Transcripts For CSPAN2 Book Discussion On Lethal But Legal 20140309

Nicholas freudenberg discusses how the food, tobacco, alcohol, pharmaceutical, gone and out of industries have negatively impacted Public Health. He offers space for the public to respond. This hourlong program is next on booktv. I am Marion Nestle and its my pleasure to start this panel. I want to say it to say it is a great honor to be here to launch next. Nick senate to me me for a blurb and i was really happy to get that. I get lots and lots of requests for blurbs, but i dont usually write them quite like i wrote this but. Would it embarrass you too much if i read the blurb . [inaudible] all right. Cover your face. Heres what i said. I meant every word. A superb, magnificently written courageous and compelling expoee of how corporations enrich themselves at the expense of Public Health and how we can organize to counter Corporate Power and achieve a healthier immerses edible food environment. They should be required reading for anyone who cares about promoting house, protecting Democratic Institutions in achieving a more equitable and just society. Not bad . And i meant every word of it. Nick asked me to talk specifically about what weve learned from that tends to incite to try to change Food Industry practices. My area of Research Institute politics and ive written a lot of books. Im currently working on one about the soda industry, cocacola and pepsicola. My comments are going to be based on that the work ive been doing on that. My starting position in all of this is to make sure people understand that corporations are not social Service Agent these, even ones that sell food that you love te. They are businesses is that quarters to please and that is absolutely their first responsibility. Is the first responsibility legally and sometimes it can seem to lethality. The easiest example to talk about his cocacola and pepsico because they make a product that is sugar and water and nothing else and there is not increasing evidence that sugar sweetened beverages are associated with problems like obesity and all of the conditions for which obesity is a risk that their emesis correlation. Its not causation. But by this time, the amount of evidence that has accumulated in this tilting up to show that sugars are in large quantities harmful and in liquid form they may be even more harmful. As Robert Lessing who is the primary proponent of sugar is poisoned these days as if you get him in a quiet corner, this is a dose problem and it does really its not such a problem to have sugar one in a while. Im a lover of sugar as anyone who knows me will say. A soda isnt poison and one a week or every few days. Nobody is going worry about. It is very, very large amounts separate Public Health people to the point where their eyebrow is raised. So the amount of sugar is pretty staggering. It is about one teaspoon per ounce. So for a 20ounce soda is going to be 20 teaspoons. They add up very quickly and because of the ray sodas are flavored, you dont note that it vastly and most people are astounded when they realize how much sugar there is this notice. And there is no plenty of evidence that adults and children who drink sodas are heavier, how worse diet and has much more problem with chronic disease than people who dont. So getting people to drink less soda has become an increasingly tall school and lots and lots of places theyre working on ways to try to encourage people to drink less soda. In order to work in this area, you immediately encounter a great deal of opposition from Soda Companies who really dont like the idea that people are going to try to restrict the way they market to children, removed their products from schools, tax them and as we saw in new york, i tend to reduce the size of the amount you can drink at any one time or buy it anyway time or most recently, to put warning labels on soda cans. The soda industry has responded to these kinds of initiatives in ways that for those of us who are millionaires find absolutely staggering. They put millions and millions of dollars into fighting advocacy at times. So advocates have to be cleverer, smarter and more sophisticated if they are going to make any progress. I think advocates and making progress because just this week, cocacola announced its fourthquarter earnings from last year and it fails the sodas are down. They have been declining at a pretty steady rate since about 1998 and they are continuing to decline. The last drop was about 9 , which is the eighth drop in any one year. With Soda Companies are doing is misleading marketing overseas. If this sounds like some thing you have heard before because it begins to remind you what happened the cigarette companies, that is not an accident. So stanford advocacy not its neat to take into consideration the fact that any Advocacy Program is going to be greatly outspent and we saw that. Just one example, and the Tax Initiative in richmond california in which Soda Companies have spent advocates for the tax by a factor of 87 to one. Richmond, california is a very, very Poor Community in the east bay. The average income is about 23,000 a year. It is 80 minority, black and hispanic internet has extremely high rates of obesity and type2 diabetes. Among the highest in the state and also the highest consumption of soda in the state. So it was a reasonable place to attempt to put in a soda tax and it lost in part because of his outspent by this enormous percentage. But i think there were other reasons it his outspent. Those reasons have to do with the lack of community organizing. It came out at the council on this kind