What — if anything — can the government do to help?
Let’s get one thing clear. This column will not examine the evidence in support of particular policies, because there just isn’t very much. Some countries have tried some ideas, and we know a few basic principles — people will buy less of something if it gets more expensive, for instance — but I have not seen a single piece of evidence connecting a government policy to an improved health outcome.
But we’ll never have any evidence unless we try some things. Let’s get a few ideas on the table here.
To do that, I asked several people with relevant expertise to weigh in with the three interventions they think would do the most good, so we could put together a kind of holiday wish list. My top three are at the end (I know you’re on the edge of your seat).
First is Jayson Lusk, who heads the Department of Agricultural Economics at Purdue University and basically says, hey, not so fast: “There are few if any policies available to government that would both make a meaningful difference in dietary patterns and that would be palatable to the public insofar as not being viewed as overly coercive or costly.”
That “coercive” part is important. Plenty of people are in Lusk’s camp, who think the government has no business interfering in people’s diets, and we’re all perfectly capable of deciding for ourselves what to eat, thank you very much. I have enough of a libertarian streak to be sympathetic to that view, but I am much more a pragmatist than an ideologue. If the government can make a difference, I think the problem is acute enough that it should.
Despite his concern about coercion, Lusk is willing to consider “investments in research to lower the cost of producing a diversity of healthy foods or into research that improves the nutritional quality of foods people like to eat.” Okay, that’s a start.
The other people I asked are a bit more optimistic.
Ricardo Salvador is director of the Food and Environment program for the Union of Concerned Scientists and a longtime advocate of policy change. He starts from a position that government’s role is to “protect the public interest against the concentrated interests and power of industry where those interests … are inimical to public well-being.”
1. “Eliminate food insecurity and malnutrition.” We can do this, Salvador writes, by signing the U.N. Covenant on the Right to Adequate Food, and expanding the Supplemental Nutrition Assistance Program (SNAP, formerly known as food stamps).
2. “Support only value chains and products that conform to the Dietary Guidelines for All Americans.” Which would mean no more “propping up production of commodity industrial and feed crops.”
3. Regulate junk food advertising, in the way we do tobacco or alcohol. Or, he adds, eliminate it.
Priya Fielding-Singh, a sociologist at the University of Utah, is author of “How the Other Half Eats,” an in-depth exploration of the barriers to healthful eating, particularly among the poor.
1. Create “a nationwide universal school meal program that serves fresh, nutritious, delicious and culturally relevant breakfasts and lunches to all students.”
2. Ban all food and drink advertising to children.
3. Improve the social safety net by increasing the minimum wage and expanding access to housing and child care.
Danielle Nierenberg is president of Food Tank, a think tank focused on our food system.
1. Simplify SNAP, particularly to help farmers sell to recipients and to help recipients buy healthy food online.
2. Leverage procurement for schools, hospitals and government institutions to support small and medium-size farms and, in turn, rural communities.
3. Revamp the Emerson Act, which governs food donations, “to make it easier for food donations from retailers, restaurants and individuals to be made without the threat of lawsuits.”
Now that you’ve heard from the professionals, it’s my turn.
I share Salvador’s commitment to the idea that government action should be consistent with public health, but also Lusk’s skepticism that interventions can change our diets much. There are nevertheless a few things I’d like to try.
1. Make SNAP like WIC (Women, Infants, and Children supplemental nutrition program).
Right now, SNAP dollars can be used for almost anything in the grocery store, but WIC dollars can be used only for a limited set of healthful foods. If we rebuilt SNAP in WIC’s image, we would guarantee that families in need had access to healthful food and create demand for those foods in neighborhoods where they are often in short supply. (I made this case in detail a couple years ago.)
The idea that taking choice away from SNAP recipients is disrespectful of the poor, a kind of pile-on, has become almost an article of faith on the political left. But if we had no program at all and someone floated the idea that we should spend $70 billion a year to make sure the poorest among us had access to a suite of healthful foods, I don’t think there would be opposition on that basis. And I’ve never heard anyone lodge that complaint about WIC.
The problem is that we’ve already created a program with few limits, but that shouldn’t mean we’re stuck with it for all time.
2. Tax sugar in the supply chain.
There’s evidence that soda taxes reduce soda purchasing, but none that they change overall diets. If we had a national tax on sugar (including all caloric sweeteners), we might have a better chance. Not only would it raise the price of all sugary foods, it would give manufacturers an incentive to reformulate products with less sugar.
This won’t cause a sea change in what we eat, but if we use the money we raise to increase SNAP dollars in the new, revamped plan, I’d settle for that.
3. Implement a joyful, hands-on food curriculum in elementary schools.
Changing adults’ habits is tough, but I think it’s possible to get kids, whose ideas are more malleable, excited about the food humans thrive on. Plant a garden. Take kids into the cafeteria to cook their own lunch. Bring vegetables into the classroom for kids to learn about and taste, a la the U.K. program called TastEd. (Lusk says this “isn’t the worst idea,” which I’ll take as a win.)
Can the government fix our diets? No, I’m quite sure it can’t. But the government has its thumb on the scale of nearly every aspect of our lives, and if it’s going to be a factor, I think it has an obligation to be a factor in a way that’s consistent with public interest.
So let’s talk about these. Let’s figure out which have the best chance of being both feasible and effective. Because one thing we know, beyond a shadow of doubt, that doesn’t work is the way we’re doing it now.