Addressing Obesity Through Policy: A Media Advocacy Plan Public Health Nutrition Capstone Spring 2016 Jessica Ng Luna Klein

Transcription

1 Addressing Obesity Through Policy: A Media Advocacy Plan Public Health Nutrition Capstone Spring 2016 Jessica Ng Luna Klein 1

2 Table of Contents Introduction..3 Problem Overview and Policy Analysis..4 Goals and Objectives...8 Framing Analysis...10 Media Advocacy Plan Evaluation Plan Limitations, Potential Problems, Recommendations for Next Steps. 20 Appendix A. Materials for Media Advocates 21 Timeline/Access Calendar.22 List of Reporters that Cover Food Advertising as it Relates to Children.. 24 Key Messages for Media Interviews.25 Frequently Asked Questions..26 Letters to the Editor Op-Ed Tweets...32 Appendix B. Media Kit Sample...33 Media Advisory.34 News Release.35 References.36 2

3 Introduction Obesity, overweight, and the poor health conditions associated with them are becoming more pressing issues worldwide, but are particularly prominent issues in the United States. 1 Worldwide, the prevalence of childhood overweight and obesity climbed from 4.2% to 6.7% between the years 1990 and 2010; with a predicted prevalence of 9.1% (approximately 60 million children) by the year Within the United States, close to two-thirds of adults and one-third of children are considered either overweight or obese, according to the Dietary Guidelines for Americans of This excess weight not only affects the individual but also society as a whole as more money is funneled toward health care efforts related to obesity. The cost is high - it is estimated that obesity among adults was associated with up to $147 billion in medical costs for the year Diseases that often accompany obesity, such as diabetes, are also associated with decreased work productivity, possibly due to the increased need to miss work for medical reasons, and additional medical costs. 5 There are many reasons the United States is seeing such high rates of obesity among its population, but the causes are complex. What are often seen as individual choices, such as the poor eating habits and physical activity patterns of many Americans, are actually influenced by other external factors such as the food environment both inside and outside of the home and the opportunities available to communities to pursue a healthy lifestyle. 6 8 To address the complex factors that contribute to high obesity rates, it is important to consider a multifaceted approach to address the issue from different angles and in a way that impacts a variety of populations. 9 One population that is of particular concern when it comes to obesity is children. Life as an obese young person can be difficult; it can present a variety of short-term health consequences such as type 2 diabetes, asthma, and emotional issues. 10 In addition, research shows that obesity 3

4 as a child or adolescent is associated with a five-fold increase in the likelihood of being obese as an adult with a particularly high risk among obese adolescents - 80% of whom are predicted to become obese adults. 11 Adult obesity is associated with an increased likelihood of suffering from health consequences such as hypertension and coronary heart disease. 10 Due to this association, it is important to find ways to work toward the prevention of childhood obesity in order to prevent further cases of adult obesity and the poor health conditions that accompany it. Prevention is critical in addressing the obesity epidemic. It is therefore important to prevent obesity in children to avert a higher prevalence of obesity when they reach adulthood. As previously mentioned, there are multiple factors that are contributing to obesity which in turn means that there are multiple ways to address the issue. Prevention through policy - as compared to program interventions or health promotion - is key in these efforts as it is a more cost-effective and sustainable method of addressing the obesity issue, both important factors to consider in today s economy. 12,13 Policy is able to address large numbers of people and to modify environments. Considering that we live in an obesogenic environment, one that in many ways promotes obesity, it is important to consider efforts that can modify that environment to make healthier choices easier for the average person. 14 Problem Overview and Policy Analysis A literature search for potential policy solutions indicated that, among the modifiable environmental factors that contribute to childhood obesity, one need is to change the influence of television advertisements impact on obesity. 8,14,15 Common prevention efforts that were mentioned alongside the modification of the ad environment included an excise tax on sugarsweetened beverages, menu calorie labeling, improved nutrition standards, improvements in the early care education environment, and increased physical activity requirements for children. 16,17 4

5 The ad environment is particularly dangerous for children, as a systematic review published by The American Journal of Clinical Nutrition showed that children s consumption of unhealthy foods significantly increased when exposed to food advertisements whereas adults consumption did not. 18 Ads can manipulate children, using incentives such as toys to capture their attention 19 along with familiar characters that studies show are associated with increased consumption of a product. 20 This is an issue given that an estimated 98.6% of food products advertised on television fail to meet a list of recommended food standards proposed by the Interagency Working Group for Foods Marketed to Children, a government agency coalition. 21 In addition, this is not just a concern that affects young children. In adolescents, it was found that food commercials activate the brain differently from other types of commercials, with the section of the brain that processes rewards showing greater activation. 22 It s important to note that a common concern associated with television viewing in general is that it is accompanied by lower physical activity, which can also contribute to a positive energy balance and obesity. 23 This concern reinforces the need for a multifaceted approach to obesity, including policies to increase physical activity, but given that the research points to advertising as the main culprit in the association between television viewing and obesity, television and physical activity in the home environment will not be explored further in this paper. There are a variety of policy possibilities to counteract these advertisements and their effects. Suggestions have included banning all advertisements to children, stricter regulations regarding the products that are advertised, subsidies for healthier ads, and changing the tax code to no longer allow for tax deductions for unhealthy food advertisements directed at children. 15,17,24,25 Advertisements have been recognized as detrimental to the wellbeing of children by many countries, such as Norway and Sweden which ban advertising to children under 12 5

