Policy Recommendations

The Trust for America’s Health and the Robert Wood Johnson Foundation offer the following specific recommendations to federal policymakers, state and local policymakers, the food and restaurant sectors, and healthcare providers and systems to combat America’s obesity epidemic.

Federal Policymakers: Congress and the Administration

Support and expand policies and programs aimed at addressing obesity at the federal, state and community level, including programs in CDC’s Division of Nutrition, Physical Activity and Obesity, community health programs like the Racial and Ethnic Approaches for Community Health program (REACH), and programs that focus on school health in its Division of Population Health.

Ensure that every state public health agency receives targeted support to promote healthy eating and active living. Maintain and increase obesity-related emphasis in the Prevention and Public Health Fund and support the Healthy Food Financing Initiative in the Administration for Children and Families to ensure that underserved communities have access to grocery stores.

Maintain and strengthen essential nutrition supports for low-income children, families, and individuals through programs—like the Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)—and expand programs and pilots to make healthy foods more available and affordable through the program.

Federal Policymakers: U.S. Department of Agriculture

Maintain nutrition standards for school meals that were in effect prior to USDA’s interim final rule from November 2017, as well as current nutrition standards for school snacks. 

Support and implement local school wellness policy rules, including the provision that all foods and beverage advertisements on school campuses meet Smart Snacks nutrition guidelines.

Expand and evaluate pilots and programs aimed at increasing consumption of fruits, vegetables and other healthy foods under SNAP and other nutrition programs.

Continue to ensure that WIC provides mothers, infants, and young children with access to affordable, healthy food and breastfeeding support.

Continue to implement the Community Eligibility Provision that allows schools in high-poverty areas to serve free meals to all students, regardless of family income.


Federal Policymakers:

U.S. Department of Health and Human Services

In partnership with the USDA, ensure that the 2020-2025 Dietary Guidelines for Americans reflect the latest and best nutrition science, include recommendations for children ages 2 and under, are developed in a transparent manner, and are issued on time.

Actively support the recommendations of “Step It Up! The Surgeon General’s Call to Action to Promote Walking and Walkable Communities.”

U.S. Department of Education

Maintain the Office of Safe and Healthy Schools, as well as Title I and Title IV programs under the Every Student Succeeds Act (ESSA), through which schools can receive funding for physical education and physical activity initiatives.

Issue regular guidance covering programs, such as early childhood programs, supported through ESSA that encourage healthy eating, opportunities for physical activity, limits on screen time and other activities that promote health.

U.S. Food and Drug Administration

Ensure no further delays to the implementation of the updated Nutrition Facts label, currently scheduled to begin in 2020, and encourage and provide guidance to companies who wish to utilize the updated label prior to the deadline.

Ensure full compliance with recently implemented menu labeling rules covering chain restaurants and similar food retail establishments.

Encourage non-chain restaurants to implement the menu labeling rules voluntarily.

State and Local Policymakers: Early Childhood

States should follow expert guidance and adopt and implement best practices—including by investment in Quality Improvement Rating Systems—for nutrition, activity and screen time requirements and regulations covering child care and day care settings.

States should support access for low-income families to targeted home visiting and community-based programs
that provide families with resources and connections to parenting education, nutrition programs and other services.

State and Local Policymakers: In Schools

States should continue to meet or exceed federal nutrition standards for school meals and snacks.
 
Education agencies and school districts should continue and expand flexible breakfast programs, such as second-chance breakfasts, breakfast on-the-go and breakfasts in classrooms.

States should ensure that all students receive at least 60 minutes of physical education or activity during each school day.

State ESSA plans should encourage schools and partners in healthcare and public health to address childhood obesity.

Education agencies and school districts should continue to support local wellness plan implementation to ensure students have healthy learning environments conducive to improved school performance.

State and Local Policymakers: Healthy Food Access and Marketing

States and localities should ensure the availability of healthy food retailers in underserved communities.

States and localities should implement evidence-based nutrition standards for foods and beverages offered in government food service and vending machines.

States and localities should ensure all restaurant meals marketed to children meet nutrition standards. and remove sugary drinks from all restaurant children’s meals.

State and Local Policymakers: Transportation and Innovation

States should support efforts to make Safe Routes to School programs universally available and secure state-level
appropriations or Transportation Alternatives Program allocations for both infrastructure and noninfrastructure
projects.

At the state and local level, require that all road construction and reconstruction projects adopt a Complete Streets approach, ensuring that transportation plans are safe and convenient for all users.

States should incentivize employers and businesses to expand effective employee wellness programs to promote healthy eating and physical activity.

States should encourage innovation by implementing and testing pilot policies that show promise and refraining from adopting preemption policies that limit the ability of local communities to improve the health of their residents.

Industry

Food and beverage companies should follow the American Heart Association’s guidance concerning children’s intake of added sugars as they develop, reformulate, and market foods and beverages intended for children.

Food and beverage companies should adopt the updated Nutrition Facts label on all products as quickly as possible.

Food and beverage companies should eliminate children’s exposure to advertising and marketing of unhealthy products.

Restaurants

Restaurants should remove sugary drinks from all children’s meals, and ensure the meals they market to children meet minimum nutrition standards.

Restaurants should incorporate more fruits and vegetables into menus and make healthy beverages and sides the default option in all meals.

Non-chain restaurants should voluntarily abide by the FDA’s new menu labeling rules.

Hospitals

Hospitals should no longer sell or serve sugary drinks on their campuses; they should also improve the nutritional quality of meals and promote breastfeeding.

Nonprofit hospitals should prioritize childhood obesity prevention programs as they work to meet their community benefit requirements.

Healthcare Providers and the Healthcare System

Medicare should encourage eligible beneficiaries to enroll in obesity counseling as a covered benefit, and evaluate its use and effectiveness. Health plans, medical schools, continuing medical education, and public health departments should raise awareness about the need and availability of these services.

All public and private health plans should cover the full range of obesity-prevention, treatment, and management services, including nutritional counseling, medications, and behavioral health consultation.

Public and private payers should cover value-based purchasing models that incorporate health outcome measures that incentivize clinicians to prioritize healthy weight.

The healthcare system should extend programs that are effective in terms of costs and performance, such as the Diabetes Prevention Program (DPP) and the community health worker–clinical coordination models. Providers and payers should allocate resources to educating and referring patients to DPP and other covered benefits as appropriate.

Priority Obesity-Prevention Policies

National Policies

Strong policies can play a key role in addressing America’s obesity epidemic. Learn about national policy efforts to improve access to healthy foods, support physical activity and more.

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State Policies

This interactive feature tracks the status of each state’s efforts on more than 20 policies aimed at preventing obesity and supporting health in early childhood, schools and communities.

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