for Future Actions
Carol Tucker Foreman
The Food Policy Institute, CFA
Thank you, Paul, for the introduction. Thank you,
Mike McGinnis and Sylvia Rowe, for your insights. Thank all of you
out there in the audience for sticking with us through this long
morning. I appreciate the invitation to speak here this morning,
and I am a little intimidated by the challenge of concluding what
has been a very important week in the nutrition community.
- The new Dietary Guidelines were published.
- Secretary Glickman announced the U.S. Department
of Agriculture (USDA) would require labeling of fresh meat and
poultry products, ending one of the more curious anomalies of
- For the first time since the 1969 White House Conference
on Food, Nutrition, and Health, the Federal Government has invited
all stakeholders to come together to explore past progress and
future challenges in eliminating hunger, improving nutrition,
and increasing calorie-burning activity.
This is the most impressive array of nutrition and
physical activity scientists, public health practitioners, food
industry representatives, and activists and advocates that I've
ever seen gathered in one place. I am honored to have been invited
to participate. Thank you for having me and thanks especially to
all of you, both inside and outside the government, who pushed and
prodded and nagged for so long to make this Summit happen.
We've heard from the President and from two gentlemen
who aspired to be President. Each would have brought to that position
extraordinary knowledge of and commitment to fighting hunger and
We knew the shape of the problems before we arrived,
and virtually every speaker has tolled out the painful statistics.
- An increasingly large number of us eat too much.
Fifty-five percent of our population is overweight, and 14 percent
of our children are obese.
- Too much food and too little activity cause more
than 300,000 premature deaths each year and cost us $71 billion
in healthcare costs and lost productivity.
- At the same time, millions of low-income Americans
regularly lack enough food to satisfy their hunger.
How did this happen? Frankly, folks, when it comes
to nutrition and physical activity, we live in a toxic environment.
We're surrounded by compelling messages to eat more and seductive
enticements to do less.
- $25 billion a year of food advertising tells us
to "eat more"; "Don't just sit there, eat something"; "Kids talking
too much? Give 'em a chewy."
- Labor-saving devices surround us at home and the
office, and a variety of barriers discourage physical activity.
How can we construct a road to a healthier future?
We could begin by
- Considering what an early observer said about the
- Examining successful strategies used to achieve
social change, both in other fields and within our own.
- Establishing an action plan.
Sometimes outsiders describe us best. The Frenchman
Alexis de Tocqueville observed 165 years ago:
||Americans "have a lively faith in the
perfectibility of man; they judge that the diffusion of knowledge
must necessarily be advantageous, and the consequences of ignorance
fatal; they all consider society as a body in a state of improvement…."
That's a pretty good description of us, isn't it?
We wouldn't be here if we didn't believe we have the power to solve
problems through knowledge and action.
There are some successful examples of social change
that we can use to shape our effortsthe campaigns to reduce
health problems associated with smoking and automobile accidents
have some similarities to the ones we have to address.
- Smoking is the single largest cause of premature
death in our country, killing more than 350,000 of us every year.
- Highway accidents kill thousands and maim many
more each year.
For many years, it was assumed that the only way to
address these problems was through individual action. When the Surgeon
General reported that cigarette smoking caused cancer, it was viewed
as an individual problem. Each smoker had to simply muster the emotional
resolve and physical discipline to stop.
Then we came to understand the role that the social
environment played in encouraging smoking and highway accidents:
- Cigarettes were given away free on college campuses
and to servicemen with the complicity of our government.
- Cigarette advertising was ubiquitous and targeted
youth, women, and minorities by showing how cool smoking was.
- Several generations of Americans learned from movies
that the last part of the sex act was smoking a cigarette.
- Beginning in the 1950s, superhighways proliferated,
cars got bigger and faster, and highway deaths exploded.
As the data about injury, illness, and death from
smoking and auto crashes began to mount, it became clear that something
more than individual action was needed. We came to realize that
if the environment is hostile to public health, you have to change
the environment. If social mores and public policies thwart healthy
lifestyles, you have to alter social standards and change laws.