6 years old, Italy which bans advertisements during cartoon shows, and Finland which does not allow advertisers to use familiar cartoon characters in their ads. 26 Meanwhile, in the United States the only current check on food advertising content is self-regulation by the industry. 27 Although the food and beverage industries have made promises to self-regulate their ads to children, research concludes that this promise is not doing much to improve the advertised content that children see and foods and beverages of poor nutritional quality continue to be promoted on television and elsewhere. 21,25,27 This may be in part due to the lack of non-industry generated definitions of what constitutes healthy food, as well as the lack of participation by some manufacturers in self-regulation efforts. 23 Self-regulation is not working and the government needs to explore other options to help protect children. Based on the alternative potential policies, getting rid of the tax benefit for unhealthy food advertisements directed at children appears to be the best option. Unhealthy food is a term that has been defined in a variety of ways with no clear consensus, as noted by an Institute of Medicine report. 28 In general, unhealthy food refers to any food that has high caloric but low nutritional value, often containing high amounts of fat, sugar, or salt and low amounts of fiber or essential nutrients. 28 The US government also has guidelines for what is considered unhealthy, using the term Foods of Minimal Nutritional Value" to refer to specific examples of soda water, water ices, chewing gum, and certain candies. 29 The specifics of what counts as unhealthy food varies from group to group, which is why it is important to keep in mind a previous version of this policy, 30 which included a provision that the Department of Health and Human Services join with the National Academy of Medicine (formerly known as the Institute of Medicine) to determine a standard definition of the term. Such a consensus, whether it includes a current or modified definition of unhealthy food, would allow for the appropriate enforcement of this policy 6

7 once it is passed. Of note, since the industry has proven that it will not strictly follow nutrition standards on its own, 25 subsidies for healthier ads are unlikely to have enough power to combat unhealthy food ads. 24 Proposing a ban on all advertisements targeted toward children will receive enormous opposition from the industry and is highly unlikely to pass due to the safeguards in place to protect commercial speech 31 and additionally will leave a huge gap in funding for television networks. 32 In contrast to an outright ban, changing the tax code may be a more subtle way of modifying the way the industry makes decisions. 33 Currently, any company can claim advertisements as tax-deductible because they are considered a business expense. 34 In other words, the money that they spend on advertisements will not be counted toward their taxable income total because it is considered essential spending for the business to function. In the end, this allows the industry to pay approximately $80 million less in taxes each year, 17 money that could be used in health promotion efforts instead. Losing the benefit of a tax deduction for advertising unhealthy foods will likely also push the industry toward reformulating their foods and beverages into healthier products in order to continue to receive the tax benefits normally afforded to advertising. 33 As of now the industry experiences minimal financial repercussions for marketing unhealthy foods that promote ill health. Getting rid of the tax deduction is a way to hopefully change that. 33 In addition to the additional tax revenue, it is predicted that getting rid of the tax deduction will ultimately lead to changes in behavior that will alter the energy balance of individuals, producing huge healthcare savings due to its population reach and potential reduction in healthcare costs associated with obesity, an estimated net savings of $343 million. 17 Given all of the potential benefits of eliminating the tax deduction for unhealthy food advertisements to children, past national bills have attempted to do just that. This includes HR

8 and the Stop Subsidizing Childhood Obesity Act of So far efforts have not succeeded, but ideally this media advocacy plan will help future advocates better navigate the political terrain to help them pass a similar bill and close the tax loophole. Overall Goal and Objectives While a major overall goal of health advocates is to contribute in the fight to reduce the prevalence of obesity, particularly among children, the particular goal of this media advocacy plan is to outline ways to pass the most recent version of a bill that will amend the tax code so that the government no longer subsidizes the advertisement of unhealthy foods to America s children. According to Colin Schwartz of the Center for Science in the Public Interest (CSPI), this bill, once again called the Stop Subsidizing Childhood Obesity Act, will be reintroduced in May of 2016 by Representative DeLauro and Senator Blumenthal. Similar to past versions of the bill, it would get rid of the subsidy that is currently given through the allowance of a tax deduction for product promotion by the food and beverage industries. In order to successfully pass the bill, it is essential that this media advocacy plan take full advantage of the current research surrounding the advertisement of unhealthy foods to children as well as take advantage of the knowledge gained from past policy successes and failures. Research highlights some of the key aspects to consider when attempting to pass a bill similar to this one. First, it is important to increase the public s awareness about the harmful effects that advertisements have on children, 17,33 particularly younger children that cannot yet distinguish between product promotions that have the intention to sell a product versus regular television programming. 35 This increased awareness will ideally translate into a public conversation about advertising, increasing news coverage of the topic and increasing pressure on policymakers to take action. Research also indicates that it is important to emphasize that it is society s du- 8

