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Since 1989, the NCI SCLD Program has monitored laws and resolutions covering numerous cancer-related topics. As of June 30, 2011, the database contained more than 8,000 records divided between general legislation and year-end status. General legislation records are abstracts of individual legislative measures (bills, resolutions, and ballot measures); year-end status records incorporate a stream of codified legislation related to a particular topic.
The SCLD Program added obesity prevention as a topic area in July 2010, with a baseline of state laws enacted as of December 31, 2009.
Acknowledgment: The authors thank Min Qi Wang, Ph.D. , The MayaTech Corporation, for his contributions to the demographic data analysis.
The Database
Standard Resources
- SCLD Program Web site
- SCLD Update quarterly newsletter and Legislative Data Byte
- Topical fact sheets and data table
Regina el Arculli, M.A. National Cancer InstituteOffice of Government and Congressional RelationsBuilding 31, Room 10A4831 Center Drive, MSC 2580Bethesda, MD 20892-2580Phone: 301.496.5217, Fax: 301.402.1225e-mail: [email protected]
Jamie Weinstein, M.P.H.Center for Health Policy and Legislative AnalysisThe MayaTech Corporation1100 Wayne Avenue, Suite 825Silver Spring, MD 20910Phone: 301.587.1600, Fax: 301.587.0709e-mail: [email protected]
Conference Presentations
Analysis of SCLD data and development of oral and poster presentations for scientific and professional organization meetings
The Web site is located at www.scld-nci.net.
National Cancer Institute’s State Cancer Legislative Database (SCLD): Decreasing obesity and promoting healthy communities by increasing access to healthy foods through state food policy�Jamie Weinstein, M.P.H.1, Jennifer Noll Folliard, R.D., M.P.H.1, Monica Holloway1, Shereitte C. Stokes IV, Ph.D., M.P.H.1, Regina el Arculli, M.A.2
Presented at the American Public Health Association Annual Meeting Washington, DC November 1, 20111The MayaTech Corporation 2National Cancer Institute
Methods and Limitations
Approach: The SCLD Program utilizes: (1) a standard approach to identifying and abstracting relevant state legislation and adopted resolutions; (2) data dictionary and hierarchical keyword system; (3) quality control procedures; and (4) multiple data output formats.
Limitations: The SCLD does not contain state-level regulations; executive orders; measures implemented by counties, cities, or other localities; opinions of Attorneys General; or data addressing the implementation of state laws. Although coverage of Medicaid and Medicare law is not comprehensive, some SCLD records include these data.
• Excess body weight has been linked to chronic diseases including certain cancers.
• The International Agency for Research on Cancer estimates that obesity and physical inactivity may account for 25 to 30% of several major cancers (Vainio and Bianchini, 2002). Studies estimate that 3.2% of all new cancers are linked to obesity (Polednak, 2003) and 14% of deaths from cancer in men and 20% of deaths in women are due to overweight and obesity (Calle, et al., 2003).
• The problem is exacerbated in underserved populations (Ward et al. 2004, Haynes and Smedley, 1999).
- The obesity rate for African Americans exceeds 40% in 15 states compared to the rate for Whites, which exceeds 30% in only four states.
- Individuals who have not completed high school have higher rates of obesity compared to only one-fifth of college graduates.
- Lower income earners have higher obesity rates than those at the highest income levels.
Centers for Disease Control and Prevention. U.S. Obesity Trends. Trends by State 1985-2010. Available at: www.cdc.gov/obesity/data/trends.html.
Background
Federal Efforts to Address Obesity Prevention by Decreasing Food Disparities
Federal – State Partnerships Addressing Food Disparities
• School Reimbursable Meals – National School Lunch Program (NSLP), National School Breakfast Program (NSBP), Summer Feeding Program (SFP), After-School Snack Program
- Children from families with incomes at or below 130% of the poverty level are eligible for free meals. Those with incomes between 130% and 185% of the poverty level are eligible for reduced�price meals, for which students can be charged no more than 40 cents.
