Wellness

Providence Food Labeling Policy Memo

“Organic”, “All-Natural”, and “Locally Produced” are all great initiatives in the momentum of sustainable food and agriculture, but they will all remain buzz words unless standards are set in place. These standards are currently out of reach due to the lack of transparency within the industry. Right now, there seems to be a deliberate veil between us and where our food comes from, rendering us powerless. We need an ideal label not from the perspective of marketers, but from consumers.

Current Laws and Regulations:

We are proposing this policy memo that aims to establish a transparent labeling system for all food products beginning with raw fruits, vegetables, and fish. Currently, food labeling for raw products are not required within Providence and the United States. According to Chapter 1 Sec. 101.45 of the FDA guidelines, nutrition labeling of raw fruits, vegetables, and fish are voluntary. No other kind of labeling is mentioned nor required. Food safety relies on the FDA's importation laws and local production laws, which are harder to trace and therefore traditionally have not been transparent either.

U.S. Government intervention in labeling began in 1906 with the Federal Pure Food and Drugs Act and the Federal Meat Inspection Act, which authorized Federal regulation of the safety and quality of food and prohibited sales of misbranded or adulterated foods. Lawmakers’ primary objective in passing the acts’ labeling regulations was to enhance fair competition by cracking down on deceptive marketing practices. Enhancing fair competition and market efficiency has remained the primary motivation behind food labeling regulation for the past 100 years.

Current Problems:

The current law only mentions voluntary labeling or health- and nutrition-related (HNR) claims which are most often "Low Fat", "Sodium Free", "Organic", "All-Natural", and "Locally Produced". Since they are voluntary however, these are not held to stringent standards. This kind of labeling just leads to consumer confusion. Companies that produce food that is anything but natural can use loopholes and vague language in current laws to label their food as natural.

Even within the required packaged food labeling, there are issues regarding transparency. Ingredients are all placed under an umbrella. If a product is using corn, it does not matter what type of corn it is.

One snapshot of this crisis is the debate over GMO products. Unlike strict safety evaluations required for the approval of new drugs, the safety of genetically engineered foods for human consumption is not adequately tested. Drugs are also labeled with possible side effects, which certain types of food has on the human body as well. As seen from a public health point of view, this lack of transparency in Providence can lead to an untraceable epidemic that can have sever adverse effects on sustainability. More than 60 countries including the EU, Japan and China already label GMO products.

This kind of lack of control and limited labeling is a sustainability problem. Our current "normal" agricultural industrial model that we rely on and its distribution has a lot of negative impacts on all sectors of sustainability including environment, equity, and economy. Lack of food sourcing transparency leads to nutritional issues and foodborne-illnesses but most importantly it creates an inefficient distribution of power through manipulation. Empowerment and choice are stifled when there is a lack of transparency.

Figure 1.1 Map with Farmers’ Markets, Grocery Retail Locations (2013) and Low Income and Low Access Tracts, as of 2010

Figure 1.1 Map with Farmers’ Markets, Grocery Retail Locations (2013) and Low Income and Low Access Tracts, as of 2010

Figure 1.2 Map with Farmers’ Markets, Grocery Retail Locations (2013) and Estimated percent of adults reporting to be obese (a body mass index of 30 or greater) in 2013.

Figure 1.2 Map with Farmers’ Markets, Grocery Retail Locations (2013) and Estimated percent of adults reporting to be obese (a body mass index of 30 or greater) in 2013.

As seen with Figure 1.1, location of farmers markets and grocery retail locations are abundant. Yet, there is still a lack of access to food especially for low income groups. The next map Figure 1.2 shows us that there is a moderately high case load of adults reporting to be obese (BMI of 30 or greater). There also seems to be a correlation between lower obesity and the proximity of a farmers market. One cause of this health issue is lack of both access to nutritional food and proper food education.

Figure 2.1 Food at home ($000), 2015 by Census Tracts of Providence

Figure 2.1 Food at home ($000), 2015 by Census Tracts of Providence

Figure 2.2 Food at home ($000), 2015 by Census Tracts of United States

Figure 2.2 Food at home ($000), 2015 by Census Tracts of United States

According to Figure 2.1, citizens in Providence pay an average of $5,797 per year for food at home. This is very high when compared to the American average of $2,273 per year for food at home according to the USDA. As seen in Figure 2.2, expenditure for food is much lower in central America, where food production is higher. Cost is decreased due to transportation and processing.

