Food Policy Research in NYC: What do we know? Where do we need to go? Brian Elbel, PhD, MPH Assistant Professor of Population Health and Health Policy Director, Section on Health Choice, Policy, and Evaluation Department of Population Health

Calorie Labeling Many see labels, some even report using them. But, no population- level changes of note in calories purchased. Clear limits to the policy. Could they work along with other initiatives in in the longer term? Funded by RWJF Healthy Eating Research 65634; NIH/NHLBI R01HL095935

Fresh Food Financing Initiatives NYC’s “Food Retail Expansion to Support Health (FRESH)” 90%: Shop for groceries in supermarket 35%: Reported noticing a new store in their neighborhood No change: fruit and vegetables consumed, “unhealthy” snack food consumed – At least for the community as a WHOLE Funded by Aetna Foundation and RWJF Healthy Eating Research 68236

Sugary Beverage Portion Cap Funded by NIH/NIDDK R01 DK099241, NYSHealth Foundation and RWJF 70823

Taxes and Different Labeling Funded by NYU CTSA UL1TR from (NCATS), NIH 26%: Increase in purchasing a healthier item with a tax No difference among taxation conditions 15%: Increase in purchasing a healthier item with labeling Relative effectiveness of smallish tax versus more effective label?

Impact of the Food Environment on Child BMI True, causal impact of food environment on BMI illusive Combining NYC FITNESSGRAM data with food environment data Child fixed effects: What happens to BMI as healthy and less healthy food stores open and close Census tract fixed effects: Fine- grained differences in food resources within the same census tract Home and school food environment, modeled together Funded by NIH/NIDDK R01 DK Legend Fast food restaurant Fast food restaurants/tract

Thoughts: Priorities for research and/or to guide the next Mayoral administration We don’t yet have (the) solution(s) Think beyond “traditional” policy levers RANDOMIZE? Multiple solutions, same place Aggressive patience