Heart on the Hill - May 2018
Menu Labeling Now Available at Restaurants and Other Food Establishments
Menu labeling is finally here! As of May 7th, restaurants and other retail food establishments with 20 or more locations must provide calorie counts on menus and menu boards, and on signs next to self-service foods on display.
Additional nutrition information, such as the amount of saturated fat, sodium, and sugar, must also be provided upon request. The requirements apply to chain retail food establishments that serve restaurant-type food, including restaurants, movie theaters, sports arenas, cafeterias, grocery stories and convenience stores.
Reaching this point is a victory for the association, our advocates, other public health organizations and consumers. Congress first directed the Food and Drug Administration (FDA) to develop menu labeling requirements in 2010 as part of the Affordable Care Act.
Since that time, the FDA released several requests for comment, issued proposed and final rules, and guidance documents, and delayed the compliance deadline several times. Some members of the food industry also tried to convince the FDA and Congress to loosen the menu labeling requirements.
The association responded to these requests and continually encouraged the FDA and Congress to provide consumers with the information they need to make healthier, informed choices. The association thanks the thousands of You’re the Cure and sodium reduction advocates who called on the FDA and Congress to maintain strong menu labeling standards.
Contact: Susan K. Bishop
Trump Administration Moves to Undermine the ACA Through Regulation
Menu labeling is finally here! As of May 7th, restaurants and other retail food establishments with 20 or more locations must provide calorie counts on menus and menu boards, and on signs next to self-service foods on display.
Additional nutrition information, such as the amount of saturated fat, sodium, and sugar, must also be provided upon request. The requirements apply to chain retail food establishments that serve restaurant-type food, including restaurants, movie theaters, sports arenas, cafeterias, grocery stories and convenience stores.
Reaching this point is a victory for the association, our advocates, other public health organizations and consumers. Congress first directed the Food and Drug Administration (FDA) to develop menu labeling requirements in 2010 as part of the Affordable Care Act.
Since that time, the FDA released several requests for comment, issued proposed and final rules, and guidance documents, and delayed the compliance deadline several times. Some members of the food industry also tried to convince the FDA and Congress to loosen the menu labeling requirements.
The association responded to these requests and continually encouraged the FDA and Congress to provide consumers with the information they need to make healthier, informed choices. The association thanks the thousands of You’re the Cure and sodium reduction advocates who called on the FDA and Congress to maintain strong menu labeling standards.
Contact: Katie Berge
House Republicans Propose Farm Bill
Last month, the House Agriculture Committee released and passed – along party lines – H.R. 2, the Agriculture and Nutrition Act. The bill filed on the House floor, with Democrats and Freedom Caucus members voting en bloc to defeat the legislation.
The legislation is viewed as a highly partisan bill that would cut at least a million individuals from the Supplemental Nutrition Assistance Program (SNAP), as well as affect access for another five to seven million SNAP recipients. SNAP plays a vital and positive role in addressing food insecurity and nutrition which has an impact on the health, educational attainment and economic self-sufficiency of its participants.
In addition, the proposed farm bill would cut nutrition education programs and fundamentally change the Fresh Fruit and Vegetable Program (FFVP), changes which would mar the integrity of these programs.
There were a few bright spots in the bill, such as the Food Insecurity Nutrition Incentives (FINI) program which would receive a funding increase, a mandate to update the Thrifty Food Plan every five years and provisions to increase data collection and mobile Electronic Benefit Transfer (EBT) access, but not enough to outweigh the bad.
In a statement, CEO Nancy Brown expressed the association’s concerns about cutting food access to our nation’s most vulnerable communities, which could jeopardize their health. This bill also fails to adequately address diet quality, which is an important policy priority of the association.
Moving forward, a draft of the Senate version of the bill is anticipated in June and unlike the House, is expected to be bipartisan. The prognosis on signing a farm bill into law before the September 30 expiration date is unclear. While the committees intend to meet this deadline, the failure of the House to pass their bill combined with the clock getting closer to the 2018 election, increases the odds that the legislative process will stall and Congress will need to pass an extension of the current farm bill.
Contact: Kristy Anderson
Association Joins Six Other Groups to Sue FDA for Delaying Tobacco Reviews
On March 27th, the American Heart Association and six other organizations filed a lawsuit against the Food and Drug Administration (FDA) for delaying several compliance deadlines contained in the final tobacco deeming rule.
