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Beverage companies spent $866 million to advertise unhealthy drinks in 2013, and children and teens remained key target audiences for that advertising, according to a new report released today at APHA by the Yale Rudd Center for Food Policy & Obesity. The report “Sugary Drink FACTS 2014” highlights some progress regarding beverage marketing to young people, but also shows that companies still have a long way to go to improve their marketing practices and the nutritional quality of their products to support young people’s health.
“Despite promises by major beverage companies to be part of the solution in addressing childhood obesity, our report shows that companies continue to market their unhealthy products directly to children and teens,” said Jennifer Harris, PhD, Rudd Center’s director of marketing initiatives and lead author of the report. “They have also rapidly expanded marketing in social and mobile media that are popular with young people, but much more difficult for parents to monitor.”
Harris and her team examined changes in the nutritional content of sugar-sweetened drinks including sodas, energy drinks, fruit drinks, and others. They also analyzed marketing tactics for 23 companies that advertised these products, including changes in advertising to children and teens on TV, the internet, and newer media like mobile apps and social media. Researchers also examined changes in the nutrition and marketing of diet beverages, 100% juice, and water. The report was funded by the Robert Wood Johnson Foundation.
Learn more about the key findings of the report in the following exclusive interview with Harris. The interview has been lightly edited for clarity and length.
NPH: You issued the first version of this new report in 2011. What are the changes since then?
Jennifer Harris: The biggest change that we saw was a very significant decline in advertising on television. Preschoolers are seeing 33% fewer TV ads for sugary drinks in 2013 than they saw in 2010. Children are seeing 39% fewer, and teens are seeing 30% fewer. So, that was really some great news to see, but some categories had bigger declines than others. Fruit drinks went down by about 50%, but advertising for energy drinks that kids see actually increased. So, there was some good news and some bad news.
If we as a nation are to succeed in building a Culture of Health that benefits every individual, it will require collaboration across sectors, open communication among diverse organizations and a willingness to step out of traditional practices to find effective interventions.
On Monday, Robert Wood Johnson Foundation Vice President Michelle Larkin showcased one example of this innovative collaboration that is occurring on the edge of a low-income neighborhood in New Orleans, just a few miles away from this year’s American Public Health Association (APHA) annual meeting.
At the corner of North Broad Street and Bienville Avenue sits The ReFresh Project—an innovative fresh food hub located in a former warehouse that had been vacant since Hurricane Katrina struck the city nine years ago. Today the site is home to a Whole Foods Market, Liberty’s Kitchen, The Goldring Center for Culinary Medicine and an onsite farm.
The goal of the hub, according to project founder Jeffrey Schwartz, is to create new eating, working, exercise and community living cultures.
Each aspect of the Refresh Project is designed to realize these goals.
- At the Whole Foods market, which anchors the Refresh project development, products are specifically chosen to be both high quailty and affordable. Specifically, the store carries more store-line products and often has more sale items than other stores in the Whole Foods chain. Two healthy eating educators are also located on-site to answer questions, craft recipes, and host tours.
- At Liberty’s Kitchen, a culinary work readiness and leadership program for at-risk youth, New Orleans youth ages 16-24 who are out of work and out of school are given an intensive and hands-on food service training, case management, job placement services and follow-up support. Ninety percent of Liberty’s Kitchen Youth Development Program participants are employed on graduation out of the program and 80 percent are still employed at the six-month benchmark, according to the organization.
Healthography—or the health of the place where you live—is the theme of this year’s American Public Health Association (APHA) annual meeting, which is taking place in New Orleans this week.
During the opening session, Georges Benjamin, MD, Executive Director of APHA, announced that APHA’s goal is to create the healthiest generation in American history within one generation. Benjamin’s announcement was coupled with announcements from local and national public health leaders that collectively took another step forward in that effort.
For example, the Partnership for a Healthier America announced a new Healthier Campus Initiative, which calls on colleges and universities to adopt recommended guidelines on food, nutrition and physical activity.
“We know that going to college is a time of change for many students—we also know that means it’s a time when new habits are formed,” said Peter Soler, the partnership’s CEO. “By creating healthier food and physical activity environments today, campuses and universities are encouraging healthier habits that will carry over into tomorrow.”
Guidelines being adopted by participating campuses include promoting the consumption of water instead of soda on campus, offering a bicycle sharing program for all students and providing certified personal trainers and registered dietitian nutritionists on campus.