• Senior Farmers' Market Nutrition Program (SFMNP)
- Provides low-income seniors with coupons that can be exchanged for fruits, vegetables, herbs and honey at farmers' markets, roadside stands and community supported agriculture (CSA) programs, and promotes the use and expansion of farmers' markets, roadside stands, and CSA programs throughout the country.
• WIC Farmers' Market Nutrition Program (FMNP)
- Provides locally grown fruits and vegetables through farmers' markets to WIC participants, and expands the awareness and use of farmers' markets.
• Supplemental Nutrition Assistance Program (SNAP)
- Helps low-income households put food on the table by providing electronic benefits that are redeemed for food at authorized stores.
• Let’s Move!
- The White House initiative is focused on five pillars:
1. Creating a healthy start for children; 2. Empowering parents and caregivers; 3. Providing healthy food in schools; 4. Improving access to healthy & affordable foods; and 5. Increasing physical activity
SCLD Program Resources
Contacts
Role of the Federal Government
• Sets the agenda for the country’s priorities
- Through Funding & Program Initiatives
• Policy Floor - Nutritional Guidelines
- WIC, SFMNP, & SNAP
- NSLP and NSBP
• New guidelines for NSLP & NSBP in January 2012 will closely mirror 2010 Dietary Guidelines for Americans
Role of the States
• Administration of Food Assistance Programs
• State Interventions
- State may provide additional funding for NSBP, NSLP, SNAP, & SFMNP
- May require more stringent nutritional guidelines than federal policy floor
- May require NSBP, and/or NSLP in schools with severe need
• Mandatory includes laws addressing the requirement that schools serve reimbursable meals.
- States that mandate school participation in a federal reimbursable meal program, such as Arizona (Ariz. Rev. Stat. § 15-242), OR
- Virginia, in which school boards must establish school breakfast programs in public schools in which 25% or more of enrolled school-age children were eligible to receive free or reduced-price meals in the federally funded lunch program during the previous school year. (Va. Code Ann. § 22.1-207.3)
• Reimbursable Meals Expansion includes laws addressing the expansion of the NSLP, NSBP or Snack Programs by: 1. increasing state funds or adding new components to the programs; or 2. increasing access to and implementation of the program(s).
- In Washington, to the extent funds are appropriated, the Superintendent may award grants to school districts to: (1) increase participation in school breakfast and lunch programs, (2) improve program quality, and (3) improve the equipment and facilities used in the programs. Also contingent upon appropriation, the Superintendent must increase state support for school breakfasts and lunches. (Wash. Rev. Code Ann. §§ 28A.235.140 and 28A.235.150 to 28A.235.160)
State Laws Mandating Reimbursable Meals and Addressing Reimbursable Meals Expansion
(Enacted as of June 30, 2011)
CA
NM
LA
NC
MA
RI
NH
MD
DC
WA
CO
TX
AR
IL IN
MI
NJ
Laws Mandating State Reimbursable Meals (n=13)
Laws Mandating State Reimbursable Meals and Addressing Reimbursable Expansion (n=10)
Laws Addressing Reimbursable Meals Expansion (n=5)
States with Food Environment Laws Addressing Health Disparities�(Enacted as of June 30, 2011)
States’ Efforts to Increase Access to Reimbursable Meals: Laws Covered in the SCLD
KSMO
GA
SC
VAWV
OH
PA
AZ
ME
States’ Efforts to Increase Access to Healthy Foods: �Laws Covered in the SCLD
• Farmers’ Markets: Laws addressing any public market where farmers or vendors sell their goods directly to the public consumer.
• Demonstration Program: Laws addressing food environment programs of a specific duration that are planned as a test or a trial in order to assess feasibility, effectiveness, and/or efficacy (e.g., pilot program).
• Access to Healthy Foods: Laws addressing primary cancer prevention/obesity prevention with a goal of reducing health/food disparities by improving access to healthy foods (e.g., fruits and vegetables, nuts, dairy, lean meats, etc.) and/or programs to reduce food insecurity.