The suit challenges the FDA’s decision to give cigar and e-cigarette manufacturers until August 2021 and August 2022, respectively, to file product safety information with the FDA and undergo premarket review. The association is concerned that this delay will allow cigars and e-cigarettes, including fruit- and candy-flavored products that appeal to kids, to remain on the market for years without agency review.
Joining the association in the lawsuit are the American Cancer Society Cancer Action Network, the American Lung Association, the American Academy of Pediatrics and its Maryland chapter, the Campaign for Tobacco-Free Kids and the Truth Initiative, as well as five individual pediatricians.
The suit argues that the FDA violated its statutory duty to conduct premarket review of all tobacco products; that the FDA failed to comply with procedural requirements before extending the deadlines; and that the FDA failed to consider relevant issues and explain why it changed its 2016 rule extending its jurisdiction to previously unregulated tobacco products. The suit asks the court to vacate the FDA’s decision and require premarket review of cigars and e-cigarettes according to the deadlines contained in the original deeming rule.
Contact: Susan K. Bishop
Association Submits 2019 Funding Recommendations
In early April, the association submitted its 2019 funding recommendations to the House and the Senate Subcommittees on Labor, Health and Human Services, Education and Related Agencies.
Specifically, this statement focused on the association’s top health funding priorities, including the National Institutes of Health, with special emphasis on the National Heart, Lung, and Blood Institute (NHLBI); and the National Institute of Neurological Disorders and Stroke (NINDS).
In the prevention arena, our statement concentrated on funding for the Centers for Disease Control and Prevention, including heart disease and stroke prevention, Million Heart and WISEWOMAN.
Contact: Claudia Louis
Congress and President Approve 2018 Spending Package
In March, the fiscal year 2018 omnibus appropriation bill was signed into law. This law contains major funding increases for federal programs that help fight cardiovascular disease, including heart disease and stroke.
“Congress delivered a great gift to Americans suffering from heart disease and stroke with passage of this legislation,” said American Heart Association CEO Nancy Brown. “The substantial budget increases provided for medical research and prevention are just what we need to take on the heavy burden cardiovascular disease will continue to place on our nation.”
The $3 billion increase approved for the National Institutes of Health (NIH) was an outstanding triumph. The funding is the most significant increase the NIH has received since the agency’s budget was doubled nearly two decades ago.
The association publicly commended the lawmakers whose bipartisanship made it possible—House and Senate Labor-HHS Education Appropriations Subcommittee Chairmen Rep. Tom Cole (R-OK) and Sen. Roy Blunt (R-Mo) and Ranking Members Rep. Rosa DeLauro (D-CT) and Sen. Patty Murray (D-WA).
NIH’s significant budget boost was divided among its 27 institutes, centers and divisions, including the two that are responsible for heart and stroke research. The National Heart, Lung, and Blood Institute will receive $177 million in additional funds, increasing its budget to $3.4 million, and the National Institute of Neurological Disorders and Stroke will receive an $361 million increase, enlarging its budget to $2.1 million.
The NIH was not the only agency to receive enhanced federal support in this law. Many of the Centers for Disease Control and Prevention’s (CDC) programs, which help Americans manage risk factors before they result in heart attacks and strokes, also obtained increases or their funding remained the same as last year’s, including:
- CDC's Heart Disease and Stroke Prevention received $140 million, a 7.7 percent increase over 2017
- CDC's Million Hearts, a program designed to prevent 1 million heart attacks and strokes over five years, received $4 million (same as 2017), despite being zeroed out in the administration’s budget
- CDC's WISEWOMAN, aimed at low-income, un-insured, under-insured women ages 40 to 64 to prevent heart disease and stroke, received $21.120 million, the same amount as last year.
“This additional support for research and prevention will be a huge help in combating America’s most costly and prevalent disease, and we commend Congress for making it possible,” said Brown.
This win for the heart disease and stroke patients and heart and stroke research funding is also due in large part to the association’s You’re the Cure advocates. Throughout the year, these supporters have contacted members of Congress to demand this NIH funding increase. Whether they were sending thousands of messages to Congressional offices or participating in hundreds of in-person meetings, the association's advocates helped earn this victory.
Contact: Claudia Louis
Omnibus Appropriations Good News for Prevention Efforts
The recently passed omnibus appropriations legislation was mostly good news for prevention policy.
On the positive side, there were no riders rolling back parts of the menu labeling law. This happened despite strong efforts from some members of the food industry to include this language in the bill and fundamentally change the law.
