Dr. Kelly Henning, Public Health Program Lead, Bloomberg Philanthropies
Food represents more than just nourishment. It’s our culture, a reason to gather, how we show love to our family and friends, and the way we pass on traditions. But with the rise of noncommunicable disease (NCD) rates across the world, food has become a critical piece of keeping communities healthy. NCDs – including heart disease, stroke, cancer, diabetes, and chronic respiratory diseases – and injuries are responsible for more than 80% of global deaths. An unhealthy diet is one of the leading risk factors for NCDs, and the bulk of public health interventions focus on reducing overall consumption of sweetened beverages and highly processed products, including those with high sodium content. In addition to local programs, local interventions can lead to the broader systemic change needed to fully transform food environments at scale.
Community-focused Interventions Lead the Way
Improving food environments like markets and restaurants is an essential part of food policy. To see progress, government leaders must work with communities to create policies that have the necessary buy-in that will ensure the changes are viewed positively by community members and can show long-term impact. In addition to helping to craft policies, local leaders are best positioned to deliver health-focused messages because they have built trust and are a part of the community.
There is so much we can learn from communities that implement local solutions to address important health issues. Bloomberg Philanthropies’ Partnership for Healthy Cities, a collaboration with the World Health Organization (WHO) and the global health organization Vital Strategies that supports more than 70 cities (over 320 million people), works to strengthen public health policies in five areas – food policy, tobacco control, road safety, surveillance and overdose prevention. This Partnership leverages the lessons learned in these communities to build and grow a network of leaders dedicated to their communities’ health with the aim of reducing preventable deaths from NCDs and injuries.
Salt Breaks Hearts: Healthy Diet Education at the Market
Approximately 40% of Sierra Leoneans live with elevated blood pressure, while Type 2 diabetes and stroke rates continue to rise. People at high risk for developing these conditions face many challenges, including added salt, packaged seasonings and bouillon cubes, which contain high sodium levels to commonly served, local dishes. But the “Salt Breaks Hearts” program in Freetown has shown success in engaging policymakers for larger scale impact to combat this trend.
Through the Partnership-supported project, nurses and nutritionists train market vendors on the dangers of excess salt and, in turn, they share tips with their shoppers for reducing salt intake, including how to cook traditional dishes without using sodium-filled seasoning packets, measuring salt based on daily sodium consumption guidelines, using more fresh ingredients, and discouraging the addition of salt after cooking.
In addition to this peer education, disease-prevention materials are on display for market shoppers showing the connection between high salt or sodium consumption and serious health conditions, such as high blood pressure and stroke. The market educators meet weekly with nutritionists for blood pressure screenings of their own, monitoring and counseling on how high salt consumption negatively affects health.
Supporting Sustainability Through Food Policy
Capitalizing on the remarkable success of the “Salt Breaks Hearts” program and fueled by the collaborative Partnership network, four West African cities—Ouagadougou, Abidjan, Dakar, and Freetown—have shared strategies around nutritional standards for public institutions and how to best implement these institutional changes. As a next step, the Freetown team is working with the Partnership’s Policy Accelerator in collaboration with the Ministry of Health and Sanitation (MoHS), and national stakeholders, to develop a procurement policy that will prevent hospitals, schools, and other public institutions from purchasing or using high-sodium bouillon cubes in meal preparation.
Another example of a local government embracing its role in creating healthy food environments is Phnom Penh, where leaders have taken steps to reduce children’s consumption of sugary drinks and unhealthy foods through the development and signing of a new measure banning the sale of these products. Local efforts in Córdoba, Argentina are focusing on adopting an ordinance to promote healthy school environments, including banning the sale of and access to sugary/artificially sweetened beverages in public and private school establishments.
The Partnership for Healthy Cities Brings Leaders Together for Long-Term Change
This year’s Partnership for Healthy Cities Summit, which took place from March 5-8 in Cape Town, South Africa, presented another opportunity for city leaders to learn from one another about programs, policies, and other health interventions they can apply to their cities. This level of knowledge-sharing and support inspires leaders to implement policies to improve lives around the world. The ultimate goal is to deliver a better future for communities by taking on the leading causes of disease and death.