of jumped on this issue without a lot of work to see how the community and how it could be encouraged to support a Public Health measure that didnt look on its face there was no community. To do that. And little attempt to get allies and the engagement. Some of those problems occurred here for as far as i could tell the mayor just dropped the 16ounce soda cap into the lap of everybody and people had to figure out onthefly how to reach onto it in the soda industry was much, much better prepared to deal with the idea of the soda cap because they had been working in the Minority Community for 50 years. They have a long, long history of supporting Community Organizations in the Minority Community and i dont think the city was prepared for an enormous pushback on this. I would give anything to know how much the soda industry spent on the attempt to defeat the 16ounce soda cap. I got a personal mailing to my home and my Research Assistant ran out and talk to people who are on wearing tshirts come in saying dont let the mayor decides what youre going to drink. When he asked them how much they were earning them to pay their salaries and they were getting 30 an hour. The best job in new york. Let me tell you. So theyre actually turns out to be an academic literature on how to do that if you see in that literature derives from the social movements of the past and the civil rights movement, womens rights movements, Environmental Movement and his books and articles or materials then you can use teaching at nyu unfitted advocacy. What im trying to teach the students is to do it right. In order to do it right, you have to identify what the problem is, choose a goal for addressing the problem, develop very strong researchbased rationale for the problem and further goal that youre trying to reach. You have to develop an effective frame for it. By fatah means the way youre going to talk about your issue to the public in a way that has some kind of emotional resonance with the public the industry is is much, much better than advocates are any gauge allies in this needs a lot of Community Organized team and doing but is actually classic public house. Planning and evaluation go into the community, silent beneath our, work with the community to figure out how to best address those needs. That takes a long time and a lot of offers. You need to be able to dress opposing views and have answers and ways of dealing with the kinds of issues your opponents are going to raise. There needs to be a big Public Education campaign that goes along with any food advocacy and of course if youre doing it right, you do ongoing evaluation of what youre doing and adjust accordingly. This is much easier in theory than practice. In that class, i send my students are too advocated may come against the reality very, very quickly. I think the issues of Community Engagement and establishing rings turned out to be the things that are hardest for them. The soda industry, for example, frames the whole question of drinking soda has freedom to choose. Pretty hard to beat that one and Public Health has a much harder time figuring out how to say that if you do this now, your help in 20 years is going to be a lot better than that would otherwise. I dont think that slides easily. The whole issue is absolutely critical so that communities have a vested interest in their own health goals. Theres lots of this going on. This advocacy around food issues, particularly soda issues going on all over the country. Numerous cities, date but have Tax Initiatives in the most recent one from california or the California Legislature has proposed a warning label on soda cans. What is going to happen with that i have no idea, although i am going to guess the soda industry since sacramento and force right now. It would be very anxious scene to see the advocacy strategy here to try to do these things in as many places as possible in order to require the soda industry to spend as much money as they possibly can and will see how it comes out. If you want to know more about that, read the book and read mine, too. [applause] the mac there a number of empty seats. If you have a number of seats next you can raise your hand for a minute and people can walk from either side of kind of empty teachers they. [inaudible conversations] you now, it is always interest and when you work for an interfaith or commit nation, the syndrome of the wood in the front row is universal. It is just one of those things that unite us. Hello again, i am so bored. I noticed the look of puzzlement as my checkered past was described. Let me just share one little piece that did not come out, but somehow or other fields like this full text all moment for me. During those five years where i was a chemical engineer, true story, my specialty was can manufacturing. Of course cans and soda cans are pretty much the same thing. But what good chemical engineers and the beer can or metal contain industry now that you may not on notice that in fact the code name to prevent the oxidation of the aluminum chair and needs to be far stronger and far more aggressive for soda. Then it does for. So i know there is wine in the back. There is however no soda and i think theres a reason reason as Public Health professionals. The other thing that i learned is that i dont have the book actually. But if i ever write one, mary ann is writing the blurb. No question about that. Working, however that the Interface Center on Corporate Responsibility and they think in a publichealth crowd im really confident that this is a group that understands complex systems and understands her to the interplay between the