In addition, the bill did not contain a rider from the past few years that would roll back school meal nutrition standards for sodium, whole grains, and fluid milk. This is in part because the U.S. Department of Agriculture (USDA) is currently considering regulatory changes to these three standards. However, removing a legislative mandate to roll back these provisions will help in efforts to encourage schools keep adopting these evidence-based nutrition standards and put the health of children first.
Finally, Title IV Part A education grants, which can be used to fund physical education programming in schools, were funded at $1.1 billion. While this amount is still below the authorized $1.65 billion level, it is a huge increase from the $400 million the program received in FY17 – and surprising since many initiatives are facing cuts.
While there were no new negative riders in this bill, it included two previous riders. The first rider prohibits the voluntary sodium targets from moving forward until a Dietary Reference Intake (DRI) on sodium is updated. While the association supports an updated DRI on sodium, there is no reason to prohibit the voluntary sodium targets from progressing.
The second rider involves changes to the Supplemental Nutrition Assistance Program (SNAP) retail stocking standards rule. The rider mandates that the USDA re-define variety in the rule, which could potentially open the door for more unhealthy foods to be counted toward the types of food retailers are required to offer.
The association will continue to push to eliminate any negative riders in future agriculture funding bills and support gains in prevention policy.
Contact: Alison Council
Office on Smoking and Health Receives $5 Million Funding Increase
The American Heart Association was pleased that the final FY18 omnibus included a $5 million increase in funding for the Centers for Disease Control’s (CDC) Office on Smoking and Health (OSH). This increase brings total funding to $210 million.
OSH operates several successful media campaigns, including Tips from Former Smokers which has motivated over half a million smokers to quit smoking. This funding increase will ensure that the Tips program can continue. The CDC recently launched the seventh year of its anti-smoking campaign.
In addition, the omnibus did not include any of the harmful tobacco riders of concern to the association. One would have exempted so-called large and premium cigars from the Food and Drug Administration’s (FDA) oversight and another would have altered the deeming rule, effectively exempting any e-cigarettes from FDA oversight. Since these riders were not included, the FDA retains its ability to oversee these products and their health impacts on Americans.
Contact: Alison Council
FDA Announces Nutrition Innovation Strategy
At the end of March, the Food and Drug Administration (FDA) announced the kickoff of a Nutrition Innovation Strategy. This new initiative will focus on promoting public health through improved nutrition, encouraging industry innovation to create healthier products and helping consumers identify those products.
The strategy was announced by FDA Commissioner Scott Gottlieb during a speech focused on reducing the burden of chronic diseases, such as heart disease and cancer. Dr. Gottlieb called improvements in diet and nutrition “one of our greatest opportunities to have a profound, generational impact on human health and on reducing health disparities.”
While the initiative is still in the early stages of development, the FDA has identified several key actions it intends to take to reduce preventable death and disease related to nutrition, including:
- Updating health claims that appear on product labels
- Making ingredient lists more consumer-friendly
- Updating standards of identity (mandatory requirements related to the content and production of certain food products such as bread, jam, juices, and cheese) to encourage industry innovation
- Implementing menu labeling and the revised Nutrition Facts label
- Encouraging industry to reduce the sodium content of the food supply.
The FDA will hold a public meeting this summer to begin discussing its proposals.
Contact: Susan K. Bishop
STATE UPDATES
Tobacco 21 Passes in Municipalities Across the Country
Across the country, more towns and cities are protecting young residents from the dangers of tobacco by supporting tobacco 21.
San Antonio has laid the groundwork for future tobacco policies in the Lone Star state by becoming the first city in Texas to raise the minimum tobacco purchasing age to 21.
Additionally, across the Midwest and Northeast, residents in cities in Illinois, Minnesota and Massachusetts, can now breathe a little easier knowing that tobacco is farther out of reach for their communities’ youth.
Contact: Lucy Culp
Local Support Saves Tobacco Tax
Oklahoma affiliate staff and volunteers went on the defensive earlier this year when Big Tobacco challenged an Oklahoma Senate bill, which increased the price of cigarettes by $1.50 per pack. By incorporating effective tactics used in the Oklahoma Cigarette Tax Campaign, association staff and volunteers were able to successfully defend the established tobacco tax.
