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Summit Agenda

Opening Ceremonies

Breakout Sessions

Breakout Summaries

Perspectives for Future Actions

Overarching Themes

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Moore speech

Rohde speech

Rowe speech

McGinnis speech

Foreman speech


Perspectives 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 Federal law.
  • 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 improving nutrition.

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 American character.
  • 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 efforts—the 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 belts.

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 country—Appalachia, the Mississippi Delta, the Southwest, and the Bronx—to 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 effect—which 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 diminished substantially.

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 job—expanding 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 and Dole.

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 Policy—a 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 statements—economic 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 governments…

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.

To researchers…

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.

To industry…

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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