Larry Soler and Dr. James Gavin Discuss Partnership for a Healthier America, Which Is Working with Michelle Obama to End Childhood Obesity
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by lisa vance, joseph shivers, and kelly close
Partnership for a Healthier America (PHA) is a new, nonpartisan organization started in partnership with First Lady Michelle Obama’s Let’s Move! initiative against childhood obesity. PHA is primarily focused on reducing obesity through collaborations with the private sector and other organizations, and it’s off to a great start. It has recently announced relationships with Wal-Mart, Bright Horizons, a few of the country’s largest grocers, and several small, innovative ones. Wal-Mart, for example, will work with its suppliers to eliminate the price disparity between healthy and unhealthy foods, as well as reduce sugar and sodium content in packaged foods by 2015.
We recently sat down with Larry Soler, President and CEO of the Partnership for a Healthier America (PHA), and James Gavin, MD, PhD, the Chairman of the PHA Board of Directors. Before coming to PHA, Mr. Soler was Chief Operating Officer at JDRF, and Dr. Gavin is currently CEO & Chief Medical Officer of Healing Our Village, Inc. During the interview, they described how they try to convince companies to collaborate with their organization, how quickly they hope to bring on new partners, and why they think the organization will survive even after Michelle Obama is no longer First Lady.
overview of the partnership for a healthier america
Kelly Close: Larry and Dr. Gavin, we really appreciate you joining us. To start, can you help us understand what you're trying to accomplish and what you see as the major goals of the First Lady’s initiative to reduce childhood obesity?
Dr. James Gavin: As you know, the First Lady has made a commitment to reducing childhood obesity within a generation and changing the slope of the line where our children are in the obesity curve. And for that, they have devised five pillars in the Let's Move! initiative, which are the underlying theme of the movement.
They include: 1) create a healthy start on life for our children, from pregnancy through early childhood; 2) empower parents and caregivers to make healthy choices for their families; 3) healthier nutrition in school; 4) increased access to physical activity; and 5) the elimination of “food deserts” [areas where healthy, affordable food is scarce] so that people can have access to more healthy foods.
Those are broad areas and they represent what it's going to take, at a minimum, to drive a change in childhood obesity. The role that we play at the Partnership for a Healthier America is to engage the many private organizations, industries, advocacy groups, and service organizations that we will need to collaborate with in this effort.
the scope of the challenge
Kelly: Larry, you have quite a background in policy work in Washington given all the strides you made on the policy front in the JDRF. Some might say this represents a different direction for you – definitely one that those of us that know you well are very excited about. Could you talk about what the surprises have been and what you think the biggest challenges are?
Larry Soler: In terms of the challenges and the surprises, one of the surprises has been the extent that Mrs. Obama’s focus on the issue has really deepened the understanding of people and companies and other players across the world about the child obesity problem. I think this effective use of her bully pulpit has helped the work that Jim and I are doing here. I see evidence of that through the increasing interest that we are getting from the private sector. We're extremely busy having meetings and talking to companies, ranging from those that make food to those that are not involved in anything related to this issue. There has generally been strong interest, which has been great for us.
I think one of the challenges we have is our ambition. The goal that Mrs. Obama and the partnership have laid out – solving the childhood obesity crisis within a generation – is a challenge. The problem is much more complex than I ever really knew. The depth of the problem is so wide that it leads to a lot of opportunities for us. But we're also going to have to be at this for a while and really build on what people have been working on over the last 10, 15, and 20 years.
Kelly: We’ve been talking about the scope of the challenge, and Larry, you were going into how it is much broader and deeper than even you anticipated. Can you discuss that at greater length for us?
Larry: I think many people come to this problem and see it in certain ways that I think are narrower than what the reality is. It’s not just about parenting. It's not just about child behavior. It's not just about food. It's a range of all kinds of things that also include whether people have access to healthy food, or whether people have safe environments so they can exercise and be physically active, so they can walk to the park. You're dealing with a whole set of factors that go beyond just food and physical activity. So getting at that makes the whole issue more complex.
