As more communities become concerned about finding ways to reduce increasing rates of obesity, many coalitions struggle to find a way to move beyond changing individual behavior and local government policies that contribute to overweight to taking on the food industry and other more upstream influences. The Strategic Alliance for Healthy Food and Activity Environments (SA) provides a model for this more holistic approach. SA works to improve the health of Californians by providing solutions for community organizations and residents to take action to create healthier food and physical environments. Here we focus on their work to change the food and beverage industry’s influence on food choices.
The alliance’s programs examine and challenge the food and beverage industry’s influence on daily life, with a particular emphasis on practices that reach the lives of children. For example, SA has worked with others to change corporate policies on food marketing in stores and on television, the use of celebrities to endorse unhealthy products, and exclusive soda and fast food contracts with school districts. are just some of the areas where SA rallies for change. By equipping advocates with resources, research, information, training and assessment tools, SA assists communities to reduce the promotion of unhealthy food.
SA views local initiatives as the driving force for changing local, state, federal and corporate policies. By supporting these initiatives with education, media analyses and policy advocacy, the Alliance strengthens and accelerates the creation of healthier food and activity environments.
SA encourages concerned citizens and organizations to learn more about the ways corporations shape nutrition and physical activity environments. To educate and mobilize parents, advocates, young people and health providers, SA publishes reports, sponsors training programs and distributes assessment tools. For example, a report called Setting the Bar: Recommendations for Food and Beverage Industry Action calls on the food, beverage and restaurant industry to “make meaningful changes to support people in making nutritious food choices.” It lists simple steps these industries can take in the areas of product, price, place, and promotion. The box below shows the suggestions that food industries can use to make products healthier. Presented in simple language, the 3 page report serves as a tool for activists and a guide for sympathetic business owners who want to make changes.
Important Steps for the Food and Beverage Industry
Provide healthy food and beverages as the standard in all children’s meals and on children’s menus.
Add new menu items that are healthy, affordable, tasty, and satisfying, including entrées, appetizers and side dishes.
Reformulate food products to decrease calories and lower saturated fat, trans fat, sodium, and added sugars, and add more fruits, vegetables, whole grains, legumes, nuts, and seeds.
Make available, and promote low calorie or no calorie beverage options without artificial sweeteners (e.g., water, low-fat milk) that help customers to manage their calorie intake.
Eliminate large and extra-large food and beverages portions.
SA also created the Environmental Nutrition and Activity Community Tool (ENACT), an interactive, networking tool and development guide designed to connect communities with effective strategies to counter health harming industry practices. The guide allows users to review successful programs, input specific needs, and evaluate ongoing projects.
For example, alliance members can use ENACT to determine the extent to which fast food endorsements of preschool educational materials effect children’s health in their communities in order to decide whether to make this action a priority.
The American Public Health Association endorses ENACT, saying it “provides a road map for change, offering a practical starting place for communities and making healthy eating and regular activity a realistic option for everyone.” 
Through its educational activities, SA provides materials to create initiatives and challenge the food and beverage industry’s influence in childcare centers, schools, after school programs, neighborhoods, workplaces, health care providers and government agencies. This support has helped local initiatives to, for example, limit fast food businesses in the neighborhood, improve nutrition standards in public schools, and remove unhealthy food marketing in local groceries.
Since the media exert a powerful influence on food choices and public opinion on food policy options, SA also assists activists and advocacy organizations to analyze media coverage of food issues, to frame their own messages more effectively, and to design media advocacy campaigns in support of policy objectives. To achieve these goals, SA teamed up with the Berkeley Media Studies Group (BMSG) to create an advocacy project called the Rapid Response Media Network. The project serves as an action network and resource for nutrition and physical activity advocates. The goal of the project is to unravel health harming messages that blame individuals for diet related diseases, and move toward an analysis that holds corporate practices and government policies responsible for shaping our daily environments.
Advocates can engage the Rapid Response Media Network through several resources. The project monitors, analyzes and produces reports on food and beverage industry current events. Armed with the network’s reports, alliance members are encouraged to carve out the front-lines of nutrition and physical activity advocacy. The project also provides consulting services and issues ‘Framing Briefs,’ helping tease out complex messages and aiding a unified voice.
To give an example, the Network helped members analyze a quote from Jim Skinner, CEO of McDonald’s, that appeared in the Wall Street Journal. “We [McDonald’s Corp] are not going to solve the world’s obesity problem. But what we can do is be productive and be part of the solution” by providing consumers with “choices” .
How can advocates contextualize the underlying health messages in Skinner’s comment? The Rapid Response Media Network ‘Framing Brief,’ Reading Between the Lines, compares Skinner’s focus on “choice” to other corporate marketing and sponsorship campaigns. Philip Morris, PepsiCo and Kraft also attempted to redirect negative media attention away from unhealthy products by evoking the same strategy.