• Environmental Risk Prevention: Laws addressing primary cancer prevention programs that include provisions to reduce environmental cancer risk factors (e.g., environmental toxins) with a goal of reducing health disparities.
• Financial Incentives: Laws addressing programs that provide primary cancer prevention/obesity prevention through implementation of financial incentives to influence people's purchasing behavior with the goal of reducing health/food disparities.
• Vouchers: Laws addressing primary prevention programs that include provisions to reduce health disparities and use a type of payment authorization provided by the state to be used only for covered services related to primary cancer prevention.
Examples
LA HB 840: Creates the Louisiana Sustainable Local Food Policy Council within the state Department of Agriculture and Forestry, for the purpose of building a local food economy benefiting the state by increasing consumer access to fresh and nutritious foods, and providing greater food security for all citizens of the state, among other things.
IL HB 4756: Requires the state Department of Human Services and the state Department of Agriculture to implement a Farmers' Market Technology Improvement Program to increase access to fresh fruits and vegetables, quality meat , and dairy for all Illinois residents.
VT
Number of Laws
1
2
3
4
5
11
3 3
2 2
3
22 2
1 1 1 1 1 1 1 1 1 1
Ariz
ona
Ark
ansa
sCa
lifor
nia
Colo
rado
Conn
ectic
utD
istr
ict o
f Col
umbi
a
Flor
ida
Illin
ois
Loui
sian
a
Kent
ucky
Mai
neM
assa
chus
etts
Neb
rask
aN
ew Y
ork
Nor
th C
arol
ina
Penn
sylv
ania
Texa
s
Wis
cons
in
Was
hing
ton
Iow
a0
Farmers' Markets
WIC/SNAP AcceptedNon WIC/SNAP Accepted
Percent of Minority Populationby Census Tract
0.0 - 20.520.6 - 42.943.0 - 74.975.0 - 91.091.1 - 100.0
Community Demographic of Farmers' Markets:Race, District of Columbia
Farmers Markets
WIC/SNAP Accepted
Non WIC/SNAP Accepted
Percent Less Than a 4-Year College Degree (Age 25-64)by Census Tract
0.0 - 22.6
22.7 - 44.3
44.4 - 63.9
64.0 - 79.3
79.3 - 100
Community Demographic of Farmers' Markets:Education, District of Columbia
Farmers' Markets
WIC/SNAP Accepted
Non WIC/SNAP Accepted
Percent Below Poverty Levelby Census Tract
0.0 - 10.1
10.2 - 22.2
22.3 - 34.7
34.8 - 54.5
54.6 - 97.0
Community Demographic of Farmers' Markets:Poverty, District of Columbia
Community Demographic of Farmers' Markets: Race, California
Farmers' Markets
WIC/SNAP Accepted
Non WIC/SNAP Accepted
Percent of Minority Populationby Census Tract
0.0 - 19.4
19.5 - 33.8
33.9 - 49.2
49.3 - 67.0
67.1 - 100.0
San Francisco
Oakland
San Jose
Sacramento
Stockton
Fresno
Los Angeles
Santa Ana
AnaheimLong Beach
San Diego
San Francisco
Oakland
San Jose
Sacramento
Stockton
Fresno
Los Angeles
Santa Ana
AnaheimLong Beach
San Diego
Community Demographic of Farmers' Markets: Education, California
Percent Less Than a 4-Year College Degree (Age 25-64)by Census Tract
0.0 - 18.3
18.4 - 26.4
26.5 - 33.8
33.9 - 42.0
42.0 - 100.0
Farmers' Markets
WIC/SNAP Accepted
Non WIC/SNAP Accepted
Community Demographic of Farmers' Markets: Poverty, California
Percent Below Poverty Level by Census Tract
0.0 - 13.0
13.1 - 23.0
23.1 - 34.0
34.1 - 49.0
49.1 - 100.0
Farmers' Markets
WIC/SNAP Accepted
Non WIC/SNAP Accepted
San Francisco
Oakland
San Jose
Sacramento
Stockton
Fresno
Los Angeles
Santa Ana
AnaheimLong Beach
San Diego