I think that the companies we are talking to understand what’s at stake, because one in three children are now overweight or obese, and the cost that obesity is placing on society is estimated to be $150 billion dollars per year, but probably a lot more. We cannot sustain that, and it's going to affect every segment of our society.
partnering with corporate america
Kelly: Some people have been very skeptical that corporate America can change its behavior because of different things we have seen in terms of their behavior – also because of its major focus on profits. Tell us how do you work with these companies, and how confident are you now, a year in, that you can really change corporate America?
Dr. Gavin: Kelly, one of the things that we've found, and Larry alluded to this, is that it hasn't been very difficult to get corporate leaders and organizations to understand the scope and the impact of this problem and what that means to the future health of this country. When we talk about our children and even beyond that, when you look at things like the military, they now understand the problems they will encounter, in terms of things like readiness for putting soldiers in the field and people in the workforce. All of these have common origins, so it’s easier for them to understand the problem.
Beyond that, it's becoming clear that, with the bully pulpit and the attention that Mrs. Obama has given to this, companies are now coming to the table and asking the right questions. Namely, Wal-Mart has asked, “What can we do in the context of how we go about our business?” And that's when the creative process takes place.
That's why it's so important to have a lot of minds . . . try and address those questions. With the Wal-Mart example, what do they do with respect to making healthy food choices? What could they do to take away price premiums from more healthy foods? What could they do to affect the composition of the foods that they get from their supply line?
These are the things that Wal-Mart has been able to negotiate around, because they recognize how they can contribute to potential solutions to the problem. That’s the kind of approach we try to develop with all of the different companies: whether they make food, manufacture processed food, market messages about food, engage in physical activity issues, or educate people.
So what we try to do is to get people to the table and create a win-win situation, which means that we have discussions about what it means potentially to the bottom line. You can't escape those kinds of questions. Our goal is not to try and put anybody out of business or in a compromised situation with respect to the market, but rather to try to work toward the same goal in the most productive way possible, in the name of improving the health of our children. So that's a broad view of our approach.
Kelly: How does the process compare when you work with companies that are already directly engaged in childhood development, like the childcare company Bright Horizons?
Larry: In the case of Bright Horizons, we were working with a true leader in the space, who had already taken important steps to ensure that their facilities were serving children well. However, we asked them to agree to not only abide by these standards, but also to sign an agreement with us, agree to be evaluated by us, and understand that we would publicly report our findings. One of the major goals of our childcare program is to utilize the Bright Horizons example of stepping up and ask others in the space to do the same. We urge parents to ask their child care facilities if they meet these standards. We partnered with Nemours [a children’s health system and founding member of PHA] who has built a website for child care providers to get resources on how to meet these standards.
Joseph Shivers: On Mrs. Obama’s message, we know there are some questions about how exactly she wants it to be perceived and how the messaging will work. What sort of historical examples are you looking at? Is this similar to the war on cancer? Is this the space race and putting a man on the moon? Is this fighting AIDS?
Dr. Gavin: Well in my own view, it’s a bit of “all of the above.” This is not exactly akin to any one of those things. We have elements of culture: the way the market operates, issues of personal choice, freedom, health, and medical outcomes. There are a lot of issues that aren’t exactly like any of those other things though, so in and of itself, I think it’s a one-of-a-kind campaign.
Larry: One of the things we want to try to help people understand is that the things that we are doing, the things that we are working on with companies, these healthy commitments, are going to make it easier for people to be healthier. So if we’re working with a company that agrees to build a grocery store in a neighborhood that was previously underserved, that’s making it easier for you to get healthy fresh vegetables and produce, right? It doesn’t solve everything, but it makes it easier. If we are working with Wal-Mart to reformulate all the food that they sell at Wal-Mart to have less sugar, less sodium, and less fat, that’s going to make it easier for people to buy more healthy foods at the stores. One of the other Wal-Mart commitments is that they’re going to have a special marker, an emblem that’s going to be added to food that they sell that passes a certain nutritional test. The typical Wal-Mart shopper shops for something like 19 minutes. It’s often a mom with two kids, so the ability to look quickly to see if something has passed a nutritional test that has been approved by an outside nutritional organization makes things easier for people. So that’s part of the message: trying to make this easier.
Dr. Gavin: If I could add – our efforts will have other benefits. For instance, in a place like Detroit, a lot of the urban blight will be minimized in a move toward increasing the number of urban gardens. That sounds like a political agenda – in part, it is – but it also has a lot of social and economic and health consequences. It’s easier to push that when you can count on a larger message that there’s a national movement afoot to improve the health of our communities.
setting goals for the future
Kelly: What would make 2011 a “home-run year” for the Partnership for a Healthier America?
