My dilemma was really excited. We hadn’t been to a conference in a while. Usually, I try to keep my nutritional dilemma quiet and out of sight. But, last week as I was heading to a meeting of the New York State Public Health Association I figured nothing would be too controversial, so I relaxed my grip on it a bit as we headed out. It was an unusually warm morning and as I rolled down the car windows, my dilemma, riding shotgun, stuck its head out into the fresh air, giddily taking in all the sights and smells like a golden retriever.

We arrived at the hotel, easily found a parking space and the right room, and settled in. I applauded the availability of Tazo Tea and forgave the choice of bad white bagels. I knew there was some consciousness on the part of the Association to be mindful of the food so I appreciated that there was an alternative to the usual sugar-laden breakfast pastries.

The title of the conference was “Transforming Communities through Public Health Practice”.  The keynote speaker was  Michelle Davis, Deputy Regional Health Administrator for the  US Department of Health and Human Services.

As I sat through the morning, I checked the program to remind myself of the focus of the day and why I had chosen to apply my limited continuing education benefits here. Though I mainly do my nutrition and health thing privately within the confines of my small offices, working with one member of the public at a time, I also try to promote health messages to a larger audience as well. I practice what I term stealth health–introducing information or programs that enhance well-being in both supportive and unsuspecting ways. Here was an opportunity to listen and learn from others who are out there doing community transformation. This is what motivated my choice–to be with my peeps–like-minded people doing great things in this arena.

As an attendee I learned of the new goals of the Healthy People 2020 initiative; I heard about some worthy activities happening on the local scene; and, I sat in on an interesting session that reviewed a relatively well-funded menu labeling education campaign that encouraged consumers to choose fast food meals containing 600 calories or less. The initial results were apparently somewhat disappointing though the evaluation data was limited. The research ironically showed that those who did not receive the message curtailed calories more than those who did.

I thought I had my dilemma well-leashed, but in retrospect, I realize it was already starting to whimper and whine. However, it was not until I attended the first session of the afternoon, “Development and Implementation of  Formal Policies and/or Local Legislation to Increase the Availability of Non-Sugar Sweetened Beverages in Public Buildings: Reports from the Field” that its bark became disruptively loud. The session was facilitated by two women who had overseen a project of the NY State Association of County Health officials wherein monies and other resources were allocated to a handful of county health departments to assist their county governments in achieving this goal.

They effectively reviewed how the different counties applied their efforts–which really were intended to decrease the availability of sugar-sweetened beverages (SSBs). They described media campaigns, seltzer water promotion activities, revenue concerns, working with government officials from the top down and with procurement managers from the bottom up. They discussed vending contracts and how these are virtually impossible to change until the contract runs out. They explained the challenges, push back and resistance that each county encountered and the small changes that were made. This was an absolutely positive action, but it required that they had to play nice politics with these good public dollars.

I suppose I know this is how the process works but the cumulative view of the public health community working so hard for such small gains–even in the public sector–turned my dilemma rabid. It circled wildly, foamed at the mouth and even raised its hand and expressed its opinion. To calm it back down, I had to go get it a fruit kabob at the next break.

Who do we still have to convince at this stage of the game that vending machine revenues will not outpace health care spending? Who do I need to invite into my office to hear the daily stories of health compromised by tepid health care policies and timid action? How many cases of people addicted to Mountain Dew, Pepsi, and other such SSBs must I detail as evidence to show how they suffer from rotted teeth that cannot be repaired; ravaged digestive systems bandaged with a plethora of damaging antacid medications; excessive weight that has literally brought them to their knees; anxiety propelled by excessive caffeine; and, destroyed glucose control that relegates them to a life with diabetes? Is it not tragic how many are children and young adults are already affected?

I always say that if I was the ruler of the food planet, I would remove sodas immediately. There is a heavy toll on health from such irresponsibly marketed products available for consumption with the clink of just a few coins in most public places–not only here but around the globe. And, though soda addiction knows no boundaries, as usual, the economically poor, are disproportionately affected. Recently, a client of mine told me that the school bus company that he works for removed soda vending from the employee break room. Cannot our own government agencies venture such a commitment? Bearing such witness, I am perforce required to display the amount of sugar in various SSB bottles wherever I may be. Right now in the lobby of the health center, I have such a display with associated handouts. People truly gasp when they see the load of sugary stuff that otherwise stays dissolved in the highly acidic medium.

This week, just a few days after the episode at the hotel, a fifteen-year-old boy who has lived a large part of his life in a home for troubled youth was brought to see me–ostensibly for his high weight problems. He was accompanied by a case manager–and another boy who came along. We had a pretty good chat and among other things, we talked about his soda drinking. I told him I really felt sodas were toxic substances that deserved some type of poison label. He asked me if I had a Sharpie. I said, of course, dug it out for him–and he drew me a page full of well-executed skulls and crossbones. I thanked him profusely for his contribution to my crusade. Who knows, perhaps through this experience of participation, he will become a stealth health advocate. When we were done, I gave him and his little buddy two water bottles that I had actually picked up at the conference.

Afterward, I realized my dilemma had been watching the whole encounter from under my desk. It pawed at me and looked me squarely in the eye. It bemoaned that private health is truly a deeply public health matter and vice-versa, and with its tail between its legs, it quietly crawled away.

Let me know what you think about this issue. Thanks.

In health, Elyn

My Plate

My Plate Haiku

Lagoon watercress

Peppers my tongue

With spring joy.

by Roxanne