Lost in the noise of the debate over Howard County Government's nutritional standards regarding sugary drinks are a few key questions. First, when, if at all, should government act in response to growing evidence linking certain behaviors to premature mortality and increased health care costs? And second, if providing only healthy options on government property goes "too far," are there interim measures beyond just education that can help address growing public health threats?
These are difficult questions to answer, but we've tackled similar ones before. While cigarette smoking is not exactly equivalent to consuming soda and the like, the evolution of a growing body of evidence demonstrating harm followed by environmental changes to reduce consumption is similar to what we are already witnessing with sugary drinks.
The Horizon Foundation has been working for the last two years to make it easier for people in Howard County to lead healthy lifestyles. Diseases caused by poor nutrition like diabetes, obesity and high blood pressure are the biggest public health threats our community faces. These diseases have reached staggering levels over the last generation and result in real human suffering. We have worked to provide an environment where residents have expanded access to more nutritious food and drink options, with a specific focus on alternatives to sugary drinks.
Indeed, our research partners and others support this focus because sugary drinks are the single biggest source of added sugar in our diets and have no nutritional value. Avoiding them represents an easy lifestyle change for those looking to improve their health in the short and long term.
We've invested millions in education and outreach efforts to help reduce consumption, but we also know from decades of research that behavioral change does not result from education alone, especially when the beverage industry spends billions on "education" of its own. Changing the environment and community norms, coupled with thoughtful education programs, have far greater and long-lasting impacts.
While the principle of personal choice has come up repeatedly in the debate about these standards, this rallying cry rings hollow in the face of facts. The crisis of diseases stemming from poor nutrition is not indicative of a collective lack of willpower. (Do we really believe that over a quarter of all kids and over half of all adults have less willpower than their parents or grandparents?) When our environment prioritizes unhealthy over healthy, it is that much harder to find and choose healthy options.
When Howard County instituted healthy nutrition and beverage standards, it joined more than 50 jurisdictions nationwide and set in motion an environmental change with positive consequences for the county's health.
The repeal of these standards means Howard County lags behind others, but that doesn't mean all progress has to be rolled back.
We would urge Howard County Executive Allan Kittleman to explore policies that complement educational programs — policies that wouldn't conflict with his convictions but would have far more efficacy than education alone. What would that look like? If the previous nutritional standards pushed people too far, perhaps a nudge is in order.
For instance, a replacement set of nutritional standards could:
•Limit unhealthy beverages to 10 percent of offerings.
•Price unhealthy beverages significantly higher than healthier options.
•Place unhealthy beverages and snacks at the bottom of vending machines — out of the line of sight.
•Require signage and vending machine markers that indicate which choices are healthier choices.
Howard County's long history in promoting forward-looking public health programs has garnered us recognition, but more importantly, the results speak for themselves: We are consistently ranked one of the healthiest places to live anywhere.
These accolades are neither accidental, nor the result of good fortune. They are the result of leadership and hard work by government, private and non-profit organizations across the county.
We are also a community that is willing to try new things. So if the first set of standards is no longer palatable, let's try something else.
There is a wide menu of options available, and we look forward to working with County Executive Kittleman and the County Council to cook something up that makes healthier options easier to consume for everyone.
Nikki Highsmith Vernick is president and CEO of The Horizon Foundation. Her email is email@example.com