Nothing Works…but Everything Might

Month: July, 2011

Sick of Food Deserts? Try California FreshWorks–And Have Some Jobs On The Side

The American Constitution Society Blog (ACSBlog) published my guest post about the launch of the California FreshWorks Fund today.  I’m cross-posting it here:

On July 19, first lady Michelle Obama announced the launch of the California FreshWorks Fund, a $200 million public-private partnership to provide financing to food retailers and distributors willing to locate in food deserts.  Spearheaded by The California Endowment (“TCE”), a private, statewide foundation with a public-health mission that it interprets increasingly broadly, the Fund pulls together an impressive array of banks, philanthropies, industry players, government agencies, and investors under the umbrella of healthy food.

Why food, and why now?  Food deserts — areas without access to healthy, fresh food, namely grocery stores, but usually with abundant access to unhealthy fast food — are disturbingly common attributes of lower-income neighborhoods.  Across California, four million people live in food deserts, which correlate with higher rates of obesity, heart disease, high blood pressure, and diabetes than areas with grocery stores. I’ve written previously in this space about the unhappy cohabitation of racially isolated poverty and diminished access to healthy food.  And we can little afford such poor healthy food access now, when our nation faces a tsunami of obesity and its attendant costs in health care and economic productivity.  As TCE Director of Community Health Marion Standish and I wrote here last week, the increasing rate of childhood obesity threatens to wreak even more havoc in future years as obese children become obese adults.  And we know that access to healthy food decreases the risk of obesity.

But that’s not all. California FreshWorks and initiatives like it bring more than fresh food to underserved communities: jobs, increased property values, and increased tax revenue roll into town too. And that’s why healthy food financing initiatives are precisely the right thing to do now, in the face of a sluggish economic recovery, including a stubbornly weak job market. On average, 24.3 new jobs are created for every 10,000 square feet of retail grocery space (grocery stores are usually 20,000 to 50,000 square feet in size). A similar initiative in Philadelphia resulted in a 4 percent to 7 percent increase in property value, along with further commercial development. And increased retail, employment, and property value means increased tax revenue.

While food deserts are often densely populated, meaning significant block-by-block income (though not per-capita income, the more usual measure) waiting to be spent in area stores, the high cost of entering food deserts has long deterred retailers — even though grocery stores in food deserts can become profitable. The Fund provides loans and some grants to retailers to help overcome this barrier to entry, with longer time horizons for payback so retailers can, over time, generate the necessary level of sales to be profitable.

The Fund, though it draws on philanthropy for some of its funding, is not itself a charitable endeavor traditionally conceived. This is Philanthropy 2.0 — a highly networked and intensely collaborative effort that seeks robust, lasting, large-scale change.  (Interested in new approaches to large-scale philanthropic efforts?  FSG Social Impact Consultants founder Mark Kramer’s work on Catalytic Philanthopy and follow-on book, Do More than Give, with Leslie Crutchfield and John Kania, are must-reads.) The Fund is in the business of investing in communities, and its industry partners and investors intend to make a profit — but the initiative only reaches its objective if a healthy share of that profit remains in the community in the form of jobs and increased tax revenue.  Keep your eye on this program as it goes to work on one of the nation’s toughest problems in a big, diverse, and economic crisis-ridden state. The combination of public health improvement and economic revival could be a tempting recipe.

Read more about cross-sector approaches to improving public health and education and fighting poverty from my blog, Nothing Works…But Everything Might.

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Why Soda Sucks–And What You Can Do About It: FTC Requests Public Comment on Advertising Regulations

Today, the American Constitution Society published a post I co-authored with Marion Standish of The California Endowment on Big Food’s fight against proposed voluntary regulations of advertising to children.  I’m cross-posting it here.  Also check out SodaSucks.org, The California Endowment’s anti-soda initiative formed to promote public comment on the proposed regulations.

By Marion Standish, Director, Community Health, The California Endowment, and Mary Kelly Persyn, Associate, Ramsey & Ehrlich

A coalition of Big Food-makers, fast-food chains, and media giants calling itself the Sensible Food Policy Coalition has joined an all-out battle against voluntary nutritional guidelines for foods marketed to children.  Opponents are fighting for the right to continue advertising soda, fast food, sugared breakfast cereal, and a wide variety of other low-nutrition, high-calorie food products to the nation’s children without even voluntary restrictions. The yearly spend on direct marketing to kids?  About $2 billion. 

The draconian (albeit voluntary) guidelines they’re battling against?  Principle 1: encourage children to “choose foods that make a meaningful contribution to a healthful diet.”  Principle 2: encourage children to “minimize consumption of foods with significant amounts of nutrients that could have a negative impact on health or weight—specifically, sodium, saturated fat, trans fat, and added sugars.” Remember, the proposal doesn’t involve limitations on the food products themselves: these are marketing guidelines.

