Recent health promotion literature contains much discussion about the need to use culture and environment to help people engage in and sustain healthy behaviors. Culture is defined by a set of expectations about how it is normal to behave; we experience culture in our family life, at work, and in social settings. Environment is the physical nature of our surroundings, including the space where we live or work and resources available to us. The combination of culture and environment can be a powerful influence on health habits.

After many years of effort to encourage healthier lifestyles, still few Americans actually do most of what they should. Why is this? What are we doing wrong? Some experts speculate that in all our striving to develop effective nutrition, physical activity, smoking cessation, and stress management programs, we’ve failed to change the most important fundamental factors in most people’s lives: culture and environment. Those experts might just be on to something!

In Pricing and Availability Intervention in Vending Machines at Four Bus Garages (January 2010 Journal of Occupational and Environmental Medicine) Simone French, et al, evaluated the effect of lower prices and higher availability of healthy food and beverage options in 33 vending machines. For 18 months, the number of healthy options was increased to about 50% of items, while their prices were reduced to an average 31% below unhealthy options. Two control garages offered vending machine choices at the usual availability and cost. Sales data was collected and analyzed. The results:

  • Less cost and more availability made sales of healthy food and beverage options jump by 10%-42% (depending on type of item).
  • Price was particularly a factor in snack food purchases; healthy items at intervention garages were 48% of total snack food items purchased compared to 6% in control garages.
  • Healthy beverage sales for intervention garages were 54% compared to 40% in control garages.
  • Healthy frozen food purchases were 24% for intervention garages compared to 14% in control garages.
  • Overall, healthy food sales at intervention garages were over double those in control garages: 55% vs. 19%.

  • While truly revolutionizing culture and environment is a complex task, a combination of small actions can begin the process. This study indicates the more available and less expensive they are, the more people will choose these items. Both strategies can be successful in changing eating behaviors where food is provided at the worksite, and can apply in other situations as well. For instance, adjusting what’s served at meetings and cafeteria choices/prices could be equally effective.

    While eating is only one of many work culture and environment factors, these findings are telling. A healthier norm can significantly improve eating behavior, with far-reaching impact. Changing availability and cost of healthy foods also can affect related elements, such as social support and knowledge as well as attitudes about healthful eating.

    Simply said, making the healthy eating choice the easy choice could have a profound effect on behaviors, and ultimately the health of, your workforce.

    John Harris is Chief Wellness Officer and Senior VP of Healthways.


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