The fast-growing thicket of regulations mandating "healthy" vending in federal, state and local facilities was the focus of a panel discussion at the National Association of Blind Merchants' recent 2013 Business Leadership and Superior Training (BLAST) conference, held at the Marriott Downtown hotel in Indianapolis. The "healthy vending" panel, moderated by Vending Times senior editor Emily Jed, brought together nutrition experts from government agencies and other health advocates, along with blind vending operators. All are members of the Randolph-Sheppard Healthy Vending Work Group, recently established by National Association of Blind Merchants executive director Kevan Worley.
"This is one of the most important topics with which we've ever dealt," said Worley. "It impacts not only the Randolph-Sheppard community, but the entire vending and concessions industry; and it's one of the most critically strategic panels we've ever had."
The Vending Times senior editor pointed out that vending is, for the most part, a concession business in which the location contracts with an operator to provide a service desired by the location's workforce, clients or visitors. As such, the location always has the final say about what is to be offered for sale, but generally relies on the concessionaire's experience in offering a product mix that will prove popular with the patrons. When a remote authority distant from the locale, the clientele and the concessionaire imposes restrictions on the sale of products readily available across the street, the operator is placed at a severe disadvantage. It is difficult to see how anyone benefits from this, she emphasized.
Moreover, "One size does not fit all when determining what's 'healthy,'" the veteran journalist observed. "A crew that has just come in from a morning spent plowing snow or filling potholes will want, and need, more calories than someone who has been doing clerical work. The key is to offer a variety of products that will meet both needs."
She observed that many operators have made good use of the National Automatic Merchandising Association's Fit Pick program, which is the healthy vending program of choice for 175 government agencies. Others have created their own programs, or implemented others, with good results.
Jed introduced panelists Dr. Joel Kimmons, a nutrition scientist and epidemiologist with the Centers for Disease Control and Prevention's Division of Nutrition, Physical Activity and Obesity; Katherine Bishop, nutrition policy associate with the Center for Science in the Public Interest; and Denise Funkhouser, director of the General Service Administration's Occupancy Administration Division and Melissa Walker, the division's wellness amenity program manager.
Rounding out the panel were Carol Voss, nutrition coordinator for Iowans Fit for Life, a joint statewide initiative between the Iowa Department of Public Health and other public health organizations, and Susan Klein, a consultant for the Iowa Department of Public Health; W. Scott Cass, a training consultant with the Colorado Business Enterprise Program; Billy Brumlow, a licensed blind vendor from Tennessee who is chairman of the committee of blind vendors with Tennessee Business Enterprises; and Sheree Edwards, National Automatic Merchandising Association southern region legislative director.
Putting operators into the big picture about the increased focus by the federal government on the nutritional content of vending products was CDC's Dr. Joel Kimmons. The nutrition scientist led the preparation of the Health and Human Services' and General Services Administration's Health and Sustainability Guidelines for Federal Concessions and Vending Operations, which are intended to assist vending and concessions providers in increasing healthy food and beverage choices and sustainable practices at federal worksites.
MORE CHOICE, NOT LESS
He emphasized that the guidelines, followed by many blind operators, are designed to make healthy choices more accessible, more appealing and more affordable -- not to restrict choice. Kimmons is also working to help the National Association of Blind Merchants secure grant funding to help educate blind vendors on the best approaches to incorporating "healthy" vending into their operations.
"The percentage of obese and overweight people will add dramatically to the nation's health problem," he said. "It will cripple the potential advancement of the nation, since we will have to put most of our money into healthcare. Health is an issue we can and should address, and we should challenge ourselves and become part of the solution."
The two fundamental ways to address the obesity epidemic are through diet and physical activity, and these are two areas that are easy to change, Kimmons said.
One push by government and health advocates is to make it easier for people to integrate physical activity into their lives by changing the physical environment where they live and work, including building sidewalks to encourage them to walk.
"It's also important to make 'healthy' food and beverage choices quick and easily accessible," the CDC official continued. "When people don't have to push and fight to make a healthy choice, it comes easier. We're working to make healthier choices easier to get to, and you're part of the food environment."
Kimmons acknowledged that defining "healthy" can be a challenge. The most straightforward generalization, based on the best science, is the 2010 Dietary Guidelines for Americans, he said. These are the standards HHS and GSA used as the basis of their collaborative Health and Sustainability Guidelines for Federal Concessions and Vending Operations.