 

Figure 3.1 Map with Estimated percent of people age 16 years or older who were employed in Agriculture, Forestry, Fishing and Hunting Industry between 2009-2013

Figure 3.1 Map with Estimated percent of people age 16 years or older who were employed in Agriculture, Forestry, Fishing and Hunting Industry between 2009-2013

Currently as seen with Figure 3.1, percent of agriculture, forestry, fishing and hunting industry is quite small compared to other industries within Providence. This showcases the lack of local production of food, which is correlated to higher food prices and lack of access.

Figure 4.1 Trend of Vegetables: Per Capita Availability in the US

Figure 4.1 Trend of Vegetables: Per Capita Availability in the US

Figure 4.2 Trend of Fruits: Per Capita Availability in the US

Figure 4.2 Trend of Fruits: Per Capita Availability in the US

This lack of access is not only a Providence issue but a nationwide one as well, according to information provided by the USDA. As seen in Figure 4.1 there is a clear decrease in vegetable availability in the US. Fruits on the other hand has been more stable but also shows dips in availability according to Figure 4.2.

Policy Memo:

This new policy memo provides all the necessary information to completely inform the consumer and aid their choices. The information provided will include but is not limited to:

  • Type of Seed Used (GMO or not)
  • Type of Fertilizer Used
  • Location of Farm
  • Location of Processing
  • Type of Processing
  • Additives Used
  • Date of Planting
  • Date of Harvest
  • Recommended Shelf Life

Alongside the aforementioned information, food will also be required to include a "stoplight" label that is based on a standardized 15-point scale. The color of the product will be determined by where it falls in this scale: 0 to 5 is red, 6 to 10 is yellow, and 11 to 15 is green. The scale is based on three key factors including nutrition and health benefits, how close the product is to real food, and production. The last metric involves quality of treatment of workers, animals, and the earth. According to a study done by the American Journal of Public Health, sales of red-lighted soda fell by 16.5% in only three months of implementation.

One factor of a successful memo is its scalability. This labeling system can be applied to all different sectors of the industry and start with a few products first. For the test pilot, this label will be first applied to apples in Providence supermarkets. Once successful, it can trickle down to all other raw food and even packaged food.

Supermarkets were chosen as the initial target because most of the parties involved in the food system converge here in where food is collected, distributed, and consumers vote with their dollars. Without transparent food systems, accountability is impossible, and the industry will be continuously motivated by inefficient market forces. By providing more information, consumers are able to make decisions that are based on facts rather than in marketing.

Impact:

This policy memo tackles the issue in where most impact can be made, by changing market forces through educating the public and increasing access. By improving access to healthy produce, Providence could reduce rates of nutrition-related disease, like diabetes and heart disease. Since many diseases are caused by - or at the very least, correlated with - poverty, improving access to healthy food for low-income communities in Providence leads to a healthier city overall.

According to a study done by the Economic Research Service as seen with Figure 5.1, a large amount of people surveyed would use nutrition information in fast-food/pizza place in deciding what to order.

Figure 5.1 Survey of Who Would Use Nutrition Information in Full-Service Restaurants in Deciding What to Order

Figure 5.1 Survey of Who Would Use Nutrition Information in Full-Service Restaurants in Deciding What to Order

As seen with Figure 5.2, availability of labels and guidelines have proved to be effective in affecting consumer choice. In a study conducted by the USDA, the whole-grain industry grew significantly when the 2005 dietary guidelines were released. This further supports the need for a new kind of transparent label.

Figure 5.2 Trend on Whole-Grain Product Introduction by Manufacturers

Figure 5.2 Trend on Whole-Grain Product Introduction by Manufacturers

Aside from health, this policy memo improves all sectors of sustainability. Environmentally, local food is better because it decreases transportation, processing, and shipping costs. Reversing industrial agriculture into a more ecological practice would decrease carbon emission, water run-off, and increase soil productivity. Economically, local food is cheaper and stimulates the local economy. It gives the state more financial independence and more resilient over nationwide financial fluctuations. With regard to equity, the information provided will highlight local farming and more ecological agricultural practices that are more beneficial to health. This would increase local food production. When food is sourced locally, it becomes more affordable and thus more accessible for more people. It also provides more jobs within the region.

The attached figures shown are just a few of the metrics that can gauge the success of this policy memo. With our current data, there is a clear need for this policy but it can have many more positive externalities. It has the ability to really impact and improve lives through creating a sustainable environment that enables smarter growth.

Sources:

 

"A 2-Phase Labeling and Choice Architecture Intervention to Improve Healthy Food and Beverage Choices." American Public Health Association -. Accessed October 22, 2015.

Law, Alex. "The DARK Act Makes Absolutely No Sense, And Here's Why." The Huffington Post. Accessed October 22, 2015. 

