Nancy Glick

A message for National Minority Health Month: Take obesity seriously

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Nancy GlickBy Nancy Glick, Director of Food and Nutrition Policy

As National Minority Health Month in April comes to a close, It is a good time to take stock of the health status of the more than 125 million Americans of color or 38.4 percent of the population now living in this country.

The good news is that improvements in disease prevention are saving lives. For example, more minority women are getting mammogram screenings for breast cancer, getting treatment with antibiotics earlier, and seeking counseling for smoking cessation.  As a consequence, Hispanic, American Indian, and Asian women all have lower death rates from heart disease when compared with white women and breast and lung cancer deaths have been declining steadily among African American women.

But while we can celebrate these advancements, now is the time to be even more mindful of the minority health problems that are often discounted and go untreated. And here, no problem needs our attention more than the disease of obesity, where people of color face an unequal burden of weight-related chronic conditions and premature death due to significant disparities in medical care.

In sheer numbers and its toll on death and disability, obesity has reached crisis proportions in the US. According to the Centers for Disease Control and Prevention, the adult obesity rate now exceeds 40 percent – the highest level ever recorded. And the costs are staggering.  Not only is obesity a serious disease by itself, but it worsens the outcomes of over 230 chronic conditions including type 2 diabetes, heart disease, and certain cancers. Thus, obesity is responsible for 300,000 premature deaths each year and costs the U.S. economy over $1.72 trillion annually in health costs.

But these statistics only begin to document the problem. Obesity disproportionately affects Black and Brown communities and is now one of the most serious health equity issues facing the nation. Due to higher rates of obesity among communities of color, Black adults are 1.5 times as likely to experience stroke, 40 percent are more likely to have high blood pressure and 60 percent are more likely to be diagnosed with diabetes than White adults. Additionally, Hispanics are 1.7 times more likely to have diabetes than Whites, Asian Americans are 40 percent more likely to be diagnosed with diabetes, and Native Hawaiians/Pacific Islanders are 2.5 times more likely to have diabetes and 3.9 times as likely to experience a stroke.

The threat is real, but hand ringing is not the answer. Obesity is a treatable disease, just like type 2 diabetes and hypertension. Yet obesity remains largely undertreated by healthcare providers.  As documented in a National Consumers League report issued in July 2022, 108 million adult Americans have obesity, but only 30 million adults have been diagnosed with the disease (source:  PharMetrics-Ambulatory EMR database, 2018. Novo Nordisk Inc.).

Compounding the problem, only 2 percent of those eligible for treatment with FDA-approved anti-obesity medicines (AOMs) have been prescribed these drugs. This means that very few Americans with obesity are benefiting from a new class of safe and effective medicines that control appetite and cravings to achieve significant weight loss. According to a study published in the New England Journal of Medicine, use of one of these drugs resulted in more than a 20 percent reduction in obesity when added to lifestyle modification.

While there are many reasons why obesity is going undiagnosed and untreated, the most pernicious are insurance barriers that keep people from getting the care they need. This includes government policy that allows states to define what are the essential health benefits that must be covered under any Affordable Care Act (ACA) marketplace plan sold on state health insurance exchanges. Yet, despite the ACA’s guarantees of providing all essential health benefits to consumers, a 2016 analysis by the Obesity Care Advocacy Network (OCAN) found that 24 states excluded coverage for weight/obesity management services in their benchmark marketplace plans, resulting in blatant discrimination against people with obesity.

An equally troubling situation involves the Medicare program, which prohibits coverage for FDA-approved anti-obesity medicines based on a policy dating back to 2003 when these drugs did not exist. This resistance to change leaves millions of seniors, particularly members of Black and Latino communities, vulnerable to disability, disease and premature death due to lack of treatment. Moreover, the extent of the disparities in obesity care will only get worse in the coming years if the status quo remains. As documented in a March 2023 report from AmerisourceBergen, the total number of Black, Native American, Asian, and Hispanics eligible for Medicare is predicted to more than double by 2038, many of whom will have obesity and a different set of chronic conditions than what Medicare is currently prepared to address.

Then, there is the Medicaid program operated by the states, which covers about three in ten Black, American Indian and Native Hawaiians/Pacific Islanders under age 65 and more than two in ten Hispanic adults. While Medicaid has helped narrow longstanding disparities in health coverage and access to care for people of color, this is not true for those Medicaid beneficiaries living with obesity. Today, only 15 Medicaid programs cover anti-obesity medications in fee-for-service Medicaid, and only four additional programs cover anti-obesity medications under at least one Medicaid managed-care plan. Moreover, only two states cover anti-obesity medications in benchmark Marketplace plans.

Adding to these coverage disparities, 15 million people on Medicaid – 30 percent of whom are Hispanics and 15 percent are African Americans  – could lose access to their health coverage in the coming months. This is due to the end of a federal program that paid states to add more low-income and disabled residents to the Medicaid rolls during the COVID-19 pandemic.

Already, five states – Arizona, Arkansas, Idaho, New Hampshire, and South Dakota – have begun to disenroll people and by the end of June, 34 states and the District of Columbia will cut their Medicaid rolls, either due to their income status or for procedural reasons, such as not completing renewal forms. For this reason, advocates are using all available levers to help enrollees keep their Medicaid coverage and to assist those dropped from the program to find coverage through the Affordable Care Act’s marketplace or other options.