In addition, Louisiana’s Secretary of Health and Hospitals, Kathy Kliebert, discussed the state’s “Well-Ahead” initiative, which promotes and recognizes smart choices that are made in the spaces and places where people live and work, and which make it easier to live healthier lives. Kliebert told the audience that Well-Ahead promotes voluntary changes without imposing new taxes or creating new rules.
Within the host city of New Orleans, a couple of initiatives to improve health within the Crescent City were also discussed at APHA’s opening session.
One such initiative to combat obesity—known as Fit Nola—now has 100 miles of bike lanes throughout the city. Also, next week legislation will be introduced to ban smoking in the city’s bars, casinos and public spaces.
APHA’s opening session ended with a talk by Pulitzer Prize winner Isabel Wilkerson, who spoke about her book “The Warmth of Other Suns.” A book 15 years in the making, “The Warm of Other Suns” describes the migration of African Americans in the 20th century from the South to the North for a better life for themselves and their children. For example, the parents of Olympian Jesse Owens worried their son would not have the strength to work in the fields, so they moved north to Cleveland, Ohio, where he started running track—a sport that would take him around the world and across the global stage.
Whether the generation of migrants profiled in Wilkerson’s book realized it, their stories epitomize the power of place, and the influence of geography on health, wellbeing and opportunity of every individual.
>>Bonus Link: Also in attendance at yesterday’s opening session was Peter Salk, son of the world famous Jonas Salk, MD, who was on hand to accept a posthumous award from APHA for his father’s discovery of a vaccine for polio. Watch the trailer above for the film “The Shot Felt Round the World” to learn more about the elder Salk’s successful search for a cure.
Public Perceptions on Obesity Are Changing
New research that looked at the opinions of both the public and health care professionals during the past year finds a shift away from seeing obesity as a personal problem resulting from bad choices. Health care professionals were already less likely than the public to view obesity as a personal problem of bad choices, according to the study was presented earlier this week at the Obesity Society Annual Meeting in Boston. The study used an online survey of more than 50,000 members of the public and more than 5,000 health care professionals, finding that the percentage of Americans seeing obesity as a community problem increased by 13 percent in 2014 over the previous year and the percent of health care professionals increased by 18 percent, although that was a smaller increase than the previous year. Wealthier and younger respondents were more likely to view obesity as a medical problem. Male and rural respondents more likely view obesity as a personal problem of bad choices. Read more on obesity.
Many People, Who Think They Have a Penicillin Allergy, Don’t
Many people have been incorrectly told that they're allergic to penicillin, and have not had testing to confirm an allergy, according to a two new studies presented this week at the annual conference of the American College of Allergy, Asthma and Immunology. The studies are very important, according to the researchers, because giving alternative antibiotics to people who don’t need them results in inferior treatment, higher costs and higher toxicity for patients. Of 384 people in one study who thought they were allergic to penicillin, 94 tested negative. In the second study, 38 people who believed they were allergic to penicillin had skin testing and all tested negative. "A large number of people in our study who had a history of penicillin allergy were actually not allergic," said Thanai Pongdee, MD, a member of the ACAAI and the author of one study. "They may have had an unfavorable response to penicillin at some point in the past, such as hives or swelling, but they did not demonstrate any evidence of penicillin allergy at the current time.” Read more on infectious disease.
School Lunches Often Healthier than Packed Lunches
Researchers from Virginia Tech recently conducted a study that compared school lunches with home-packed lunches and found that school lunches were typically more nutritious. The researchers reviewed more than 1,000 lunches—about half packed and half prepared by three public schools—and found that rates of calories, carbohydrates, fat, saturated fat, sugar, vitamin C, and iron were significantly higher for packed lunches compared to school lunches. Protein, sodium, fiber, vitamin A and calcium were significantly lower for packed lunches compared to school lunches. "Habits develop in early childhood and continue into adolescence and adulthood. Therefore, this is a critical time to promote healthy eating. Determining the many factors which influence the decision to participate in the [school lunch program] or bring a packed lunch from home is vital to addressing the poor quality of packed lunches," says Elena L. Serrano, PhD, Family Nutrition Program Project Director, and Department of Human Nutrition, Foods and Exercise at Virginia Tech and the lead author of the study. Read more on nutrition.
