Food Policy Research in NYC: What do we know?

Where do we need to go?

Brian Elbel, PhD, MPHAssistant Professor of Population Health and Health Policy

Director, Section on Health Choice, Policy, and Evaluation

Department of Population Health

Calorie Labeling

• Many see labels, some even report using them.

• But, no population-level changes of note in calories purchased.

• Clear limits to the policy. Could they work along with other initiatives in in the longer term?

Funded by RWJF Healthy Eating Research 65634; NIH/NHLBI R01HL095935

Fresh Food Financing Initiatives

NYC’s “Food Retail Expansion to Support Health (FRESH)”• 90%: Shop for groceries in supermarket• 35%: Reported noticing a new store in their neighborhood• No change: fruit and vegetables consumed, “unhealthy” snack

food consumed– At least for the community as a WHOLE

Funded by Aetna Foundation 4036366 and RWJF Healthy Eating Research 68236

Sugary Beverage Portion Cap

100

90 80 70 60 50 40 30 20 10 0-80-60-40-20

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Figure : Simulated Calorie Changes

All Transactions with BeveragesOnly Transactions that include SSBs Subject to Ban

The Percentage Shift to 16 Oz. Beverages with Remainder Purchasing 32 Oz.

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Funded by NIH/NIDDK R01 DK099241, NYSHealth Foundation 12-01682 and RWJF 70823

Taxes and Different Labeling

Funded by NYU CTSA UL1TR000038 from (NCATS), NIH

• 26%: Increase in purchasing a healthier item with a tax• No difference among taxation conditions

• 15%: Increase in purchasing a healthier item with labeling

• Relative effectiveness of smallish tax versus more effective label?

Impact of the Food Environment on Child BMI

• True, causal impact of food environment on BMI illusive

• Combining NYC FITNESSGRAM data with food environment data

• Child fixed effects: What happens to BMI as healthy and less healthy food stores open and close

• Census tract fixed effects: Fine-grained differences in food resources within the same census tract

• Home and school food environment, modeled together

Funded by NIH/NIDDK R01 DK097347

Legend Fast food restaurant

Fast food restaurants/tract

Thoughts: Priorities for research and/or to guide the next Mayoral administration

• We don’t yet have (the) solution(s)

• Think beyond “traditional” policy levers

• RANDOMIZE?

• Multiple solutions, same place

• Aggressive patience