Oakland, CA, United States
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Mosher J.F.,Alcohol Policy Consultations | Adler S.S.,ChangeLab Solutions | Pamukcu A.M.,ChangeLab Solutions | Treffers R.D.,Morgan Hill
Journal of Studies on Alcohol and Drugs | Year: 2017

Objective: Building on the extensive research literature demonstrating that increasing alcohol prices reduces excessive alcohol consumption and related harms, this article presents the results of a 50-state review of local authority to tax alcohol in the United States. Method: Between 2013 and 2015, legal databases and government websites were reviewed to collect and analyze relevant statutes, ordinances, and case law. Results reflect laws in effect as of January 1, 2015. Results: Nineteen states allow local alcohol taxation, although 15 of those have one or more major restrictions on local authority to tax. The types of major restrictions are (a) restrictions on the type of beverage and alcohol content that can be taxed, (b) caps on local alcohol taxes, (c) restrictions on the type of retailer where taxes can be imposed, (d) restrictions on jurisdictions within the state that can levy taxes, and (e) requirements for how tax revenue can be spent. Conclusions: The number and severity of restrictions on local authority to tax alcohol vary across states. Previous research has shown that increases in alcohol taxes can lead to reduced excessive alcohol consumption, which provides public health and economic benefits. Taxes can also provide funds to support local prevention and treatment services. Local alcohol taxes therefore present an important policy opportunity, both in states that restrict local authority and in states where local authority exists but is underused. © 2017, Alcohol Research Documentation Inc. All rights reserved.


Kristensen A.H.,Partnership for Prevention | Flottemesch T.J.,HealthPartners Institute for Research and Education | Maciosek M.V.,HealthPartners Institute for Research and Education | Jenson J.,Partnership for Prevention | And 5 more authors.
American Journal of Preventive Medicine | Year: 2014

Results The microsimulation predicted that afterschool physical activity programs would reduce obesity the most among children aged 6-12 years (1.8 percentage points) and the advertising ban would reduce obesity the least (0.9 percentage points). The SSB excise tax would reduce obesity the most among adolescents aged 13-18 years (2.4 percentage points). All three policies would reduce obesity more among blacks and Hispanics than whites, with the SSB excise tax reducing obesity disparities the most.Conclusions All three policies would reduce childhood obesity prevalence by 2032. However, a national $0.01/ounce SSB excise tax is the best option.Background Childhood obesity prevalence remains high in the U.S., especially among racial/ethnic minorities and low-income populations. Federal policy is important in improving public health given its broad reach. Information is needed about federal policies that could reduce childhood obesity rates and by how much.Purpose To estimate the impact of three federal policies on childhood obesity prevalence in 2032, after 20 years of implementation.Methods Criteria were used to select the three following policies to reduce childhood obesity from 26 recommended policies: afterschool physical activity programs, a $0.01/ounce sugar-sweetened beverage (SSB) excise tax, and a ban on child-directed fast food TV advertising. For each policy, the literature was reviewed from January 2000 through July 2012 to find evidence of effectiveness and create average effect sizes. In 2012, a Markov microsimulation model estimated each policy's impact on diet or physical activity, and then BMI, in a simulated school-aged population in 2032. © 2014 American Journal of Preventive Medicine. All rights reserved.


Patel A.I.,University of California at San Francisco | Hecht K.,California Food Policy Advocates | Hampton K.E.,Changelab Solutions | Grumbach J.M.,University of California at San Francisco | And 2 more authors.
American Journal of Public Health | Year: 2014

