable consumptionand behavior data.4 Data for each indicatorwas collected from verified, publicly availablesources. Indicator definitions and datamethodology are provided in Appendix I.TABLE 1.INDICATORS ON FRUIT AND VEGETABLE ACCESS AND PRODUCTIONIMPROVING FRUIT ANDVEGETABLE ACCESS FORINDIVIDUALS AND FAMILIES1. Number of Farmers Markets per100,000 Residents, 20172. Percentage of Farmers MarketsAccepting the SupplementalNutrition Program for Women,Infants, and Children (WIC),Farmers Market NutritionProgram vouchers, 20173. State Policy on Food ServiceGuidelines, 2014IMPROVING FRUITAND VEGETABLEACCESS FOR CHILDREN4. State ECE Licensing Regulationsthat Align with NationalStandards for Serving Fruitsand Vegetables, 20165. State Farm to School or Farm toECE Policy in Place, 2002–2017FOOD SYSTEMSUPPORT FOR FRUITSAND VEGETABLES8. State Food Policy Council, 20189. Number of Local Food PolicyCouncils, 201810. Number of Food Hubs, 20176. Percentage of School DistrictsParticipating in Farm to SchoolPrograms, 20147. Percentage of Middle andHigh Schools Offering SaladBars, 2016CDC released a State Indicator Report on Fruits and Vegetables in 2009 and 2013. Because of methodological differences in data collection, some indicators maynot be comparable to previous reports. See Appendix for details on which indicators are comparable.

State Indicator Report on Fruits and Vegetables2 01 86Improving Fruit and Vegetable Accessfor Individuals and FamiliesIn the United States, there are2.7 FARMERS MARKETSper 100,000 citizens.30.8% OFUS FARMERSMARKETSaccept WIC,Farmers Market NutritionProgram vouchers.ERCHUVO10 STATESADOPTEDA POLICY ONFOOD SERVICEGUIDELINESthat ensures healthy foodoptions be sold or servedin government-ownedor -controlledfacilities.RATIONALEStates and communitiescan do more to make fruitsand vegetables accessible.Although most Americans wouldbenefit from improving their fruitand vegetable intake, for someindividuals and families, this maybe more difficult.3 Research showsthat residents of low-income,minority, and rural neighborhoodshave less access to stores that sellhealthy foods, including a variety offruits and vegetables at affordableprices.11 To address these disparities,states can support strategies thatmake quality produce moreaccessible and affordable inunderserved neighborhoods.6A farmers market is one wayto increase access to fruits andvegetables.6 Farmers markets helpconnect local farms to underservedneighborhoods or rural areasthat may lack brick and mortarstores selling affordable fruits andvegetables. These markets canexpand operating hours and locatenear places that make it easy forlow-income individuals to shop, forexample, near public transportationstops or close to community healthclinics.12,13 Having farmers marketsthat accept WIC Farmers MarketNutrition Program vouchers, or thattake part in incentive programs tomake fresh produce more affordable,can help lower-income familiesaddress food insecurity and meetdietary recommendations for fruitsand vegetables.14,15Adopting food service guidelines, ornutrition standards that align withthe current Dietary Guidelines forAmericans, is another strategy statesand communities can use to improvethe availability of healthy foods,including fruits and vegetables.Collectively, public facilities (e.g.,state agencies, government worksites, public hospitals, seniorcenters, public parks, recreationcenters) sell or serve foodto millions of Americans each day.7By adopting food service guidelines,these institutions can use theirpurchasing power to provide foodsthat support overall health andwellness, such as leaner proteins,whole grains, lower fat dairy, andfruits and vegetables.16,17

2 01 8State Indicator Report on Fruits and Vegetables7Kentucky Farmers MarketsImprove Access to Fresh Producein Underserved NeighborhoodsIn 2013, 46% of Kentucky adults ate fruit less than once aday, and 25% ate vegetables less than once a day. Often,residents in low-income or rural communities do not haveaccess to full-service grocery stores that carry a widevariety of produce, including, low-sodium canned products,frozen, or fresh produce.Community farmers marketsare a good solution, but in 2014,only a small number of Kentuckymarkets accepted federal nutritionassistance benefits, such asWIC Farmers Market NutritionProgram vouchers or the SeniorFarmers Market NutritionProgram coupons.To address the issue, theKentucky Department ofPublic Health partnered witha coalition of communityorganizations across the stateto improve healthier food accessin low-income communities.Through a collaborative effort,the Community Farm Alliancedeveloped the Double Dollarsprogram. The Double Dollarsprogram provides technicalassistance and funding tofarmers markets, enabling themto fully accept federal nutritionbenefits. As of 2017, low-incomecustomers are able to shop at 41participating markets and havetheir federal nutrition benefitsmatched when purchasing fresh,local produce.Customer surveys administeredafter the initial phase of theprogram found that:yyyyyyLearn more about thesuccesses of the KentuckyFarmers Market SupportProgram at: ams/pdf/programhighlights/HR-KY.pdfThis project is supported by CDC’s StatePublic Health Actions to Prevent andControl Diabetes, Heart Disease, Obesity,and Associated Risk Factors and PromoteSchool Health cooperative agreement(DP13-1305).

