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October 6, 2009
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Sue Ducat

From Health Affairs: Three New Articles Assess the Success of Two U.S. Cities' Efforts To Fight Obesity

Bethesda, MD -- In 2001, the U.S. Surgeon General issued a warning that this country was facing an "obesity epidemic." Since that time, there have been public policy responses from all levels of government. Today Health Affairs released three studies about municipal responses, one from Los Angeles and two from New York.

• Zoning For Health? The Year-Old Ban On New Fast-Food Restaurants In South LA
By Roland Sturm and Deborah A. Cohen

The authors, researchers at the RAND Corporation, examine the impact of a 2008-09 Los Angeles City Council ordinance that placed a one-year moratorium on new fast-food chain restaurants in South Los Angeles, a low-income region of the city. They found that there were proportionately fewer fast-food chain restaurants in South Los Angeles than in other parts of Los Angeles County. In contrast, the density of small food stores in South Los Angeles was far higher than elsewhere in the city, so the authors concluded that the ordinance was unlikely to reduce obesity. "The Los Angeles ordinance may have been an important first by being concerned with health incomes," said Roland Sturm, the study's lead author. "It is not the most promising approach to lowering the high rate of obesity in South Los Angeles because it fails to address the main differences we see in the food environment." The research was funded by the National Institutes of Health.

• New York City's Fight Over Calorie Labeling
By Thomas A. Farley, Anna Cafferelli, Mary Bassett, Lynn Silver and Thomas Frieden

• Calorie Labeling and Food Choices: A First Look At The Effects On Low-Income People in New York City
By Brian Elbel, Rogan Kersh, Victoria L. Brescoll, and L. Beth Dixon

A month before Los Angeles' ban took effect, New York City passed a law requiring calorie labeling on menus and menu boards in restaurants belonging to chains with more than 15 locations nationwide. The Farley et al. study recounts the two-year struggle between the city's health department and opponents of the legislation (especially the New York State Restaurant Association). While the authors, all affiliated with the New York City Health Department when the paper was written, do not address the impact of the law, they conclude that "An unhealthy diet may be second only to smoking in importance as a determinant of health…The recent history of tobacco control has shown that innovation in public health is sometimes easier to accomplish locally than nationally, primarily because the industry lobbies do not have nearly as much influence on municipalities as they do with federal and state governments."

Do patrons change their food choices when they see how many calories their selections contain? The Elbel et al. study evaluates how likely customers of these restaurants in New York were to make healthier decisions. Researchers Elbel, Kersh and Dixon are affiliated with New York University, where Kersh and Elbel are with the Wagner School of Public Service. Elbel is also affiliated with the NYU School of Medicine. Brescoll is with the Yale School of Management.

Patrons of fast-food restaurants in New York City were compared with those in nearby Newark, NJ, a city which had not introduced menu labeling. Receipts and survey information were collected from demographically similar neighborhoods in both cities immediately before and soon after the law took effect. The authors found that labeling increased the percentage of consumers who saw calorie information in restaurants. But, they did not find evidence that menu labeling influenced the total number of calories purchased by New York residents. They concluded, "In an ideal world, calorie labeling on menus and menu boards would have an immediate and direct impact on everyone's food choices. However, as has been seen in previous attempts to change the behavior of vulnerable populations (for example, [regarding] smoking cigarettes), greater attention to the root causes of behavior, or multifaceted interventions, or both, will be necessary if obesity is to be greatly reduced in the overall U.S. population." The research for the Elbel study was funded by the Healthy Eating Research Program of the Robert Wood Johnson Foundation, the Yale Rudd Center for Food Policy and Obesity, and the New York University Wagner Dean's Fund.


Health Affairs, published by Project HOPE, is the leading journal of health policy. The peer-reviewed journal appears bimonthly in print with additional online-only papers published weekly as Health Affairs Web Exclusives at www.healthaffairs.org.


©2009 Project HOPE–The People-to-People Health Foundation, Inc.