Dr. Gavin: The number of major commitments that we get, and the nature of the goals those commitments attempt to achieve. Those are the kinds of things that let us know that we are on track to being successful as an organization. Obviously, there are other things like the attention that we bring to this: the visibility and the level of advocacy and so forth. There are a lot of little things like that but at the end of the day, it really is about commitments and measurable achievements.
Larry: Absolutely. Coming back to your earlier question, Joseph, I would probably compare what we’re doing more to the fight against tobacco. And while clearly there have been significant gains that have been made in the fight against tobacco, many doubted that it was really going to happen. But once the movement made it to a certain level, then you saw significant, dramatic progress. So maybe that’s a better comparison to where we want to be.
I feel like we’re approaching that level. When I go out and speak, people understand the significance of this problem. They see it in their families. They see it in the schools and their churches. They see it in their companies. There’s really no way to hide from it any longer.
The number one thing I want to see happen this year is that I want us to announce a lot of commitments, realizing that it takes time to get these started. And then I want us to do more in the second and third years. But I think in this first year, we have a good opportunity to make somewhere in the range of ten commitments.
Kelly: Ten is not a small number given the size and scope of these agreements. We're really excited to see which healthcare company will be the first to show the kind of leadership that these type of agreements require. That's about an agreement and a half each month for the rest of the year.
Larry: Over a three-year period, I’d like to see us have somewhere in the range of forty or more commitments. When I say commitments, we’ll be turning down more than we will be signing. So these are going to be ones that we feel really good about – ones that are solid and we think are going to actually make a difference. Also, as a new organization, our ability to continue to be impactful in the future is partially dependent on how well we are known in the community, and how well our brand is known. In the childhood obesity space, we’re a group that a company can actually be a member of – you can’t be a member of a government agency, so we’re going to try to build our brand significantly so that we can bring that value to companies and have our own kind of seal of approval.
There’s also another area of opportunity; it’s not so much a goal and this is not something I think we are going to do this year as a startup organization, but I’d like to see us do it down the road. There is a lot of interest from local non-profits and local companies about the work that they’re doing in this space. And we don’t have the means and resources right now to work with our local companies, but I think that there’s definitely something out there for a local presence to help do what we’re doing nationally, at the local level. There’s so much that can happen both locally and nationally. So that’s something that I see on the horizon.
working with washington
Kelly: Mrs. Obama has very ambitious goals, and of course, she’s so deeply admired by everyone – possibly more than anyone in any generation I’ve personally seen, and certainly on the level of a First Lady like Eleanor Roosevelt, for example. It would be fascinating to hear a bit more about working with her and her involvement in the campaign.
Larry: I hadn’t met her until I started. I think the commitment and passion that you see in her public remarks is real, and she will push and fight and do, I think, anything to try to achieve these goals. So I found her to be as inspiring as you’ve seen her. I feel the same way, and I think it also trickles down to her staff that we work with even more frequently who are really devoted to this issue. Her involvement, though, is a driving force. She’s incredibly passionate about this issue and, while I won’t speak for her, I think it shows how personal this issue is for her and her family. You saw this again earlier this June when Jim [Gavin] stood with her to announce the Bright Horizons commitment. When it comes to the fight against childhood obesity, she’s as much General Patton as she is Eleanor Roosevelt, and it’s that drive that makes this hard fight that much more winnable.
Kelly: Can you talk more about the bipartisan nature of the organization? We have heard some concerns about the organization’s ties with the current administration.
Larry: I am hopeful that the organization will exist as long as we are providing value in this space. I’m pretty convinced of that. We have the good fortune of having the First Lady of the United States as our honorary chair, and of having the creation of our organization announced in the White House. That’s something that not everyone gets. So that’s a great start for us.