"Food Policy: Check the List of Ingredients." USDA ERS -. Accessed October 22, 2015. 

Gregory, C., T.A. Smith, and M. Wendt. 2011. How Americans Rate Their Diet Quality: An Increasingly Realistic Perspective. U.S. Department of Agriculture, Economic Research Service, EIB-83, September.

Kim, S.Y., R.M. Nayga, and O. Capps. 2001. “Food Label Use, Self-Selectivity, and Diet Quality,” Journal of Consumer Affairs 35(2):346-63. 

"Obesity and Other Health Concerns Lead Food Companies to Step up Health and Nutrient Claims." USDA ERS -. Accessed October 22, 2015.

"USDA ERS - Food Expenditures." USDA ERS - Food Expenditures. Accessed October 22, 2015.

Seiders, K., and R.D. Petty. 2004. “Obesity and the Role of Food Marketing: A Policy Analysis of Issues and Remedies,” Journal of Public Policy & Marketing 23(2):153-69.

 

Manifesto: A Nation Built on Wellness

It is clear that alternatives to our current state of capitalism has to be formulated due to major inefficiencies inherit within it. These inefficiencies manifest itself in inequality, inequity, and environmental unsustainability. We believe that we have progressed far from our ancestors and yet we still face the same issues that they have faced, if not worse. With all the technological and societal advancements we have achieved as a race, how have we not solved these issues? Is it part of our nature? I don't believe so. I believe that the root cause of these issues is how we perceive value and in parallel our commerce and economic system.

Read More

DESINELab Student Lecture

I was recently invited to give a student lecture on healthcare as part of an ongoing series by DESINELab here in Rhode Island School of Design. I wanted to share what I talked about here in this blog to extend the conversation to a wider audience. Any kind of feedback or comments would be much appreciated.

My interest in healthcare was sparked in an advanced studio class I took with Nathan King and Olga Mesa called Future Health Systems. In this class, I realized that most of my personal efforts in trying to affect positive change, within systems like business, the food industry, agriculture, and education were all connected with healthcare, or at least my own vision of healthcare. For that studio, I proposed an ideal healthcare system for the Philippines through architecture, which you can find here. I am currently writing a manifesto for it, in the hopes of making it a reality. 

This narrow focus on a specific area of design has opened many doors for me. I recently did an internship in MASS Design Group, as one of the first RISD students to do so. I have been asked to start consulting with a group of doctors in Manila who are building about 40 hospitals and clinics across the country. The pace of my understanding and knowledge on the field has been increasingly fast due to my niche interest in specializing coupled with the demand of good designers in the field. 

Paradigm Shift in Healthcare

Healthcare has long been ignored by the majority design community. Yet, it is currently experiencing a paradigm shift in where designers are crucial components. This shift is in response to a universal effort of decentralizing and defragmentizing traditional healthcare: from reactive to preventive, from medicine to wellness, from the hospital to the home, from the wealthy to the masses. Therefore, the definition of healthcare is as complex as ever.

Traditionally it is defined as the diagnosis, treatment, and prevention of disease, illness, and other physical and mental impairments in human beings. However, a lot more attention has been focused on just diagnosis and treatment. It is traditionally delivered within primary, secondary, and tertiary care, as well as public health. 

However, projecting forward this definition, as I have mentioned, will change. Therefore, looking forward, my own definition of healthcare is the maintenance of a persons complete wellness system, which includes social, spiritual, physical, occupational, intellectual, emotional, and environmental.

For this lecture, I will be using the lens of architecture in talking about design in healthcare but I want to emphasize that any field of design is just as important. To help understand the current context of healthcare architecture, I want to quickly talk about its history. Just like design movements, healthcare has gone through several revolutions since its inception. 

Prehistory of Western Hospital Architecture

Prehistory of Western Hospital Architecture began in Ancient Greece where the concept of health was closely linked to religious rites and rituals. It emulated the model of their classical temples. In the middle ages, monastic hospitals were built that resembled monasteries like Hotel Dieu. Most hospitals until the 1700's were designed in parallel to the architecture style of their time. They were rarely designed with the pure intention of being a place for treatment. In the renaissance, hospitals were designed according to the geometrical principles that were popular at the time like the Ospedale Maggiore in Milan in 1468. Then in the 70's western countries started producing statistics that triggered the first revolution in hospital design

Ancient Greece

Ancient Greece

Middle Ages

Middle Ages

Renaissance

Renaissance

First Revolution: Built Natural Healing.