individual group and Larger Society and how some of the problems that we as a society create even those individuals who we are rigorously committed to avoiding getting that dynamic right is a very interesting challenge. So throughout my career, which is kind of had this theme of problem solving for public good just in different kinds of nes, dat has been in the m. Bit is a very interesting place to be because in the Capital Market, like it or not, there are folks who have said many, many times that capitalism may be an unfair greedbased system. However, we have not yet come up with an alternative that works as well. So when you think about this idea of allocating capital, how do we make money flow . But is it the investors do . User to ask yourself, is it working . And then you start to think about problems with a publichealth crisis all over the world of obesity. All of a sudden you start to say, maybe there is a better system because we are certainly not pricing externalities properly. So coming from the Interfaith Center on corporate infidelity, by the way, other peoples speeches to recognize investors. We have a very, very long history of straddling the line between the building and access to power because of our role as investors. This all goes back to the apartheid south africa years. I will not tell that along the way. But what i will say is that the movement btm where investors primarily in faith institutions who had pension, foundations, Mission Related money started to say, if we are going to fund nations, if we are going to ensure that dickman may someday, if we are to travel around the world doing whatever it is we do, we need to make sure that we feel our capital is being justly allocated. We need to take responsibility for her. Thats where the whole notion of Corporate Responsibility for started to bubble up in the 1970s. Fast forward from the Antiapartheid Movement for civil rights and all of a sudden you have an organization celebrating our 43rd year of operations and we have become very specific with the issues that we take on and very broadly approached. One of the things that i absolutely love about next book is that it took at least six sectors and looked at the interplay of of marketing, different roles that the corporate consumers complex if you will have to use to convince folks, their customers, to do things good for them. And so, the work of the investors and the challenges on the one hand we are dust. We have pension obligation and in fact when you think about investors, theres always this tension about shortterm investing versus longterm investing. Frankly i would argue that we actually have the longest time horizon of eternity. We take this as very, very seriously. We try to encourage corp. Rations across a number of mispriced externalities to change how they operate. We are absolutely convinced and i think the record bears this out. By paying attention to these mispriced externalities, by sitting down with companies and talking about some team with an orientation that we actually anticipate problems and opportunities in the marketplace. One of the reasons that Corporate America let us into the board room, into the Conference Room to raise some of these issues that can be uncomfortable, that can be challenging and can be on the surface threatening to their business models, threatening to ideas about possibilities. They know we are straddling the sign. Investors need good return. We are investors who represent organizations working for the social good and we want them to do well and do good. But as this have to do with food politics . We have a group known as the access to nutrition group. We have the odd situation in modern society of both wrestling with obesity and having lack of access to good healthy food. We believe strongly that Corporate America has a huge role in mass in the very same way the 70s folks who made manufactured and marketed rice milk substitute in countries where milk was the clear best choice for infant morbidity and mortality that by helping companies to see that their investors might have a different point of view on issues like how they report their political contributions. The kind of lobbying that mary ann talked about. Right now there is absolutely no requirement for corporations to report to the fec where they spend their money. Either way, corporations are not a whole bunch of things. One of the things they arent these people. So no matter what to do since united had to say about the right of corporations to spend public dollars, the reality shareholders see this differently. So we are Encouraging Companies to report their lobbying expenditures and if you are a shareholder, if you read their own individual shares or if you have a Retirement Plan or yuan mutual fund shares, you need to do one simple action to encourage division that iccr represents in this area. Could you tell me how you voted on corporate lobbying disclosure . The good ones will give you the answer. They said we voted for disclosure. So first come of corporate, political expenditure disclosure is extraordinary important because regulation they are looking to encourage nutritional balance of their product portfolios. Whether youre an advocate of fun food or better for you food or whatever, the reality is in the marketplace, higher nutrition foods are more profitable. It can be shown by some on likely suspect and using that Business Case is important as an investor for the role of getting the less Healthy Options out of the marketplace. Strengthening to responsible marketing. Companies are very, very clever about how the market portfolios. Around the ats