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Slide1: 

Victor Colman , JD Senior Policy Advisor Washington State Department of Health Public Health Prevention: Working in a Policy Context February 2007

LEARNING OBJECTIVES: 

LEARNING OBJECTIVES Present various public health frameworks Highlight contemporary public health work Describe challenges in prevention and policy development

Factors That Influence Health: 

Factors That Influence Health

PUBLIC HEALTH MODEL: 

PUBLIC HEALTH MODEL ENVIRONMENT HOST AGENT Problems arise through the relationships and interactions among the agent, the host, and the environment

PUBLIC HEALTH MODEL: 

PUBLIC HEALTH MODEL

Slide6: 

The Spectrum of Prevention

Public Health Prevention: Ease of Maintenance: 

Public Health Prevention: Ease of Maintenance Environmental approaches can be cost-effective >> costs associated with implementation, monitoring, enforcement and political action can be considerably lower than those associated with individual efforts (i.e., ongoing education, health care treatment)

Promotion  Place Product  Price : 

Promotion Place Product Price “Total Marketing… combines all the key marketing elements into a single orchestrated thrust.” August A. Busch, III

PROMOTION: 

PROMOTION

Promotion: 

Promotion

Fast Food Promotion: 

Fast Food Promotion

Slide17: 

CHILDREN FOCUSED

86% of 5th grade boys know the Budweiser Frogs’ slogan: 

86% of 5th grade boys know the Budweiser Frogs’ slogan 68% know Tony the Tiger’s slogan 57% know Smokey the Bear’s slogan

YOUNG PEOPLE: 

YOUNG PEOPLE

Slide20: 

HISPANIC

Slide21: 

Native American

Slide22: 

Asian American

Slide23: 

WOMEN

Slide24: 

MEN

Slide25: 

SPORTS

Slide26: 

SEX APPEAL

Slide27: 

BILLBOARDS

Latino and African- American Communities: 

Latino and African- American Communities Have a disproportionate number of billboards and other outdoor advertising

Slide29: 

HOLIDAYS

Halloween: Stealing a Children’s Holiday: 

Halloween: Stealing a Children’s Holiday

Counter-Strategies: A Quick Snapshot : 

PROMOTION Food: restricting TV advertising during prime viewing hours for children Alcohol & Tobacco: limit sponsorship of sports and other youth-related events Food, Alcohol & Tobacco: counter-advertising Tobacco: restrict/ban sampling activities All: Promote media literacy curricula in schools Counter-Strategies: A Quick Snapshot

Slide32: 

Counter-Strategies cont.: Healthy vending options Healthy cafeteria items, promotes farm to school programs

Slide33: 

COUNTER ADS

Slide34: 

COUNTER ADS

Slide35: 

COUNTER ADS

PRODUCT: 

PRODUCT

Product: 

Product Portion size and nutrition content Products in grocery stores, gas stations and school food displays

Slide39: 

POWER & MALT LIQUOR

LIGHTS & DRYS BOOSTS BEER SALES: 

LIGHTS & DRYS BOOSTS BEER SALES

Product: 

Product Counter-Strategies:

Counter-Strategies cont.: : 

PRODUCT (all) Ingredient labeling (including alcohol content) Warning labels (stronger, larger) Restrict placement according to product Menu labeling (food) Trans fat ban (food) Counter-Strategies cont.:

PRICE: 

PRICE

Price: 

Price Cost of sugary, high fat foods Cost of a soda Cost of fast food very cheap

IMPACT OF “SIN” TAXES: 

IMPACT OF “SIN” TAXES Raising taxes can increase state revenues and reduce consumption Lowering consumption reduces alcohol and tobacco-related problems Future public and private health care expenditures can also be reduced Raising sin taxes represents an efficient public policy with multiple benefits

Price: 

Price Provide healthy affordable food items in school cafeterias and a la cart displays Use price incentives to encourage healthy purchases in schools Raise excise taxes Counter-Strategies:

PLACE: 

PLACE

Place: 

Place Advertising and vending machines in schools Unhealthy foods in school stores, a la cart displays and in cafeterias

Low-income communities have an over-concentration of alcohol outlets: 

Low-income communities have an over-concentration of alcohol outlets

Chicago-Area Communities : 

Chicago-Area Communities

Slide51: 

WINCHELL’s

Place: 

Place Counter-Strategies: Eliminate soft drink contracts or switch to healthier options in schools Close campuses to promote consumption of on-site foods Restrict the establishment of fast food restaurants near schools

Counter-Strategies cont. : 

PLACE Restrict retail availability (all) Give adequate zoning and licensing powers to cities & counties (all) Restrict “special use” availability for public places, i.e., parks, beaches, cultural events, stadiums, college campuses (alcohol & tobacco) Institute responsible hospitality programs managers & servers (alcohol) Counter-Strategies cont.

TRANSITION: 

TRANSITION

Nutrition and Physical Activity: The Washington State Story: 

Nutrition and Physical Activity: The Washington State Story Coalitions and Partnerships Washington’s Action For Healthy Kids Team Access to Healthy Foods Coalition Washington Coalition for Promoting Physical Activity Transportation Choices Coalition Bicycle Alliance of Washington Breastfeeding Coalition of Washington Anti-Hunger Nutrition Coalition WA Association of Local WIC Agencies

Nutrition and Physical Activity: The Washington State Story: 

Nutrition and Physical Activity: The Washington State Story Why Coalitions? Scattered approaches to policy development not most efficient Local (grass roots) activism needed to identify and make changes at all levels Coalition-building is proven and necessary method for moving policy agendas

Nutrition and Physical Activity: The Washington State Story: 

Nutrition and Physical Activity: The Washington State Story Importance of Collective Policy Development Emerging Role of the Nutrition and Physical Activity Policy Leadership Group Ongoing development of a broad policy platform

Nutrition and Physical Activity: The Washington State Story: 

Nutrition and Physical Activity: The Washington State Story Importance of Activated Coalition SB 6533 – syrup tax bill (2006 legislative session)

Nutrition and Physical Activity: The Washington State Story: 

Nutrition and Physical Activity: The Washington State Story Importance of Policy Implementation – Recent Bills SB 5436 – school policy (2004) SB 5186 – physical activity and planning (2005)

Nutrition and Physical Activity: The Washington State Story: 

Beware of Unintended Consequences DARE example (drugs) FAS Warning Labels (alcohol) Restrictions on Advertising (tobacco and alcohol) Sobriety Checkpoints (alcohol) Taxes (tobacco and alcohol) Smart Growth (built environment) Nutrition and Physical Activity: The Washington State Story

SOME TAKE-HOME THOUGHTS: 

SOME TAKE-HOME THOUGHTS Population-based behavioral change is possible Policy approaches are a legitimate part of the business of public health Policy change is also about understanding politics Learning how to move policy agendas is the other part of successful policy change

Slide64: 

Victor Colman, JD Senior Policy Advisor Division of Community and Family Health, Washington State Department of Health Tel. # 360.236.3721 victor.colman@doh.wa.gov What is a health which merely makes people ripe to be damaged, abused, and shot at again? Bloch, Ernst (1995), The principle of hope. Cambridge, Mass.