Search results: the corporation not me

Readers Robyn and Will sent me a link to an ABC News story about Yum! Brands efforts to get more states to authorize the use of food stamp (SNAP) benefits in fast food restaurants.

Michigan, California, Arizona, and Florida already do this.  Yum!, the parent company of KFC, Taco Bell, and Pizza Hut, wants it to go national.

They write:

We believe that food stamps should be used to buy nutritious food for kids and families, not junk food! This nonsense has to stop!  This is a government program–it should not be a means for corporations to sell products that will eventually lead to ever-increasing health problems–obesity, heart issues, diabetes, etc. What can we do to be heard?

USA Today did a story on this last week.  It elicited more than 1,000 comments.  I’m not surprised.

The issue thoroughly divides the food advocacy community.   Public health and anti-hunger advocates sharply disagree on this issue, as they do on the question of whether sodas should be taxed.

USA Today quoted Kelly Brownell, director of Yale’s anti-obesity Rudd Center:

It’s preposterous that a company like Yum! Brands would even be considered for inclusion in a program meant for supplemental nutrition.

But then the article quoted Ed Cooney, executive director of the Congressional Hunger Center and a long-time anti-hunger advocate:

They think going hungry is better?…I’m solidly behind what Yum! is doing.

Of course he is.  Want to take a guess at who funds the Congressional Hunger Center?

Yum! is listed as a “Sower,” meaning that its annual gift is in the range of $10,000.   I’m guessing Yum! is delighted that it is getting such good value at such low cost.

USA Today was negligent in not mentioning Mr. Cooney’s financial ties to Yum! and other food brands.  Such ties matter, and readers deserve to know about them.

But Mr. Cooney’s argument worries me on grounds beyond the evident conflict of interest.

For one thing, it smacks of elitism.  “Let them eat junk food” argues that it’s OK for the poor to eat unhealthfully.  I think the poor deserve to be treated better.

For another, promoting use of SNAP benefits for fast food and sodas makes it and other food assistance programs vulnerable to attack.

Rates of obesity are higher among low-income groups, including SNAP recipients, than in the general population.

Anti-hunger and public health advocates need to work a lot harder to find common ground if they want food assistance programs to continue to help low-income Americans.

Let’s be clear about what’s at stake here.  SNAP is an entitlement program, meaning that anyone who qualifies can get benefits.

In June 2011 alone, according to USDA, 45 million Americans received an average of $133 in benefits at a total cost to taxpayers of more than $6 billion.

That’s a lot of money to spend on fast food.  Yum!’s interest in getting some of that money is understandable.

If you think low-income Americans deserve better:

• Complain to Congress for permitting the legal loophole that allows this.
• Insist to USDA that SNAP benefits be permitted only for real food.
• Get your city to recruit farmers’ markets, grocery stores, and other sources of healthy food to low-income areas.
• Let your congressional representatives know that you want a safety net for people who are out of work that enables people to eat healthfully.
•  And tell the Congressional Hunger Center and similarly inclined anti-hunger groups that you think conflicts of interest interfere with their ability to help the clients they are supposedly trying to serve.

Michelle Obama, who has made elimination of “food deserts” a cornerstone of her campaign to end childhood obesity, announced this week that several supermarket and drug store chains—Walmart, SuperValue, and Walgreens among them—have committed to finding ways to put healthier foods into low-income areas.

The USDA issued a press release and a fact sheet on the initiative.

This week, the Food Marketing Institute released “Access to Healthier Foods: Challenges and Opportunities for Retailers in Underserved Areas.”  The report summarizes the risks and benefits of locating grocery stores, describes how to get local governments to provide incentives, and gives some examples of success stories.

Mrs. Obama’s event was thoroughly covered by ObamaFoodorama, which notes that recent research suggests only minimal benefits from putting grocery stores into low-income areas and observes that it’s going to take a lot more than just better access to encourage people in underserved areas to eat more healthfully.

Some advocates worry that the access issue is being used as an excuse for large retail corporations to get a foothold in inner cities than it is for residents to have better food choice, and that an influx of big chains will put small grocers out of business.

Maybe, but I’m guessing that people who live in areas without decent grocery stores will be more than delighted to have them nearby, especially if the stores keep their promises to provide fresh produce.

Just for the record, the research on food deserts (or swamps as some prefer) makes it clear why this is an important issue:

• Access to Affordable and Nutritious Food: Measuring and Understanding Food Deserts and Their Consequences. USDA, 2009 .
• “The Public Health Effects of Food Deserts: Workshop Summary.” Institute of Medicine, Washington, DC: National Academies Press (Washington, DC). 2009.
• Treuhaft, Sarah and Karpyn, Allison. “The Grocery Gap: Who Has Access To Healthy Food and Why It Matters.” Oakland, CA: Policy Link, 2010.