juries. They are trying to sell their product to make a buck. There are essays and standards being developed. Marion works hard in the wings. Ms consumers, we can make our voices known by what we buy, who we talked to him how he advocate. Expanding access to healthy choices. One of 50 that valuesbased investors to you is not only look at the come in if they pioneer stock or folio, but also start to look at to whom they lend money. So for example, in many, many urban neighborhoods where there are food deserts, there are more and more and testers particularly in the community in which i work better after getting money to fund highquality agribusiness and to fund all kinds of development. My hometown is the particular emphasis there. Finally, this is sent to admin is very familiar to the Public Health community. Labeling. How are products labeled . How easy are they to decode . If youre going to make the argument we are in the business of Consumer Choice and that somebody wants a soda and 47,000 ounces in one cup, we should at least help them make the decisions. Good front to package labeling, things like the Healthy Heart check labeling and these techniques Encouraging Companies to take an honest part of what iccr and its members do. I will end with limitations. But i will say is that you have to pension plan our best to mutual on our bank account you have a second place to let your voice be known in my thoughts and lots of techniques available. I encourage you to look at our website. There is a wonderful tension between investment. Investors, Movement People and corporations in which they engage by mobilizing investor voices in mobilizing advocate. Thank you for your attention. [applause] thank you for coming. And Public Health, we find every Society Faces the Health Threats to do things, political and economic arrangements make. That threat comes from chronic diseases and injuries. Chronic diseases cause 79 of 10 deaths and 49 have one or more chronic diseases which account for three out of every 4 on health care. 7900 a year for every american with a chronic disease. At 2030, chronic disease such as heart disease, cancer, stroke and diabetes will cause more than three quarters of all deaths in the world and the cost of the World Economy over the next two decades is estimated at 47 trillion. Injuries are the other leading cause of death and disability both in the u. S. Globally. Global andover traffic crash stats are projected to increase from 1. 2 million in 2002 to not 2. 1 million in 2030 primarily due to increased Motor Vehicle fatalities associated with Economic Growth and lower middle income countries. In addition, wrote crashes and wrote crashes interactive Million People a year. Violence and suicide became important causes of death in young people contributing between a quarter and a third death in young men aged 10 to 24 in all regions of the world. The 21st century, injuries from cars and can was the dominant cause of death among young women and men in as part of the world. The conventional explanation for these increases is growing affluence and changing lifestyles. Of course in part thats true. In epidemiology, our task is to uncover the cause of the causes come into the go deeper city can find more effective prevention strategies. And we sold both legal, im in the case that the fundamental cause of the rising burden of chronic diseases and injuries is the emergence of what i call the Corporate Action complex. Borrowing from president eisenhowers 1961 warning that the militaryindustrial complex after world war ii posed a danger to our democracy and wellbeing. In the 1970s a network of demur corporations, banks, trade associations, Public Relations firms and scientists and politicians coalesce to reassert authority over our politics and economy. The corporate consumption complex solidified response to changes in the Global Economy and the consumer and Environmental Movements of the 60s and 70s. In the next two decades, the complex became the dominant voice of american society. What is relevant to health . To reduce its agenda and ensure continued Economic Growth. The complex about the ideology of what i call hyper consumption. That is sending promotion of lifestyle, health behaviors, social environments and policies that encourage consumption of sodas the with premature death and preventable illness and injuries. In the book, described how the alcohol, automobile, fire them of food and beverage, pharmaceutical and Tobacco Industries developed a marketing Product Design, lobbying another product says that have created our current burden of ill health. This analysis offers both bad news and good news. The obvious bad news is this is right, in order to achieve the most basic national and Global Health goals, we have to take on the worlds mightiest economic and clinical institutions. If we simply want to leave our children and grandchildren, a world where they expect to be as healthy as their generation, if we want to shrink the growing socioeconomic and racial ethnic inequalities in health, our country and the world to change how corporations decided market their products, how they use science, how they interfere with democratic processes and how they damage the environment and sustain life. But heres the goodness, only a few dozen corporations produce most of the worlds goods and services. It should not easier to change a not so many come needs to business and helped the billion or so people overweight to lose pounds or help the 1. 