While this is a short-term solution, it is part of the national commitment by the public health community, minority health leaders, clinicians, patient advocates, and consumer organizations to change outdated and discriminatory policies that restrict coverage and access to obesity treatments. Our message is clear: the health of all Americans depends on taking obesity seriously and ensuring that those with the disease receive timely, comprehensive obesity care.

Debunking the myth of prepared foods being cheaper and healthier

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By Ryan Barhoush, Food and Nutrition Program Associate

As we finish the holiday season (maybe a few pounds heavier) and get ready to put in place our New Year’s Resolutions, we recommend making one of them NOT buying prepared foods. and Instead, commit to cooking up healthier, cheaper, and quicker meals from scratch. With minimal shopping and prep time, we can all feed ourselves and our families with healthier options. Let’s debunk a few of these prepared food myths.

Myth 1. It takes too much time to shop for healthy food 

Grocery stores in the U.S. can be overwhelming, and we all feel the stress of walking into these sometimes exceptionally large stores, but do not be intimidated!  You can easily tackle the task of shopping quickly and efficiently with some practice and shopping discipline. In fact, if you do it right, you can be in and out of the store in 20-30 minutes with a healthy grocery basket full of food for you and your family. Here is how:

  • Make a shopping list and stick to it
  • Shop online and get your groceries delivered, or
  • Identify your favorite grocery store, get to know where products are and get in and out efficiently.

Myth 2. Prepared and frozen foods have the same nutritional value as a home cooked meal.

Prepared frozen meals are loaded with sodium and sugar; home cooked meals typically have much lower levels of both, thus are healthier and more nutritional.

Let’s compare some labels to prove it.  Start with one of most popular frozen food items, pizza. We looked at the Red Baron brand and compared its nutritional content to a standard meal of baked chicken, broccoli, and potatoes.

The results are staggering. One slice of the pizza contains 810 mg of sodium. The Dietary Guidelines for Americans  recommends adults limit sodium intake to less than 2,300 mg per day—that’s equal to about 1 teaspoon of table salt!  For children under age 14, recommended limits are even lower.

So, one slice of pizza is one-third of the total recommended daily intake. High sodium in prepared foods contributes to the hypertension epidemic in the U.S. Nearly half of adults in the United States (47%, or 116 million) have hypertension, defined as a systolic blood pressure greater than 130 mmHg or a diastolic blood pressure greater than 80 mmHg according to the CDC. Hypertension can lead to stroke, heart attack and other serious illnesses.

Red Baron’s Frozen Pizza Roasted Chicken with Potatoes and Broccoli
One serving of Red Baron’s is 380 calories per slice!

 

 Amount per serving 353 calories
39g of carbohydrates

 

 29g of carbohydrates
18g of Total fat

 

  8g of Total fat

 
45mg of cholesterol

 

  89mg of cholesterol

 
810mg of sodium per slice* 106mg of sodium

 
* That’s 3240 mg of sodium per pizza! Almost 1000 mg over the daily recommended limit!

 

Myth 3. It takes too much time to cook healthy meals for myself or my family. 

Meal prep can be amazingly fast, efficient, and fun! There are many websites with healthy meals that can be prepared in 5-10 minutes, with cooking times of 30 minutes or less. For example, this one: “The best meal of the day doesn’t have to take your whole day!  I have compiled a list of 25 easy weeknight dinners to get you in and out of the kitchen in a flash.”  

Myth 4. Prepared frozen foods are cheaper than shopping and cooking my own food.  

Wegmans and other grocery stores have suggestions for affordable nutritious meals, as low as $2.75 a serving. Each 20.6 oz. Baron Frozen Pizza costs from $4.99-6.25 plus tax and includes four servings. But if you look at the label closely, each serving is one piece of pizza and that is an unrealistic serving size for an adult’s meal. Let’s say one pizza feeds two people, that doesn’t include anything else besides the pizza, such as salad or other side dishes. That is at least $2.50 – $5 a person. Already the frozen prepared food option is more expensive than a tofu dinner with vegetables or a chicken dinner with potatoes and broccoli.

Another great place to find affordable, filling, healthy and easy recipes is the Delish website. The internet is full of great suggestions but stay away from sites that suggest using canned soups or packaged or frozen prepared foods, because they are often filled with elevated levels of sodium, sugar, and fat.

Myth 5. I only have a microwave, I do not have a kitchen, or the right kind of cooking utensils.

Do not be discouraged. With the unbelievable amount of cooking videos on social media you would think you would need a commercial kitchen just to have a normal healthy meal. Today with just a microwave you can still make many healthy meals. Check this out: 20 Easy to Cook Microwave recipes.

Also, electric stove tops are a terrific addition to any household. Even without a kitchen, just a few pots and pans and some YouTube videos; you could be well on your way to being a kitchen-less chef! Dried fruits and nuts are easy and healthy snacks that you do not have to store in the fridge. Apples and pears are great fresh fruit that do not need to be refrigerated.

As you can see, there are many ways to avoid processed foods and create healthy meals at a reasonable price. Here are a few links we include to create healthy, fast home-cooked meals that are reasonably priced. Plus, cooking for your family is fun and an effective way to get everyone together around the table. Good luck, eat healthy and enjoy!