2 01 8State Indicator Report on Fruits and Vegetables8Improving Fruit and Vegetable Accessfor ChildrenRATIONALE3 STATESHAVE ECELICENSINGREGULATIONSthat align withnational standardsfor serving fruitsand vegetables.47 STATESADOPTED APOLICY that supportsfarm to school or farm to ECE(2002–2017).42% OFUS SCHOOLDISTRICTSparticipate infarm to school programs.Across 48 statesand D.C.,a median of44.8% OFMIDDLE AND HIGH SCHOOLSOFFER A SALAD BARTO STUDENTS.Schools and ECEproviders are key partnersin supporting children’sfruit and vegetable intake.Most US children do not meetnational recommendations forfruit and vegetable servings.5, 18Helping children develop healthyeating habits early in life may leadto healthier behaviors that last alifetime.19 States can partner withschools, ECE providers, and afterschool programs to ensure thatnutritious foods, including fruits andvegetables, are affordable, appealing,and accessible to the children theyserve.20-23 Improving the nutritionenvironment in schools and ECEsettings can also support the foodsystem and stimulate economicdevelopment through large-scalepurchasing of fruits and vegetablesfrom local or regional farmers.24,25States can support the developmentof farm to school and farm to ECEprograms. These programs providefruits and vegetables and teachhealthy eating behaviors throughnutrition-based curriculum andhands-on learning experiences,for example, farm visits, schoolgardens, and healthy cookinglessons.26,27 Introducing a salad barinto the school lunch room may alsoincrease the amount and varietyof fruits and vegetables consumedby students.28-30In addition to schools, ECE settings,which include childcare centers,family childcare homes,prekindergarten classrooms, andHead Start, are an important venuefor obesity prevention and healthyeating promotion.31,32 Currently,almost 14% of preschool-agedchildren (2 to 5 years) haveobesity.33 ECE settings directlyinfluence what millions of youngchildren eat on a daily basis.34Some states and communities areadopting ECE licensing regulationsthat include best practices forobesity prevention and require ECEproviders to increase the amountand variety of fruits and vegetablesserved at meals or snack times.35

2 01 8State Indicator Report on Fruits and Vegetables9Increasing Access to Fruitsand Vegetables in Ohio Early Careand Education CentersIn Ohio, 13% of children aged 2 to 4 years whoparticipate in the WIC federal nutrition assistanceprogram have obesity. In addition, approximately 41% ofchildren are cared for outside of their homes by a nonfamilymember on a part-time or full-time basis.In 2016, Ohio childcareregulations did not fully meetthe national standards for obesityprevention, including regularlyproviding access to fresh fruitsand vegetables.As a result, the Ohio Departmentof Health worked with partnersacross the state to improvenutrition standards in 80% of Ohiocounties. Working together withthe Ohio Child Care Resources &Referral Association and Children’sHunger Alliance, the Departmentof Health provided licensedchildcare centers, preschools, andhome-based childcare programswith resources, trainings, andtechnical assistance on reachingbest practices for healthy eating.The initiative worked with over1,600 ECE centers across thestate, serving approximately110,000 children, to improvefood menus and educate parentsabout healthy eating practices.Examples of menu improvementsinclude eliminating fried foods,offering fresh fruit and vegetablesat every meal, and providingmilk and water instead of sugarsweetened beverages.To learn more about howthe Ohio Department ofHealth is making healthyfood choices easier for Ohio children,visit: px?s 12608&dt 0This project is supported by the CDC‑fundedState Public Health Actions to Prevent andControl Diabetes, Heart Disease, Obesity,and Associated Risk Factors and PromoteSchool Health cooperative agreement(DP13-1305).My class is goingthrough a food revolution.My pickiest eaters are themost eager to try new foodsnow, and they look forwardto lunch as an activity ratherthan just something weneed to get through.”— CHILD CARE PROVIDER,OHIO HEALTHY PROGRAMPARTICIPANT