3 billion smokers to quit and prevent more young people from taking up the habit would help the 140 million alcoholics and the many more problem drinkers to cut down the drinking that is killing them. The conventional inking says its only people were better educated and more responsible, our health would improve. Sadly, the empirical evidence doesnt support that view. There are no data to suggest that global increases in tobacco, alcohol and unhealthy Food Consumption result of growing it is in response ability. No evidence that gun and not a deaths and injuries come from generations less able to drive our shoot. No evidence that the growing rates of harm from inappropriately used prescription drugs come from more ignorant consumers. There is however an 11 and that the relentless marketing of these products, and ubiquity of their availability and their makers political manipulations have contributed to the increased use unharmed. In Lewis Carrolls through the looking glass, the white queen urges alice to imagine six impossible things before breakfast. Alice response, no use trying when cant believe impossible things. I daresay you havent had much to his surprise the queen. Another series come i always did it for half an hour a day. Building a movement that can successfully challenge the Corporate Action complex and abstract this hyper consumption will require a matching name and then carrying out for tasks that many would today consider impossible. For the next five minutes, i want is to do some impossible thinking. First, we need to evaluate past successes and changing corporate practices and extract the lessons, the practical lessons to guide the creation of a more powerful, cohesive and successful movement. Our success in creating the food and drug restoration 1906 thank you, Upton Sinclair firaxis in the jungle and cutting Pesticide Use in the 1960s, thank you Rachel Carlson are two examples of how scientists, writers and social movements force governments and corporations to act differently. It needs another successful campaigns, we can extract lessons for cooking up a successful movement and these lessons can dipak is for an emerging movement to engage peoples minds and emotions to invite new partners and prepare leaders to take on the task of confronting Corporate Power. Impossible task number two. We need to construct and popularized an ideology of hope and democracy that can successfully compete with the corporate consumption ideology and its prescription of hyper consumption. For many people around the world, hyper consumption is the norm. The very definition of modern society. Alternatives are seen as primitive, its demands, undesirable or at best utopian and unattainable. In this view, since few would choose to give up this lifestyle voluntarily, the only possible route to a different future is dreaded nanny state in which government textures that citizens and deprives them of ice pleasures. Its a tribute to the corporate consumption complex that these beliefs are so common to persuade people that a lifestyle that brings many premature death, pain illness, horrible suffering, preventable injuries is highly desirable is really remarkable achievement. Any movement that wants to mount a successful challenge to hyper can unction must offer attractive alternative patterns of consumption. Creating alternatives to hyper consumption requires two simultaneous processes. We need to reduce the demand for unhealthy products and reducing the supply and also reduced the supply and promotion of these products. Movement organizers often debate we should be primary. Work on the supply side were demandside. In my view the most effective approaches to reduce demand and supply of unhealthy products. To do those things simultaneously with success on one front reenforcing advances in the other. Impossible task number three, we must weakened and dismantled to corporate unction complex. The powerful alliance of corporations and their supporters that dominate politics, the economy and society. This most impossible dream hyssop against Maggie Thatchers famous dictum that there is no alternative to corporate capitalism. As inevitable as the air we breathe. But as long as corporations occupy our minds, our media, shopping malls and political processes, they will have an advantage in shaping patterns that can unction and discouraging healthier, more sustainable alternatives. Escom evicting corporations from their privileged positions is an essential task. And how can we serve eviction notices in place with the corporate unction complex now exercises its power . Our consciousness, communities and political processes. In the book come i describe some of the ways that this come Health Professionals, Government Investment have reduced the power of corporations to shape the environment, behaviors and lifestyles that influence our health. These responses are as varied as the Africanamerican Community group in philadelphia the first reynolds tobacco, me too and test marketing of a new cigarette found marketed to blacks. They did it by organizing a coalition of civil rights, health, religious and Community Groups who say no, not in our community. Reclaim the right to say no for our community. Another example of the California Air Resources Board and at the global Auto Industry to set more stringent standards for air pollution and fuel efficiency to the recent apparent success of a coalition of labor, environmental and Health Groups to end fasttrack approval of the Transpacific Partnership of corporate written trade deal that would give me rights to the Tobacco Industry and Drug Companies and a very important victory that they seem to be successful in stopping congress from fasttrack approval for that. Each of these campaigns led to