Policy Tools to Change Food Consumption Behavior
Aug 18, 2017
According to the U.S. Centers for Disease Control (CDC), 70 percent of adult Americans over the age of 20 were overweight or obese in 2013--35.7 percent were obese This is not a problem limited to the United States--a 2014 Lancet study estimates that there are more than 2 billion people in similar condition globally, in both developed and developing countries.
In addition to potentially causing health problems for the individuals involved, there are also significant costs for the U.S. economy. It is estimated that addressing chronic health problems like diabetes and hypertension often associated with obesity cost between $147 billion and $210 billion every year, or as much as one-fifth of total medical spending in this country.
These high shares of Americans suffering from being overweight or obese has come about relatively quickly. In less than 15 years, we have gone from no states reporting statewide obesity rates greater than 14 percent in 1987 (18 states reported no data in that year) to all states but Colorado reporting rates of 15 percent or higher as of 2001.
There are a number of factors contributing to this phenomenon, but it basically boils down to two trends--on average, people are eating more calories, with much of the gains coming from highly processed foods that are energy-dense but nutrient poor, like junk food and soda. A 2012 survey by Gallup found that more than half of Americans drink at least one soda per day, with average per capita consumption at 39 gallons in 2016. Interestingly, that level represents a more than 25 percent decline since its peak in 1998, although some of that decline has been offset by increased consumption of other caloric beverages, like energy drinks. Today’s Americans eat out at restaurants more frequently as well, often receiving bigger portions leading to increased food consumption. In 1970, such food accounted for 29 percent of all food consumed by Americans--by 2012, that share had risen to 43 percent.
On the other side of the ledger, many people are getting less exercise than did their counterparts of past generations, in day to day living both on and off the job. Statistics maintained by the labor confederation AFL-CIO indicates that the share of white collar jobs in the U.S. economy rose from 18 percent in 1900 to 60 percent one hundred years later. While such jobs are typically better paying than industrial occupations, they are also largely sedentary and less likely to be physically taxing. Most Americans don’t engage in regular exercise either--a recent survey found that only 20 percent undertake the recommended level of exercise on a weekly basis.
In response to these developments, a range of policy options have emerged that seek to change the downward health spiral that Americans find themselves in. With the major exception of the ‘Let’s Move’ campaign initiated by former First Lady Michelle Obama, which included an effort to encourage children and teenagers to exercise more, most recent policy initiatives have focused on the ‘eating’ side of the ledger.
These policies can be divided into two categories--those that provide positive incentives for people to eat more nutritiously, and those that attempt to restrict or otherwise penalize the consumption of less nutritious foods. Many policies of both types have focused on low-income households because most of them directly participate in federal programs aimed at improving their nutrition, even though problems with obesity affect Americans of all income categories.
Policies on the positive side include making fresh fruits and vegetables more accessible and affordable to low-income households, such as the ‘Double-Up Food Bucks’ program offered at farmers markets and grocery stores around the country. At those locations, participants in the Supplemental Nutrition Assistance Program (SNAP) have the opportunity to receive coupons that enable them to buy twice as much fresh produce with their SNAP resources than they could otherwise afford. The program started in Michigan in 2009, which is now available at 250 farmers markets and groceries in that state alone, as well as dozens of locations in 23 other states.
On the restriction side of the ledger, a number of jurisdictions have sought to bar SNAP recipients from using their benefits to purchase soda and/or junk food at grocery stores. For example, in 2011, New York City mayor Michael Bloomberg sought to bar purchase of soda and sweetened drinks by SNAP recipients in his city. To date, all such proposals have failed to receive approval from the U.S. Department of Agriculture, which oversees the SNAP program. In general, USDA officials have determined that such efforts would be too difficult to implement, with stores needing detailed guidance as to which specific food items would fall under the ban and which would not.
There are also policies which are designed to discourage consumption of such foods by the general population, such as by imposing additional taxes on such consumption. The drinking of soda has been the target of most such efforts, starting in Mexico in 2014. Several U.S. cities, such as San Francisco, Oakland, Philadelphia, and most recently Cook County Illinois (which includes the city of Chicago), have followed suit over the last year or so. A recent study showed that soda sales fell for two consecutive years in Mexico after the tax was imposed--it is too early to gauge impacts in the U.S. cities where the soda tax in now in place.