Advocating for Healthy Foods in School

Nov 8, 2011, 11:46 AM, Posted by

Every five years, Congress reauthorizes child nutrition legislation which sets guidelines and provides funding for a variety of programs: the National School Lunch Program and School Breakfast Program, the Child and Adult Care Food Program, the Special Supplemental Nutrition Program for Women, Infants, and Children, and others. The most recent reauthorization, passed at the end of 2010, was the focus of long-term advocacy efforts to increase funding and improve nutritional standards for these programs, particularly for foods and beverages in schools.

A session at the APHA Annual Meeting last week examined a broad advocacy initiative focused on helping to ensure passage of a strong Child Nutrition Reauthorization. Tracy Fox, MPH, RD, president of Food and Nutrition Policy Consultants, was part of the effort, and NewPublicHealth had a chance to speak with her after the panel.

NewPublicHealth: What was the Child Nutrition Initiative?

Tracy Fox: The Child Nutrition Initiative (CNI) was created in early 2010. A number of funders got together, including California Endowment, Pew Charitable Trusts, Kellogg Foundation and Robert Wood Johnson Foundation, to discuss how we could accelerate the advocacy efforts surrounding child nutrition reauthorization. We knew the foundations were interested in this issue but needed to figure out how to work together, building on the expertise of the various advocates already on the ground. So we decided to pool resources and come together under one unified campaign and campaign manager.

NPH: How did it work?

Tracy Fox: There were two things that really helped CNI be effective. Those four funders all appointed one person to be the point policy person. That core group was able to act quickly and respond to issues in a timely manner. Having a small group versus a cast of thousands was an important factor. The other factor that helped make the initiative successful was having a discrete set of policies that guided our discussions and decision making. Those were: improving the quality of school meals and competitive foods, and strengthening wellness policies. So there was a small set of work that we were really able to focus and target on, preventing us from getting distracted by the many other policy issues that came up. Those two factors were key: that we had a small group that could be nimble and make decisions, and we had a compass that could really direct us.

NPH: Why were these efforts so important?

Tracy Fox: Engaging the public is critical. We really need the public to be engaged in this because they really do help influence policymakers. And when it comes right down to it, eventually these are policy changes, whether it’s through legislation or regulation, and the public needs to be engaged because it is obviously something that will impact them. The more we can educate them and get them engaged, the better off we’re going to be because we know we can turn to them and ask for their help in supporting important policy changes.

NPH: Why was it important to identify and work with a broad range of partners?

Tracy Fox: Two reasons. They brought numbers with them, so they could activate their own members, whether it’s Feeding America and the foodbanks, or nutrition educators and dieticians across the country through the Society for Nutrition Education and the American Dietetic Association or public health experts through American Public Health Association. Not only do you get the banner of the organization name to support strong policies, you also get their members. It is also important to show the diversity of organizations involved. It’s not just nurses, it’s not just foodbanks. But if you look at the entire canvas of organizations and their members involved, it’s pretty impressive.

NPH: What were some of the goals of the initiative that ended up as part of the reauthorization?

Tracy Fox: Probably one of the biggest pluses was the funding, it really was unprecedented, the increase in reimbursement. Six cents a meal doesn’t sound like a lot but when you talk about 30 million meals a day it really adds up. It was $4 billion over 10 years, already over and above the base funding of the bill. So the funding was a big win.

Another big win was a provision that gave USDA authority to set nutrition standards for competitive foods—those are the foods and beverages that are sold in places like vending machines and school stores. That was something we’d been advocating for over the past 10 years. And finally when the food industry realized that having a uniform set of national standards was far easier to manage than a patchwork of regulations across the country they were some of the strongest allies. When they came on board, coupled with the education and advocacy we’ve been doing for a decade, that really helped, so that was one of the strongest provisions in the bill.

One of the other provisions helped make school meal prices more equitable. That, and a few other more technical pricing pieces, has been really helpful in paying for the improvements to school meals that also came out of it. And finally, there was language that called on school districts to be more transparent in developing and promoting local wellness policies, and to include an array of stakeholders in the process.

NPH: What should foundations and other public health organizations learn from this effort?

Tracy Fox: I think that foundations find it difficult to let go a bit and not be in charge of process and decision making. And I do think it’s important if they want to play in this advocacy space and be really integral, helpful, useful contributors, they need to recognize where their strengths are and where they’re not. The CNI really showed foundations are great, they can bring the resources to the table, oftentimes they can bring the experts and their research to the table. But they often can’t get it to the policymakers in a way that will be most effective. And that’s fine.

We want foundations to do a good job at what they do a good job at. But also recognize when others need to come in and kind of hand over the reins sometimes. Once you’ve done the research and built the evidence base, and even establish some of the good advocacy networks out there, it might be worthwhile to then hand the baton over to those who can really take it across the finish line. And I think more and more foundations are coming along and realizing that’s the case. So we can learn a lot from these kinds of models.


They also need to be comfortable with risk, which is hard. For the most part, Foundations like to play it safe and would like things to proceed with as little controversy as possible. However, with advocacy and advocating for policy change, that is rarely the case. If you’re going to make change you’re not going to be friends with everyone along the way, so that sort of risk is an inherent part of public health advocacy.

And many foundations obviously have to be aware of lobbying restrictions. CNI worked well because although some of the organizations couldn’t lobby, some could. So it was key to combine resources in ways that enabled the effort to educate policymakers most effectively.

This commentary originally appeared on the RWJF New Public Health blog.