one small but jury. Woven together they can make to a Tipping Point of change. The antidote to their is no alternative is the message another road as possible. As Public Health professionals, as researchers, as public intellectuals, we have to use every ounce of our imagination to bring that message to wider audiences and practical, respectful and maybe even entertaining ways. The final Impossible Task is to be a few strands of activism into movement. To do so, we need to forge a policy agenda that offers a vision of a healthier more democratic future and unites a diverse individuals and organizations working to change the role of corporations to nurse zaidi and to provoke an ongoing dialogue on this, i suggest six possible planks for such an agenda and of course go into more detail in the book. First, expand consumers right to know and corporations duty to disclose the consequences of corporate practices and products. Second, require corporations to pay for the health and environmental consequences of their products and product says. Third come establish Global Standards for Product Design and marketing. Shame on us that our success in controlling the Tobacco Industry here in the United States is going to lead to a billing and premature at tobacco deaths, mostly in africa and a shot in latin america in the 21st century. Lets make sure that when we work on the Food Industry that we dont allow that to happen the same way. Fourth, we need to restore Public Ownership of science and technology. Fifth, we need to restore the visible hand of government and Public Health protection. Finally, we need to prevent corporations from using their money and power to manipulate democratic processes. In the book, i provide a rationale for each of these planks. As a movement makes progress in achieving these goals, the lack of imagination that Maggie Thatcher prescribed may dissipate. As organizers learn how to broaden and deepen their appeals, the movement will create new opportunities for success. Movements never grow in linear, predict the fashions. One moment. And nothing but darkness. Next moment, thousand points of light leafed out. Today, thousands of organizations around the world are lighting up the many tasks that lead to an end of corporate practices that promote hyper consumption, premature death and illness and injuries. We dont know yet which paths are dead ends and which will lead to transformative Tipping Point that will show another world is possible. But what we do know is that business as usual will ensure and health burdens, increasing inequality, rice and environmental damage and deteriorating democracy. But our society grasp this opportunity to start a different future . The choice is ours. Thank you. [applause] well, a riveting and challenging present patient. Hopefully it will open the door for a lot of discussion today. I was in a car and came at me something that gave me fetch a physical reaction that i had to think about. It was an ad for each cigarette. It had been so long since i heard on the radio an ad for a cigarette is any color, nature, form, epc air otherwise and it reminded me what nick is suggesting to last is an ongoing and continuous endeavor. There is no endpoint. This is something we have to be vigilant about. We have to be serious about. We have to be consistent about. The impact is greater today because of the Communications Industry that spreads messages very effectively among status and influence people in a very direct way. Thank you for being vigilant. Thank you for being consistent. Thank you for being forceful. These are the kinds of advocates we need. The floor is open to your questions, please. Please come up to the microphone. Please introduce yourselves and ill try to find the right response to your question. Hi, my name is natalie ferguson. I work for city groups in the Capital Market and this is more directed towards you, laura. Have a question terms of how to make a change from within a company. We are issuing debt. Pressuring stocks, but how do you make sure you do it for companies and how do you change that culture from within when youre talking about the risk framework or any of that . That is such a good question and i could give such a long and very. To honor the question would require a whole other panel. But let me give you some quick ideas and then a little bit of followup. Its a wonderful paper that was done by behavioral economist at the London School of economics called understanding voice and it talks about what the secret sauce is at iccr, how it is we have found in turn onto kids within companies and how we help support them with facts and businesses and stuff. Theres a whole bunch of other organizations that can do that. The trick is to first of all not forget what the corporation and culture is about. You know, so chacon not at even if u. S. We are coming up many questions for the right thing. If i may even use unmarred morality standpoint, it just aint right. Step doing it. Cut it out. Making the Business Case and a really awful, pragmatic way is incredibly powerful. Theres a lot of people that can help you with that. I think beyond that, having an inside outside game, having folks like at the kids and folks like investors who will take the heat so that you can sort of say we have a happen not attend the corporate dialog where we will have this sort of tense conversation about changes we want to come these two may and then we will leave the meeting and someone from Senior Management will come out and say thank heavens he said that. I cant say that, but you can. Those are just two techniques that can really create a lot