A Local Perspective New York City s Strategies to Reduce Sugary Drink Consumption

Transcription

1 A Local Perspective New York City s Strategies to Reduce Sugary Drink Consumption Kim Kessler, JD Assistant Commissioner, Bureau of Chronic Disease Prevention and Tobacco Control June 21, 2017

2 Health Inequities Are Unfair Race by Neighborhood Poverty Premature Mortality Source: NYC DOHMH population estimates, matched from US Census Bureau intercensal population estimates, , updated June U.S. Census Bureau; American Community Survey, year Estimates, Table S1701; generated using American Fact Finder ( Bureau of Vital Statistics, based on events occurring in Population (based on zip code) defined as percent of non-hispanic black and Hispanic residents, per 2010 Census. : Neighborhood poverty (based on Community Districts) defined as percent of residents with incomes below 100% of the Federal Poverty Level, per American Community Survey Population (based on zip code) defined as percent of non-hispanic black and Hispanic residents, per 2010 Census. Self-Reported health NYC DOHMH Community Health Survey,

3 Patterns of Sugary Drink Consumption SUGARY DRINK CONSUMPTION Sources: NYC DOHMH Community Health Survey,

4 The Challenge of Sugary Drinks: Health Risks + A Saturated Environment Sugary drinks are associated with long-term weight gain, and increased risk of heart disease and diabetes 1-6 Retail environment is saturated with sugary drinks Marketing is ubiquitous Sources: 1. Fung TT, et al. Sweetened beverage consumption and risk of coronary heart disease in women. AJCN 2009;89(4): Welsh JA, Sharma A, Cunningham SA, Vos MB. Consumption of added sugars and indicators of cardiovascular disease risk among US adolescents. Circulation 2011;123(3): Schulze MB, et al. Sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes in young and middle-aged women. JAMA 2004;292(8): Malik VS, Popkin BM, Bray GA, Despres J-P, Hu FB. Sugar-sweetened beverages, obesity, type 2 diabetes mellitus, and cardiovascular disease risk. Circulation 2010;121(11): Malik VS, Schulze MB, Hu FB. Intake of sugar-sweetened beverages and weight gain: A systematic review. AJCN 2006;84(2): Mozaffarian D, Hao T, Rimm EB, Willett WC, Hu FB. Changes in diet and lifestyle and long-term weight gain in women and men. NEJM 2011;364:

5 Make the Healthy Choice the Easier Choice Individual Culture Attitudes/Beliefs Skills Knowledge Time Affordability Healthy Behaviors Environment & Systems Physical Access/Availability Pricing/Economic Communication/Media Point of Decision Education/Promotion Environment Adapted from presentation by Dr. Heidi Blanch, CDC, NCCHPDP, DNPAO

6 What NYC is Doing Increasing access to and awareness of healthy foods Decreasing availability and overconsumption of unhealthy foods

7 Promoting Healthy Children s Spaces Health Code Amendments Child Care Centers Sugary drinks: not permitted Juice: only 100%, only for ages 2+, maximum serving of 4 oz./day Milk: 1% or less for ages 2+, unsweetened Water: must be available, easily accessible Day Camps Sugary drinks: not permitted Juice: only 100%, maximum serving of 6 oz./day Milk: 1% or less for ages 2+, unsweetened Water: available, easily accessible Eat Well, Play Hard

8 Transforming City and Community NYC Food Standards Meals/Snacks Purchased & Served Food and Beverage Vending Machines Schools and Communities Healthy beverage initiatives and water promotion NYC Food & Beverage Guidelines Environments

9 Changing Broader Policies (Attempts) NYS Sugary Drink Excise Tax-2010 Penny-per-ounce excise tax on sugary drinks in NYS Withdrawn under pressure from lobbyists SNAP Waiver Request Portion Cap Proposal Maximum size of sugary drinks Overturned by courts

10 Educating Individuals: Nutrition Education and NYC Sugary Drink Campaigns

11 Youth-focused Campaigns

12 34% Decline in Sugary Drink Consumption Among NYC Adults Percent of New York City adults consuming 1 or more sugary drinks per day 50% 45% 40% 35% 30% 25% 20% 15% 10% 5% 0% 35.9% 32.6% Sugary drinks restricted in child care centers Surveillance Food standards for city agencies; Calorie labeling 31.6% Community outreach; State tax attempt 30.3% 29.9% Food standards for city agency vending machines 28.2% Nutrition education Hard hitting media campaigns 23.3% Portion cap rule (attempt); Sugary drinks restricted in day camps 22.5% 23.7% Source: New York City Department of Health and Mental Hygiene, Community Health Survey Sugar sweetened beverage includes soda and other sweetened drinks like iced tea, sports drinks, fruit punch/other fruit flavored drinks. NYC Community Health Survey included adults with landline phones since 2002 and, starting in 2009, also has included adults who can be reached only by cell-phone is baseline for Take Care New York 2012.

13 Trends in Sugary Drink Consumption Among NYC Adults 60 Adult Daily SSB Consumption (1+) by Race/Ethnicity, NYC CHS Percent of NYC adults White Black Latino Asian/PI Source: New York City Department of Health and Mental Hygiene, Community Health Survey Sugar sweetened beverage includes soda and other sweetened drinks like iced tea, sports drinks, fruit punch/other fruit flavored drinks. NYC Community Health Survey included adults with landline phones since 2002 and, starting in 2009, also has included adults who can be reached only by cell-phone.

14 Sugary Drink Consumption Among Youth (6-12) Percent of NYC children 6-12 who consume 1+ sugary drinks/day NYC Children s Sugary Drink Consumption (1+/Day), * White Black Latino Asian/PI Source: Child Health Survey, 2009 * Estimate should be interpreted with caution. Estimate s Relative Standard Error (a measure of estimate precision) is greater than 30% or the sample size is less than 50, or the 95% Confidence Interval half width is greater than ten, making the estimate potentially unreliable

15 Takeaways Cross cutting efforts are needed Layering of strategies, cumulative efforts Role of localities State and national context Progress doesn t always take expected form Surveillance efforts are critical Onward!

16 With thanks to many NYC DOHMH colleagues Kim Kessler, JD Assistant Commissioner, Bureau of Chronic Disease Prevention and Tobacco Control June 21, 2017 CONFIDENTIAL AND PROPRIETARY Any use of this material without specific permission of DOHMH is strictly prohibited