Food Fight

A Strategic Guide for Nutrition Advocacy at the State Level

In the quest to influence state legislatures towards policies that prioritize health and nutrition, Dariush Mozaffarian, Dean of the Friedman School of Nutrition Policy and Science at Tufts University, has offered valuable guidance. According to Mozaffarian, there are three significant federal tools that states can utilize, each backed by substantial funding, to foster a healthier population.

Firstly, Medicaid, which is administered by states, stands as the most influential tool. Through Section 1115 waivers, states now have the opportunity to leverage Medicaid for the provision of nutritious food. Although only five states, including Oregon, Arkansas, Arizona, Massachusetts, and recently California, have been approved to do so, the potential pathways for using Medicaid in this manner are relatively new. Mozaffarian is actively engaging with the Department of Health and Human Services, urging them to provide clear guidance to all states on how to harness Medicaid to enhance nutrition.

The second federal tool is the Supplemental Nutrition Assistance Program (SNAP), a vital program for ensuring food security. However, Mozaffarian contends that unlike Women, Infants, and Children (WIC) program or school meals, SNAP does little to guarantee nutrition security. He advocates for states to implement pilot programs that explore innovative ways of utilizing SNAP, such as using it to cover the costs of hot meals or introducing incentives for healthy food purchases. “We have to have more innovation in SNAP,” Mozaffarian asserts.

The third avenue for states to pursue is improving school meals, which is another federally supported program. One approach is to establish permanent free school meals for all children, regardless of household income, as an increasing number of states are doing. Additionally, states can impose nutrition standards that surpass federal guidelines, particularly focusing on whole grains, sodium, and added sugars.

At the state level, various regulatory actions can be taken, such as implementing taxes on soda and sugary beverages or introducing warning labels on high-sodium foods. Mozaffarian shared these insights at a summit organized by the Hunger to Health Collaboratory and recently brought to light through the organization’s newsletter.

Mozaffarian, who co-chaired a task force advising the White House Conference on Hunger, Nutrition, and Health, remains optimistic that many legislative recommendations from the conference will be adopted, despite a slight Republican majority in the House following the mid-term elections. A key factor behind his optimism is the economic impact of poor public health. Subpar nutrition contributes to increased healthcare spending, hampers children’s ability to learn in school, and escalates costs for private businesses providing health insurance. Healthcare spending currently accounts for almost one-third of the federal budget, while obesity stands as the top medical reason preventing young Americans from enrolling in the military, thereby posing a national security threat. Mozaffarian emphasizes that these issues are nonpartisan.

Mozaffarian points out three “exciting” developments in the food and nutrition sphere that enjoy broad support from both political parties. Firstly, “Food as Medicine” initiatives, including doctors prescribing healthy food, have garnered significant Republican support. Secondly, there is bipartisan backing for scientific research, such as cancer and genetics studies, which can drive progress in nutrition research. Lastly, both parties demonstrate support for applying business innovation to the food industry, much like the focus on clean energy.

Mozaffarian underscores the importance of making nutrition as crucial a pillar as hunger for the anti-hunger community. Simply advocating for increased funding for basic food assistance programs would be considerably more challenging. Prioritizing nutrition alongside hunger is crucial for achieving meaningful progress, Mozaffarian emphasizes, as that is the path to success.

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