Regulation roll back could pose health risk for many counties that backed Trump

The largest margins of President-elect Donald Trump’s victory came overwhelmingly from counties plagued by diet-related chronic diseases likely to worsen because his administration and the new Congress are aiming to roll back common-sense policies and undermine proven programs.

Consider these facts about the 500 counties spread across 29 states where Trump received more than 75 percent of the vote:

• In 495 counties the rates of persons with diagnosed diabetes in 2013 (the most recent numbers from the Centers for Disease Control and Prevention) were above the national average of 6.7 percent;
• In 73 counties the rates of persons with obesity were above 35 percent in 2016 (the most recent numbers from County Health Rankings, a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute), and the national average is 36.5 percent; and
• In 276 counties the obesity rates were between 30 and 34.9 percent, and another 142 had rates between 25 and 29.9 percent.

{mosads}These counties also have depended on a strong food security safety net.  In almost 200 of the counties, 10 to 20 percent of the population used Supplemental Nutrition Assistance Program (SNAP) benefits in 2013.

Take Clay County, Ky., that gave Trump 86 percent of its vote.  A third of its population suffers from obesity, and the diabetes rate is 14 percent, while more than 40 percent of its population relied on SNAP.

Reporters for The New York Times in 2014 described Eastern Kentucky and its “persistent poverty’ as a “…  land of storybook hills and drawls — [that] just might be the hardest place to live in the United States. Statistically speaking.” Using measures of “educational attainment, household income, jobless rate, disability rate, life expectancy and obesity rate,” the Times reporters ranked every county in the nation.

And this is what they wrote of Clay County: “. . . [it]might as well be in a different country.”

Or take Wayne County, Tenn., where Trump received his largest margin in that state, 86 percent of the vote. A third of its population suffers from obesity, the diabetes rate is 12 percent and almost 1 in 5 residents depended on SNAP in 2013.

The problems of these communities are clearly deep and many, from revitalizing their local economies to ensuring education and training of their young people, to providing access to affordable healthcare. But people in them also need the benefit of healthy and nutritious food, especially in a food environment where many of the choices are not really theirs, but are in fact being made by food industry giants who supply their corner and grocery stores and gas stations.

For instance, in 2014 the top 25 food manufacturers spent $14.9 billion advertising their products, using all their marketing savvy to sway consumers’ choices toward high-calorie, sugar- and salt-laden foods. My organization recently published a report documenting how the food industry rigs the system in grocery stores with slotting fees and “category captains” determining what products get the best placement and in fact drive consumers’ choices toward the less healthy products.

That’s the issue underlying giving consumers a real choice by providing them with information to make their own determination – whether it’s the coming calorie information on menus or the revised Nutrition Facts Label for processed food that will disclose for the first time how much added sugar is in a product and how that compares to the maximum they should have on a daily basis. Another example is the effort by the Food and Drug Administration to provide voluntary guidance to food companies on how much sodium should be in processed and restaurant foods. The excess sodium – mainly in the form of salt – in our foods increases our risk of high blood pressure, leading to heart disease and stroke.

To address rates of chronic diseases, we need to preserve and reinforce strategies that allow consumers to make informed choices (menu labeling, Nutrition Facts Label) and policy approaches to reduce harmful nutrients like sodium.  Similarly, we need to be talking about how we can strengthen food security programs like SNAP and ensure they provide healthy and nutritious food to their recipients who usually turn to them in time of critical need, such as loss of employment.

What we don’t need to be talking about is “regulation rollback” – code words for doing the bidding of special interests and ignoring the real needs of our fellow citizens.

Jim O’Hara is Director, Health Promotion Policy, at the Center for Science in the Public Interest.

The views expressed by authors are their own and not the views of The Hill.