Nancy Glick

Alcohol labeling: We’re in it to win it

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Nancy GlickBy Nancy Glick, Director of Food and Nutrition Policy

For historians, 2003 will be remembered as the year that the space shuttle Columbia crashed, scientists finished sequencing the human genome, and the U.S. launched war against Iraq.

But 2003 also marks an important milestone for American consumers. In December of that year, three national consumer organizations – the National Consumers League (NCL), Center for Science in the Public Interest (CSPI), and the Consumer Federation of America (CFA) – first petitioned the federal government to require an easy to read, standardized “Alcohol Facts” label on all beer, wine and distilled spirits products. This sparked a 19-year battle that is finally paying off for the estimated 67 percent of Americans[1] who drink alcoholic beverages.

In 2003, the Nutrition Facts label on processed foods and non-alcoholic beverages had been in use for almost a decade (1994) and many consumers said they frequently or almost always read the label. Thus, public acceptance and use of the Nutrition Facts label created built-in public support for an Alcohol Facts label. In fact, polling NCL commissioned in both 2005 and 2007 showed overwhelming public support for comprehensive alcohol labeling. Now, polling consistently shows that 75 percent of Americans think alcoholic beverages should have standardized alcohol content labels and 72 percent say this labeling will encourage responsible alcohol use.

Even more significantly, not knowing what is in a beer, wine or distilled spirits drink increases the risk for overconsumption of alcohol, a serious and costly public health problem. According to the latest research findings, alcohol is a source of empty calories that contribute to obesity,[2] and can impact blood sugar control in people with diabetes.[3] Additionally, alcohol is a roadway killer accounting for about 30 percent of all traffic crash fatalities in the U.S.,[4] and excessive drinking increases the risk of liver disease, hypertension, cardiovascular disease, alcohol use disorders, certain cancers and severe injuries.[5] Consequently, an estimated 140,000 people in the United States die annually from alcohol- related causes,[6] which is why the cost of excessive alcohol use reached $249 billion in 2010 and is likely higher today..[7]

Based on this documented evidence, the 2003 petition, which was also signed by 73 nutrition/public health organizations and experts, called for a label that gives consumers the needed information to make responsible drinking decisions, such as the serving size, amount of alcohol and calories per serving, the percent alcohol by volume, and the number of standard drinks per container. And yet, the lead federal agency that regulates alcoholic beverages – the Alcohol and Tobacco Tax and Trade Bureau (TTB) – deliberated but failed to take meaningful action for almost two decades.

The arcane process started in 2005 with an advance notice of proposed rulemaking, which produced over 19,000 public comments. In 2006, TTB issued another notice of proposed rulemaking on allergen labeling followed by a notice in 2007 on alcohol and nutrition labeling. Unfortunately, however, TTB allowed these proposed rules to languish, ultimately deciding in 2013 to issue a voluntary rule allowing companies to decide what nutrition and calorie information to disclose – and what to keep hidden. Not surprisingly, many manufacturers opted out of TTB’s program so most alcoholic beverage products on the market remain unlabeled or carry incomplete information.

Even with these setbacks, the consumer community kept up the pressure on TTB because the need for alcohol labeling has only increased. This became apparent during the COVID-19 pandemic when a 2020 RAND study charted a 14 percent increase in alcohol consumption among adults over age 30 in one year.[8] Another national study found that excessive (binge) drinking increased by 21 percent during the pandemic, with the potential for 8,000 additional deaths from alcohol-related liver disease by 2040.[9]

And then, the sand started to shift. Also related to the pandemic, consumer demand skyrocketed for hard ciders, some types of beers, wine coolers and the other low-alcohol drinks sold in supermarkets and convenience stores and what consumers saw were complete alcohol labels on these products. This is because low-alcohol drinks fall under the purview of the Food and Drug Administration, not TTB. Armed with this evidence, NCL leaders met online with Department of Treasury and TTB officials in June 2021 and put TTB in the uncomfortable position of having to explain why often the same manufacturers who must put a standardized content label on brands regulated by FDA don’t bother to do so when their products are under TTB’s jurisdiction.

Not long after this meeting, the Treasury Department conducted its own review and on February 9, 2022, issued a report, Competition in the Markets for Beer, Wine and Spirits, that advanced the importance of labeling information to foster competition within the beverage alcohol industry. The report contains several recommendations, including the recommendation that “TTB should revive or initiate rulemaking proposing ingredient labeling and mandatory information on alcohol content, nutritional content, and appropriate serving sizes.”

This was encouraging news, so NCL doubled down, combining forces with CSPI and the Consumer Federation of America to get TTB to mandate alcohol labeling across the board. Recognizing that public pressure alone will not ensure success, the organizations turned to Congress, hosting briefings for lead staffers of the House and Senate appropriations committees with jurisdiction over TTB’s budget and sending a joint letter to key Congressional leaders from 23 consumer, health/nutrition, and alcohol policy organizations about the need for mandatory alcohol labeling. This led to report language in the draft House and Senate 2023 appropriations bills that encourages TTB to initiate a final rulemaking.

The last step was filing a lawsuit against TTB in the United States District Court for the District of Columbia on October 3, 2022, asking the court to direct TTB to grant or deny the 2003 petition within 60 days. The lawsuit was a gamble, but it worked: on November 17, 2022, TTB accepted the 2003 petition and committed to publish three rulemakings covering mandatory nutrient and alcohol content labeling, mandatory allergen labeling, and mandatory ingredient labeling within the next year.