Massachusetts Now Has the Nation’s Strongest Paid Sick Leave Requirements
Massachusetts now has the nation’s strongest requirement for providing paid sick leave. Under a ballot question passed yesterday, people who work for businesses with 11 or more employees are now entitled to up to 40 hours of paid sick time each year. Workers at smaller companies will receive 40 hours of annual unpaid sick time. NewPublicHealth has previously written on the benefits of paid sick leave, including about an American Journal of Public Health study which found that a lack of paid sick leave can be a significant factor in the spread of disease. Read more on business.
Study: Fast Food Marketing to Children Disproportionately Affects Certain Communities
Fast food marketing directed toward children disproportionately affects black, middle-income and rural communities, according to a new study out of Arizona State University (ASU). Researchers studied the marketing practices of 6,716 fast food restaurants, determining that “while most fast food restaurants sampled were located in non-Hispanic and majority white neighborhoods, those situated in middle-income neighborhoods, rural communities and majority black neighborhoods had higher odds of using child-directed marketing tactics.” “Marketing food to children is of great concern not only because it affects their current consumption patterns, but also because it may affect their taste and preferences,” said ASU researcher Punam Ohri-Vachaspati, an associate professor of nutrition in the School of Nutrition and Health Promotion. “We know that consumption of fast food in children may lead to obesity or poorer health, and that low income and minority children eat fast food more often.” Read more on nutrition.
Study: No Link Between Media Violence and Real-Life Violence
Despite the popular notion that media violence is a factor in real-life crime, homicide rates have actually fallen over the past several decades as media violence—in movies, on television and in video games—has increased, according to two new studies in the Journal of Communication. One of the studies examined the level of violence in 90 movies from 1920 to 2005, while the other looked for links between violence in video games and real-life violence among American young people from 1996 to 2011. "The idea that media has big effects on us or shapes our society is probably untenable," said author Christopher Ferguson, chair of the psychology department at Stetson University in Florida. "This doesn't mean media has no effect at all, of course, only that we need to try to move media research out of these culture wars if we're going to make any progress." Read more on technology.
DOT Launches New Website for Cruise Ship Passengers
The U.S. Department of Transportation has launched a website with information and resources from several federal agencies to help people considering cruise ship vacations make informed decisis. Information includes consumer assistance, vessel safety and cruise line incident reporting statistics. “We are committed to providing the traveling public with as much information as possible to make informed decisions about their travel and making sure they know their rights before, during, and after their trip,” said U.S. Transportation Secretary Anthony Foxx, in a release. Read more on transportation.
Ten Foundations Receive HUD/USDA Secretaries’ Award
The U.S. Department of Agriculture and the U.S. Department of Housing and Urban Development (HUD) recently honored ten foundations for helping to improve communities in across the country. According to the departments, the ten foundations have helped foster significant improvements in housing and neighborhoods, education, health and recreation, transportation, community participation, arts and culture, public safety, sustainability and economic development across all American geographies—urban, suburban and rural. “These foundations understand that strong communities connect families with the promise of living the American dream,” said HUD Secretary Julián Castro, in a release. “Powerful outcomes occur when the philanthropic and public sectors come together to solve problems, enhance neighborhoods and expand opportunity for others. Read more on housing.
Americans Still Eating Trans Fats
A new study in the Journal of the American Heart Association finds that Americans are eating less trans and saturated fats than they were three decades ago, but they’re still consuming them in higher quantities than recommended for good cardiovascular health. The study was based on surveys of approximately 12,000 adults ages 25 to 74. Read more on nutrition.
EBOLA UPDATE: U.S. Begins Isolating Soldiers Returning from West Africa; Australia Institutes Visa Ban
(NewPublicHealth is monitoring the public health crisis in West Africa.)
The U.S. military has begun isolating soldiers returning from Ebola-fighting efforts in West Africa, while Australia has become the first “rich nation” to impose a visa ban on the affected countries. Public health officials, including those in Washington, D.C., say such measures risk turning the doctors and nurses who help Ebola patients into “pariahs,” according to Reuters. "Returning health workers are exceptional people who are giving of themselves for humanity," said Stephane Dujarric, spokesperson for United Nations Secretary-General Ban Ki-moon. "They should not be subjected to restrictions that are not based on science. Those who develop infections should be supported, not stigmatized." Read more on Ebola.
