In an op-ed published today in the Orlando Sentinel, Sarah Peck, director of PHAI’s #UnitedOnGuns initiative along with Northeastern Professor James Alan Fox consider the impact of lingering trauma from the horrific Pulse Nightclub shooting, which occurred 5 years ago on June 12, 2016.
Peck and Fox note that the psychological toll on survivors, families, first responders, and others in the community is substantial and long-lasting. Recovery requires time and resources. Unfortunately, Florida Governor DeSantis has slashed funding for families and survivors of the attach who are in need of recovery services. These needs are not only relevant to the Pulse Shooting survivors and families, but to those of all mass shootings.
In many ways, the recovery response of Orlando Mayor Buddy Dyer has been a model, but continued funding is needed to assist with recovery services that are still needed more than five years after such a traumatic and tragic event.
Breastfeeding protects against overweight and obesity, asthma, eczema, and type-II diabetes, and has long-term health benefits for women. The health benefits of breastfeeding are so valuable that in 1981, the World Health Organization established the International Code of Marketing of Breast-Milk Substitutes (WHO Code) that prohibits marketing infant formula to the public. The U.S. has not adopted the WHO Code and currently has few protections from most digital marketing to adults. As a result, the vast amount of consumer data expectant parents and infant caregivers generate as they navigate daily life can be used to target them with digital advertising for infant formula.
This report explores the policy frameworks and self-regulatory bodies that govern the use of sensitive consumer information about pregnancy and infant feeding used to market infant formula. It addresses the following questions:
How do marketers identify expectant parents and infant caregivers?
What digital marketing tactics are used to promote infant formula?
What laws and policies govern the collection and use of consumers’ pregnancy and infant-feeding-related information?
What role do company privacy policies and user agreements play?
How can self-regulation be used to limit infant formula marketing?
The report contains recommendations for how to better protect the public from infant formula marketing by the infant formula industry and through third-party retailers and digital platforms like Facebook and Google. Issue briefs on the topics of Consumer Privacy, Self-Regulation and Recommendations for Action summarize key findings from the full report.
Ben Kelley, a leading authority on automotive safety, is a member or the Board of Director for the Public Health Advocacy Institute. Recently he published a scholarly article and op-ed discussing the safety implications of autonomous, i.e., “self-driving,” vehicles.
The article appeared in the Journal of Public Health Policy. JPHP is co-published by another of our board members, Anthony Robbins. The article examines key safety issues in long transformation to autonomous vehicles.
The op-ed appeared in the excellent investigative journalism site, FairWarning.org and, in a shorter form, in the Oregonian. It considers the impact of Trump Administration policies that may impact the safety of autonomous vehicles.
The Boston Globe has published on opinion piece by PHAI’s executive director, Mark A. Gottlieb, which summarizes the organization’s legal research concluding that paid Daily Fantasy Sports games are illegal under Massachusetts law. The piece, entitled, “Fantasy Sports Gambling is Illegal Under State Law,” explains the law and several reasons why it is important to enforce it.
Gottlieb argues that Daily Fantasy Sports games operated by DraftKings and FanDuel are a consumer rip-off as currently operated with almost all of the winnings going to full-time professionals. He goes on to criticize Internet gambling as posing a threat to current and potential compulsive gamblers, and that it is inconsistent with the limited casino gambling authorized by the state.
Massachusetts is among several states considering regulatory approaches to these games. Six states have banned them entirely.
The Coca-Cola Company’s pouring of millions of dollars into the Global Energy Balance Network (GEBN), a front group focused on exercise as opposed to diet to combat obesity, has crystallized an issue that the public health community has long been concerned about: the role of industry funding to research and develop solutions to public health threats. A New York Times story exposing this funding arrangement has led to a public relations nightmare that finally culminated in a formal statement from Coke’s Chairman and CEO, Muhtar Kent. Mr. Kent stated that the accusation that the company is deceiving the public about its support for scientific research “does not reflect our intent or our values,” and promised more transparency. He promised to make available a list of the funding it supports, and to convene expert panels to assist with future “investments in academic research.”
Coke’s funding of GEBN is part of a well-articulated company strategy it calls “Balancing the Debate.” Coca-Cola’s chief scientific officer, Rhona S. Applebaum , PhD, laid out the Balancing the Debate strategy at a 2012 conference for the sugar industry. (CLICK HERE FOR THE FULL PRESENTATION) The strategy seeks to discredit what the company calls “detractors” in the scientific community like Kelly Brownell, Dean of the Sanford School of Public Policy at Duke University (formerly of Yale University), and public health organizations like Center for Science in the Public Interest.
At that 2012 industry conference, Ms. Applebaum told participants that she had come with a “plea from Coca-Cola” that “we all have to work together and use science.”
To that end, Ms. Applebaum, shared Coke’s strategy to “Balance the Debate” by using three interdependent steps: “Cultivate Relationships,” “Collaborate Research,” and “Communicate Results.” These steps, if properly taken, will result in a balanced debate that will “Address the Negative” and “Advance the Positive” for the food industry.