However, this is not the end of the story. The proposed rules will be accompanied by open public comment periods where we can anticipate that segments of the alcohol industry will be aggressive in fighting robust consumer labeling.  Therefore, NCL will also be actively engaging a wide range of stakeholders to weigh in on behalf of consumers so the American public to have access to standardized and complete labeling information on beer, wine and distilled spirits. It has taken 19 years to get to this point, but our message is clear: alcohol labeling is long past due, consumers overwhelmingly want to see it, and we will stay in the fight until alcohol labeling is a reality.

[1] Gallup. Alcohol & Drinking. July 2022

[2] U.S. Department of Agriculture and U.S Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9Th Edition. December 2020.

[3] Emanuele NV, et al. Consequences of Alcohol Use in Diabetics. Alcohol Health Res World. 1998; 22(3): 211–219.

[4] National Highway Traffic Safety Administration. Risky Drunk and Drugged Driving Statistics.

[5] U.S. Centers for Disease Control and Prevention. Alcohol and Public Health. Last reviewed April 14, 2022. https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm

[6] U.S. Centers for Disease and Control Prevention. Deaths from Excessive Alcohol Use in the U.S. Page last reviewed April 14, 2021. https://www.cdc.gov/alcohol/features/excessive-alcohol-deaths.html . Accessed June 2, 2022.

[7] U.S. Centers for Disease Control and Prevention. Alcohol and Public Health. Page last reviewed April 14, 2022. https://www.cdc.gov/alcohol/features/excessive-drinking.html. Accessed June 2, 2022.

[8] Pollard MS, et al. Changes in Adult Alcohol Use and Consequences During the COVID-19 Pandemic in the US. JAMA Netw Open. 2020;3(9):e2022942.

[9] Julien J, et al. Effect of increased alcohol consumption during COVID-19 pandemic on alcohol-associated lover disease: A modeling study. Hepatology. Vol. 75; Issue 6; June 2022; 1480-1490.

Food safety tips this holiday season

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By Ryan Barhoush, Food and Nutrition Program Associate

As we are gearing up for this upcoming holiday season, food safety  is something important to keep in mind. If this is your first time or even your 20th being the Thanksgiving head chef, it is always good to review some simple safety tips in the kitchen. There is nothing worse than getting your relatives sick…unless that is the only way to get your uncle to stop talking about politics at the table. Just kidding, of course. Here are some food safety recommendations from National Consumers League for Turkey Day tomorrow. Happy Holidays!

Roasting a Turkey this year? Don’t be intimidated but keep these ideas in mind.

  • Keep poultry separated from other items in the fridge.
  • If brining a turkey, make sure it is properly secured or in a cooler away from your other food items. Be careful of spillage or drippings from contaminating other items.
  • If thawing a frozen turkey in the fridge, allow about 24 hours for each 4 to 5 pounds of Turkey
  • Never thaw a turkey by just laying it out on the counter, this could lead to bacteria growth, even if it is frozen.
  • You can thaw in cold water, keep it in a bag to prevent contamination, and change the water every 30 minutes. It takes about 30 minutes per pound to defrost a frozen turkey.
  • Remember to wash your hands before and after handling the turkey. Every time!
  • Use separate cutting boards and scrub with warm, soapy water after use.
  • Use a thermometer and make sure your turkey has an internal temperature of 165 degrees.

Frying a turkey? Don’t be scared but be aware of the risks!

  • Never leave oil unattended, even a small amount of oil reaching a lit flame can cause a large fire.
  • Make sure your turkey is dry and completely thawed! Pat dry the inside and the outside of the turkey. Any kind of moisture can cause combustion when in contact with oil.
  • Do not overfill the fryer with oil. Pre-test the oil levels with something in the same weight range as your turkey.
  • Always fry a turkey outside, away from the house, and on level surfaces.
  • Keep children and animals away from the fryer, even after use, as oil can remain hot for hours.
  • Remember that the sides and handles will be dangerously hot.
  • Have an all-purpose fire extinguisher nearby.

Besides the turkey, here are few more things to keep your eye on in the kitchen.

  • Be mindful of the “danger zone”. Bacteria and germs can grow rapidly between 40 and 140 degrees.
  • Keep warm food with warm food and cold food with cold food!
  • Don’t leave out any food past two hours
  • Don’t put warm leftovers away in the fridge
  • Follow these steps and enjoy a safe and Happy Thanksgiving!
Nancy Glick

At last: FDA is updating the definition of a “healthy” food

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Nancy GlickBy Nancy Glick, Director of Food and Nutrition Policy

It is rare when new regulations from the Food and Drug Administration (FDA) warrant a song. But borrowing a phrase from Sam Cooke, FDA’s recent proposed rule changing the meaning of the term “healthy” has been a long time coming – 28 years to be exact. Yet, as the song goes “a change is gonna come.”

Why is this a good thing? Simply put, the term “healthy” is out-of-date, both with the state of nutrition science today and with the latest Dietary Guidelines for Americans, recommendations from experts on what to eat and drink to meet nutrient needs, promote health, and prevent disease.