Advocates for change organized to accomplish their
goals. They developed data to demonstrate the scope of the crisis;
built strategic plans and citizen campaigns; employed sophisticated
communications and media efforts; built public-private partnerships;
galvanized government; passed local, State, and Federal laws.
It worked. We've made progress in those efforts. In
the late 1960s, 44 percent of Americans smoked. Today the number
has dropped to 25 percent. Today all cars must have driver side
airbags and seat belts, and 70 percent of Americans use those seat
Anti-hunger advocates have used many of these same
methods and strategies. In 1967, the Field Foundation sent a group
of doctors to several places around this countryAppalachia,
the Mississippi Delta, the Southwest, and the Bronxto survey
poverty and its impact on hunger. They reported that hunger was
a daily fact of life for large numbers of children, who were more
than malnourished. They were weak and sick and "directly or indirectly,
dying from the effectwhich is exactly what starvation means."
Media coverage of the report was a major factor in
stimulating the 1969 White House Conference and changed the American
approach to fighting hunger. For the first time, people acknowledged
that thousands of Americans were not hungry as a result of some
personal failure or individual character flaw but because of social
and economic forces.
Americans also recognized that hunger imposed costs
on society. Hungry people weren't likely to be good students or
good workers. Hungry children were more susceptible to disease,
more likely to have chronic health problems, bear smaller, less
healthy children, and become dependent on public support systems.
The delegates to the 1969 White House Conference recommended
making a major national commitment to reducing hunger. Private and
public groups launched campaigns for change. The results were impressive.
Within a couple of years, Congress had expanded the food stamp program
and made it nationwide. The school lunch program was expanded. In
1972, Congress created the Women, Infants, and Children (WIC) Program.
In 1979, physicians went back to the same places and found that,
although poverty was still evident, the indications of hunger had
The nation's food assistance programs have worked
amazingly well. There is no evidence of starving children in this
country, but for a variety of reasons there are still large number
of people who are hungry at least part of every month. Food stamp
benefits aren't adequate to get families through the month, and
many have to rely on food pantries to make up the difference. Many
who are eligible for food stamps don't get them. Many children don't
have access to free meals during the summer to replace school lunch.
WIC doesn't have sufficient funding to reach all the women and children
who are eligible. Most importantly, many working poor just don't
earn enough to feed themselves and their families. Addressing that
problem requires increasing minimum wages.
We must leave here today committed to finishing the
jobexpanding food assistance programs and assuring a decent
wage for all Americans. One important and immediate step would be
to pass the bipartisan Hunger Relief Act introduced by Senators
Kennedy and Specter. Doing so would be an impressive way to begin
a new millennium and a fitting tribute to the work of Senators McGovern
These examples of social change provide us some important
models for action to improve nutrition. But changing dietary habits
is in many ways more challenging than reducing hunger and smoking
and increasing seat belt use. We have to affect the lives of 270
million people who eat three times a day, every day for the rest
of their lives.
Whether we succeed depends largely on what the people
in this room do after we leave here. Now is the time to act. We
have the data to demonstrate that diet-related disease has risen
to critical levels. Most of the excuses for failing to mobilize
a major public effort, if once persuasive, aren't any longer. Our
economy is booming. Business is prospering. Both Federal and State
budgets are showing surpluses. The Cold War that absorbed our attention
and resources for so long is ended. It is time to turn our attention
to the problems we have allowed to fester for too long.
We need a National Nutrition Policya central
guiding document that lays out the problem and a plan of action.
We have Dietary Guidelines and Healthy People 2010, but we need
one core statement that sets goals and timetables, lays out specific
programs and actions, assigns responsibilities for achieving them,
identifies sources of funding, and writes the first phases of the
programs into the FY 2002 budget. The group reports from yesterday
and Mike McGinnis today have provided a good list of specific proposals.