2 01 8State Indicator Report on Fruits and Vegetables10Increasing Food System Support forFruits and VegetablesRATIONALE32 STATEShave anactivestate foodpolicy council.There are 234 ACTIVE LOCALFOOD POLICY COUNCILSin the United States.There are 212 ACTIVEFOOD HUBS in theUnited States.Strong regionalfood systems are awin-win for producersand consumers.Some states and communities areworking to create strong regionalfood systems that enable residentsto buy more locally sourced foods,including fruits and vegetables.Local produce farmers often sellfruits and vegetables in directto-consumer venues, such ascommunity farmers markets, andthrough farm to institution programsin schools, businesses, universities,and hospitals.36,37 This may helpkeep money spent on food withinthe local economy, and support newjobs and economic growth. This is awin-win for citizens who want to eata diet rich in fruits and vegetables,and for the local farmers thatgrow them.37-39To build a strong food system,states can partner with a varietyof stakeholders, including regionalfarmers, large-scale purchasers,community food banks, publichealth practitioners, nonprofitorganizations, and interestedcitizens. A food policy council bringstogether these diverse stakeholdersto discuss food system issues andplan for collective action. Thesecouncils often work to guide policiesand programs that improve thefood system and make nutritiousfoods, such as fruits and vegetables,accessible and affordable.40, 41In addition, states can supportregional food hubs as a strategy forincreasing access to locally grownproduce. Food hubs are businessesor organizations that managethe aggregation, distribution, andmarketing of products from regionalfarms.42 The majority of food hubsin the United States carry fruits andvegetables from local or regionalgrowers.43 They make it easier forsmall and midsize farmers to meetthe volume and quality demandsof large, institutional purchasersof fruits and vegetables, forexample, food retailers, schools,and hospitals.42, 43

C D C ’ S STAT E I N D I C ATO R R E P O RT O N F R U I TS A N D V E G E TA B L E S , 2 0 1 470712842044.8 *41.726.149.540.954.8N/A37.1State Food PolicyCouncil, 2018**41.830.876.325.322.354.941.870.3Percentage of Middle andHigh Schools OfferingSalad Bars, 201647YesYesYesYesYesYesYesPercentage of SchoolDistricts Participatingin Farm to SchoolPrograms, 20143NoNoNoNoNoNoNoState Farm to School orFarm to Early Care andEducation Policy in Place,2002–20179NoNoYesNoYesNoNoState ECE LicensingRegulations thatAlign with NationalStandards forServing Fruits andVegetables, 201610NoNoNoNoYesNoNoVegetableNumber ofFood Hubs, 2017Delaware (DE)Dist of Columbia (DC)Florida (FL)Georgia (GA)Hawaii (HI)Idaho (ID)Illinois (IL)Indiana (IN)Iowa (IA)Kansas (KS)Kentucky (KY)Louisiana (LA)Maine (ME)Maryland (MD)Massachusetts (MA)Michigan (MI)Minnesota (MN)Mississippi (MS)Missouri (MO)Montana (MT)Nebraska (NE)Nevada (NV)New Hampshire (NH)New Jersey (NJ)New Mexico (NM)New York (NY)North Carolina (NC)North Dakota (ND)Ohio (OH)Oklahoma (OK)Oregon (OR)Pennsylvania (PA)Rhode Island (RI)South Carolina (SC)South Dakota (SD)Tennessee (TN)Texas (TX)Utah (UT)Vermont (VT)Virginia (VA)Washington (WA)West Virginia (WV)Wisconsin (WI)Wyoming (WY)30.89.938.538.019.648.55.127.6FruitNumber of Local FoodPolicy Councils, 20182.72.95.31.33.61.92.84.3Food System SupportState Policy on FoodService Guidelines, 2014NationalAlabama (AL)Alaska (AK)Arizona (AZ)Arkansas (AR)California (CA)Colorado (CO)Connecticut (CT)For ChildrenPercentage of FarmersMarkets Accepting WICFarmers Market NutritionProgram Vouchers, 2017StateNumber of FarmersMarkets per 100,000Residents, 2017For Individuals and Families32* Median across 48 states and D.C.**As of 2018, there are three active tribal food policy councils at various phases of development, including: Mvskoke Food Sovereignty Initiative Oklahoma, Pryor Food Policy Council Oklahoma, and Hoopa Food Policy Council California.For the purposes of this indicator, tribal food policy councils were excluded.