The guidelines recommend that 25% of the items sold in vending machines meet those standards. "It's not rigid and not intended to restrict 'unhealthy' items, but to add more 'healthy' choices," Kimmons explained, adding that CDC is encouraging similar guidelines at the state level, too.
"You all have a stake in making the food system healthier, and in becoming involved to build a model for healthier eating," Kimmons stated. "We want consumers to choose 'healthier' by giving them more choice. A choice has to sell and be consumed, if it's to work for the health of the nation. We're all in this together, and this session and the Randolph-Sheppard Healthy Vending Work Group are the beginning of a process to explore and succeed at operationalizing vending as a healthy food solution to the nation's eating disorder."
Joining the discussion by conference call were GSA's Denise Funkhouser and Melissa Walker,who collaborated with Kimmons on developing the healthy vending guidelines for federal facilities. In her role with GSA (the purchasing arm of the federal government), Funkhouser works closely with state licensing agencies that contract with blind operators to help them execute effective programs in federal facilities. GSA currently has more than 1,100 Randolph-Sheppard facilities in its portfolio.
"Customers are asking for healthier foods, especially as the new generation is coming into the workforce, and we have the relationship with you to make it happen," she said. "We are great partners with Randolph-Sheppard, and we understand that this is your livelihood."
GSA committed to providing access to affordable "healthy" food in its own building by following the guidelines, and many other agencies are seeking its assistance to improve the "health" of food in their facilities, according to Funkhouser.
She emphasized the importance of getting the word out to employees and visitors who patronize the machines, and to those who may become patrons once "healthier" options are made available. "That's an essential piece of making it work," she said. One method with which GSA has had success is hosting a product sampling in its lobby, with the assistance of Randolph-Sheppard vendors.
The official also advised operators to take advantage of the Healthy Vending Toolkit developed as part of the federal guidelines, which provides simple, effective ways to implement a program.
Katherine Bishop of CSPI, an advocacy organization focused on food, nutrition and public health issues, emphasized that government at every level and health advocates are increasingly focused on the selections available in vending machines across the country.
"They're concerned with increasing obesity rates and the many health problems associated with poor diet and obesity," she said. "But what is good for the nation's health doesn't have to negatively impact your business. Many vendors are finding that providing healthy options can make their businesses stronger."
Bishop underscored the importance of workplace nutrition, stating that people spend almost half of their waking hours at work; and that the foods available in employee cafeterias and vending machines often determine what they eat throughout the day. These workplaces include government facilities, which employ 17 million people and have many daily visitors.
"States and localities don't want to undermine their obesity-prevention work," Bishop said. "It sends the wrong message if they have big statewide obesity campaigns and then lack healthy options in their vending machines, concession stands and cafeterias."
She pointed out that the American Heart Association has made "healthy" food in public places a priority for its state affiliates across the country. Other health organizations have followed its lead in working with governors, health departments, boards of health and legislators to develop policies to improve the nutritional quality of foods in public venues.
State and local governments are at various stages of exploring "healthy" vending as well, Bishop said. Some are putting together taskforces to assess how they can make changes and where to start, while others are creating standards for specific public sites like state agency buildings and parks.
"Some of you are already working with public health partners in your state or locality," said Bishop. "And I hope more of you will become a part of this movement, and work cooperatively with government and health advocates to improve the nutritional quality of foods in public places, while still making money -- and maybe even improving your business."
The public health advocate emphasized that consumers increasingly want "healthier" choices, and that operators who are not providing a selection of them are likely missing out on some customers.
One approach CSPI suggests is for operators to replace their slowest-selling products with "healthier" options. "Doing that shouldn't cost you money, because the products you are taking out aren't making you much money in the first place," she stated. Bishop also urged operators to partner with state and local public health advocates, who can provide resources and support to help determine which wellness-oriented products are most likely to sell by conducting taste-tests or polling customers, for example.
Once better-for-you selections are added to the mix, it's essential that operators inform and remind people that they're there, Bishop advised. Public health partners can help spread the word through email messages to staff, articles in newsletters, flyers in hallways, and presentations at staff meetings.
"Vending consumers are conditioned to make the same choice each time, without looking at all the products available to them," Bishop continued. "If all the healthy options are in the bottom row of the vending machine, many people won't see them or realize they are there. If you display them at eye level, it's more likely that customers will notice them."
