Transcript What do we know? Where do we need to go?

Food Policy Research in NYC:
What do we know?
Where do we need to go?
Brian Elbel, PhD, MPH
Assistant Professor of Population Health and Health Policy
Director, Section on Health Choice, Policy, and Evaluation
Department of Population Health
Calorie Labeling
•
Many see labels,
some even report
using them.
•
But, no populationlevel changes of note
in calories purchased.
•
Clear limits to the
policy. Could they
work along with
other initiatives in in
the longer term?
Funded by RWJF Healthy Eating Research 65634; NIH/NHLBI R01HL095935
Fresh Food Financing Initiatives
NYC’s “Food Retail Expansion to Support Health (FRESH)”
• 90%: Shop for groceries in supermarket
• 35%: Reported noticing a new store in their neighborhood
• No change: fruit and vegetables consumed, “unhealthy” snack
food consumed
– At least for the community as a WHOLE
Funded by Aetna Foundation 4036366 and RWJF Healthy Eating Research 68236
Sugary Beverage Portion Cap
60
40
20
0
-20
-40
-60
-80
-100
All Transactions
with Beverages
Only Transactions
that include SSBs
Subject to Ban
100
90
80
70
60
50
40
30
20
10
0
Change in Beverage Calories
Purchased
Figure : Simulated Calorie Changes
The Percentage Shift to 16 Oz. Beverages with Remainder
Purchasing 32 Oz.
Funded by NIH/NIDDK R01 DK099241, NYSHealth Foundation 12-01682 and RWJF 70823
Taxes and Different Labeling
• 26%: Increase in purchasing a healthier item with a tax
• No difference among taxation conditions
• 15%: Increase in purchasing a healthier item with labeling
• Relative effectiveness of smallish tax versus more effective
label?
Funded by NYU CTSA UL1TR000038 from (NCATS), NIH
Impact of the Food
Environment on Child BMI
• True, causal impact of food
environment on BMI illusive
• Combining NYC FITNESSGRAM
data with food environment data
• Child fixed effects: What happens
to BMI as healthy and less healthy
food stores open and close
• Census tract fixed effects: Finegrained differences in food
resources within the same census
tract
• Home and school food
environment, modeled together
Legend
Fast food
restaurant
Fast food
restaurants/tract
Funded by NIH/NIDDK R01 DK097347
Thoughts: Priorities for research and/or to
guide the next Mayoral administration
• We don’t yet have (the) solution(s)
• Think beyond “traditional” policy levers
• RANDOMIZE?
• Multiple solutions, same place
• Aggressive patience