The more I have studied the issue of obesity, the more convinced I am that one of the highest leverage points in attacking the problem is getting agricultural food subsidies changed.

We tend to blame individuals for their eating habits, particularly obese poor people. What we fail to take into account is the extent to which their eating habits are dictated by the relative costs of different foods, particularly the costs of unhealthy vs. healthy foods. We fail to understand that both the availability and cost of foods is heavily influenced by long-standing agricultural subsidies baked into federal laws and U.S. Department of Agricultural regulations.

I first learned about this in reading an article in my local newspaper, the Darien Times, about a lecture in Westport, Connecticut, at which Congresswoman Rosa DeLauro, among others, commented on the influence of agricultural subsidies on producing more sugar and grain-based foods. She and others commented that fruits and vegetables are considered “specialty foods” which are not given subsidies and therefore more expensive. (more…)

Recently, the Partnership for Prevention, an organization that is trying to promote prevention and wellness as key health care strategies, issued a report entitled A National Profile on Use, Disparities, and Health Benefits.

The value of preventive care is clearly demonstrated by the Report. Most interesting is the fact that, with respect to childhood immunization, an area of strong public policy focus, disparities based on race, ethnicity, and income have largely been eliminated. However, for other areas, like the taking of aspirin to prevent heart disease, adult immunization, colo-rectal screenings, and smoking cessation, there are huge disparities among races, ethnic groups, and income levels.

Medicare inadequately covers these treatments, but, beyond that, there has been inadequate focus on what the obstacles to adherence to recommended prevention and wellness approaches might be. Coverage and cost are certainly issues, but there are basic access gaps in our health care system.

For example, in New York City, our Management Services employees tend to work in Manhattan during the day, but live in the outer boroughs. Even if they have primary care physicians, those physicians do not tend to have evening and weekend hours, with the result that these employees use the emergency room for after-hours care. Emergency rooms are extremely hostile to people who use them for preventive screenings or immunizations. I know, because years ago, I needed to go to a medical facility to get allergy injections, and I was told that I did not belong in an emergency room because the ER was for life-threatening conditions, not for preventive care. (more…)

One of my commitments to readers of this blog is to “see a different game.”  At times, that involves linking seemingly unrelated events and experiences.

Last week, we all watched the tragedy of the Minnesota bridge collapse unfold.  Unfortunately, although there will be a study that will detail the technical reasons the collapse occurred, a study that will be completed months or even more than a year from now, the fundamental reason underlying the collapse is that all accountable levels of government paid insufficient attention to preventive maintenance.

By the way, I reject the notion advanced by some political partisans that, if we were not spending so much in Iraq, money would be available for bridge repair and maintenance.  Neglect of preventive maintenance of our infrastructure has been going on for decades, and it long predated the Iraq war.  Stephen Flynn of the Council on Foreign Relations wrote a book called On the Edge of Disaster which detailed our long-standing neglect of vital infrastructure of all kinds. 

Why do we allow infrastructure neglect to happen?  Our experience here in Connecticut with the Mianus River bridge collapse along I-95 in 1983 tells the story.  Many government officials have defined success in governing by highly visible projects and accomplishments in which there is a great photo-op.  Thus, it is far more tempting to break ground on a new highway or bridge, or to celebrate the purchase of a new rail car or bus than to do the boring, low-visibility, but absolutely essential work required to repair and maintenance existing assets.  Not surprisingly, with this mindset, preventive maintenance is given a far lower priority than increasing capacity by new building activity.

In a seemingly unrelated story that appeared in the New York Post the French actress and environmental activist Julie Delpy was appropriately concerned about a truck idling outside a restaurant at which she was having a meal.  As the story goes, the driver explained that he had to keep the engine running because he was carrying perishable meats that required continuous refrigeration.

The question should have been: why was he there, rather than along a highway which had generators to which his truck could have been hooked up?  The answer again is that governments under-invest in amenities for truckers, such as rest stops which they need to make sure that they are not driving while fatigued, and generators that they can use to keep power flowing to their storage cabins, so they do not have to keep engines running.  Like bridge maintenance, the decision to spend money on truck stops is not the kind of event that gets politicians media coverage because it lacks the elements that get media people interested.  Additionally, few people want truck stops or weigh stations near them.

As a result, truckers end up eating or resting in more crowded residential and commercial areas off the major highways with their engines idling as they are eating or resting.

Likewise, one of the best techniques for reducing traffic congestion is to promote demand reduction strategies, such as increased use of mass transit, car pooling, and van pooling. In our area, rail station parking is a major constraint on rail usage.  In 1985, I got my start in volunteer work trying to get funding for rail station parking expansion, but there are other ways to expand rail station access, including the provision of bicycle storage areas, like Amsterdam does, encouraging smaller vehicle usage to increase available parking capacity, and building satellite parking lots at which rail commuters can park.  Unfortunately, none of these techniques create photo-ops.

