Rogan Kersh

Calorie Labeling And Food Choices: A First Look At The Effects On Low-Income People In New York City

We examined the influence of menu calorie labels on fast food choices in the wake of New York Citys labeling mandate. Receipts and survey responses were collected from 1,156 adults at fast-food restaurants in low-income, minority New York communities. These were compared to a sample in Newark, New Jersey, a city that had not introduced menu labeling. We found that 27.7 percent who saw calorie labeling in New York said the information influenced their choices. However, we did not detect a change in calories purchased after the introduction of calorie labeling. We encourage more research on menu labeling and greater attention to evaluating and implementing other obesity-related policies.

Personal Responsibility And Obesity: A Constructive Approach To A Controversial Issue

The concept of personal responsibility has been central to social, legal, and political approaches to obesity. It evokes language of blame, weakness, and vice and is a leading basis for inadequate government efforts, given the importance of environmental conditions in explaining high rates of obesity. These environmental conditions can override individual physical and psychological regulatory systems that might otherwise stand in the way of weight gain and obesity, hence undermining personal responsibility, narrowing choices, and eroding personal freedoms. Personal responsibility can be embraced as a value by placing priority on legislative and regulatory actions such as improving school nutrition, menu labeling, altering industry marketing practices, and even such controversial measures as the use of food taxes that create healthier defaults, thus supporting responsible behavior and bridging the divide between views based on individualistic versus collective responsibility.

Child and adolescent fast-food choice and the influence of calorie labeling: a natural experiment

Objective:Obesity is an enormous public health problem and children have been particularly highlighted for intervention. Of notable concern is the fast-food consumption of children . However, we know very little about how children or their parents make fast-food choices, including how they respond to mandatory calorie labeling. We examined childrens and adolescents’ fast-food choice and the influence of calorie labels in low-income communities in New York City (NYC) and in a comparison city (Newark, NJ).Design:Natural experiment: Survey and receipt data were collected from low-income areas in NYC, and Newark, NJ (as a comparison city), before and after mandatory labeling began in NYC. Study restaurants included four of the largest chains located in NYC and Newark: McDonalds, Burger King, Wendys and Kentucky Fried Chicken.Subjects:A total of 349 children and adolescents aged 1–17 years who visited the restaurants with their parents (69%) or alone (31%) before or after labeling was introduced. In total, 90% were from racial or ethnic minority groups.Results:We found no statistically significant differences in calories purchased before and after labeling; many adolescents reported noticing calorie labels after their introduction (57% in NYC) and a few considered the information when ordering (9%). Approximately 35% of adolescents ate fast food six or more times per week and 72% of adolescents reported that taste was the most important factor in their meal selection. Adolescents in our sample reported that parents have some influence on their meal selection.Conclusions:Adolescents in low-income communities notice calorie information at similar rates as adults, although they report being slightly less responsive to it than adults. We did not find evidence that labeling influenced adolescent food choice or parental food choices for children in this population.

Assessing the Feasibility and Impact of Federal Childhood Obesity Policies

Research on childhood obesity has primarily been conducted by experts in nutrition, psychology, and medicine. Only recently have public policy scholars devoted serious work to this burgeoning public health crisis. Here the authors advance that research by surveying national experts in health/nutrition and health policy on the public health impact and the political feasibility of fifty-one federal policy options for addressing childhood obesity. Policies that were viewed as politically infeasible but having a great impact on childhood obesity emphasized outright bans on certain activities. In contrast, education and information dissemination policies were viewed as having the potential to receive a favorable hearing from national policy makers but little potential public health impact. Both nutrition and policy experts believed that increasing funding for research would be beneficial and politically feasible. A central need for the field is to develop the means to make high-impact policies more politically feasible.

Obesity, courts, and the new politics of public health.

Health care politics are changing. They increasingly focus not on avowedly public projects (such as building the health care infrastructure) but on regulating private behavior. Examples include tobacco, obesity, abortion, drug abuse, the right to die, and even a patients relationship with his or her managed care organization. Regulating private behavior introduces a distinctive policy process; it alters the way we introduce (or frame) political issues and shifts many important decisions from the legislatures to the courts. In this article, we illustrate the politics of private regulation by following a dramatic case, obesity, through the political process. We describe how obesity evolved from a private matter to a political issue. We then assess how different political institutions have responded and conclude that courts will continue to take the leading role.

State autonomy & civil society: The lobbyist connection

Abstract The much‐noted decline of “state autonomy” theories owes partly to external challenges to state power, such as globalization, supranational regimes, and the like. But advanced democratic states have also long been seen as threatened from within, especially by powerful private interest groups. The extent of private‐interest influence on policy making depends in important part on corporate lobbyists, a group whose activities are chronicled in this essay. Lobbyists exercise considerably more autonomy from the private clients who hire them than has previously been acknowledged. This portrait ultimately suggests that the national state and civil society may be mutually supportive rather than strictly separate spheres.

