Food Policy Research in NYC: What Do We Know?
Where Do We Need to Go?
In the last decade, food policy and food policy research have made great leaps in New York City. On October 22nd, the NYC Food Policy Center sponsored a seminar in which researchers from several New York City institutions summarized their research findings in food policy and identified priorities for the next period. A specific goal of the forum was to begin to formulate research priorities that can inform the food policy agenda of the next Mayor and City Council.
The first speakers , Isobel Contento, Professor of Nutrition and Education and Faculty Director, and Pamela Koch, Executive Director of the The Laurie M. Tisch Center for Food, Education & Policy at Teachers College, Columbia University, described research studies that examined how schools work with outside organizations to provide nutrition education in ciy schools. They found that 20 outside nutrition education organizations in New York City were providing services in 237(39%) of the 619 schools they surveyed. They concluded that New York City schools need organizations to provide services in more schools, especially schools with higher needs.
Brian Elbel, an Assistant Professor and the Director of the Section on Health Choice, Policy, and Evaluation in the Department of Population Health and Health Policy at NYU Medical Center and School of Medicine described his work that applies behavioral economics to food choices. He reported on his evaluation studies of New York City’s calorie labeling, which found that while people read and use the labels, to date there is not evidence showing population-level changes of note in calories purchased attributable to the labeling regulation. Similarly, an evaluation of the FRESH program that provides subsidies to super markets in low income neighborhoods did not find changes in fruits and vegetables consumed or “unhealthy” snack food consumed, at least for the community as a whole. His conclusion: New York City’s food policy innovation has not yet found “the solutions” for the high prevalence of overweight. Elbel also suggested that it might be worthwhile to launch and evaluate multiple interventions in a single community to assess the cumulative impact of varying policy changes. Whether cumulatively these changes will ultimately have an impact—as we have seen with a different mix of programs designed to reduce tobacco consumption—or whether more transformative and robust programs are also needed has yet to be determined.
Andrew Rundle, Associate Professor of Epidemiology at the Mailman School of Public Health, Columbia University, spoke about his research studies on the association between food environments and body mass index (BMI) in New York City neighborhoods. His study found that low-income communities with higher proportions of unhealthy food outlets had higher mean BMIs while in low poverty neighborhoods, areas with a higher density of all types of food outlets had lower mean BMIs. In other words, it is the mix of food outlets in a neighborhood as well as their density that influences body weight and this effect operates differently in neighborhoods of differing socioeconomic status. His recommendations for future research were to develop a deeper understanding of the food environment as an ecological system that is part of the larger retail ecology characterized by distinct food niches that undergo ecologic succession. He also suggested additional research designed to better understand what different communities want from their food system and he urged further attention to the policy causes and nutritional consequences of disparities in access to healthy and unhealthy food
Susan Kansagra, MD,MBA, the Deputy Commissioner for Health Promotion and Disease Prevention in the New York City Department of Health and Mental Hygiene described a few of her agency’s food policy efforts and the findings from evaluation studies. She described the New York City Food Standards, which mandate cit y agencies to meet nutritional standards in the food they purchase and serve; Green Carts, food vendors who sell fruits and vegetables in low income communities; and the city’s campaigns against sugary beverages. For the first two, evaluation data are not yet available to assess impact on food choices. Survey data, however do show a steady decline in the consumption of sugary beverages in New York City. While it cannot be ascertained with confidence what role the city campaigns played, the declining trend in sugary beverage consumption is a welcome sign.
Among the questions Kansagra hoped could be answered in the coming years are: What is the impact of vending and cafeteria standards on consumer purchases? What message themes and channels are most effective in selling healthy foods and unselling unhealthy foods? What is the impact of pricing, placement, and promotion on consumer purchasing of healthier products? Where do people most commonly purchase foods in NYC? Answers to these questions can help gudie th next round of health policy.
Kansagra’s recommendations were to design studies that use modeling to help answer what we don’t know. She also urged better access to sales data so that, like the food industry, public health professionals can use these data to hone their messages and marketing. She also urged more studies using behavioral economics and greater use of surveys on social norms and public opinion data.
Finally, Jacqueline Martinez Garcel, MPH, the Vice President of the New York State Health Foundation described her organization’s work in diabetes and diabetes prevention and their plans to expand their prevention portfolio.
In his opening remarks, moderator Nicholas Freudenberg, Distinguished Professor of Public Health at the CUNY School of Public Health and the Faculty Co-Director of the New York City Food Policy Center at Hunter College, made an analogy to the city’s response to the HIV epidemic. “In the first decade of the AIDS epidemic,” he observed, “health department staff, researchers and advocates met frequently to synthesize research knowledge, identify problems and develop shared priorities. While we didn’t always agree with each other, these forums helped to accelerate progress in responding to the epidemic and highlight research needs that could improve policy. Our hope is that today’s session can begin a similar process for creating food policies that better prevent diet-related diseases and reduce food insecurity n New York City. ”