Objectives. We examined free drinking water access in schools. Methods. We conducted cross-sectional interviews with administrators from 240 California public schools from May to November 2011 to examine the proportion of schools that met excellent water access criteria (i.e., location, density, type, maintenance, and appeal of water sources), school-level characteristics associated with excellent water access, and barriers to improvements. Results. No schools met all criteria for excellent water access. High schools and middle schools had lower fountain:student ratios than elementary schools (odds ratio [OR] = 0.06; 95% confidence interval [CI] = 0.02, 0.20; OR = 0.30, 95% CI = 0.12, 0.70). Rural schools were more likely to offer a nonfountain water source than city schools (OR = 5.0; 95% CI = 1.74, 14.70). Newer schools were more likely to maintain water sources than older schools (OR = 0.98; 95% CI = 0.97, 1.00). Schools that offered free water in food service areas increased from pre-to postimplementation of California's school water policy (72%-83%; P < .048). Barriers to improving school water included cost of programs and other pressing concerns. Conclusions. Awareness of the benefits related to school drinking water provision and funding may help communities achieve excellence in drinking water access.


Burris S.,Temple University | Ashe M.,ChangeLab Solutions | Levin D.,Network for Public Health Law | Penn M.,Centers for Disease Control and Prevention | Larkin M.,Robert Wood Johnson Foundation
Annual Review of Public Health | Year: 2016

Public health law has roots in both law and science. For more than a century, lawyers have helped develop and implement health laws; over the past 50 years, scientific evaluation of the health effects of laws and legal practices has achieved high levels of rigor and influence. We describe an emerging model of public health law that unites these two traditions. This transdisciplinary model adds scientific practices to the lawyerly functions of normative and doctrinal research, counseling, and representation. These practices include policy surveillance and empirical public health law research on the efficacy of legal interventions and the impact of laws and legal practices on health and health system operation. A transdisciplinary model of public health law, melding its legal and scientific facets, can help break down enduring cultural, disciplinary, and resource barriers that have prevented the full recognition and optimal role of law in public health. Copyright © 2016 by Annual Reviews. All rights reserved.


Huang T.T.-K.,City University of New York | Huang T.T.-K.,University of Nebraska Medical Center | Cawley J.H.,Cornell University | Ashe M.,ChangeLab Solutions | And 9 more authors.
The Lancet | Year: 2015

Public mobilisation is needed to enact obesity-prevention policies and to mitigate reaction against their implementation. However, approaches in public health focus mainly on dialogue between public health professionals and political leaders. Strategies to increase popular demand for obesity-prevention policies include refinement and streamlining of public information, identification of effective obesity frames for each population, strengthening of media advocacy, building of citizen protest and engagement, and development of a receptive political environment with change agents embedded across organisations and sectors. Long-term support and investment in collaboration between diverse stakeholders to create shared value is also important. Each actor in an expanded coalition for obesity prevention can make specific contributions to engaging, mobilising, and coalescing the public. The shift from a top-down to a combined and integrated bottom-up and top-down approach would need an overhaul of current strategies and reprioritisation of resources. © 2015 Elsevier Ltd.


McClintock N.,Portland State University | Pallana E.,Oakland Food Policy Council | Wooten H.,ChangeLab Solutions
Land Use Policy | Year: 2014

As interest in urban agriculture sweeps the country, municipalities are struggling to update, code to meet public demands. The proliferation of urban livestock-especially chickens, rabbits, bees, and goats-has posed particular regulatory challenges. Scant planning scholarship on urban livestock focuses mostly on how cities regulate animals, but few studies attempt to characterize urban livestock, ownership and management practices in the US in relation to these regulations. Our study addresses this gap. Using a web-based survey distributed via a snowball technique, we received responses from 134 livestock owners in 48 US cities, revealing the following: why they keep livestock; what kind of, livestock they keep and how many; the proximity of their livestock to property lines and dwellings; the extent to which they raise animals for meat; how they manage waste and other possible nuisances or public health risks; and their interest in exchanging animal products through sale and barter. We also examine whether such practices conform to the regulatory context. Results suggest that urban livestock ownership is more akin to pet ownership and should therefore not be restricted under planning codes as if it were a commercial-scale agricultural activity. Given the diversity of livestock ownership practices and lot sizes, we recommend that planners consider the following when developing urban livestock codes: (1) more appropriate setbacks and animal limits per lot; (2), promotion of high standards for animal welfare; (3) addressing sales and slaughter; and (4), making regulations more visible to the public. We, conclude by laying out an agenda for future research on urban livestock regulation and management. © 2013 Elsevier Ltd.