The proposed guidelines are the work of an interagency working group formed by a bipartisan Congressional directive; the group includes the FTC, the Centers for Disease Control and Prevention, the FDA, and the USDA, and the guidelines are supported by the American Heart Association, the American Cancer Society, and others.  Lining up in opposition is the Sensible Food Policy Coalition: Viacom, Time Warner, the U.S. Chamber of Commerce, PepsiCo, General Mills, Kellogg’s, the American Association of Ad Agencies, and others.  Together, the Coalition has spent about $60 million on lobbying during the Obama administration.

One side knows health; the other side knows the free market.  Or does it?  According to the Washington Post, “advertising agencies touted one economic analysis that suggested the government’s guidelines would kill 75,000 jobs annually,” and Rep. Jo Ann Emerson (R-Mo.) earnestly requested an economic impact analysis of the regulations before they are put into effect.

Game on, Rep. Emerson. It could well be that these regulations would cost thousands of jobs, and that would have an economic impact for sure.

But let’s look at the ultimate impact of all this marketing on the targeted public and the economy as a whole. Advertisers dangle Tony the Tiger, buckets of Pepsi, and bags of Doritos in front of young noses unable as of yet to sniff out and reject manipulative advertising.  That $2 billion a year goes directly into creating demand for low-nutrition, high-calorie food products and soda. The massive sales that result mean money in the coffers of Big Food, surely, and more jobs too.

And also more externalized cost.  Because here’s the thing: as children consume more and become afflicted by overweight and obesity, health costs soar—and as children grow up, the wave of obesity rises too.  It’s not just about health care, either; it’s also about productivity, and in children, it’s about the ability to concentrate and learn.  Let’s look at what the unbridled marketing of sugar, salt, and fat has wrought on the next generation of Americans.

  • One in three children is now overweight or obese, and the percentage is growing.  According to the CDC, obesity among children aged 6 to 11 years increased from 6.5 percent in 1980 to 19.6 percent in 2008.   The American Academy of Child & Adolescent Psychiatry notes that childhood obesity is extremely difficult to treat; and overweight children are much more likely to become overweight adults.
  • Children who watch more TV consume more of the high-calorie, low-nutrient foods they see advertised; the link to physical inactivity is not as strong as the link to junk-food marketing.  Randomized trials have demonstrated the link between TV exposure, food advertising, food choices, and intake levels.
  • The increasing prevalence of sugar-sweetened beverages is strongly linked to the rise in American obesity.  Soft drinks “contribute more energy to the diet than any other single type of food or beverage,” and they are some of the cheapest energy sources available.  Increasing portion sizes, decreasing prices, and increased marketing have very likely contributed to increased consumption of these beverages.

Make no mistake.  Whatever the big-food marketers may claim, this is about pushing unhealthy food on children who lack the cognitive skills to discern manipulative advertising or identify foods and drinks that stand a good chance of making them sick.  The battle for regulation of junk food marketing to children is one we must fight, again and again, in the years to come. 

And we cannot afford to loseOne estimate pegs thenational cost of childhood obesity at approximately $11 billion for children with private insurance and $3 billion for those with Medicaid; obese children are two to three times more likely to be hospitalized.  The CDC estimates the overall direct and indirect cost of obesity at approximately $147 billion in 2008 dollars.  And remember—obesity rates are rising, and quickly.  Obesity rates rosein 16 states in the past year.  They did not decrease in any.

Let’s return for a moment to that economic impact analysis that Rep. Emerson requested.  The voluntary regulations may cause job loss if (1) companies follow them (because the government would not have any enforcement power), and if (2) following them significantly decreases children’s demand for the products.   That job loss, where workers are unable to shift to another sector, could cause economic loss to an unspecified degree. But what happens if Big Food starts pushing healthy food products? Sales decreases and job losses are simply not necessary consequences of regulation.

If we make no changes to marketing, and the childhood obesity rate continues to increase, we are looking at costs associated with childhood obesity that stand at $3 billion and rising for Medicaid child patients alone, and $14 billion for all children.  And the big-food industry completely externalizes these costs: the bills are paid either directly or indirectly by the public—not by the profiting junk food purveyors.  Those costs do not stem entirely from marketing, of course, but consider the recent steep rise in childhood obesity and concomitant rise in exposure to food advertising.  The link is there.

If the voluntary regulations work as well as the Coalition claims they will, children will consume less low-nutrient, high-calorie food.  Even small changes here add up to big advantages, especially in obesity prevention.  And that translates to dollars coming off our common health care bill.

The FTC is taking public comment on the proposed voluntary regulations right now.  Please use this form to have your say by the July 14 deadline.   The California Endowment has also posted commentary and suggestions on this issue.

[image via awrose]