Going back to 1994 when FDA’s old definition of “healthy” went into effect, the agency focused on individual nutrients in a food, not the actual foods we eat. Accordingly, foods now qualify as “healthy” if they are low in total fat, saturated fat, cholesterol and sodium and must contain a significant amount of fiber and at least two additional beneficial nutrients such as vitamins A, C, D, calcium, iron, protein, or potassium. This covers about 5 percent of foods, including white bread, highly sweetened yogurt, and sugary cereals.

The problem is that many healthy foods do not qualify for the use of a “healthy” claim based on FDA’s outdated standards. This includes avocados, nuts, seeds, olive oil, and salmon because they are high in fats now known to be heart healthy. And right now, plain, non-carbonated water and plain, carbonated water cannot be labeled as “healthy,” which makes no sense.

These absurdities have been apparent to consumer organizations for decades, but the impetus for change was the introduction of the KIND bar in 2015. KIND advertised its bars as healthy because they contain whole foods like nuts and grains, but because the nuts have more fat than what FDA now allows for a “healthy” claim, the agency sent a warning letter about the use of the claim.  When KIND responded with a Citizen Petition that documented the healthfulness of nuts, FDA permitted KIND to use the term “healthy” and issued a proposed rule change in 2016, signaling its intention to revise the definition.

At the same time, nutrition science has evolved over 28 years. Not only is it clear that not all fats and carbohydrates are the same but getting the nutrients needed for a healthy diet result from making food choices based on healthy dietary patterns. This understanding is especially noteworthy because more than 80 percent of Americans consume too much added sugars, saturated fat and sodium but aren’t eating enough vegetables, fruit and dairy, according to the Dietary Guidelines for America, 2020-2025.

Based on these developments, FDA’s proposed rule will do away with counting individual nutrients in a food. Instead, FDA’s plan is to define the term “healthy” on food packaging based on two criteria:

  1. The product must contain a certain “meaningful amount” of food from at least one of the food groups recommended by the Dietary Guidelines, such as fruits, vegetables, or dairy; and
  2. The food must stay within specified limits for certain ingredients, such as saturated fat, sodium and added sugar, based on a percent of the Daily Value (DV) of the nutrient. This includes a limit for sodium of 230 milligrams (mg) per day, or 10 percent of DV per serving – an important action by itself since Americans on average consume 50 percent more sodium per day than is recommended in the Dietary Guidelines.

The proposed rule is also consistent with recent changes to the Nutrition Facts label. For example, the Nutrition Facts label must now declare added sugars to help people maintain healthy dietary practices.

Applying these criteria, a cereal could only carry a “healthy” claim if contained ¾ ounces of whole grains and no more than 1 gram of saturated fat, 230 milligrams of sodium and 2.5 grams of added sugars. This would disqualify almost all breakfast cereals now marketed to children.

To help make the new “healthy” claim meaningful for consumers, the FDA is also researching a symbol that food manufacturers can use on the front of the package. The symbol would act as a quick signal that the food contributes to a healthy dietary pattern and is part of a labeling system the National Consumers League has long supported.

FDA’s proposed rule addresses several of NCL’s food policy issues. For many years, we have been pressing for a new definition of the term “healthy” that aligns with the latest nutrition science and we support a “Traffic Light” symbol to depict “healthy” foods on the front of the package. We also have been at the forefront in pressing for ways to lower excess sodium in the diet.

But while we believe FDA’s plan is a significant step forward for consumers, there are still some shortcomings. Although the Dietary Guidelines call on consumers to limit calories from added sugars and fats, FDA’s proposed rule fails to consider calorie limits.

Moreover, the new rules won’t stop “healthy” products from being loaded with artificial colors and will have the unintended consequence of incentivizing food processors to replace natural sugar with questionable artificial sweeteners and sugar alcohols without disclosing these ingredients. Even as NCL has advocated for a modernized definition of the term “healthy,” we have been supporting a Citizen Petition to ensure transparent labeling of substitute sweeteners, which have surged in use by more than 300 percent in the last five years and can produce digestive effects. The Citizen Petition asks FDA to add the term “sweetener” in parentheses after the name of all non-nutritive sweeteners in the ingredient list, and for children’s food and beverages, to indicate the type and quantity of non-nutritive sweeteners, in milligrams per serving, on the front of food packages.

FDA published its proposed rule, Food Labeling: Nutrient Content Claims; Definition of Term “Healthy,” in the Federal Register on September 29, 2022, and is encouraging anyone interested in the topic to submit written comments by December 22. NCL plans to use this opportunity to ensure the consumer’s voice is heard and to offer solutions that will advance better food and beverage choices. We all have a stake in labeling claims that are science-based and ensure that consumers have access to more complete, accurate, and up-to-date information about the foods they consume and serve their families.

Ad-Blocking: Is it a dirty word or good security practice? – National Consumers League

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Ad blocking is a dirty word for many in the online publishing and advertising industries. The head of one of the largest industry associations famously called a AdBlock Plus, one of the biggest ad blocker software companies an “unethical, immoral, mendacious coven of techie wannabes.”Why the hate? Unsurprisingly, the answer comes down to money. As their name suggests, ad blocking technology allows Web users (i.e. you and me) to prevent advertisements from appearing in desktop and mobile browsers. When consumers don’t see ads online, websites don’t make as much money, which makes it harder to produce the content that draws users in the first place. In the publishing industry’s nightmares, this threatens to create a vicious cycle that leads to the end of free content on the Web.