According to the ‘Framing Brief,’ “The emphasis on choice reinforces the common frame in American culture that individuals are solely responsible for their own health. Choice links directly to personal responsibility. Personal responsibility is extremely important, but decisions are always made in a context. Focusing on choice obscures the context” (p. 3).
Larry Cohen, founder of SA’s parent organization, The Prevention Institute, and author of Prevention is Primary (2007), details the importance of broadening media coverage around nutrition and physical activity environments. Cohen’s 2005 article in the California Journal of Health Promotion, The O Word , says that an individual-focused prevention response to obesity does not improve health and, in fact, can adversely affect communities. “…The persistent drumbeat of ‘obesity’ oversimplifies a complex issue. It places the blame squarely on the individual, without taking into account the social and economic influence of where people live, work and play” (p. 154).
Using similar reasoning, Lori Dorfman of BMSG, calls on advocates to “reframe” public health issues. To Dorfman, nutrition is just one example of how health prevention efforts can shift from individually-focused efforts to a more holistic context. In order to “reframe” issues, Dorfman says the social, economic and political context must also be considered .
By supporting media analysis and advocacy, SA and The Prevention Institute advance their mission of strengthening local efforts to influence corporate and government practices that shape daily nutrition and physical activity environments.
In addition to its educational and media work, SA also seeks to advance a policy agenda that addresses local, state, federal and corporate food policies. Its steering committee includes such organizations as The California Adolescent Nutrition and Fitness Program, California Center for Public Health Advocacy, California Food Policy Advocates, California Pan Ethnic Health Network; California Park & Recreation Society; California Project LEAN; California WIC Association, Child Care Food Program Roundtable; Latino Health Access Prevention Institute, and the YMCA of the East Bay, giving the group access to hundreds of organizations and thousands of individuals. By bringing consistent policy messages to legislators, Mayors and the Governor from these sources, SA enhances its political clout.
Its policy recommendations, included in reports such as Taking Action for a Healthier California: Recommendations to Improve Healthy Food and Activity Options, recommend steps the food and beverage industry can take to improve food environments and also public policies to monitor industries impact on health more carefully. Several recommendations are open-ended, allowing communities to tailor community-specific programs. For youth involved in pre-school, public school and after-school settings, for example, SA recommends the removal of advertising and marketing of unhealthy food, provisions for nutritious food standards, and increasing physical activity programs.
Taking Action for a Healthier California is changing the way some California cities approach prevention efforts. As a result of local policy advocacy, San Francisco and the City of Berkeley have endorsed many of SA’s recommendations, joining more than 75 organizations that have committed to improving nutrition and physical activity environments.
Working to further develop action at the policy level, SA tracks local policy decisions related to food and physical activity through the ENACT Local Policy Database (ENACT LPdB). Policy coverage includes school district, city, county and state levels where community activities and coalitions have worked to achieve change.
Advocates are encouraged to use the ENACT website and ENACT LPdB as both educational and development models. The approach endorsed by SA is designed to motivate advocates to “act locally” through social organizing around the role of the built environment.
A year ago, the Strategic Alliance issued a report called Where’s the fruit? charging the food industry with deceptive labeling and advertising of many processed foods by implying they contained more fruit than they did. The report attracted broad television and newspaper coverage, educating millions of people about the issue. “The deception is really intolerable,” Larry Cohen, executive director of the Prevention Institute, told the San Francisco Chronicle . “There is really no excuse for misleading parents in a way that weakens their ability to encourage their children’s health” . By bringing together researchers, community organizations and policy advocates SA had helped to ‘reframe’ the way society views health behavior and politically popular policy recommendations. Equally important, SA had given local activists the tools they needed to move their fight for healthier food upstream, from individual and parental responsibility to corporate accountability.
1. Food and Nutrition Resources. American Public Health Association. Summer 2006 Newsletter. Available at: http://www.apha.org/membergroups/ newsletters/sectionnewsletters/food/summer06/2494.htm.
2. Adamy J. Boss Talk: How Jim Skinner Flipped McDonald’s. Wall Street Journal. Jan 5, 2007. B1. Available at: http://wsjclassroomedition.com/monday/mx_07jan08.pdf.
3. Cohen L, Perales DP, Steadman C. The O Word: Why the focus on obesity is harmful to community health. California Journal of Health Promotion. 2005;3(3):154-61. Available at: http://www.csuchico.edu/cjhp/3/3/154-161-cohen.pdf.
4. Dorfman L, Wallack L. Moving Nutrition Upstream: The case for reframing obesity. J Nutr Educ Behav. 2007;39(2 Suppl):S45-50. Available at: http://linkinghub.elsevier.com/retrieve/pii/S1499404606006014.
5. Finz S. Fruit Shown on Lable Often Not in Box, Kids’ Food Study Says. San Francisco Chronicle. Jan 26,2007. Available at: http://www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2007/01/26/ MNGMHNPK671.DTL.