Health reform: the politics of implementation.

It was a long, hot summer, figuratively and literally. Members of Congress, back home in their districts, faced angry constituents firing questions about health reform. Providers expressed distress about particular legislative provisions, with (for example) medicaldevice manufacturers “reeling” in response to a proposed

The Growth of American Political Development: The View from the Classroom

20 million tax on their industry (Coburn and Barrasso 2010). Lobbyists, registering anew by the dozens each week to represent health care clients, buttonholed congressional and administration health staff while issuing urgent public statements. “The current proposal,” intoned Karen Ignagni, health insurers’ chief lobbyist, “could have the unintended consequence of turning back the clock on efforts to improve patient safety, enhance the quality of care, and fight fraud” (America’s Health Insurance Plans 2010). State insurance commissioners bluntly warned that “if you like your health insurance you may not be able to keep it” (Kliff and Haberkorn 2010b). All this could well describe the summer of 2009, preceding the passage of health reform the following March. But these quotes and details are drawn from summer 2010, with the new Patient Protection and Affordable Care Act (ACA) on the books; regulations beginning to flow out of federal departments and agencies; and policy makers’ attention ostensibly turned to such matters as energy and climate change, immigration, and the looming fall elections. Instead, the activity following the ACA’s passage has been scarcely less intense than the monumental debates preceding it. To take one tell-

Childhood Obesity: Public Health Impact and Policy Responses

American Political Development (APD) is among the fastest-growing areas in political science. Barely two decades ago, the “field” consisted of a handful of works by a few scholars. Since then political scientists have been joined under the APD banner by researchers from other disciplines in issuing dozens of books and hundreds of articles, organizing a biennial APD conference, and teaching numerous graduate and undergraduate courses. The flagship APD journal, Studies in American Political Development , in print since 1986, is ranked among the top political science journals; also well regarded is the Journal of Policy History , begun three years later. The Politics and History section of the American Political Science Association, likewise founded recently, has the eighth largest membership of the disciplines 35 subgroupings. Newly minted PhDs list APD as a specific research and teaching interest, and political science departments are matching that surging interest with job postings. And overviews of recent scholarship on the American polity separately highlight APD approaches. Perhaps inevitably, however, the rapid emergence of APD as a full-fledged disciplinary concentration has been accompanied by developmental problems. Rogan Kersh is associate professor of political science and public administration at Syracuse Universitys Maxwell School (rtkersh@maxwell.syr.edu). He is the author of Dreams of a More Perfect Union , as well as articles on APD in numerous journals. For helpful advice and commentary, the author thanks Brian Balogh, Dan Galvin, Jennifer Hochschild, Shelley Hurt, David Mayhew, Suzanne Mettler, Sid Milkis, Jim Morone, three anonymous Perspectives reviewers, and audience members at the APD workshop at the University of Virginias Miller Center.

Anti‐democratic demos: The dubious basis of congressional approval

Publisher Summary Evidence is emerging, especially from European countries, that the most effective policies to stem the tide of child obesity involve numerous concentrated interventions, implemented simultaneously. In the United States, policy change has been scattershot and episodic, and therefore minimally effective. The American polity, dominated by interest groups and featuring a system of elaborately separated powers, may not permit the type of focused, multiple-approaches policy change that seems necessary. Possibly exacerbating this problem is the nature of evaluation research—testing a single intervention, often during the formative stage of implementation—which may communicate to policy makers and the public alike the wrong signals about the efficacy of achieving sustainable reform. Since the rise in childhood obesity became a source of widespread public concern early in the present century, a fierce debate has centered around causes: What are the principal elements contributing to this “epidemic”? The increasingly inactive lifestyle of American children is the primary culprit, according to one well-publicized view—a position encouraged, as it happens, by the food and beverage industries. Efforts to enhance exercise among youth have thus been the predominant public response to rising childhood obesity rates. But a host of recent research suggests that altering American childrens relatively sedentary lives—through school-based physical activity interventions, for example—has at most limited benefits, without simultaneous and dedicated attention to the effects of caloric overconsumption.Although obesity rates among US children have increased during the past 3 decades, effective public policies have been limited, and the quest for workable solutions raises ethical questions. To address these concerns, in 2010, the Robert Wood Johnson Foundation convened an expert panel to consider approaches to the ethics problems related to interventions for childhood obesity. On the basis of recommendations from the expert panel, we propose frameworks for policy approaches and ethical aspects of interventions and evaluation. We present these frameworks in the context of other papers in this collection and make recommendations for public health practice.