Perris healthy checkout ordinance shifts the register zone toward healthier options
Perris, California, entered a small but growing group of jurisdictions trying to reshape what shoppers see at the cash register. Six months after the city’s healthy checkout ordinance took effect, the retail environment within 6 ft of registers looked measurably different: healthier products occupied more space, while the broader checkout area changed less consistently.
The policy matters because checkout lanes are not neutral real estate. Candy, sugary drinks, salty snacks, and other impulse items have long been positioned where shoppers pause, often through paid placement agreements that turn waiting time into a sales opportunity. Perris attempted to interrupt that pattern by limiting the products allowed in the zone closest to the register. In practice, the ordinance required stores to stock only items meeting nutrition standards within 6 ft of registers, including products such as water without caloric sweeteners, low-calorie beverages, fruits, vegetables, nuts, seeds, and legumes.
The shift was real, but it was not uniform across the store.
Compliance rose where the ordinance actually reached
Investigators used a natural experiment, comparing 13 Perris stores subject to the ordinance with 51 matched stores in three comparison cities without the policy. They measured 65,271 product facings, the individual product displays from which shoppers can choose, in June 2023 before implementation and again in June 2024, six months after implementation. A difference-in-differences analysis then estimated how checkout products changed in Perris relative to the comparison cities.
Within the policy zone, the results were clear. Among all product facings within 6 ft of registers, compliance with Perris standards increased from 50% to 67%, a 37% relative increase versus comparison cities (PR = 1.37; 95% CI [1.12, 1.68]; p = 0.002). Among food and beverage facings in the same zone, compliance rose from 36% to 55%, a 52% relative increase versus comparison cities (PR = 1.52; 95% CI [1.11, 2.07]; p = 0.009).
Within the checkout zone, healthier beverages expanded quickly. Compliant beverages increased from 6% to 18%, a 141% relative increase versus comparison cities (PR = 2.41; 95% CI [1.40, 4.14]; p = 0.001). 100% fruit juice also rose from 0.7% to 1.7%, a 200% relative increase versus comparison cities (PR = 3.00; 95% CI [2.04, 4.41]; p < 0.001).
The broader checkout changed less than the 6 ft rule promised
Outside the regulated zone, the policy’s footprint weakened. In product facings more than 6 ft from registers, the increase in items meeting HCO standards was not significant. Across the entire checkout area, the rise in compliant facings was smaller than the increase observed inside the 6 ft boundary, even though the full checkout still showed improvement (PR = 1.31; 95% CI [1.06, 1.61]; p = 0.011).
This pattern points to a structural limitation in the ordinance itself. A 6 ft radius can reshape the immediate cashier-facing environment while leaving adjacent shelves, endcaps, and longer checkout runs partially untouched. Retailers can comply with the letter of the law in the most visible space and still preserve a substantial inventory of discretionary items just beyond the regulated perimeter. In practical terms, a narrow boundary may reduce the policy’s ability to erase the impulse-purchase architecture that has defined checkout marketing for years.
The product mix tells the same story. Among food and beverage facings within 6 ft of registers, the study did not find significant reductions in the proportion of facings belonging to specific noncompliant categories: candy, sugar-sweetened beverages, salty snacks, or other sweets. The healthier share increased, but the less healthy categories did not disappear. Retailers appear to have added compliant options without fully dismantling the familiar checkout assortment.
Policy design shaped the size of the effect
Perris is the second jurisdiction in the United States and the third worldwide to implement a mandatory healthy checkout policy, following Berkeley, California, and England. The comparison is useful because the policies do not operate in the same way. Berkeley’s ordinance applies to the entire checkout area and uses per-serving nutrient limits, while Perris limits only products within 6 ft of registers and uses per-container limits with exemptions for fruits, vegetables, nuts, seeds, and legumes. Those design choices likely influence how stores respond.
The contrast with Berkeley is especially informative. Earlier evaluations of Berkeley’s ordinance found larger increases in compliance and significant reductions in unhealthy categories such as sugar-sweetened beverages, candy, and other sweets after one year. Perris showed improvement, but the gains were more modest and more concentrated in the immediate register zone. When policy scope narrows, retailers retain more room to preserve the merchandising strategy that makes checkout a high-pressure sales point.
The biological logic behind the policy is indirect but credible. Checkout exposure is a cue-driven environment: products placed at eye level and within arm’s reach can trigger spur-of-the-moment purchases, especially for highly processed foods and beverages engineered for convenience and reward. Changing what is physically present at the register changes the choice architecture. It does not alter appetite physiology, but it does alter the retail prompt that can steer a shopper toward a sugar-sweetened beverage or candy bar in the final moments before payment.
Evidence of effect, with one caution attached
The results support mandatory healthy checkout policies as a tool for improving the retail food environment. Perris did what the ordinance intended most directly: it increased the presence of healthier foods and beverages where customers stand closest to the register. The policy was less effective at transforming the checkout beyond that narrow zone, which is exactly where design choices become consequential.
One limitation remains important. The analysis assumed parallel trends between Perris and the comparison cities, but could not verify that assumption. If the checkout environment would have changed differently in Perris even without the ordinance, the estimates could be biased. That caveat does not erase the observed gains inside 6 ft of registers, but it does frame them as policy effects estimated through a quasi-experimental lens rather than as definitive proof of causality.
For jurisdictions weighing similar ordinances, the takeaway is concrete. A healthy checkout rule can move the register environment in a healthier direction, but the size of the impact depends on how much of the checkout it governs and how stringent the nutrition standards are. Narrower rules may improve the front line of the retail environment while leaving enough unhealthy merchandise in place to blunt the policy’s reach.