Ms. Applebaum, was clear that cultivating relationships and research collaborations comes down to dollars and cents. She outlined how to use research funding for “defensive and offensive science and research” to address the issues faced by the food industry.
The GEBN seems to have been tailor-made for the offensive and defensive research Coke had in mind, and it amplifies and expands the mission and capabilities of Coke’s Beverage Institute for Health and Wellness, which is run by Ms. Applebaum. On a slide entitled “What Experts Tell Us,” Ms. Applebaum gave insight into the company’s research agenda to “Shift energy balance,” “Inspire/Motivate consumer behavior change,” and “Bring opportunities (on energy in/out).”
To add a gloss of legitimacy to Coke’s vision for funding science to serve its agenda, its chief scientific officer, Ms. Applebaum, co-authored two papers: one in 2009 with guiding principles for industry funding of food science and nutrition research, and one in 2012 with guiding principles for establishing panels of scientific advisers. With respect to funding food science and nutrition research like that conducted by GEBN, Ms. Applebaum co-wrote the following guiding principles:
In the conduct of public/private research relationships, all relevant parties shall:
1) conduct or sponsor research that is factual, transparent, and designed objectively; according to accepted principles of scientific inquiry, the research design will generate an appropriately phrased hypothesis and the research will answer the appropriate questions, rather than favor a particular outcome;
2) require control of both study design and research itself to remain with scientific investigators;
3) not offer or accept remuneration geared to the outcome of a research project;
4) prior to the commencement of studies, ensure that there is a written agreement that the investigative team has the freedom and obligation to attempt to publish the findings within some specified time frame;
5) require, in publications and conference presentations, fully signed disclosure of all financial interests;
6) not participate in undisclosed paid authorship arrangements in industry-sponsored publications or presentations;
7) guarantee accessibility to all data and control of statistical analysis by investigators and appropriate auditors/reviewers; and
8) require that academic researchers, when they work in contract research organizations or act as contract researchers, make clear statements of their affiliation; require that such researchers publish only under the auspices of the contract research organizations. (emphasis added).
These guiding principles clearly were not adequately followed in the case of Coke’s funding of the GEBN, and it remains to be seen what other research it has been cultivating as part of its effort to “balance the debate.” Moreover, the whole concept of funding “defensive and offensive science and research” is completely at odds with the principles of objective research design contained in the guiding principles.
Coke has had a concerted effort to fund science in its favor pursuant to a specific plan laid out by its chief scientist in 2012, and it failed to adequately follow the ethical guidelines its chief scientist helped to write in 2009. The remedies CEO Kent now promises are to disclose who the company has funded (something, according to their chief scientist, the company should have already been doing), and enlisting more experts to help sort things out. For Coke’s CEO to say that the criticism of actions that were clearly in line with a well-articulated Coca-Cola Company strategic plan and failed to comply with basic ethical principles co-written by its chief scientific officer “does not reflect” the company’s “intent” or “values” is partly right and partly wrong. It clearly reflects Coke’s intent to fund science to serve its interests. It does not, however, reflect the purported values of the company with respect to working with scientific researchers.
One of the Public Health Advocacy Institute’s founding board members, Ben Kelley, is a longtime auto safety expert with considerable experience with the issue from both in and outside of government. He has just published an op-ed in the Los Angeles Times (and Fair Warning) that benefits from his long memory of General Motors’ apologies and promises made to Congress over nearly a 50-year span. It puts GM’s failure to recall its defective ignition systems in a new and especially unflattering light. It also describes the difference in regulatory interest from Congress in 2014 as compared to 1966.
In a study examining availability of water fountains in schools published in the May, 2014 issue of the CDC journal, Preventing Chronic Disease,
PHAI’s senior staff attorney, Cara Wilking, along with CDC researchers, Stephen J. Onufrak and Sohyun Park found that state plumbing codes were a predictor of whether and how many water fountains were available to children.
Because the availability of plain drinking water to schoolchildren is an important strategy to reduce sugary beverage intake of empty calories, understanding the factors that facilitate or frustrate prevalence of water fountains is a key to successful implementation of this strategy.
In an editorial published in the May, 2014 issue of the journal, Tobacco Control, PHAI’s Executive Director, Mark Gottlieb, calls the FDA’s approach to implementation of the Family Smoking Prevention and Tobacco Control Act, “Overcautious,” and urges the agency and the White House to take a much more aggressive approach to saving lives.
The summary of the editorial, entitled “Overcautious FDA has Lost its Way,” states:
Five years after the passage of the Family Smoking Prevention and Tobacco Control Act, little progress has been made in the effort to regulate the US tobacco industry and advance the public health goals of tobacco control. Legal challenges by the tobacco industry, and evidence of political interference from the White House have resulted in the US Food and Drug Administration’s (FDA) overcautious approach toward advancing a meaningful regulatory agenda. While the White House bears final responsibility, it is incumbent upon the FDA and its Center for Tobacco Products to become more aggressive and seize the extraordinary opportunity to save lives that the Family Smoking Prevention and Tobacco Control Act has created.