Beyond the lack of media visibility many of these transportation programs entail, they also tend to cost money in the current year and hit operating budgets.  Big capital projects, like highway construction, can be financed by bonds and their cost is deferred.  The repayments on the bonds hit current-year budgets, but, very often, these have a smaller current-year impact than a much lower actual expenditure on maintenance or on upgrading a truck stop, or on a program to subsidize mass transit usage increases. 

Because of poorly-conceived balanced budget requirements, constitutional provisions and statutes, many politicians avoid spending money to avoid current-year hits.  They starve transportation departments of the staffing needed for maintenance projects.  They defer current-year maintenance expenses.  They also spend less money on smaller, but very important, transportation enhancement initiatives because they do not produce the political and media “bang for the buck” that larger projects do. 

Strong government leadership would organize stakeholders, define measurable goals for how to spend public money, make the achievement of the metrics the media event, and trust in the intelligence of the voters.  They would also balance the need for current-year budget discipline with investment in the future.  We also need to demand that governments do more life-cycle costing and explain to voters what it should cost to maintain infrastructure assets.  We do not demand enough disciplined thinking from government officials, and, therefore, we get short-term, high-media-intensity actions that do not constitute good government.

If the bridge collapse has any positive consequence, it will be to refocus governments on the need to do the boring, but necessary, current-year expenditures that will make our public infrastructure better and safer.

I just attended the annual conference of the National Urban League in St. Louis. I have been on the NUL Board for 10 years, and just completed a nearly five-year stint as its Chairman. The National Urban League has an outstanding CEO, Marc Morial, and I have an equally outstanding successor as Board Chair, John Hofmeister, Country President for Shell.

Marc Morial’s keynote speech eloquently and meticulously described an Opportunity Compact that the Urban League has committed to as a mission for the people it serves, and that it wants government officials and partners to support as well. This compact, which can be accessed on the NUL website, NUL.org, consists of four cornerstone values: (1) The Opportunity to Thrive; (2) The Opportunity to Earn; (3) The Opportunity to Own; and (4) The Opportunity to Prosper. These cornerstones are supported by policy priorities described in the Compact.

The Urban League has been offering social services for 97 years and has over 100 affiliates around the country. Historically, it has been most known for its workforce readiness programs, and for supporting educational initiatives. More recently, it has focused on increasing homeownership among African-Americans.

What Marc has brought to the NUL in his four-year tenure as CEO has been a substantially increased focus on entrepreneurship to increase the pool of available jobs, and an even more significant focus on driving civic engagement through voting for African-Americans, and in having the Urban League play a more pivotal educational role in public policy debates.

The conference inspired me because four Democratic candidates, Senators Clinton and Obama, former Senator Edwards, and Congressman Kucinic, thoughtfully and positively presented their agendas to the attendees, and Senators Clinton and Obama specifically endorsed the Opportunity Compact.

I was particularly pleased that, through ground-breaking research led by Drs. Silas Lee and Bernard Anderson, we were able to validate that, at a minimum, the Urban League service network has delivered over $2.5 billion of economic value to America over the last three years.

I also had one-on-one meetings with members of the Urban League movement. Bonnie Boswell, a Los Angeles-based newscaster and the niece of Whitney M. Young, the NUL CEO in the 1960’s and a civil rights leader whose contribution to civil rights has been underestimated because of the low-key way in which he influenced events, is raising money to do a documentary on Whitney Young’s life. His leadership skills are noteworthy because they go far beyond what he accomplished as a civil rights activist. He united white and black Americans, civil rights activists, corporate leaders and governments, and other diverse stakeholders in ways that enabled them to work together far beyond the specific tasks that initially brought them together. I will be helping Bonnie get this project completed because I believe strongly in it.

I also met with Melinda Emerson, a former NUL trustee and now a successful entrepreneur with her company, Open for Business with Melinda Emerson at www.melindaemerson.com. She is both passionate and extremely thoughtful about the key levers for success for any small business, not just female and minority-owned businesses. She is focused on the specific needs of “Mompreneurs,” businesses formed and operated by working mothers, particularly first-time working mothers, but her insights on how to succeed are more broadly applicable: the focus on targeting the right customers and getting to know their specific needs, networking, delegating effectively well before women have less time to spend on the business because of child-care needs, and finding ways to build continuous, long-term relationships with the best customers of a business.

Marc, Bonnie, and Melinda are just a few examples of the kind of people that keep me excited about the NUL. Their focuses on driving thoughtful policy positions and measurable success in implementing them, driving and educating people about effective leadership, and role-modeling excellence in entrepreneurial small business leadership respectively are just a few of the reasons I continue to support this great movement.