Read, think, advocate!

Among the many thoughtful comments on yesterday’s post is one from the Director of Oxfam America’s Private Sector Department, Chris Jochnick, who writes that I did not “quite capture the scope and intent of this project.”

As part of our work, Oxfam has a responsibility to engage with global corporations, through both collaboration and campaigns, in order to have constructive dialog on their business practices.

….Throughout the work, Oxfam has maintained complete independence including the ability to undertake advocacy against either company if the situation warranted. The Coca-Cola Company and Oxfam America shared the costs of the collaboration roughly in the proportion of 2:1, with The Coca-Cola Company contributing two-thirds of the costs (US $400,000) and Oxfam America contributing one-third of the costs in kind including staff time.

Unrelated to the study, The Coca-Cola Company made an earlier donation of $2,500,000 to Oxfam between 2008-2010 for humanitarian work in Sudan, with an emphasis on work related to water, sanitation and hygiene.

….Our independent voice keeps Oxfam’s approach to private sector collaborations dynamic and honest.

Let me add a bit more about what I think is wrong with this picture.

The goal of Coca-Cola is to sell more Coca-Cola.  The goal of Oxfam is to address world poverty.  I’m having trouble understanding how these goals could be mutually compatible.

Coke sales in the United States are flagging.  Last year, three quarters of Coke’s revenue derived from sales outside of North America in emerging economies where rates of obesity are increasing rapidly.

Sugary beverages like Coke are increasingly associated with obesity and its health consequences, problems now rampant in developing economies.

In the past year, Coke has embarked on an aggressive campaign of contributions to potentially critical groups such as the American Academy of Family Physicians, the Children’s Hospital of Philadelphia, Save the Children, and now Oxfam.

These groups are now highly unlikely to advise their constituents to cut down on sugary sodas.  If nothing else, sponsorship buys silence.

Oxfam may have done the work of its Poverty Footprint Report without company interference.  It is what is not in the report that is so much in Coke’s interest.

For just under $3 million, Coke has purchased an endorsement from Oxfam of its “anti-poverty” practices and silence on the role of sugary drinks in obesity.  This kind of public relations is well worth the price.

What does Oxfam get in this bargain?  The money, of course, but at the cost of serious questions about the credibility of its report and its independence.  Perhaps these are tolerable, but what about loss of respect?

I score this as a win for Coca-Cola.

I keep arguing that partnerships and alliances with food corporations put agriculture, food, nutrition, and public health advocacy groups in deep conflict of interest.

The latest example is Oxfam America’s partnership with Coca-Cola and bottler SAB Miller to evaluate the effectiveness of these corporations in reducing poverty (again, you can’t make these things up):

Despite the challenges involved, The Coca-Cola Company and SABMiller have each made ambitious and laudable commitments to labor rights, human rights, water, gender, and sustainability. However, there is little accountability to such commitments without the informed engagement of affected groups. By looking across all relevant issues (no cherry-picking) with an organization like Oxfam America and reporting out to stakeholders, these companies have opened themselves to heightened public scrutiny and hopefully increased accountability.

Hopefully, indeed.

The Oxfam Poverty Footprint Report describes the work Coca-Cola and SAB Miller are doing in Zambia and El Salvador to empower and promote sustainability.  It highlights Coca-Cola’s sustainability initiatives.

It does include some telling recommendations for follow-up.  For example:

• Engage sugar farmers and producers to improve safety and health of sugarcane harvesters.
• Investigate why independent truck drivers in Zambia work more than eight hours per day and discuss with drivers potential mechanisms to ensure safe driving.
• Ensure The Coca-Cola Company’s global Advertising and Marketing to Children Policies are being effectively and consistently implemented at a regional level.

You have to read between the lines to see what this report really says.

And what about health, obesity, or the shocking increase in childhood tooth decay that is occurring in Latin America these days as a result of the influx of sugary drinks?  Not a word.

Why is Oxfam America helping Coca-Cola to market its products in Latin America and Africa?  I can only guess that Coca-Cola’s grant to Oxfam must have been substantial.

And thanks to Kelly Moltzen for sending the links.

I am a member of the editorial board of the Journal of Public Health Policy, which publishes research and commentary on matters that affect international public health.  Dr. Anthony Robbins, one of its editors, and I are calling on authors to submit articles that consider ways to change behavior—not, as is all too common, of individuals but of the food industry.