9 ty to protect children since they are a vulnerable population. 33 As such, the main objective of this plan will be to increase public awareness of the harmful effects of unhealthy food advertising on children in order to increase public pressure on Congress and increase the priority of the issue on the policy agenda. To obtain this objective, the plan makes use of a few different tactics. First, the plan suggests general generation of a public conversation about advertising and the tax deduction via opeds and letters to the editor in national newspapers (See Appendix A for ideas of when to submit these opinion pieces). The target of this conversation is Congress with a specific focus on members of the Senate Committee on Finance 36 and the House Committee on Ways and Means 37 since the bill will be introduced by both the Senate and the House and these are the respective committees in which past versions of the bill stalled. The second tactic is to create and distribute a petition nationwide asking the US Congress to pass the bill, again with a special focus on members of the previously mentioned committees. Alongside a nationwide march, the petition will be presented during a news conference prior to consideration of the bill to demonstrate its nationwide support and put increased pressure on Congress to consider it. Finally, the march and the petition will be used to increase the media s likelihood of publishing related news and opinion pieces and also will be used as a way to find more people that are in support of the bill that can be called upon for future events and for writing in letters to the editor. This will serve to once again increase the pressure on Congress to consider the bill seriously as well as increase the public s awareness around the dangers of advertising and the importance of this bill. A framing analysis, below, will take a closer look at how exactly the issue was portrayed during the last attempt to pass a bill to end tax benefits for advertisers of unhealthy foods to children in The framing analysis will then analyze how this portrayal has contributed to the 9

10 successes and challenges that past policy efforts have had. In particular, it will explore whether the above recommendations made by researchers have been reflected in the media coverage of past bills. The paper will then go into detail about how the framing analysis informs the media advocacy plan regarding ways to improve upon past efforts as well as how to evaluate if current efforts are working. In addition, materials will be included so that an advocate will easily be able to use what has been provided in the media advocacy plan to more effectively promote this bill in order to help to promote healthier choices among America s children. Framing Analysis A framing analysis, one that examines how an issue is portrayed by looking at both what is included and what is left out in a story about an issue, 38 was conducted to see how the media covered the last federal bill that attempted to eliminate the tax deduction for unhealthy food advertising. The last bill, the Stop Subsidizing Childhood Obesity Act, was introduced in May of 2014 by Senators Harkin and Blumenthal but did not make it past the Senate Finance Committee. 39 Given that the bill did not make it out of the Finance Committee in 2014 and that the senators that make up the committee are from around the country 40 it made the most sense to look at how various news sources nationwide were portraying the issue in The initial analysis plan was to look at the coverage that the bill received by large media outlets that are read nationwide. ProQuest, a database that covers the popular Wall Street Journal (circulation 2.3 million) 41 and the New York Times (circulation 2.2 million) 41 was the first database searched. Unfortunately, it did not find results with the search terms Stop Subsidizing Childhood Obesity Act. Since the 10

11 bill number itself (S.2342) also did not result in any articles, the database of another popular newspaper, USA Today, was searched. That search did not come up with any results either. The next search was of The Hill, the most widely circulated news source in Washington DC. 42 Again, a search was conducted of the official name of the bill Stop Subsidizing Childhood Obesity Act. There was one result. Based on these search results, I concluded that the media coverage of the bill was minimal. This is interesting to note because a lack of coverage indicates that the public may not have been aware that this bill was being considered, an important aspect to keep in mind when thinking about where pressure is coming from when trying to pass subsequent versions of this bill. To find more articles, the search was expanded to include the databases Factiva, News- Bank, UC Berkeley s Library, and Google News. These databases drew from a variety of sources, including Forbes, Advertising Age, and The Fiscal Times. However, the yield of results using the search terms for the bill s official name, Stop Subsidizing Childhood Obesity Act, within these databases while including all possible publication dates was low (n=6, n=6, n=3, and n=9, respectively). After eliminating non-news sources and duplicates, the final number of news articles including the words Stop Subsidizing Childhood Obesity Act was 18. In two of these news articles, the bill was mentioned briefly and without opinions in favor or against the bill. The search also returned press releases made by Senators Blumenthal and Harkin when they introduced the bill and most articles quoted these in some way. Many news articles expanded on the written statements of the senators based on different points of views, otherwise known as frames. A frame that came up multiple times in the sample mentioned the importance of parental responsibility. With this frame, the bill was portrayed as misguided or pointless because the parents are responsible for making sure that their children choose healthy 11