We should consider a requirement that all new laws
and regulations include an assessment of their impact on diet and
physical activity. If you want to write a Federal regulation, you
have to prepare a number of impact statementseconomic impact,
environmental impact, small business impact, paperwork reduction
impact. Perhaps we should require every Federal regulatory decision
to determine what the impact will be on nutrition and physical activity
of each housing development, each new highway, the NIH budget, and
the USDA budget.
Advocates for change must organize and secure resources
for a major communication program. We need partnership, all of us
working together. I want to address some specific requests to each
of the groups here today.
To those of you representing local, State, and Federal
If achieving the goals outlined in Healthy People
2010 is really important, you have to think differently, try some
new things, color outside the lines. You have to put away the
"Can't do this. OMB won't accept it."
"Can't do that, Congress won't like it."
"Can't do the other things; I might have
to think differently about my own role and my own turf."
To school boards and school administrators…
Much of the responsibility for progress will fall
on you. If bad diets and physical activity are problems and problems
that are more easily avoided than cured, we must focus on children.
That means deciding that getting school breakfast programs is a
priority. It means making time for lunch and for daily physical
education. It means deciding that schools should offer good nutrition
education everywhere within the school. It is not good nutrition
education, nor is it morally acceptable, to surround children with
soda and snack machines in school buildings. It is not acceptable
to allow fast food chains to buy their way into school cafeterias.
We need you now more than ever. But you have to be
willing to help us on a timely basis. Science is always evolving.
There are never final answers. Give us the best information you
have. Acknowledge any weaknesses, and let us know how comfortable
we should be in using it as a base for public policy. We have to
eat three times a day. We have to know what to feed the kids, tonight.
To activists and advocates…
We need you to keep prodding and poking. But if you
get up every morning persuaded that everyone in the food business
is the ultimate enemy and must be vanquished and that there is only
one way to skin a cat, we just won't get anywhere. We live in a
regulated market economy. And we will continue to do so. Some of
our greatest success stories are win-win projects like food stamps
and WIC. These are the programs that feed hungry people and also
increase the income of retailers, processors, and producers.
We need your help, politically and socially. Food
isn't widgets. Because food is so basic to our physical and emotional
well-being, the people who produce, process, and sell it have to
answer to a higher standard than just the bottom line on a corporate
financial report. I know many of you and have worked for some of
you. You are all responsible individuals. Our country, especially
its children, need for you to think and act responsibly.
It is unlikely that, in this country, we're going
to curtail your right to advertise food, but you can and should
consider the moral implications both of the message and the pervasiveness
of your advertising, especially advertising directed at children.
No one is going to prohibit advertising candy bars, even to children.
On the other hand, no one is requiring you to advertise them to
children, or at all.
You have an obligation to your stockholders, but you
also live in, raise your children in, and have an obligation to
the larger community. Senator Dole said yesterday that he never
got any political benefit from fighting hunger. It didn't generate
campaign contributions and probably didn't get him many votes. He
did it, he said, because it was the right thing to do. The food
industry could decide to develop a code of conduct that foreswears
buying television advertising that is directed at children or airs
during peak viewing times for children. You don't have to do it,
but it would be the right thing to do.
Some of the recommendations springing from this meeting
may make you flinch, but you wouldn't be here if you didn't think
we have a problem that must be addressed. Don't reject any new limitation
or obligation immediately. If there are one or two you just hate,
say we can't go there. But we can do this, and it will get you 75
percent of the desired effect.
To trade associations…
You could be among the most important people here.
Instead of crowing that you have protected the least efficient and
least responsible member of your group from any Federal action,
protect the interests of the best and most socially responsible.
Stretch your members and yourselves. Do the hard thing.
Returning to de Tocqueville, he marveled that Americans
believe that "what is not yet done, is only what they have not yet
attempted to do." That's my view of our task from here. We have
a need. We have the economic strength. All we need now is to make
a commitment, to each other and to public health, and then muster
the energy for action. Or, to move from the 18th century to the
21st and quote a more current mandate…"Just do it."
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