The journal has published many papers on obesity policies aimed at improving the diet and exercise behavior of individuals.  These may be necessary, but they are not sufficient.  It is now time to deal with the behavior of the food industry.  Food industry profits are

generated by capturing increasingly larger shares of the market and by selling the population more food – and calories –than it needs. In this marketing environment, obesity is collateral damage.

The food industry’s ultimately anti-social behavior – whether conscious or inadvertent – is spreading globally. In higher income countries, it is ubiquitous, whereas in places where people have less disposable income, it is but the camel’s nose under the tent.

Thus, effective strategies to reduce obesity may vary depending on penetration by the industry – and less developed nations may still have more opportunities to avoid obesity, by getting ahead of the curve.

How are countries to do this?

Efforts to control obesity will have to enlist the public to focus on behavior, with a shift from a sole focus on citizens to a new one on the behavior of food corporations…We cannot eliminate the food industry to reverse the obesity epidemic, but we can constrain its anti-social behavior…We encourage authors to reach beyond the kind studies of policies on eating and activity that we receive so frequently.

We have come to believe that research studies concentrating on personal behavior and responsibility as causes of the obesity epidemic do little but offer cover to an industry seeking to downplay its own responsibility.

Instead, we urge authors to submit articles that consider how to understand and change the behavior of the food industry.

As a starting point for thinking about how to approach this topic, we ask: does the industry need to overfeed the population to remain profitable?

Have ideas?  Write them up and submit them to JPHP.  There is no deadline.  The journal will consider submissions whenever they arrive, but sooner is better than later.

Michael Siegel, MD, MPH, a Professor at the Boston University School of Public Health (whom I do not know), has been mailing me copies of his recent blog posts on partnerships between food corporations and health organizations, particularly the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP) (see my previous posts), and the American Dietetic Association (ADA) (see my previous posts on this one too).

Dr. Siegel’s current post discusses two reasons why these partnerships do more for the food companies than they do for the organizations:

1. Coca-Cola and other Big Food companies are using these partnerships to enhance their corporate image, and therefore, their bottom line: sales of unhealthy products that are contributing towards the nation’s obesity epidemic.

In its 2010 annual report, Coca-Cola writes: “…researchers, health advocates and dietary guidelines are encouraging consumers to reduce consumption of sugar-sweetened beverages, including those sweetened with HFCS or other nutritive sweeteners. Increasing public concern about these issues…may reduce demand for our beverages, which could affect our profitability.”

…Pepsico, in its 2010 annual report, also makes clear the connection between the company’s public image and its bottom line: “Damage to our reputation or loss of consumer confidence in our products for any of these or other reasons could result in decreased demand for our products and could have a material adverse effect on our business, financial condition and results of operations, as well as require additional resources to rebuild our reputation.”

2. The American Dietetic Association, American Academy of Pediatrics, and American Academy of Family Physicians are supporting companies that oppose virtually every state-specific public health policy related to improvement of school nutrition, reduction of junk food and soda consumption, and environmental health and safety.

…Through its contributions to the Grocers Manufacturers Association (GMA), Coca-Cola is opposing any and all taxes on sugar-sweetened beverages (soft drinks), opposing the removal of BPA from bottles containing liquids consumed by infants, opposing legislation to simply require the disclosure of product ingredients, opposing taxes on candy, opposing bottle bills, opposing all restrictions on BPA-containing packaging, opposing standards for food processing, and opposing school nutrition standards.

…That the AAP, AAFP, and ADA have fallen for Coca-Cola’s tricks is one possibility. The other, which I find more likely, is that they have been bought off. In other words, that the receipt of large amounts of money has caused them to look the other way. It’s amazing what a little financial support will do. And of course, this is precisely the reason why companies like Coca-Cola and Pepsico include the sponsorship of public health organizations in their marketing plans.

I’m just back from the American Society of Nutrition meetings in Washington, DC, where the daily newsletter put out by the society included full-page advertisements from Coca-Cola, the beef industry, and the Corn Refiners Association (see yesterday’s post).  And then there is the astonishing example of Coca-Cola’s $10 million gift to Children’s Hospital of Philadelphia to head off a potential city soda tax.

It is completely understandable why food and beverage companies would want to buy silence from health professionals.  It is much less understandable why health organizations would risk their credibility to accept such funding.  Professor Siegel’s analyses of these issues are worth close attention.

Not everyone liked Sam Kass’s speech as much as I did (see previous post) and I’ve been asked to expand on the idea that we need to pressure the White House to do more.  Here’s how I see the situation.