12 food. Accompanying this frame was also the mention of a nanny state and the need for government to be less intrusive and stop telling Americans what to eat. Along these lines, another frame was the idea of government versus industry regulation. This was discussed within the context of the previously mentioned voluntary guidelines that the industry has set out for itself. While most articles acknowledged that the industry was strongly opposed to this type of bill and had defeated similar bills and efforts by the government to regulate advertisements in the past, some articles were less convinced that there was a need for the government to step in or believed that the industry s self-regulation was enough. Others articles sided with the bill and its intentions, stating that the government needs to protect our children from the constant barrage of advertisements bombarding them on a daily basis. This view in support of government responsibility was often accompanied by statements about the effect of advertising on children s eating habits. Another idea that often accompanied this frame was that the bill is not the only approach to addressing the obesity epidemic but just a part of the solution. This analysis pointed to different viewpoints about which party is responsible for the health of children as the main frames. An important note is that there was more variety in the articles written by those that opposed the bill. Among those in favor, the same facts were often used with regard to obesity prevalence and the effect of eliminating the tax deduction, making the articles repetitive at times. Another important takeaway is that there were not that many articles written about the bill, a possible area of improvement to increase awareness in the future. These conclusions are important to keep in mind when crafting the media advocacy plan. To further explore how the national media portrays advertising directed toward children in general and not specifically with regard to the bill, the news search was expanded to include 12

13 the three most widely distributed newspapers in the nation (USA Today, The Wall Street Journal, and The New York Times). The Wall Street Journal and The New York Times were searched using Proquest and USA Today was searched using the newspaper s online database via usatoday.com. In both databases, the timeframe was restricted to the 2014 calendar year, with the search term of (children youth) AND (ad OR ads OR advertising OR advertisement OR marketing OR marketed) AND (food OR snack OR obesity). This search string was decided upon after multiple searches of the Proquest database. Different terms were added and removed from the search term to produce the maximum relevant results based on preliminary searches conducted to compile a list of potential relevant articles based on titles and dates of publication. USA Today, although a widely circulated news source, did not have a systematic way to search for news and therefore the search was limited to The New York Times and The Wall Street Journal. The search of The New York Times and The Wall Street Journal articles yielded 74 initial articles, which were reviewed for relevance. The final 17 articles were then more thoroughly reviewed for content and frames (See Figure 1). These articles contained references to advertising food products to children or youth (nine from The New York Times, eight from The Wall Street Journal). Of the 17 articles considered relevant only five were opinion pieces (one op-ed and four letters to the editor). This shows a general lack of community voices in the media and could be an area of improvement. Of the voices that were included via opinion pieces, two were academics, one was from industry, one was a leader at a community organization, and one was a health care professional. There was a lack of voices of those directly affected by these food advertisements, such as mothers expressing concern for their children or youth upset about advertising efforts targeting them. 13

14 Figure 1. Proquest Search of The New York Times and The Wall Street Journal Although there were some interesting frames included in these articles, it is interesting to note the frames that were missing. For example, none of the articles mentioned needing to protect children due to their inability to distinguish advertisements and promotions from television programming, an issue that research has highlighted as important for furthering the bill s progress. Only two articles mentioned restricting ads during television time for children but did not explain why it was important. Another similar missing frame was a social justice frame. In fact, only one of the articles (a letter to the editor) mentioned the ethnic health disparities of the child obesity epidemic. Zero articles mentioned the bill itself. Seven of the articles mentioned a method by which the food industry was attempting to contribute to improving the food environment, including self-regulation. The potential effect of this frame on the reader is that it can ameliorate the frames that portray the industry in a negative light, such as the economic and political influence that the industry has on legislators who decide how the industry should be regulated (an influence that was mentioned in eight of the articles) or 14

15 try to negate the risks associated with their products or marketing strategy (six of the articles attempted to minimize the risks associated with the company s products). Finally, six of the 17 articles included information about a policy or policies addressing advertising to children or the unhealthy food environment as a whole. Of these six articles, none of them specifically mentioned the need to rid advertisers of the tax benefit they receive for unhealthy food advertisements. The lack of emphasis of the harmful effects of advertising on children and the lack of any mention of a junk food subsidy for advertisers are important gaps in coverage that will inform the media advocacy plan. Media Advocacy Plan According to the Berkeley Media Studies Group, a media advocacy plan involves using media to support a grassroots effort in order to make progress with regard to a public policy initiative. 43 The goal of this media advocacy plan is to increase the public s awareness of the potential of the Stop Subsidizing Childhood Obesity Act with the ultimate goal of passing it and amending the IRS Tax Code so that advertisers of unhealthy foods to children do not receive a tax benefit for such advertisements. This is done by increasing the public s awareness about the issue with the intent to increase discussion of the topic by legislators as more news stories and opinion pieces cover different aspects of it. Increasing the news coverage about the issue will move it to become a higher priority for the public and for lawmakers, also known as agendasetting. 38 The intention of making the bill a higher priority for policymakers is to increase the likelihood that they will pass the bill. There are many important key players in this media advocacy plan. With regard to those in support of the bill, one major player is the Center for Science in the Public Interest (CSPI). CSPI is a nonprofit advocacy organization that focuses on health and nutrition. 44 Based on com- 15

