| SSB taxation |
Consistent evidence of SSB taxation efficacy in contrast to education and marketing campaigns alone. SSB taxation pilot implementations in various US cities, regions and international cities, countries demonstrate an overall acceptance of this approach (59). Tax revenue has the potential to aid in additional supportive community health promotion initiatives to reduce diet inequity.
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Higher taxes may be financially regressive in lower income communities. Vital for tax revenues to be used for targeted health promotion strategies within these communities. Need to accompany SSB taxation with accurate marketing and education for specific demographic groups tailored to risk. Children, adolescents, low-income, and racial minority groups (Black, Hispanic, and AI/AN individuals, etc.) are the most harmed by unhealthy beverages and poor nutrition standards. ASB taxation linked to SSBs show mixed outcomes; ASBs have potential carcinogenic health risks in larger doses.
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| F/V subsidy |
F/V consumption directly addresses both nutritional insecurity and food insecurity among SNAP participants. Expansion of FINI and GusNIP are proven demonstration routes to encourage nutritious food and F/V consumption in low-income communities across the U.S. and its Territories. Every $5 of new SNAP benefit generates $9 economic activity. Program modernization enhancements for access, integrity, technology, and operations efficiency improves SNAP experience for both retailers and participants, particularly for virtual shopping, online grocery stores and e-benefits.
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F/V are a specialty crop commodity and require specialized considerations, such as crop insurance, to mitigate climate change disasters. Subsidy does not guarantee behavior change among SNAP participants who choose less healthy options. Eligibility and workforce participation requirements may cause undue participation barriers and should be carefully considered. There can be inflation impacts on SNAP food prices for participants. Health and nutrition literacy—accurate science-based nutrition labeling for healthy foods—for virtual consumers and electronically purchased products may not always be available. Child specific nutrition programs (i.e., WIC, school nutrition programs) are not necessarily aligned with SNAP structures and appropriations, but could still benefit from shared F/V specialty crop commerce supply chains.
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| Reduce UPF by incentivizing climate-smart foods |
Has the potential to promote industry reformulations toward healthy foods, taking advantage of consumer demand and ultimately leading to a lasting, longer-term effect on diet and public health. Climate-smart agricultural production is a tremendous opportunity to support longer-term productivity, prosperity, and resilience of U.S. farms, forest lands and rural communities. Obtaining and setting reasonable GHG, quality standards for sustainability, food-waste reduction in procurements for a wide range of public venues, including healthcare systems. Voluntary multi-sectoral partnerships for climate-smart commodities can be an effective low-cost government strategy. Simultaneously helps reduce GHGs, risk of catastrophic shifts in Earth’s fragile ecosystems while directly impacting diet related chronic disease, a powerful win-win synergy strategy. Directly address food supply inequity by neutralizing food deserts and food swamps.
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More difficult to reduce and directly disincentivize ultra-processed foods (UPFs) due to partisan political and corporate climates. UPF, concentrated animal feeding operations, animal source protein, industrial hemp loopholes (non-drug component <0.3% THC) vs. marijuana (>0.3% THC, especially in unregulated states with unclear FDA specs) need to be re-considered in hot spot areas of severe undernutrition, malnutrition, economic poverty, and environmental injustice. Incentives for healthy diet goals must be paired with dramatic reduction in food waste and improved food production practices to achieve safely operating and resilient food systems. Adequate community engagement for crop insurance during shift(s) to climate-smart agriculture production, specialty crops to ensure climate resilience through extreme weather, climate disaster events. Need trade mitigation supports and practical GHG targets. Need cooperative bipartisan networks and alliances to work with industry stakeholders, for addressing the most harmful market impacts on distressed communities and small-medium farmer agriculture sources.
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| “Food is Medicine”: MTM benefits, research and development; implementation pilots & scale-ups |
Provides directly prepared meals to vulnerable patients who are unable to grocery shop and/or cook. Adequate access to nutritious food is a key component of any SDOH framework for promoting human health and preventing, treating human illness. Provides customized diet and health solutions based on a person’s unique biologic makeup, environment, and lifestyle choices. Valuable opportunity for technology innovations to advance digital nutrition and health for underserved and vulnerable populations (i.e., dual eligibles). Diverse cultural traditions and preferences present myriad possibilities for healthy nutrition systems pathways and for cultivating a diverse nutrition science workforce.
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Would need direct involvement and facilitation within a healthcare setting, creating another significant step in implementation and potential barriers. Some interventions do not have sufficient scientific evidence and need rapid R/D investment for piloting and strategic interagency coordination for rapid scale up. Must pay particular attention to adequate inclusion of vulnerable and underserved populations in research participation and health insurance benefits reimbursement to fully address the most severe chronic diet-related health inequities. Ethical applications and stewardship of technology advancements in empowering use of digital innovations (i.e., health information, privacy and confidentiality, artificial intelligence, insurance benefits). Need to account for other SDOH factors, including insurance access, housing, poverty, education, and literacy levels, etc.
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