The advertising industry’s heartburn about ad blockers is driven by the explosive growth of the technology. As of December 2016, nearly one in five (18 percent) Web users in the United States had an ad blocker installed on their browser. In other countries, the use of ad blockers is far higher. For example, 58 percent of Web users in Indonesia and 29 percent of German users use ad blockers. Globally, the number of devices using ad blocking software grew by 142 million from 2015-2016, a trend which shows no signs of slowing, particularly on mobile devices.

That said, there are efforts to address the need for consumers to have ad blockers installed in the first place. For example, on June 1 Google confirmed reports that it plans to have its Chrome browser automatically block ads that do not conform to advertising standards published by the Coalition for Better Ads. That standard prohibits egregious ads that do things like autoplay videos, take up too much screen real estate, or make users wait to see content while an ad displays.

Given Google’s 53 percent market share, this announcement has the potential to significantly improve consumers’ data security. That’s because insecure ads can pose a significant malware threat to users. A May 2015 study by Google, the University of California, Berkeley and University of California, Santa Barbara found that tens of millions of visitors to Google’s services had unwanted adware installed on their computer. Within that group, half had at least two, and nearly one-third of users had at least four such programs infecting their machines. A similar study by security firm Namogoo found that 15-30 percent of e-commerce website visitors were infected with malware that causes them to view injected ads, malicious links, and fraudulent spyware on otherwise legitimate sites.

Given these threats, moving ad-blocking into the mainstream could have a significantly positive impact on consumers’ vulnerability to malware. By dramatically increasing the number of users with ad-blocking technology on their browsers, the pressure on the worst offenders in the advertising ecosystem to clean up their acts in increased. When users see fewer bad ads, it increases user trust in online advertising overall. In the long term and somewhat counterintuitively, this may actually reduce the need for users to rely on third-party ad blockers to help reduce their data security risk.

The New York Times has called the growth of ad blocking an “existential threat” to the $50 billion online advertising industry. It is therefore serendipitous that the ultimate solution to the war over ad blocking may be more, not less ad blocking.

The failure of the AHCA is a victory for the American people – National Consumers League

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j_johnson92.jpgSpotlight on Health Care Series, Part 2: As America’s health care system is facing uncertainty, NCL staff is exploring the topic in a new weekly blog series.

Ding dong, the bill is dead! Democrats, health advocates, patients, and consumers across the country are rejoicing after the GOP’s first attempt to repeal and replace major pieces of the Affordable Care Act (ACA) crashed and burned. Republicans ultimately could not coalesce around House Speaker Paul Ryan’s (R-WI) American Health Care Act (AHCA) and, in a stunning turn of events, the bill was pulled from the House floor without a vote last Friday.While inability to build a solid block of support for the AHCA in Congress became painfully obvious over time, the American people made their disdain of the bill apparent from the start. In the weeks following its introduction, citizens from every corner of the nation fervently expressed their disgust with the attack being waged on their health care. By the time the would-be vote was to have taken place, the AHCA had a meager 17 percent public approval rating, according to a Quinnipiac poll. Though dismal, this figure is hardly surprising, as the bill did nothing to improve access to care or quality of coverage for a clear majority of Americans – and, in many cases, the bill would have left many worse off than before the ACA.

The AHCA touted several policy changes that would have undoubtedly wreaked havoc on our health care system. Paramount was the spending cap (read: MASSIVE CUT) on Medicaid, the defunding of Planned Parenthood, an exponential premium increase for older Americans, a cost shift from the federal government to states and their citizens, and a general rationing and reduction of care to cover massive tax cuts for the wealthy. Arguably, one of the bill’s most odious aspects was the elimination of the essential health benefits – a measure put on the table in a last-ditch effort to get the unyielding, far-right, so-called “Freedom Caucus” block of the House on board. The essential health benefits are 10 services the ACA requires all plans to cover, including maternity and newborn care, ambulatory services, preventive and wellness services, and substance use treatment that can address issues such as the opioid epidemic ravaging communities across the country. Women of child-bearing age would have experienced significantly higher health care costs due to the elimination of maternity care and contraception from the standard benefits package – and they would either have considerably higher premiums than their male counterparts or be forced to pay for their maternity care or contraceptive methods out-of-pocket.

In addition, the AHCA would have effectively gutted consumer health protections, particularly for patients with pre-existing conditions, by eliminating out-of-pocket caps and reinstating lifetime coverage limits. In the long run, adequate care would be far beyond the reach of many Americans who would be left with bare-bones coverage and a higher cost burden. What is worse, by 2026, 24 million Americans would lose their coverage altogether. Americans heard that message loud and clear and they didn’t like what they heard.

While we can breathe a sigh of relief that the ACA is still the law of the land, NCL is among the many groups that agree that the ACA needs some tweaks to make it work better for all Americans. Now more than ever, a bipartisan approach to bringing affordable care and coverage to ALL Americans is not only desired, but essential. Rather than trying to undermine the ACA, Republicans and Democrats should embrace this opportunity to work together to come up with solutions that address the current insufficiencies in health care and make our system one that works for everyone.