16 munication with CSPI, they are the organization that is currently working with Senator Blumenthal and Representative DeLauro to gain support for the 2016 version of the bill. The plan requires extra coordination from CSPI and also requires continuous monitoring and evaluation of advocacy efforts by CSPI. Senator Blumenthal and Representative DeLauro are also key players in this media advocacy plan because they are the Congress members reintroducing this bill in May of Among the many organizations in support of this bill, a final key support player in this plan is MomsRising, a large network of moms and allies that advocates on behalf of moms and families. 45 It is important that CSPI work with a lead contact in a parent coalition such as MomsRising so that any media representative who would like to do a news piece on the issue can easily contact the coalition to hear real stories from parents. MomsRising is an ideal organization to work with as they already have an established presence and have goals that align with those of this media advocacy plan. 45 They also have a large number of followers and supporters. 46 An important part of this media advocacy plan is that the movement is captured in the news; the media presence of MomsRising will hopefully facilitate that. Alongside MomsRising, important players include allies not directly affiliated with MomsRising but that support the bill. With regard to the initial targets of this bill, the main targets include the US House of Representatives and the US Senate. Since the bill will be introduced by both Senator Blumenthal and Representative DeLauro, it will need to pass committees in both the House and the Senate. Targeting both the House and Senate means that nationwide news coverage of this bill is preferable to localized coverage that may only reach a few Congress members. Opponents to this plan likely include companies included in the Children s Food and Beverage Advertising Initiative (CFBAI) under the Better Business Bureau which is a group of 16

17 companies that believe that self-regulation by the industry is sufficient when it comes to protecting children s health. Along these same lines, additional opponents include other food and beverage manufacturers that aren t CFBAI members, those that generally oppose regulation by the government, or those want to protect their revenue. Based on the framing analysis, there is very limited coverage of the bill currently. Food advertising toward children is also minimally covered and when it is covered it often does not include a specific solution that the reader can help work toward. Although it is important to have a multifaceted approach when addressing the obesity epidemic, it is also important that advocates use news attention to give readers specific actionable objectives to work toward, such as passing a specific bill, because it will help the task seem more manageable. But first, the public must be aware that advertising that targets children is a problem in the first place, of which there is minimal news coverage. As such, the first step in this media advocacy plan is to increase the public s awareness of the issue that unhealthy food advertisements are dangerous for children s health and that the food and beverage companies are financially benefitting from advertising to children in this way. The goal of this process is to encourage action in relation to the issue, in this case passage of a bill to close the junk food advertising tax loophole. Based on the research and news reviews, the best method of gaining media attention would be to involve key stakeholders that have not been very involved in previous efforts - parents. It is important to involve parents for two reasons. One reason is because they have a huge stake in this fight, the health of their children. The second reason is that opponents alternative framing of the issue as an individual choice will be harder to make a convincing argument for if parents understand the influence of the food environment on their children's eating habits. This goes along with the argument that parents need help to keep their children healthy. As such, this 17

18 media advocacy plan involves building grassroots support through the involvement of parents. This will involve getting parents passionate about changing their children's food environment and then spreading the word to other parents via opinion pieces in the newspaper and social media (such as Twitter), always referencing the bill as a part of the solution. It is recommended that MomsRising begin a petition to Congress to pass the bill, thereby helping gain recognition for the bill and also building a support system of community members that can be drawn upon for additional opinion pieces and as participants in events. To ensure that the work surrounding this bill is highlighted by the media, it is recommended that a nationwide event take place in multiple state capitals in order to involve the most people and to capture the most media attention. One suggestion for this event is a march of families to an important government building in the city. Families could include local members of MomsRising but could also include local community members that want to support the effort. Signs should be carried that emphasize the current ask to prioritize children s health over industry s profits. The media should also be alerted ahead of time via a media advisory (See Appendix B) that this event will take place. These marches would ideally end on the Capitol steps, providing good photo opportunities for media to use with their news coverage. Advocates and community members should be encouraged to write in letters to the editor and op-eds in response to this nationwide march. Alongside nationwide marches, it is recommended that a group march to the Capitol in Washington D.C. where a press conference with Senator Blumenthal and Representative DeLauro could take place and include the official acceptance of the signed petition circulated by MomsRising that calls on Congress to pass the bill. 18