of Energy Around change, making good strong Business Cases and have been in and had come out again. Look up the paper because its actually really good. Good evening. Thank you, dr. Freudenberg, i have my book on order ready to read. Im a registered dietitian and i know within the academy of nutrition intake headaches, one of the issues this kind of some people feel like corporate sponsorship working together with corporations this kind of be a moral issue at some people feel like it okay that you have to work with you cant be a separate entity appears to reverse in the organization, theres a lot of debate and a lot of partnerships with corporations, even when ive gone through some ask those, i kind of feel a certain way about it. Your dietitians that work within these corporations as well a nail salon that good products and not so good. I dont know if we speak to partnerships. I know we have to have a multilevel approach, but this is a big issue within that organization. I dont even know where to begin on that one. I am not a dietitian. So i am speaking outside the organization, but it is an organization that is completely sold out to the Food Industry. What that have done to the credibility of dietitians is really difficult because although there are many dietitians within the organizations that are concerned about this, they are greatly outnumbered and also there is a long history of involvement with corporations. When i wrote my book, food politics, one of my aunts stated goals was to get the american dietetic corporation to stop issuing stack sheets that were sponsored by Food Corporation because you can look at the fact sheet and just look at the top pick them up with a sponsor is know exactly what it was today. So with montana sponsored a comment is going to be how genetically modified foods were terrific. If cocacola sponsored, it was going to be about how sodas were good for you and so forth. And i am not exaggerating by very much. There is an organization within the academy now cant dietitians for professional integrity. They have a website and what theyre trained to do is to organize dietitians to at least set some limits on what the Food Companies are allowed to do and i hope they succeed. To my mind, one of the questions for us as Health Professionals is what are the consequences of our interactions with corporations and i think its often the case that we are being used to buy a posh products. We are given a fairly defined set of questions. I talk in the book some about the Scientific Advisory board for pepsico. They were asked a set of questions about redesigning products about supporting physical activity, but not should we be making sure great beverages and that should be our main product. It would seem to me we have some responsibility for the consequent is that the advice in the credibility question is also important. We want to be around to be terse and by the public for the next group. So many Family Physicians quit their membership in the American Academy of Family Practice for me to keep a grant from cocacola to promote the value of physical at tbd. I wouldve been one of those leaving. [laughter] hi, david rosner, teacher of Public School of health around here. I really appreciate the piano and the book is extraordinary. I have a little cynical question. It is a question that i was pushed on me by my own students when i talk about the need for organizing. They always pick up on the difference between changing the world one person at a time versus trying to do something about the corporations. But they always point out that some of the companies that we are dealing with really cant change their behavior because they are selling the deadly product. Its not that they can substitute a different kind of paint its not toxic for the on their cars. Its a question that they sublet for the south oil or sugar and thats all they do. So i am just wondering, you know, if you could give me an ear for them, basically something that can talk about how we can address the problem of toxic companies, companies that just are not going to be able to leave and didnt use cigarette, as horrible as that is onto the market. I guess the second question is how do we address the other big question my students raised from the u. Say not to stop, change the world, not just one person at a time and you say do it by corporation. Then they say we going to change it doesnt corporations to stop Global Warming . So i have these big, how do we go about even addressing the kind of problem where students have embedded in them the cynicism that doesnt allow us to give answers that we change the world. At the risk of saying this to an historian, i was a look at history. Where have the improvements in Public Health in this country come from . When have we seen the most dramatic to clients and to . Citizen in society has acted together to make clean water available, to make healthy food available. Those are not individual choices, but collective voices. To my mind, the question is and should corporations be more responsible . The Corporate Responsibility effort are one tactic among many to bring about changes. The ultimate question is what is the role of government in what is the role of the market . I think almost everybody agrees theres some role for government in some role for market. The question is where do we find the line in specific circumstances . The case i make in the book is at least a 1970s there has been a radical shift towards the market in making decisions around how and that is at the expense of healthy environment and democracy in a jeopardizes all of us. So your students who want