Contact: Lucy Culp
Virginia Helps Give Stroke Patients Greater Access to Care
Stroke survivors in Virginia, thanks to the passage of Virginia House bill 1198, will now have greater access to life-saving medical services. Nearly 25,000 Virginia residents suffer a stroke each year. This legislation requires the Board of Health to develop, implement and review regional stroke triage plans for the transport of acute stroke patients in the commonwealth.
Contact: Douglas Dunsavage
Three States Vote to Create a Stroke Registry
Virginia, West Virginia and Utah have each passed legislation mandating a statewide, centralized stroke registry. These policies require all nationally certified comprehensive, primary stroke centers, acute stroke-ready hospitals and centers with levels of distinction to report to the registry. These registries will help the thousands of individuals who experience a stroke each year have greater access to a more comprehensive stroke system of care.
Contact: Douglas Dunsavage
Utah Establishes a Centralized Cardiac Registry
Utah joins the growing list of states implementing mandatory statewide, centralized cardiac registries. This latest policy, through the passage of Utah Senate Bill 150, will greatly improve the care of the more than 7,000 stroke and cardiac patients who visit Utah’s emergency rooms each year. In 2016, heart disease and stroke-related conditions combined for an annual treatment cost of nearly $400 million in Utah alone.
Contact: Douglas Dunsavage
Kentucky Becomes the First State to Pass High-Quality Telephone CPR
Thanks to the final passage of state Senate legislation, Kentucky has become the first state to pass a bill on high-quality telephone CPR. This groundbreaking legislation requires that all 911 telecommunicators that answer emergency medical calls be trained in providing telephone CPR that incorporates recognition protocols, compression only CPR for calls reporting suspected OHCA and continuing education opportunities. This legislation will ensure that almost 4.5 million people in Kentucky will be more likely to receive high quality CPR in an acute event.
Contact: Douglas Dunsavage
Michigan Helps to Close the Food Gap
Michigan took proactive steps to put healthy foods in the hands of its residents with the passage of Michigan Senate bill 239. This new policy requires that for the next five years, five percent of annually appropriated funds from the state’s Community Revitalization Program go to programs aimed at increasing access to healthy food.
Specifically, the funds must be allocated to properties that are primarily used as retail supermarkets, grocery stores or produce markets. These businesses must sell fresh fruits and vegetables, unprocessed USDA-inspected meat and poultry products, and dairy products.
The legislation also expands the definition of “eligible property” for community revitalization incentives to include property utilized for a neighborhood and commercial corridor food initiative. It requires at least five percent of community revitalization incentives be awarded by the Michigan Economic Development Commission to these food initiatives.
The sum of money allocated towards increasing healthier food options for all Michiganders by the end of the five-year period will be approximately $12-$15 million.
Contact: Kim Milbrath
Long Beach, CA Votes to Improve Biking and Walking Lanes
Long Beach residents will enjoy greater access to outdoor spaces thanks to a recent allocation of $14 million to improve mobility, with over $10 million dedicated to bike and pedestrian safety. Specifically, the investment allocates:
- $6.2 million for sidewalk mobility
- $3.3 million for sustainable transportation programs
- $1.3 million for traffic management related improvements
- $2.1 million for smart street lighting
- $1.37 million to transit related improvements, such as bike lane repairs
This measure is especially meaningful for residents in the assembly’s 1st and 6th districts, who are historically underserved and in dire need of improvements to address health outcomes, access to healthy food options and improved access to safe spaces for physical activity. The investment ensures that more than 50 miles of streets and sidewalks will be repaired to include a “complete streets” design.
Contact: Katie Bishop Kendrick
Complete Streets in Oklahoma City
Oklahoma City joins the growing list of municipalities striving to improve access to safe outdoor spaces. With the recent passage of an updated city comprehensive plan, city leaders will direct officials to prioritize projects based on socioeconomic data. This policy has the potential to provide more than 600,000 Oklahoma City residents with greater opportunities for physical activity.
Contact: Katie Bishop Kendrick
Kansas City Votes to Provide Healthier Options in Vending Machines
A new policy ensures that over 4,000 Kansas City employees will now have easier access to healthier options in vending machines. Like many cities across the country, Kansas City has struggled to improve the health of its residents, particularly those in underserved communities.
Today, 86 percent of city employees in Kansas City are overweight or obese, compared to 65 percent of the city population at large. Some attribute this disparity to the fact that 43 percent of city employees reside in zip codes with lower life expectancies.
Contact: Katie Bishop Kendrick