19 Finally, in addition to this big event, it is important during committee meetings to highlight the support for the petition and the support from the public as shown by letters to the editor and op-eds. This will increase the pressure felt by policymakers to consider the bill. Based on an informational interview with CSPI, it appears that it is likely that it will take a while to convince policymakers that removing the tax benefit is a good idea, especially when considering industry opposition. As such, it is likely that this iteration of the bill will not move forward but it is important to continue to keep the issue on policymakers radar by having a public conversation about the detrimental effects of junk food advertising on children. Ideally this continued conversation will eventually lead to the passage of a similar bill. This pressure can be maintained by advocates who continue to utilize current events or anniversaries to submit opinion pieces and therefore encourage the media to remain interested in this topic. Accompanying this media advocacy plan is a packet of resources that will help advocates bring this issue to the public s attention including a strategic timeline, opinion piece outlines for advocates to submit to newspapers, and key messages to use when talking to the media. Evaluation Plan Since news coverage is so important, it is crucial to continuously monitor news coverage of the latest version of the bill. The evaluation will consist of setting up Google alerts for the keywords Stop Subsidizing Childhood Obesity Act and related terms such as the bill number to aid advocates in the monitoring of news coverage. An understanding of how much or how little attention the news is giving the bill will be important when determining follow-up strategies. If the legislative session ends without the passage of the bill, advocates can reevaluate which overall strategies worked and did not work to increase awareness of the bill and the harmful effects of unhealthy food advertisements. Some important considerations include looking into 19

20 how the issue was shaped by the news: Did the news utilize the advocates frame of protecting children from environmental exposures and harmful ads? If not, was there more of a focus on the responsibility of individuals and their choices? These sorts of questions will help advocates determine if the current strategy is effectively getting their message across. Another important fact to consider is the need for more media attention. As mentioned previously, media attention can help set the political agenda and so it is important to increase the media attention given to the issue. It s also important that the media attention is consistent with the advocates frame to help shape the discussion of the issue among lawmakers. Some questions to consider include: Is there a bigger event that advocates could utilize as a platform to inform the public about their message? How are advocates encouraging a public discussion of this bill? Considering these questions both during and after the legislative session would help advocates better approach the promotion of this bill in the future. Limitations, Potential Problems, Recommendations for Next Steps Although this media advocacy plan has many strengths, there are limitations. The framing analysis was based on the small sample of articles and some articles may have been missed based on the search terms used. In addition, this plan involves the time and commitment from parents that are already leading busy lives, which could prove to be a limiting factor when involving them in the march or sending opinion pieces to newspapers. Finally, given that this bill has been introduced multiple times and failed to succeed at passing, it is feasible to assume that policymakers may have competing priorities and that this bill may not be high on that list. As previously mentioned, next steps would include considering evaluation measures when moving forward to promote a similar bill in the future, with consideration for how to increase news coverage and ensure that the media is using frames that would help pass the bill. 20

21 Appendix A. Materials for Media Advocates These materials are included so that advocates can easily modify samples as they see fit and use them to promote public awareness about the dangers of junk food advertising and increase pressure on policymakers to pass the Stop Subsidizing Childhood Obesity Act. 21

22 Timeline/Access Calendar This timeline was created to help advocates find dates or events that they can tie to the Stop Subsidizing Childhood Obesity Act and increase the likelihood that their opinion pieces will be of interest to journalists/considered for publication. Date Action or Important Event January Congress Convenes April Op-ed referencing the anniversary of when the IWG requested input about their proposed voluntary principles for marketing food to children (4/28/11) E.g. It s a shame that 5 years after the voluntary standards that the IWG put forth were shot down we are still struggling to protect our children from junk food ads Tax Season write in a letter to the editor/op-ed E.g. Although many of us complain about tax season, not everyone is hurting from the way our system is set up Summer Early May: MomsRising creates a petition for others to sign throughout the year in favor of the bill; sends the petition to all Congress members; make a list of those that sign the petition and are willing to be contacted to send out letters to the editor/op-eds at appropriate times (*if bill reintroduced again, this process would ideally start in January) June: March on multiple state capitals involving parents and children, march on Washington DC with leaders from MomsRising that will hand over a petition to Representative DeLauro and Senator Blumenthal asking Congress to pass the bill Advocates (particularly those from MomsRising and other parents and children) should send in letters to the editor or op-eds in response to the march E.g. I applaud all of the families that came out to march and showed their support for the Stop Subsidizing Childhood Obesity Act Children out of school and watching more TV, good opportunity for op-ed or letter to the editor E.g. School s out for the summer but just because kids are at home doesn t mean that parents can protect them from danger - in fact it can be as close as your nearest TV that s showing the latest food ad Mid-July through early September: Congress takes summer recess 22