Hospitals were the first buildings that were completely determined by scientific and philosophical concepts. It was inspired by the poor outcomes of existing hospital designs that pushed designers to rethink hospital design. Two concepts were brought forth in Paris: the radial system and the pavilion system. Both systems believe that healing is not derived from medicine but from being in a purified, natural environment that provided clean air. The Hopital Lariboisiere by M.P. Gauthier built between 1839 and 1854 is credited as the first pavilion hospital. Pavilions maximized sunlight and windflow. Apart from designing hospitals using the beneficial effects of nature, architects designed hospitals to become iconic. By housing medicine in such a way, it influenced the public to believe that it was important and thus provided more investment, which drove medical science. 

Second Revolution: Medical Science and Technology.

At this time period, we begin to see the shift from using nature to using technology. This shift in balance began with the invention of the x-ray. Pavilion type hospitals were replaced with block hospitals because they thought long corridors made it more inefficient. Block hospitals were good for centralizing common utilities like the x-ray which was too expensive to place in every building/pavilion. The first of this block type was the Columbia-Presbyterian Medical Center in New York by James Gamble Rogers built in 1930. However, with the introduction of the block type, we lost an essential architectural feature: the ambition to create healing environments that emulated nature.

Third Revolution: Hospital for the Masses.

This revolution was the product of WWII and the 'social revolution' which fostered the idea of the Welfare State. Social Security Systems were set up in most countries to safeguard the public from unemployment, disability, old age, and illness. Due to the influx of new patients, technology was focused on treatment facilities and outpatient wards. Hospital architecture became synthetic and a new type of hospitals emerged called Matchbox on a Muffin Type. The idea with this new type was that it is much easier to rebuild and redesign the ground floor than to make changes in high-rise buildings. It combines a flat spreadout building and a high rise building containing the patient ward on top. It allowed changes to occur without disturbing the patient wards. The first of this type was the Hopital Memorial France-Etats-Unis in Saint-Lo by Nelson in 1956. Since hospitals were now open to a larger population patients stopped being treated as people but collection of possible diseases or just data. This ran parallel with the capitalistic trend of the Western culture and the rise of bureaucracy. 

Fourth Revolution: Empowering the Patient.

Hospital embodies conflict between the individual, and the needs of the medical staff and equipment. This led to the invention of a neutral, industrially-built, unexpressive structure that was no longer recognizable as an individual building. An example of this would be the Medical Center of Groningen in the Netherlands which emulated the city by introducing covered streets, a huge hall, and many shops and restaurants. Unfortunately, The transition from a medicine-dominated to a management-dominated hospital has not curbed the process of institutionalization. It failed to return the hospital to the people. Technology and science that was once the main justification for hospital architecture and design is now what is driving it to the opposite direction. 

Fifth Revolution: Returning the Hospital to the People.

This revolution should initiate the return to the basic principles of decent management, empowerment of the patient, de-institutionalization, and the courage to re-conceptualize healthcare and to let it go back to its core business. We are the generation currently undergoing this paradigm shift. Healthcare is shifting from being purely reactive to preventive, but we still have a long way to go. 

Designing Forward

How can we design for this new shift towards preventive healthcare, or what we can even call responsible design? I believe the answer lies in research and evidence-based design. When I interned in MASS Design Group, I learned that there should be 4 stages in design. Traditionally especially in architecture, there are two that we mostly focus on: Design and Construction or Manufacturing. However, there should be two more stages to make design more efficient and effective. 

Prior to the design phase, there should be a pre-design phase in where you research the context holistically. RISD design students are very aware of this and most of us approach projects this way anyways. However, where I think we are lacking are looking at things from a systemic point of view. Here is where ID students do better than architecture students in my opinion. In architecture, we often use the pre-design phase as basis of form and program making, which I think is still very shallow. Pre-design must be thought of from the scale of systems all the way to the people that use the system. 

The fourth phase goes after construction or manufacturing called Impact Analysis. This is often very difficult to do because it costs money outside the traditional budgets that are given by clients. However, it is one of the most important phases because it teaches the designer what actually works and what doesn't outside the theoretical realm. Without Impact Analysis, we cannot achieve a complete feedback loop and that is why history of design has been so inefficient and ineffective. We are currently designing objects and buildings without considering what kind of futures they will create both environmentally and socially. This is a manifestation due to the lack of impact analysis of our designs. 

With all 4 phases completing a feedback loop, designers can truly achieve research and evidence-based design. This means that your design is an efficient use of resources because your design meets a real need and demand rather than a theoretical one. From this we can start designing an environment that actually suits our human needs and prevent us from being unwell and getting sick. We cannot use money anymore as an effective way to gauge the flow of resources. Why not try using wellness as a metric of developing a project and as a way to see its following success?