2 01 8State Indicator Report on Fruits and Vegetables12A P P EN D I X 1S TAT E I N D I CAT O R S O N F R U I T S A N D V E G E TA B LES —DATA D EF I N I T I O N S A N D S O U RC ESIndicators on Fruit and Vegetable Access for Individuals and Families1)Number of Farmers Markets per 100,000 Residents, 2017This indicator represents number of farmers markets per 100,000 state residents in 2017.a. Numerator: Total farmers markets per state. United States Department of Agriculture, Agriculture marketing Service. LocalFood Directories: National Farmers Market Directory Data accessed January 18, 2018. Available /farmersmarketsb. Denominator: Population Estimates United States Census Bureau. July 1, 2017. Date accessed December 31, 2017. Availableat: t/state-detail.html. Table Name: Estimates of the Total ResidentPopulation and Resident Population Age 18 Years and Older for the United States, States, and Puerto Rico: July 1, 2017 (ColumnB, “Total Resident Population”).c. This indicator is comparable to the indicator in both the 2009 and 2013 CDC State Indicator Report on Fruits and Vegetables.2)Percentage of Farmers Markets Accepting WIC Farmers Market Nutrition Program Vouchers, 2017This indicator represents the percentage of farmers markets accepting WIC Farmers Market Nutrition Program vouchers in 2017.a. Numerator: Number of farmers markets that accept WIC Farmers Market Nutrition Program vouchers.b. Denominator: Total number of farmers markets per state.c. This indicator is comparable to the indicator in both the 2009 and 2013 CDC State Indicator Report on Fruits and Vegetables.Source: United States Department of Agriculture, Agriculture Marketing Service. Local Food Directories: National Farmers MarketDirectory (2017). Data accessed January 18, 2018. Available at rmersmarkets.3)State Policy on Food Service Guidelines, 2014This indicator represents whether a state’s legislative body enacted or adopted a policy on food service guideline as ofDecember 31, 2014.a. Types of policies included: state bills, statutes, regulations, and executive orders.1. Data Sources: WestlawNext (Thomas Reuters, New York, NY); The CDC’s Chronic Disease State Policy Tracking System;Lexis-Nexis an online commercial legal database.b. The following inclusion and exclusion criteria were used to identify relevant state Food Service Guidelines Policies:2. Inclusion Criteria:i. The policy had to specify the development or reference nutritional guidelines that apply to foods and beveragesserved or sold to adult populations in government-owned or -controlled facilities, including conferences and onsite or off-site events OR the policy had to specify the development of task forces or other committees delegatedto develop food service guidelines.3. Exclusion Criteria:i. Policies that dealt with only children and adolescents.ii. Policies that dealt with only food insecurity.iii. Policies that were defined as “standards of care,” or policies that maintain care that is expected of the average,prudent provider, but do not operationalize nutritional guidelines.c. This indicator was not included in CDC’s State Indicator Report on Fruits and Vegetables, 2009, or the State Indicator Report onFruits and Vegetables, 2013.Source: Zaganjor H, Kendrick KB, Warnock AL, et al. Food Service Guideline Policies on State Government-Controlled Properties.Am J Health Promot. Available at 7116667117.