We live in an era when corporations run government.  You don’t believe this?  Take a look at the appalling events in Wisconsin.  Consider the implications of last year’s Supreme Court decision in Citizens United, allowing corporations virtually unlimited funding of congressional election campaigns.

Election campaign funding is the root source of corruption in American government.   If corporations were not allowed to fund election campaigns, we might be able to elect legislators who are more interested in public health than corporate health.

The First Lady’s Let’s Move campaign aims to reduce childhood obesity.  This, in itself, is fundamentally anti-corporate.  Why?  Because fixing obesity means eating less and eating better, and both are very, very bad for business.  And they are especially bad for the corporations that make highly profitable junk foods—snacks, sodas, and the like—and for retailers who display these products on supermarket shelves.

From the perspective of the White House, the food business is not going away.  If the Obama administration is not going to be perceived as anti-business, it has to work with corporations.  But what can food corporations really do to help kids eat more healthfully?

I worried about this question when I returned from the World Economic Forum in Davos a few years ago.  There, I met high-level executives of food corporations and realized that I needed a clear, unambiguous agenda for them.  But because I think people would be healthier if they ate mostly unprocessed foods, and I’m not much impressed by small nutritional tweakings of junk foods, I had a hard time thinking of positive things they could do.

The only agenda items I could think of were negatives: stop marketing junk food, stop marketing to kids,  stop marketing junk food as health food, stop attacking critics, etc.  Negatives won’t sell.

I think Mrs. Obama’s choice of childhood obesity as her First Lady’s Cause was a courageous decision.   In the current corporate context, the accomplishments listed by Mr. Kass add up to something meaningful.  The First Lady is doing what she can.  And let’s face it: nobody else in that position ever has.  Never have issues of food and nutrition been made so legitimate.  For that alone, she deserves thanks.

If the Obamas think they have to work with business, they have to work with Walmart—it’s the 800-pound food gorilla.  In theory, if Walmart tweaks food products, reduces the price of healthier food options, sources lower cost fruits and vegetables, and moves stores into inner cities, the net result will be healthier choices for Walmart customers.  In practice, we have to wait and see.

The White House must think these potential gains are worth the cost of the nose-holding they have to do about Walmart’s labor and business practices.  Nose-holding is the price of getting things done at that level.

I am in the privileged position of not having to make those kinds of compromises (thank you, NYU).

It is not an accident that Mr. Kass’s riff began with “parents told us.”  The First Lady cannot budge without substantial popular support and pressure.  If we think she is in a position to do any good at all for the movement to reverse childhood obesity and improve the food system, we have to let her know what we’d like her to try to do—loudly and repeatedly.

So maybe the First Lady’s—and Sam Kass’s—next speech will begin: “Everyone who cares about how our food is produced and consumed told us….”

Maybe I’m overly optimistic (it’s my nature), but I still see Mrs. Obama’s efforts as an opportunity.  We ought to be using it to push for what we think is right.

If you were a UK Health Secretary faced with soaring rates of obesity, alcohol misuse, and diet-related diseases, what would you do? Were you to take an evidence-based approach, you might consider minimum pricing per unit of alcohol and restrictions on its availability. You might look at toughening the regulation of how the least healthy foods are marketed to children.

You could even demand that manufacturers reformulate their least healthy products to meet minimum nutritional standards. Or you could, if your name was Andrew Lansley, dismiss all of the above and instead invite representatives of McDonald’s, PepsiCo, and the drinks giant Diageo among others, to submit their policy suggestions on how best to deal with the UK’s public-health crises for a forthcoming governmental white paper.

After the initial surprise, it can still take a while for the bizarre reality to sink in—that the companies who have profited the most from the epidemics of obesity and alcohol misuse should now be responsible for setting the agenda on public health simply beggars belief.

…The creeping influence of corporate power on public policy is not news to anyone in the UK, but the breathtaking speed and scale by which the UK coalition Government is embracing the agenda of business at the expense of the health of the electorate is an unwelcome novelty. By putting the interests of big business at the heart of public-health policy, Lansley is ensuring that the UK’s big society will not be shedding the pounds any time soon.

The Lancet is a British medical journal with unusual and highly commendable editorial interests in international public health.  I’m happy to see it take on questions about the role of corporations in obesity.  The British Food Standards Agency was doing a good job of trying to institute policy approaches to obesity prevention, but these are not popular with corporations.  Recall: eating less is very bad for business.

And this kind of resistance to policy approaches is not just a British or European problem.  Our corporations also prefer what they do to be voluntary. So this is a cautionary tale.