Despite the capabilities of the FDA’s Center for Tobacco Products and its director, Mitchell Zeller, who directed the FDA’s tobacco efforts in the 1990s under commissioner David Kessler, progress in meaningfully regulating tobacco products is moving at a glacial pace. Predictably, the tobacco industry is utilizing its full legal arsenal to challenge and delay FDA’s efforts. It is becoming apparent that the White House is also responsible for the FDA’s inaction through delays caused by its Office of Management and Budget.
Gottlieb believes that the agency should be: (1) eliminating menthol; (2) regulating nicotine levels to reduce dramatically abuse liability and toxic exposure; (3) implementing arresting and effective graphic warnings; (4) facilitating an increase of the national minimum tobacco sales age to 21; and (5) responsibly controlling new tobacco products’ entry into the market. This is simply not happening.
Gottlieb suggests that because litigation by the tobacco industry to challenge regulatory action is inevitable, the best strategy is for the FDA to use the best available evidence now and rollout the regulatory agenda as fast as the law will allow. Delay only serves to benefit the industry and, consequently, increase the morbidity and mortality that the industry’s products cause in the United States.
Another suggestion by Gottlieb is for FDA to consider how Sharon Eubanks, lead attorney for the U.S. Department of Justice, handled similar legal and political challenges when litigating the racketeering case, U.S. v. Philip Morris.
The editorial concludes by noting that, “[t]here exists no better public health opportunity of any kind than this one, now in the hands of the FDA. They should run with it, not from it.”
After much criticism and prodding, Fast food giants McDonald’s and Burger King agreed to depict healthier food options in advertising directed at children. Researchers at the Norris Cotton Cancer Center at Dartmouth-Hitchcock, along with the Public Health Advocacy Institute (PHAI) at Northeastern University School of Law, found that attempts to honor these pledges by depicting healthier kids’ meals frequently go unnoticed by children ages 3 to 7 years-old. In research published on March 31, 2014 in JAMA Pediatrics, these researchers found that one-half to one-third of children did not identify milk when shown McDonald’s and Burger King children’s advertising images depicting that product. Sliced apples in Burger King’s ads were identified as apples by only 10 percent of young viewers; instead most believed that the ads were depicting french fries.
Children in the study were confused by the images of food. One typical participant said, “And I see some…are those apples slices?”
The researcher replied, “I can’t tell you…you just have to say what you think they are.”
“I think they’re french fries,” the child responded.
“Burger King’s depiction of apple slices as ‘Fresh Apple Fries’ was misleading to children in the target age range,” said principal investigator James Sargent, MD, co-director Cancer Control Research Program at Norris Cotton Cancer Center. “The advertisement would be deceptive by industry standards, yet their self-regulation bodies took no action to address the misleading depiction.”
Mark Gottlieb, Executive Director of PHAI and an author of the study, observed that, “when young children believe they will be getting french fries with their meals because of deceptive or confusing advertising imagery, they may insist that the adult bringing them orders french fries instead of apple slices. Likewise, if advertising leads children to expect a sugary drink rather than milk, they may well end up getting the sugary drink. This has the effect of undermining the self-regulatory pledges that the companies made.”
Study author and PHAI Senior Staff Attorney Cara Wilking said she found it, “troubling that fast food giants would publicly make a self-regulatory pledge, fail to live up to the pledge, and receive no sanction from the relevant self-regulatory body. Such failures suggests that self-regulation is often more about public relations than about fulfilling the role of actual governmental regulation.”
Sargent and his colleagues studied fast food television ads aimed at children from July 2010 through June 2011. In this study researchers extracted “freeze frames” of Kids Meals shown in TV ads that appeared on Cartoon Network, Nickelodeon, and other children’s cable networks. Of the four healthy food depictions studied, only McDonald’s presentation of apple slices was recognized as an apple product by a large majority of the target audience, regardless of age. Researchers found that the other three presentations represented poor communication.
This study follows an earlier investigation conducted by Sargent and his colleagues, which found that McDonald’s and Burger King children’s advertising emphasized giveaways like toys or box office movie tie-ins to develop children’s brand awareness for fast food chains, despite self-imposed guidelines that discourage the practice.
While the Food and Drug Administration and the Federal Trade Commission play important regulatory roles in food labeling and marketing, the Better Business Bureau operates a self-regulatory system for children’s advertising. Two different programs offer guidelines to keep children’s advertising focused on the food, not toys, and, more specifically, on foods with nutritional value.
“The fast food industry spends somewhere between $100 to 200 million dollars a year on advertising to children, ads that aim to develop brand awareness and preferences in children who can’t even read or write, much less think critically about what is being presented.” said Sargent.
Ben Kelley, a leading authority on automotive safety, is a member or the Board of Director for the Public Health Advocacy Institute. Recently he published a scholarly 