Roberto C.A.,Harvard University | Swinburn B.,University of Auckland | Hawkes C.,World Cancer Research Fund International | Huang T.T.-K.,City University of New York | And 8 more authors.
The Lancet | Year: 2015

Despite isolated areas of improvement, no country to date has reversed its obesity epidemic. Governments, together with a broad range of stakeholders, need to act urgently to decrease the prevalence of obesity. In this Series paper, we review several regulatory and non-regulatory actions taken around the world to address obesity and discuss some of the reasons for the scarce and fitful progress. Additionally, we preview the papers in this Lancet Series, which each identify high-priority actions on key obesity issues and challenge some of the entrenched dichotomies that dominate the thinking about obesity and its solutions. Although obesity is acknowledged as a complex issue, many debates about its causes and solutions are centred around overly simple dichotomies that present seemingly competing perspectives. Examples of such dichotomies explored in this Series include personal versus collective responsibilities for actions, supply versus demand-type explanations for consumption of unhealthy food, government regulation versus industry self-regulation, top-down versus bottom-up drivers for change, treatment versus prevention priorities, and a focus on undernutrition versus overnutrition. We also explore the dichotomy of individual versus environmental drivers of obesity and conclude that people bear some personal responsibility for their health, but environmental factors can readily support or undermine the ability of people to act in their own self-interest. We propose a reframing of obesity that emphasises the reciprocal nature of the interaction between the environment and the individual. Today's food environments exploit people's biological, psychological, social, and economic vulnerabilities, making it easier for them to eat unhealthy foods. This reinforces preferences and demands for foods of poor nutritional quality, furthering the unhealthy food environments. Regulatory actions from governments and increased efforts from industry and civil society will be necessary to break these vicious cycles. © 2015 Elsevier Ltd.


Pomeranz J.L.,Temple University | Adler S.,ChangeLab Solutions
Journal of Law, Medicine and Ethics | Year: 2015

The regulation of food marketing is a strategy to address obesity. Marketers engage in both commercial speech, which receives some First Amendment protection, and non-speech activities that fall outside of the First Amendment's realm; no marketing practice constitutes fully protected speech. We explore these distinctions in the public health context. © 2015 American Society of Law, Medicine & Ethics, Inc.


Reeve B.,University of Sydney | Ashe M.,ChangeLab Solutions | Farias R.,ChangeLab Solutions | Gostin L.,Georgetown University
American Journal of Public Health | Year: 2015

Municipal and state governments are surging ahead in obesity prevention, providing a testing ground for innovative policies and shifting social norms in the process.Though high-profile measures such as New York City's soda portion rule attract significant media attention, we catalog the broader array of initiatives in less-known localities. Local innovation advances prevention policy, but faces legal and political constraints-constitutional challenges, preemption, charges of paternalism, lack of evidence, and widening health inequalities.These arguments can bemet with astute framing, empirical evidence, and policy design, enabling local governments to remain at the forefront in transforming obesogenic environments.


McLaughlin I.,ChangeLab Solutions | Pearson A.,ChangeLab Solutions | Laird-Metke E.,Golden Gate University | Ribisl K.,University of North Carolina at Chapel Hill
American Journal of Public Health | Year: 2014

Higher prices reduce consumption and initiation of tobacco products. A minimum price lawthat establishes a high statutory minimum price and prohibits the industry's discounting tactics for tobacco products is a promising pricing strategy as an alternative to excise tax increases.Although some states have adopted minimum price laws on the basis of statutorily defined price "markups" over the invoice price, existing state laws have been largely ineffective at increasing the retail price.We analyzed 3 new variations of minimum price laws that hold great potential for raising tobacco prices and reducing consumption: (1) a flat rate minimum price law similar to a recent enactment in New York City, (2) an enhanced markup law, and (3) a law that incorporates both elements.

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