Pricing is another marketing tactic Bishop advised operators to use to promote "healthier" options. "You can increase the cost of an 'unhealthy' option, to offset the price of 'healthy' options and make them less expensive," she suggested. "We've seen that places that use pricing techniques do not see profits decrease, because they are balancing out potential losses by increasing overall purchases, or offsetting the cost by changing the price of 'less healthy' items." In some cases, such a pricing strategy can even increase revenue, according to Bishop.
"You can make changes on your own, or with the support of your health department, procurement office, nonprofit health organization or whomever is leading the effort to improve food in public places in your state or locality," advised Bishop." Interest in nutrition is growing; change is happening. We hope we can all work together to ensure that change is good for the nation's health, as well as your financial health."
Tennessee blind vendor Billy Brumlow informed seminar participants that two years ago, his state mandated that 25% of vending machines be merchandised with "healthy" products that meet NAMA's Fit Pick criteria. Now some local jurisdictions are seeking a far more restrictive -- and unsustainable -- 50%.
Brumlow said data from a survey of operators impacted by the nutritional restrictions suggest that devoting 21% to 25% of the machine to Fit Pick selections, accompanied by static clings and shelf markers that draw attention to them, is the most sustainable model, and does not have a "devastating" effect.
"Many operators still have 12% to 15% of product go out of date, or not move at all, when they implement 'healthy' vending," said Brumlow." Some will have to lay employees off or go out of business because of these mandates, when there's a 70% unemployment rate among the blind already. And that means there's less money to the state in sales tax and less money to fund Business Enterprise programs."
He cited a survey of more than 7,000 state workers in Tennessee, conducted as part of an executive order by the governor, that concluded that 15.6% of them use the vending machines operated by blind vendors weekly; but only 6% do so daily.
"This clearly indicates that the majority of food -- and calories -- consumed does not come from vending machines," he stated.
In Brumlow's opinion, the most "meaningful and sustainable" change in eating and snacking habits will not result from mandating what can be sold in vending machines. What he believes would drive positive change is the "more sensible" approach of health advocates who suggest parents pack healthier lunches and involve their children in the process, cut off their electronic devices and send them outdoors to play.
"This sensible and balanced approach will result in a lasting and sustainable demand in the future for healthy vending in the workplace," said Brumlow. "Placing the burden on the blind vendors to reform the eating and snacking habits of adults, taking away people's choices through mandates and attempting to create demand for 'healthy' vending via mandates, is unconscionable."
Iowans Fit for Life's Carol Voss reported that close collaboration with blind vendors through Iowa's Business Enterprise Program was critical to piloting and refining Iowans Fit For Life's "healthy choices" assessment tool for vending machines.
PHOTO: National Association of Blind Merchants works closely with other groups defending small business and consumers' right to choose, and the National Automatic Merchandising Association is one of them. Pictured here, from right, are NABM president Nicky Gacos; NAMA senior vice- president, government affairs Eric Dell; NABM executive director Kevan Worley; NABM senior policy consultant David Paterson, a former New York State Governor; and veteran New York City metro area operator John Murn, Answer Vending (Farmingdale, NY). The group got together at the NAMA OneShow in Las Vegas to discuss the impact of "healthy" vending mandates on blind vendors serving government locations.
Called Nutrition Environment Measurement Survey for Vending (NEMS-V), the tool's snack and beverage criteria are consistent with HHS and GSA federal "healthy" vending and concessions guidelines. It builds on a tool originally developed by Emory University to measure the availability of healthy food and beverage choices in grocery and convenience stores and in restaurants.
"In developing the 'healthy' vending program, we formed a working group to look at the guidelines from the perspectives of the consumer/employee, employer and vendor," said Voss. "It's key to have right partners on board."
Over the past three years, Iowans Fit for Life's program has been implemented in more than 375 vending locations. The basis of the program is a "healthy choices" calculator, which is available as an Android application for smartphones and tablets and at the group's website, nems-v.com. It classifies food and beverages into categories identified by the colors green, yellow and red, with green being the "healthiest" and red being the "least healthy." It also assists operators with determining the color codes of new products as they arrive on the market.
An online video at nems-v.comoutlines reasons to convert to "healthy" vending, along with strategies the organization has learned from its Business Enterprise Program partners.
Iowans Fit For Life also created social marketing tools to accompany its healthy vending program, based on focus group findings from blue- and white-collar worksites and rest areas. For the test, piloted by blind vendors, 30% of choices in machines were yellow or green.
"With all three groups, our message was to mix it up, and that now balancing your snacks has become even easier," Voss explained. "Green is great for you; red is not as good and yellow is somewhere in-between. So add a little variety in your snacking routine."