23 Date Action or Important Event September Back to school, fresh start, good opportunity to encourage lawmakers to protect children from ads E.g. Now that school s back in session, it s important to learn the facts about television advertisements and the harmful effects on children December Christmas/holidays, time at home to watch more TV, op-ed or letter to the editor about commercial content E.g. Did you know that advertisers use Santa to convince our children to eat unhealthy food and receive the added benefit of a tax-deduction for doing so? This holiday season, don t allow for this financial gift to continue to be given to the industry... Other potential events that you can use to access the media via letters to the editor or op-eds include: praising/questioning a celebrity s decision to endorse a food product, a breaking news story that relates to protecting children, etc. ** When the bill is being considered, the media should be invited to a formal spoken statement made by Congresswoman DeLauro that should include the current state of the petition and previous media attention (letters/op-eds) should be brought up during the committee meeting** 23

24 List of Reporters that Have Covered Food Advertising as it Relates to Children Organization/ Individual Amy Guthrie Rachel Nuwer Tom Gara Julie Jargon Description The Wall Street Journal Mexico Reporter Freelance Science Journalist (Contributes to The New York Times) Current editor of BuzzFeed Business, formerly worked for The Wall Street Journal Restaurant Reporter at The Wall Street Journal Website/Contact Information g=en =twsrc%5egoogle%7ctwcamp%5 Eserp%7Ctwgr%5Eauthor Michael Rosenbaum Professor of pediatrics and medicine at Columbia University Medical Center and a practicing pediatrician diatrics/division/endocrinology/faculty 24

25 Key Messages for Media Interviews Messages should be personalized but incorporate talking points below. Remember to refer back to the policy ask of passing the bill. The problem: One third of children in the United States are overweight or obese. Children are being targeted by food companies that are constantly advertising unhealthy food to them. Self-regulation by the industry is not working. The majority of foods advertised to children are nutritionally lacking. Young children are unable to distinguish between their television shows and food advertisements, making them especially vulnerable to food advertisements. The industry is not only profiting from the sale of its products, but it also pockets an additional $80 million a year as a result of tax benefits for advertising unhealthy food to children. The solution: Research about possible policy solutions to address childhood obesity named getting rid of the tax deduction for unhealthy food advertising as a cost-effective and beneficial choice. It would generate approximately $80 million a year in tax revenue that would go toward buying fruits and vegetables for children instead of toward the profit gains of the food and beverage industry. It is also predicted to lead to nearly $3.5 million in societal savings after a 10 year period due to health care savings and BMI reductions among children. We need to encourage our respective Congress members to support this bill. We can do that by signing the MomsRising.org petition, writing letters to the editor or op-eds, and contacting our Congress members. Values We need to protect our children from the harmful effect of advertising that is created with the goal of getting them to buy unhealthy foods. The government has a duty to help parents protect their children from the food industry because our children s health should be valued over industry s profits. 25

26 Frequently Asked Questions What is the Stop Subsidizing Childhood Obesity Act? The Stop Subsidizing Childhood Obesity Act is a national bill that will be reintroduced by Representative DeLauro and Senator Blumenthal in May of If passed, this bill would amend the tax code to no longer allow for advertisements of unhealthy foods directed at children under the age of 14 to be considered tax-deductible. Why should I support it? The United States is a nation with high overweight and obesity rates. The Stop Subsidizing Childhood Obesity Act would be a step in the right direction and help parents protect their children by promoting an environment that prioritizes children s health over industry s profits. What about physical activity and other causes of obesity? Although physical activity is important, exercise can only burn a limited number of calories and excess consumption of unhealthy foods is the main contributor to the imbalance of calories among children. Will it work? Although this policy change has never been enacted at a national level in the United States, models predict that it will help lower children s BMI and in turn increase health care savings. This policy is predicted to be one of the most cost-effective policies we can implement to start addressing childhood obesity, another important reason why it would be a recommended policy over other potential policies. What can I do as an average citizen to help the cause? There is plenty that you can do. Contact your Congress member to ask them to support the bill and sign the petition that is being circulated by MomsRising to help us demonstrate the wide support that this bill has from the community and from people nationwide. You can also visit MomsRising.org to learn more about the local march that is being organized in support of this policy as well as write letters to the editor and op-eds urging others to call on their Congress members to support the bill and to spread awareness of the harmful effects of advertising to children. Isn t it parents responsibility to watch what their kids eat? Although it is parents responsibility to help their children make health choices, they can t do it alone. An environment that supports healthy food choices is essential if parents want to teach their children to make healthy choices. This policy would help lead us toward that type of environment by discouraging advertisements of unhealthy foods to children, thus helping parents to encourage their children to choose healthy foods over unhealthy ones. 26

27 Won t regulation cost me money? No, in fact this policy has been predicted to save money. In addition to the $80 million it is predicted to generate in tax revenue per year, it is also predicted to contribute to increased health care savings. Is the US the only country considering regulating advertising? No, in fact countries such as Norway and Sweden have banned advertising to children under 12 years old, Italy has banned advertisements during cartoon shows, and Finland does not allow advertisers to use familiar cartoon characters in their ads. When it comes to protecting our children from food advertisements, the United States is falling behind. 27