What we are trying to do right now is get as much as we can possibly get accomplished to get the ball rolling, to get the brand built, and to utilize all these great resources that we have, including the First Lady. But I’m recruiting highly talented people who are leaving good jobs to come here, because I think we all see that there’s so much opportunity, and no matter what happens in the next election, whether it’s two years or six years when there will be a change in the administration, this will continue. We are purposefully an independent organization, founded by nonpartisan foundations. We have the former Senate Majority Leader Bill Frist as our honorary vice chair, and I also think that when the Obamas are no longer in the White House, we will probably be able to utilize Mrs. Obama in different ways, because we know that her commitment to this issue isn’t going away.
the role of diabetes companies
Kelly: How could you see diabetes companies in particular making an impact? This is an incredible opportunity for the very first one to stand up and lead the way. Also, do you have any other strategies to raise awareness from the patient perspective?
Larry: Let’s start with the companies. There’s probably no sector I know as well as the diabetes sector, and the same with Dr. Gavin, so it’s really natural for us. We are talking about obesity, but what we are really talking about is diabetes and other obesity-related conditions that are part and parcel of the obesity epidemic. I really think that companies involved in diabetes, while they are not selling food, are right in the middle of this problem.
So there’s a huge opportunity for companies in this space. Many of them have made prevention strategies top priorities within their companies and their diabetes divisions, and I think we will offer companies in the diabetes space a real opportunity to be clear leaders. Again, that’s going to require us to sit down and talk about what that’s going to entail and sign an agreement, but I think that many diabetes companies are going to find value in it because number one, it’s going to help the companies communicate to their customers and other key constituents that they are not just talking, but also really willing to go the extra mile to join the fight against obesity and obesity-related causes of diabetes. I think that this has actually been a very interested group of people for us to work with, and I’ve already had some good communications with some of them, so I’m really excited about what that offers us. As far as patients go, I think we are starting with our first goal of touching industry, but our goal after that is touching patients.
In particular, I think we’re going to reach out to families, and moms who are making a lot of the decisions on some of these key issues. It’s funny coming from me, because you know me as a real fighter and a lobbyist from my background, but coming from where we are right now as a neutral broker, I don’t think we will use the families in efforts to lobby companies. Instead, we will be trying to bring together families and key opinion leaders that companies would find valuable for communicating all the good they are doing through their own networks.
Kelly: This was a wonderful opportunity to speak with you. We will be following your work closely.
In collaboration with the Partnership for a Healthier America, Wal-Mart announced a major initiative in January 2011 to increase and improve healthy food choices. The company has committed to reformulate its packaged food products, make healthy foods more affordable, and educate consumers on healthy choices through front-label packaging. By 2015, Wal-Mart intends to reduce sodium in its packaged food products by 25% and reduce added sugars by 10%. The company also stated that it will save consumers $1 billion each year in lower prices for fresh fruits and vegetables, and the company said it will also work to reduce price premiums on “better-for-you” items.
Bright Horizons, a provider of employer-sponsored childcare, early education, and work/life solutions, also recently announced a major deal with the Partnership for Healthier America. In June, it said it would eliminate fried foods and sugar-sweetened beverages during mealtime in its nearly 600 childcare centers (hurrah!). Bright Horizons also pledged to continue its emphasis on promoting family-style dining, encouraging in-center breastfeeding, and providing at least one to two hours of physical activity per day at its health centers, just as the US Department of Health and Human Services recommends all children receive.
In July, First Lady Michelle Obama announced the Partnership for a Healthier America’s collaboration with Wal-Mart, SuperValu, and Walgreens, as well as several regional retailers, in opening fresh grocery outlets in food deserts. Since 2007, Wal-Mart has opened 218 stores in areas that lack access to healthy foods, and the company plans to open up to 300 more stores in food deserts by 2016. In the next five years, SuperValu intends to open 250 Save-A-Lot stores in food deserts, and Walgreens will convert or open at least 1,000 food oasis stores that offer a larger assortment of fresh fruits, vegetables, and whole grains. In addition, several regional grocers also promised to open stores in food deserts. Calhorn Grocer, a local chain based in Alabama, said it would open 10 stores over the next five years, which would serve at least 10,000 individuals in low-access areas. Brown’s Super Store committed to building one store and expanding one store in food deserts near Philadelphia, and Klein’s Family Markets said it would open one store in an underserved area in Baltimore. The California Endowment pledged $200 million to support the opening of stores in food deserts, and the federal government pledged $35 million this year and possibly $300 million next year. We sure hope this makes it through the red tape of deficit reduction – to end childhood obesity, significant investment by the government is needed today.