The defeat of the AHCA is a big victory for the American people. The persistence and hard work of everyday Americans who spoke up, who called their members of Congress, who attended rallies, wrote to their local papers, and used social media ultimately made the difference. The National Consumers League, which since our inception in 1899 has spoken up for consumers and supported health insurance for all Americans, is proud to have stood alongside our colleagues in the consumer and public health communities in this battle to defend our care and oppose policies that would send us backward. We will continue to fight to protect the ACA, preserve consumer health protections, and argue that it is good for the economy and good for America’s future if all of us have access to health care coverage.

Medicaid per-capita caps: A recipe for disaster – National Consumers League

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j_johnson92.jpgSpotlight on Health Care Series, Part 1: As America’s health care system is facing uncertainty, NCL staff is exploring the topic in a new weekly blog series.

No matter how you slice it, the proposed changes to Medicaid in the GOP’s new health care bill are not a spending compromise–but rather a massive cut in funding that will decimate the Medicaid program as we know it.House Republicans recently introduced the American Health Care Act (AHCA) as a first step in fulfilling their promise to repeal and replace the Affordable Care Act (ACA).  The AHCA would cut $880 billion in federal support for state Medicaid programs over the next decade, while dramatically altering the funding structure of Medicaid from a flexible federal entitlement to a rigid per-capita cap. Under the current system, the federal government matches state Medicaid spending as enrollment increases and health care needs change. The new plan proposed by Republicans would cap federal funding solely based on the number of Medicaid enrollees.

This cap would not match the dynamic nature of health care. If Medicaid spending increases–perhaps due to a natural disaster, a sudden disease epidemic, or even a breakthrough drug the state wants to cover–states would be left to foot the bill for any costs over the strict per-person cap. This policy also makes Medicaid particularly susceptible to deeper cuts in the future; if Congress succeeds in divorcing federal support from the actual cost of providing health care, it will have greater liberty to continue to slash funding over time to generate more federal savings.

Republicans assert that the capping approach will slow the growth of Medicaid and expand states’ flexibility to innovate and provide patients with the care they want. The reality is, rather than curtailing spending, the costs will simply shift away from the federal government and onto the backs of state governors–sending state budgets into turmoil and placing millions of Americans at risk. Ultimately, states will be faced with the choice of raising taxes on their residents to meet funding needs, cutting funding from critical programs such as infrastructure or education, or imposing devastating cuts to Medicaid eligibility, benefits, and coverage for millions.

Among those most severely affected by a Medicaid spending cap are rural communities, where at least one-quarter of residents rely on public insurance. Several health crises already plague this population, including the onset of disease in coal workers and the Opioid epidemic. These issues, among many others, have contributed to a spike in the mortality rate of lower and middle class white Americans, and a huge reduction in federal funding would only further limit states’ ability to respond.  Capping will also have negative ramifications for children, who account for approximately 40 percent of the Medicaid population. According to the Center on Budget and Policy Priorities (CBPP), a slash in funding for Medicaid will have devastating consequences for children’s health, educational attainment, and earning potential, leading to long term damage to state economies. In short, this colossal overhaul of Medicaid would jeopardize health care for our country’s most vulnerable populations.

Today, 70 million low-income and disabled Americans rely on Medicaid to fulfill its guarantee to provide coverage for all eligible men, women, and children just as it has done for over 50 years. The GOP proposal reneges on that guarantee. Capping funding for a program that serves as an essential lifeline for so many will not lead to a more efficient health system or healthier Americans–it’s a recipe for disaster.

EITC Awareness Day: Millions of Americans eligible for tax break – National Consumers League

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SG_HEADSHOT.jpgThis blog post was originally published in the Huffington Post.

If someone told you that you may be one of the more than five million Americans missing out on as much as $6,269 in prize money, you’d almost certainly dismiss it as a fantasy or fraud, right? What if I said that you could get that prize money without paying a dime? It definitely sounds too good to be true, I know.

Fortunately, millions of working families actually can get a significant check from the federal government, thanks to the Federal Earned Income Tax Credit (EITC). For more than 40 years, the EITC has been, by many accounts, the nation’s most successful anti-poverty program. Last year, it lifted 6.5 million Americans out of poverty, including 3.3 million children, and reduced the severity of poverty for another 21.2 million qualifying workers. Studies show that the tax credit is used by working families to pay for necessary expenses like home and auto repairs and to boost earning power by getting more education. This in turn allows large numbers of single parents to leave welfare for work, saving taxpayers money.

Despite these benefits, more than 20 percent of people who qualify for the EITC fail to claim it. We think that’s because many consumers are never made aware of the EITC due to a lack of reliable, affordable tax preparation resources in their communities.

January 27 is EITC Awareness Day, which is a perfect time to make sure that every American who qualifies for the EITC knows about it. That’s why the National Consumers League is working to promote free tax preparation services like Baltimore’s CASH Campaign, whose volunteers are ready to help educate the one in five workers who are missing out on this benefit. The Baltimore CASH Campaign is one of the 12,000 Volunteer Income Tax Assistance (VITA) programs that the IRS relies on to help qualifying individuals prepare and file their taxes, free of charge.

Working families making less than $64,000 per year can also take advantage of free name-brand tax preparation software offered through the IRS’s Free File program. An added benefit of using resources like VITAs and Free File is that they can help taxpayers navigate a new wrinkle this tax season. Because of a new law designed to protect consumers from tax identity fraud, the IRS will hold refund checks until February 15 for consumers claiming the EITC. This is important, because there are likely to be unscrupulous tax preparers who promise they can get EITC-qualified taxpayers their refunds sooner than February 15. In reality, any money a consumer gets before February 15 will probably be in the form of a refund anticipation loan, which comes loaded with predatory fees.