28 Sample Letters to the Editor Here is a sample letter to the editor written in response to an article in The New York Times. The New York Times prefer letters that are between 150 and 175 words. For more information about their specifics, see Edit the first line (hook) based on a recent relevant event. Remember to keep the letter concise and send it in as soon as possible after the original article is published. Letters to the Editor [Newspaper name: Example: The New York Times] [Newspaper address, fax or } From: [Your name] [Your address] [Your phone number] Date Affiliations: [Relevant affiliations. Example: Children s food and health researcher] Re: [Article Title (Date) Example: Cap'n Crunch Is Looking at You (May 5, 2014)] Dear Editor: While I am happy that the marketing strategies of cereal manufacturers is being discussed, it is important to understand that the nagging of children doesn t occur just because they see fun characters staring at them in the cereal aisle. In fact, children are bombarded constantly with characters trying to market products to them. The scary fact is that young children can t even distinguish these characters as different from characters in their TV shows. What s worse, companies are profiting at the expense of children s health. The federal Stop Subsidizing Childhood Obesity Act will fix this by taking away the tax benefit that accompanies advertising junk food to children. We need to create a healthier environment for our children. I urge readers to contact their state representatives to tell them they should support this bill. Sincerely, [Your Name] 28

29 Here is an alternative version written from the perspective of a mother. Letters to the Editor [Newspaper name: Example: The New York Times] [Newspaper address, fax or } From: [Your name] [Your address] [Your phone number] Date Affiliations: [Relevant affiliations. Mother of two young children] Re: [Article Title (Date) Example: Cap'n Crunch Is Looking at You (May 5, 2014)] Dear Editor: The image of screaming children in the cereal aisle is not a foreign concept to me or most other mothers. Every visit to the store is a constant struggle between me and my two young children, who tend to be most attracted to the least nutritious foods. This comes as no surprise when I see the sorts of advertisements that are constantly playing during my children s television shows. As a mother, although I would like to protect my children from all potential harm, I know that I can t do it alone. I need the help of those around me to help keep my children healthy. Imagine my surprise when I learned that our government has failed multiple times in the past to pass a bill that would do just that. The latest version of the bill, the federal Stop Subsidizing Childhood Obesity Act, would fix a flaw in the tax code by taking away the tax benefit that is given to companies for advertising junk food to children. The government should protect our children, not encourage companies to continue marketing unhealthy food to them. I urge readers to contact their state representatives to tell them they should support this bill. Sincerely, [Your Name] 29

30 Sample Op-Ed This is a sample op-ed created for The New York Times and with a word restriction of 400 to 1,200 words. It is written from the perspective of a Public Health Nutrition student in the MPH program at UC Berkeley s School of Public Health. As a soon-to-be mother, the issues that affect children have all of a sudden become extremely personal to me. I want my child to grow up to be a healthy, thriving member of society. This is something that all parents want for their children. As a current Public Health Nutrition student studying to receive my MPH at UC Berkeley, I was particularly shocked to learn that food companies receive a tax benefit for advertising unhealthy foods to children. This benefit should not be afforded to companies that are literally profiting from making our children sick with their products. That is why we need to urge Congress to amend the tax code and prevent this tax benefit by passing the Stop Subsidizing Childhood Obesity Act, a bill whose most recent version will be reintroduced in May If this bill were to become law, $80 million in potential tax revenue would stop going into the pockets of advertisers pushing unhealthy food on our children and start going toward buying fruits and vegetables for them instead via the USDA s Fresh Fruit and Vegetable Program. But this obvious benefit is not the only reason we should support this bill. The majority of television advertisements aimed at children have consistently been shown to advertise unhealthy foods. On top of that, studies show that young children are unable to distinguish between what they see in an advertisement from what they re watching in a show. Combine these two factors with the advertising techniques that companies use such as associating toys with fast food meals and using familiar characters to promote food products, and it s no wonder that increased television viewing is associated with increased rates of obesity. Other countries have already acted in response to the dangers of advertising to children. Norway and Sweden ban advertising to children less than 12 years of age while Italy bans advertisements during cartoon shows and Finland does not allow advertisers to use familiar cartoon characters in their ads. Countries around the world are realizing the harms associated with advertising to children. The fate of our children s health is not a time for the United States to fall behind on progressive policy. The classic opponent s argument is that it s the parent s responsibility to monitor what the child eats. However, bring a child to a store and you can see the immediate effects of advertising. Children want what they ve been told to want, adorn the box with smiling characters and bright colors and a parent is greatly outnumbered. Yes, parents are responsible for their children, but when there are so many factors pushing their children to want unhealthy products it can seem 30