to have a better world for their kids and grandkids will need to take action now to shift the balance into a more stable and sustainable one. Hi, i just wanted to follow on that last point. I just had a last thought about the recent vote on the farm bill. I think we were all talking about how we might permit. Of hunger if you talk about the restaurants in the 30s and we came from a period of flow or malnutrition to what you could say over and attrition and that was largely because of the evolution of the agribusiness. So if we want to say we go back to more family farm and encouraged local farmers to grow produce, but then we didnt get that in the farm bill. I guess my question is what you say that we should all be trying to do more local advocacy around the farm bill . What can we as individuals, not just Public Health professionals , but what can we say frankly and can safely do to influence the political process around these issues . Ran for office. [laughter] okay. And in addition . When i consider that . But i think around nutrition and around food people working at the local level to create alternative food systems, people pressuring to adopt healthier policies. Still lot of changes in city policy. That child nutrition act is coming up for reauthorization in 2015. A very important provisions around school, and there are several groups in new york that are mobilizing people. Those are just a few of the opportunities. I find there are too many opportunities. These other ones that are important to us. Everyone was confined to do. I think there is relationship between the two questions as well. Exactly. And that think that there is a place that we all understand instinctively. Not to paraphrases the berra, but the problem was globalization is that it is global. As many barriers have fallen down sadly the gain to generic lots and lots of profits and to adjust as nec describes so eloquently in this book sort of shift the impact on vulnerable communities, its almost infinite. That trip for my view, there are lots of technical approaches that investors can take better focused on the side the f transparency around corporate lobbying is that we all know instinctively somehow or other what we used to call multinational corporations have gotten to a level of power and influence in terms of deterring the rules by which we all run our lives that exceeds their purview, that exceeds there sort of institutional obligation to do the right thing. One of the most important things in the book is talking about how we shine a light on that. You know we talked a lot about where the money flows. Watching went up close. Whether it has really been annoying about saying i want to know where youre lobbying money goes. I want my government to force companies to say what exactly are you paying for. One very quick example, during the health care, the universal health care debate, we had a number of companies that were willing to publicly make a commitment to a universal right to health care we discovered that they were funding the u. S. Chamber of commerce was investing tons of money to defeat precisely this very same. You could example after example after example of abuses in vulnerable communities across a wide variety of sectors. And so i think it is really saying how do we recognize as Corporate Power. What can we as people do about it. We dont run for a. That is kind of the business that think we are all in in some ways. Thank you. [laughter] i wanted to followup on a couple of questions certainly agree with you, the issue was how do we get government to be more effective in controlling some of these abuses and talking about a degree of skepticism. And we see an attack from the right clearly on government as an institution. They cite examples in the book of cases that can be used in that clashed to say these are government actions that have had dramatic and positive protective. They can look at the examples and see how government is used properly. I think the california Resources Board is a good example of that. A locally based state agency says he took seriously their mandate because people in california cared about their environment californias love affair with the automobile turn into a lot of people coughing in los angeles and not being able to breed. There was pressure on State Government to do something degrees of the California Air Resources Board took that seriously, to that mandate seriously and really set standards that are no Global Standards for a mission control. That seems to be an example of a government doing its job, having support from the community, using Research Evidence and having backbone and being willing to stand up to industries. They have been sued numerous times and they have been victorious because they have science on their side. Lucky last question. The number of us, of course, in the audience have been looking at their recent decision to stop selling cigarettes. Thinking about it, you know, this is just a ploy or an opportunity for us to maybe get in there and say, well, what else are they selling that is not good for our health . What some of the awful foods that they sell. So i wondered if they acquire marion might have some thoughts about lessons that can be drawn. On Public Record as saying that i think they ought to look. I dont know how this cvs thing came about. I dont know whether it was the result of anti does anybody here know . How did it happen . There is lot of press up there. Icc and cbs. You will see that there has been a huge history of investor access. Buy one share. Powerful citizens and Public Health Tobacco Movement that has made it realistic