On EITC Awareness Day and throughout this tax season, let’s make sure that the Earned Income Tax Credit gets the credit it’s due. Working families should be able to keep 100 percent of the money they’ve earned. Thanks to programs like VITAs and IRS Free File, they can.

A threat to public health: Resurfacing of the anti-vaccine movement in Trump presidency – National Consumers League

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clare.jpgGuest blog by Clara Keane, a graduate of Drew University, Madison, NJ.

In the midst of a news avalanche in recent days as the Senate holds hearings for cabinet positions and new information breaks out related to Russian hacking, it is easy to miss what may be the most dangerous development of the incoming Administration: reopening vaccine skepticism and linking vaccinations to autism.On Tuesday, January 10, just ten days before President-elect Trump’s inauguration, Robert F. Kennedy Jr., an anti-vaccine crusader with no medical training who alleges causation between vaccines and autism, said that he accepted the position of chair to a new commission on vaccinations. In a statement from the transition team, spokeswoman Hope Hicks did not confirm Kennedy’s claims, although she did say that Trump is considering creating a commission on autism.

President-elect Trump has spoken out against vaccines multiple times in the past, although it was not discussed in great detail on the campaign trail. As is the case for determining Mr. Trump’s beliefs on many issues, Twitter provides some insight. In a tweet from 2012, Mr. Trump wrote: “I’m not against vaccinations for your children, I’m against them in 1 massive dose. Spread them out over a period of time & autism will drop!” Mr. Trump shows an alarming disregard to the facts, both in scientific research and in current medical practices.

The only study ever published that connected vaccinations to autism appeared in a 1998 issue of the Lancet and has since been completely discredited as a fraud. The study, which included only 12 handpicked cases, now serves as a textbook example of the danger of poorly executed experiments and the importance of sample size and representation in scientific studies. Returning to the warnings of a “massive dose,” a quick look at the CDC’s childhood vaccine schedule reveals that vaccines are administered in precise intervals from birth through age six.

Sadly, President-elect Trump is not alone questioning solid science. According to a national survey conducted by the National Consumers League in 2013, while most survey respondents (87 percent) say they support mandatory vaccination of school-aged children in theory, 64 percent of adults say parents should have the final say about whether or not to vaccinate. In addition, 33 percent think there’s a link between vaccines and autism.

How did we get to the point where vaccines—one of the greatest public health achievements of the 20th Century that have, among other things, eradicated smallpox globally and polio in the U.S.—are being considered by some as unnecessary or even damaging to their children’s wellbeing? Two equally dangerous contributing factors at play are the distance that vaccination success has granted us from the cruel reality of these diseases and the continued stream of false claims linking vaccines with autism.

It is easy to take for granted the security we enjoy from devastating diseases like polio, which was declared eradicated in the U.S. in 1979. However, it is important to remember that in the 1950’s, polio outbreaks caused more than 15,000 cases of paralysis each year in the United States. Parents during these dark times witnessed their children becoming paralyzed and were told there was nothing doctors could do to help. We are fortunate not to have these worries today. But in order to maintain the luxury of a polio-free nation, we must continue to have full participation in vaccinations. The Disneyland California measles outbreak of 2014 is but a small example of what can happen when people choose to stop vaccinating their children. According to a CDC report, among the 110 California patients, 45 percent were completely unvaccinated and only one percent had the full three doses that are recommended.

The reason for opting out of vaccinations may have felt safe for parents because those children had been protected by the surrounding children who were fully vaccinated. This concept is known as “herd immunity.” However, when large numbers of people stop vaccinating, disease breaks into the herd, as was the case in California. Indeed, the California outbreak led pediatrician and California state Senator Dr. Richard Pan, who was honored by NCL at our 2016 Trumpeter Awards Dinner, to sponsor legislation in California doing away with the “personal exemption” option for parents who don’t want to vaccinate their children.

The CDC lists some individuals who should forego vaccination, such as people with cancer and those with compromised immune systems. Because these people have no choice but to rely on herd immunity, members of the herd who are not vaccinated because of personal choice are causing an even bigger public health risk to those who are advised not to be vaccinated.

We must not take for granted the privilege of living in a society where parents no longer have to worry about a child’s death or disability from polio, whooping cough, diphtheria, hepatitis, measles, mumps, chicken pox, or influenza. It is remarkable that we have access to enough vaccines for the entire population and at no cost to parents. We cannot sacrifice this security. For this reason, we reject the messages of those fanning the flames of false information and promote fear of these life-saving vaccines.

So what might the new Administration mean for vaccine laws? Stat News provides a useful guide to what the President-elect can and can’t do. Of course, he will not be able to control vaccination schedules, but he may appoint agency officials who raise questions about vaccine safety. This should trouble all Americans because it puts our children and all immune-compromised Americans at risk of illness and even death. NCL plans to speak out in support of mandatory vaccinations and against false connections between vaccines and autism. We will continue to remind Americans how lucky we are in 2016 not to have to worry that any of us—but especially our children—will become sick, crippled or die of diseases. We have very safe and very effective vaccines to thank for that reality.