Study: Brain Injuries After Age 65 May Increase the Risk for Dementia
Brain injuries after the age of 65 may increase a person’s risk of developing dementia, according to a new study in the journal JAMA Neurology. Researchers analyzed data on almost 52,000 emergency room patients who had suffered traumatic injuries in California from 2005 to 2011, finding that while just under 6 percent of those with injuries outside the brain went on to develop dementia, more than 8 percent of those with moderate to mild traumatic brain injuries did so. While at ages 55 and older, moderate to severe brain injury was associated with increased risk of dementia, by age 65 even mild brain injury increased the dementia risk. "This was surprising and suggests that the older brain may be especially vulnerable to traumatic brain injury, regardless of the traumatic brain injury severity," said study lead author Raquel Gardner, MD, a clinical research fellow with San Francisco Veterans Affairs Medical Center. "Or to spin it more positively, the younger brain may be more resilient to mild traumatic brain injury or may take longer to show symptoms of dementia.” Read more on aging.
Study: Greater Use of Spices, Herbs Could Promote Healthier Eating
Using spices and herbs to make healthy food more appealing can help reduce sodium, calorie and fat intake, according to a new study in the journal Nutrition Today. A special edition of the publication, titled Spices and Herbs: Improving Public Health Through Flavorful Eating, includes 16 papers exploring the latest research on spices, herbs and their links to healthy eating. "We now understand that spices and herbs have a meaningful role to play in bringing flavor to the forefront of today's health and wellness conversations," said Johanna Dwyer, DSc, RD, professor of medicine and community health at Tufts University School of Medicine, editor of Nutrition Today. "It will take all of us working together – from scientists to chefs and product developers to policy makers – before we can really begin to improve public health through flavorful eating." Read more on nutrition.
Oral health received some recent attention with the passage of a law in California that allows dental hygienists to perform some procedures under the supervision of a remote dentist checking in via video screen. The goal is to improve the oral health of kids in that state. Other states are watching the rollout in the hopes of implementing similar programs.
With that same goal in mind, the Ad Council and dozens of partners have just launched a new series of quirky public service announcements (PSAs) aimed at getting kids to brush their teeth twice a day, two minutes each time. The PSAs highlight how teaching kids to brush their teeth is far easier than other lessons parents impart, including cooking, manners and getting dressed.
The PSAs will appear as television, radio, print, outdoor and digital ads, and can also be found online. Campaign partners include the American Dental Association and the American Academy of Pediatrics. Ad Council spokeswoman Ellyn Fisher said the campaign is timed to coincide with Halloween—“as kids get ready to dig into their candy bags.”
A recent Ad Council survey found that three quarters of parents said their kids often forget to brush their teeth. The survey also found that while it’s estimated that children miss more than 51 million school hours each year due to dental-related illnesses, parents rank their children’s dental health as a low priority relative to other health issues, such as nutrition or cold and flu season.
The new PSAs are available in both English and Spanish and direct viewers to the campaign’s website, where parents and children can watch the videos—all 2 minutes in length, or the exact amount of time they should spend brushing their teeth. More than 1.7 million people have visited the website since its launch in 2012. A 2013 Ad Council survey showed that in one year, English-speaking parents reported that their children were significantly more likely to brush twice a day (55 percent in 2013, up from 48 percent in 2012) and significantly more likely to brush for two minutes each time (64 percent in 2013, up from 60 percent in 2012). Spanish-speaking parents also saw significant increases in brushing twice a day, from 63 percent in 2012 to 66 percent in 2013; 77 percent reported kids brushed for the recommended two minutes 2013, up from 69 percent in 2012.
“We’ve had some extraordinary success with this campaign so far,” said Fisher, “But we have a long way to go to make brushing for 2 minutes, twice a day a social norm.”
Have a Story about Implementing the National Prevention Strategy? The Office of the Surgeon General Wants to Hear It
The National Prevention Strategy (NPS), a federal-level initiative coordinated by the Office of the Surgeon General (OSG), was launched three years ago with the goal of promoting prevention and improving the nation’s health by engaging all sectors, not just health care.
Communities across the country are hard at work integrating different sectors in the joint purpose. For example, transportation agencies and senior health agencies are working to improve travel logistics for seniors who have different needs and schedules than the average commuter. The benefits for seniors can be many and huge, including engaging in social activities, recreation, timely visits to doctors, access to food shopping and greater independence.