2 01 8State Indicator Report on Fruits and Vegetables13Indicators on Fruit and Vegetable Access for Children4) State ECE Licensing Regulations that Align with National Standards for Serving Fruits and Vegetables, 2016This indicator represents whether a state adopted ECE licensing regulations that align with the national standards for servingfruits and vegetables.a. Data for this indicator were derived from the National Resource Center for Health and Safety in Child Care and EarlyEducation’s (NRC) analysis of the degree to which state ECE regulations for licensed childcare centers, large or groupfamily childcare homes, and small family childcare homes align with national standards for serving fruits and vegetables.b. The national standards are defined by the 3rd Caring for Our Children: National Health and Safety Performance Standards forEarly Care and Education Programs. The fruit and vegetable standard specifies that children be served:A variety of fruits, especially whole fruits (NB3) AND a variety of vegetables, specificallydark green, orange, deep yellow, and root vegetables (NB2)c. States whose ECE licensing regulations were given a score of 4, meaning the licensing regulation fully addresses theNB3 and NB2 standards across all 3 childcare types, are designated as “yes.” States that received a score of 1, 2, or 3 inany childcare type were designated as “no.” States that received a score of “0” for a childcare type do not regulate thatchildcare type, and that childcare type was not included in the analysis.d. Because of methodological differences, this indicator is not comparable to CDC’s State Indicator Report on Fruits andVegetables, 2009, or CDC’s State Indicator Report on Fruits and Vegetables, 2013.Source: National Resource Center for Health and Safety in Child Care and Early Education. Achieving a State of Healthy Weight:2016 Update. Aurora, CO: University of Colorado Denver; 2017. Available at: http://nrckids.org/HealthyWeight/Archives.5)State Farm to School or Farm to ECE Policy in Place, 2002–2017This indicator represents whether a state adopted or enacted a farm to school or farm to ECE policy during January 1, 2002–March 31, 2017. Data for this indicator is accurate as of March 31, 2017; enacted policies may no longer be in effect becauseof repeal, sunset, or loss of appropriated funding.a. State policies included in this indicator support any of the 3 core elements of farm to school programs that target K-12or ECE settings. The 3 core elements of farm to school programs, include: local procurement, agricultural and foodeducation, and school gardens.b. Policy types included state legislative bills or resolutions.c. Policy Inclusion Criteria:1. For a policy to be included in this indicator, the status had to be one of the following:i.ii.iii.iv.v.Adopted or enacted.Codified in state code.Enacted; yet to be codified in state code.Appropriated funding in annual state budget documents.Codified in state statute, but repealed. These policies were enacted by the state legislative body anddemonstrate support for farm to school programs and activities for a period of time.d. Policy Exclusion Criteria:1. Policies coded as “pending” or “dead.”2. Policies coded as adopted or enacted, but with farm to school provisions removed from bill language before itsadoption.e. Because of methodological differences, this indicator is not comparable to CDC’s State Indicator Report on Fruits andVegetables, 2009, or CDC’s State Indicator Report on Fruits and Vegetables, 2013.Source: National Farm to School Network, State Farm to School Legislative Survey: 2002–2017. Data accessed December31, 2017. Available at: pdf.

20186)State Indicator Report on Fruits and Vegetables14Percentage of School Districts Participating in Farm to School Programs, 2014This indicator represents the number of school districts that report participating in farm to school programs relative to thetotal number of school districts in the state in 2014.a. Data were derived from USDA’s 2015 Farm to School Census survey, Question #2:Farm to school activities generally center around the procurement of local or regional foods, agriculture or nutrition‑based educational activities, such as: Serving local food products in school (meals and snacks). Serving local food products in classrooms (snacks, taste tests, educational tools). Conducting educational activities related to local foods, such as farmers in the classroom and culinary educationfocused on local foods, field trips to farms, farmers markets or food processing facilities, and educational sessionsfor parents and community members. Creating and tending school gardens (growing edible fruits and vegetables).Based on the definition above, did your district or any schools in your district participate in farm to school activitiesduring the 2013–2014 school year? (Please check one) Response options included:a. Yes.b. No, but started activities in the 2014–2015 school year.c. No, but plan to start activities in the future.d. No activities currently and no plans.e. I don’t know.b. For the purposes of this indicator, answer options (a) and (b) were counted as participating in farm to school programs.Access the calculated percentages for answer options from the following source: https://farmtoschoolcensus.fns.usda.gov/about. (Use Excel file, 2015 Farm to School Census State-National Data 1.11.17 web.xlsx.)c. Use Excel sheet: 2015 F2S Census State. Column B denotes variable“pctf2s2013,” which is the percentage of respondingdistricts that had farm to school activities in school year 2013–2014. Column C denotes variable “pctf2s2014,” which isthe percentage of responding districts that started activities in school year 2014–2015.d. This indicator was not included in CDC’s State Indicator Report on Fruits and Vegetables, 2009, or CDC’s State IndicatorReport on Fruits and Vegetables, 2013.Source: United States Department of Agriculture. Farm to School Census (2015). Data accessed December 31, 2017. https://farmtoschoolcensus.fns.usda.gov/about. Document Name: 2015 Farm to School Census St

US adults eat the recommended amount of fruits or vegetables each day. 4 Fruit and vegetable consumption among American youth is also lo. w; just 9% of high school students meet the fruit recommendation, and only 2% meet the vegetable recommendation. 5. Income-related dis

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