Based on the differences it found between blue- and white-collar audiences, the agency further refined and targeted its messages. "Blue-collar is not interested in nutrition information, but more interested in taste," Voss reported. "White-collar consumers justified their food purchases because they worked out that day, are under a lot of stress -- and sometimes just need chocolate!"
Klein said that over the past three years, the agency has worked closely with four vendors in the state capital complex to flesh out the best approaches once the program was implemented. One takeaway is that replacing the 20% of products in the machine that turn most slowly with "healthier" options minimizes the impact of "healthy" vending on profit.
Klein also emphasized the importance of operators knowing which products meet "healthy" criteria, then tracking the sales of each one they merchandise and modifying the mix, as necessary.
"You need to define and follow a system, which is very important; people need to know what is indicated as 'healthy,'" emphasized Klein. "People often do not expect to find healthy choices in vending machines, so making them aware that these options are available is another important step. We also have many resources available to motivate customers to purchase 'healthy' choices."
She encouraged operators to take advantage of the worksite kit on the NEMS-V website. It features signs, table-tents, snack tracking calendars, and a series of newsletters that promote healthy vending. "If you pay attention to promotion and placement, the volume of sales of healthier items will increase over time," Klein assured the BLAST participants.
The next phase of the "healthy vending" project for the Iowa Health Department is developing procurement guidelines to provide consistent criteria throughout state, county and local government facilities. They will also serve as a model for other businesses.
NAMA's Sheree Edwards assured operators attending the BLAST conference that the vending association is working diligently to represent their best interests on the state, local and federal levels, and is keenly aware of the unique way in which blind vendors are impacted by health and nutrition policies as operators in government-owned locations.
"We want to make sure we have a seat at the table to protect the industry while making sure consumers make the best choices they can," Edwards said.
She underscored the difficulty in classifying any particular foods or beverages as being "healthy" when mandating nutritional standards.
"How do you define what's healthy? Some things that are 'healthy' in one context are not in another, such as someone who has diabetes versus someone who has high blood pressure," Edwards said. "It can be a big discrepancy, depending on each consumer, and you can't have a one-size-fits-all approach."
She also emphasized that vending operators have been proactive in addressing the wellness movement by offering programs like NAMA's Fit Pick to provide a balanced mix of vending choices to the locations they serve, without the need for legislation mandating it.
"[New York City Mayor Michael] Bloomberg's 16-fl.oz. sugary beverage ban did not gain much traction when people pulled it apart," the NAMA counsel observed. "You could drink a 64-fl.oz. milkshake, but not a 20-fl.oz. soda, which made no sense. You can't make those choices for consumers and you can't cause harm to business owners; we don't want to injure the people we're trying to help. Freedom of choice encourages lawmakers not to legislate choices when dealing with adults."
Edwards said NAMA is lobbying intensively against such supposedly obesity-related initiatives as sugary beverage taxes, which in many cases are being eyed as revenue generators for cash-strapped states.
W. Scott Cass of the Colorado Business Enterprise Program said the organization is rolling out new "healthy" vending initiatives throughout the state, and taking measures to ensure they're profitable for the vendors it serves.
"Entrepreneurs and health departments have to have conversations to implement programs mindfully, and know what's at stake," he emphasized. "Our entrepreneurs need to make money, which is critical."
Cass said the Colorado BEP program focuses on incremental "healthy" product additions, with some locations wanting as much as 50% of vending machine menus to meet the criteria.
He stressed the importance of establishing partnerships. "The good thing about working closely with our health department is that they are willing to partner with us on some of the transition expenses," Cass pointed out.
The "healthy" vending training consultant urged operators to establish realistic goals for modifying vending and food concessions menus with a larger proportion of better-for-you selections. After implementing incremental "healthy" additions, Cass advised, it's important that operators evaluate sales results weekly, to ensure that they're offering a good mix.
"Critically evaluate sales; pull poor-selling 'healthy' items and replace them with others, and continue tracking their sales history," Cass recommended.
He also suggested that operators use waste-tracking sheets to gauge the movement of "healthy" products on a monthly basis. "Then review these product sales results with your health department contact, evaluate the success of this transition and adjust accordingly," he said. "It's very important to keep the dialogue open."
National Association of Blind Merchants president Kevan Worley took the podium, agreeing in conclusion that an open dialogue between operators and health officials will lead to the best possible outcome for all "healthy vending" stakeholders.
"We have to have open minds ourselves to tackle challenging change and still make a profit," he summed up.