In its 2014 required annual status report to the president and Congress on the progress of implementing the National Prevention Strategy, the OSG shared for the first time stories—called Partner Implementation Models (PIMs)—about communities and organizations implementing the strategies. One PIM showcased the work of the Robert Wood Johnson Foundation (RWJF), including:
- In 2013, RWJF re-convened the Commission to Build a Healthier America—an interdisciplinary group of leaders in the public, nonprofit and private sectors originally brought together in 2008—to develop recommendations to reduce health disparities. The Commission’s January 2014 report references the National Prevention Strategy.
- RWJF’s County Health Rankings & Roadmaps show how health is influenced by where people live, learn, work and play. Counties are ranked using data on health behaviors; clinical care; the physical environment; and social and economic factors such as family and social support. In 2014, new measures related to housing, transit, access to mental health providers, injury-related deaths, food environment and exercise opportunities were added to the Rankings. All of these measures directly reinforce the priorities outlined in the National Prevention Strategy.
Another PIM was shared by the Henry Ford Health System (HFHS) in Detroit, Mich., the fifth-largest employer in the city, which launched Henry Ford LiveWell (HF LiveWell) to improve the health of HFHS employees, patients, and surrounding communities.
UPDATE: Sierra Leone Ends Three-Day Lockdown, Reports 130 New Cases
(NewPublicHealth is monitoring the public health crisis in West Africa.)
Officials in Sierra Leone have ended a three-day curfew designed to help contain the continuing spread of the Ebola virus, calling the effort a success. Authorities reported 130 new cases during the lockdown and are waiting for tests on 39 more people. The West African country has been one of the hardest hit by the outbreak—more than 550 of the nearly 2,800 total deaths have been in Sierra Leone. In addition more than 100 tons of health-related supplies are being flown to Sierra Leone and Liberia. They include gloves, masks, gowns, goggles, saline, antibiotics, oral rehydration solution and painkillers. "We must do all we can to reduce further the human tragedy caused by this deadly outbreak and help communities avoid an even deeper setback than has occurred already," said Chief Executive Thomas Tighe of Direct Relief, according to USA Today. Read more on Ebola.
Study: Medicare Patients Less Likely to Receive Post-Stroke Surgery
Despite the fact that it can significantly help recovery and reduce the risk of long-term disability or even death, a common post-stroke surgical treatment is far less likely to be referred by physicians of patients with Medicare, according to a new study in the journal PLOS One. Researchers at the University of Florida (UF) analyzed data on more than 21,000 adult patients discharged from 2003 to 2008 with a diagnosis of subarachnoid hemorrhage, finding that—when compared to patients with private insurance—Medicare patients were almost 45 percent less likely to receive surgery and were more than twice as likely to die in the hospital. Azra Bihorac, MD, the study’s senior author and an associate professor of anesthesiology, medicine and surgery at the UF College of Medicine, said the results could indicate a conscious or unconscious bias. “Not every hospital has skilled neurosurgeons who specialize in subarachnoid hemorrhage,” he said in a release. “If these hospitals don’t have the necessary expertise, then they may actually overestimate the risk of a bad prognosis. They may assume that the patient won’t do well anyway, so they won’t proceed with surgery.” Read more on access to care.
Study: Weekly Text Reminders about Calories Help People Make Healthier Choices
Something as simple as a weekly text reminder may help U.S. adults develop a better understanding of basic nutrition and make healthier food choices, according to a new study in Health Promotion Practice. Researchers from the Johns Hopkins Bloomberg School of Public Health sent either a weekly text message reminder, a weekly email reminder, or no weekly reminder about the U.S. Food and Drug Administration’s recommendation of a reasonable daily caloric intake—2,000 calories—to 246 participants dining in the Johns Hopkins Hospital cafeteria. They found that at the beginning of the study approximately 58 percent knew the recommended benchmark, but after four weeks the participants who received texts were twice as likely to know the benchmark. “While daily energy needs vary, the 2,000-calorie value provides a general frame of reference that can make menu and product nutrition labels more meaningful,” said study leader Lawrence J. Cheskin, MD, director of the Johns Hopkins Weight Management Center, in a release. “When people know their calorie ‘budget’ for the day, they have context for making healthier meal and snack choices.” Read more on nutrition.