Summary
Summary: The Healthy Food Procurement Initiative in Los Angeles County is a Policy, Systems, and Environment (PSE) Change intervention designed to improve the quality of food purchased and offered in food service contracts through the implementation of nutrition standards. In 2011, the County of Los Angeles (County) Board of Supervisors adopted Healthy Food Promotion in Los Angeles County Food Service Contracts, a motion aimed at County departmental food procurement policies and practices as they relate to nutrition. The motion established a process for the County’s Department of Public Health (DPH) to develop nutrition standards and/or healthy food procurement practices in new and renewing Requests for Proposals (RFP) for food service and vending contracts across County departments.
The County of Los Angeles has 37 departments and over 100,000 employees. An internal assessment found that fifteen out of the 37 departments procure (sell, serve, and/or distribute) food. The initial assessment involved an extensive survey of the settings (e.g., cafeterias, vending machines, and concessions), practices (current nutrition standards, dietary accommodations), and challenges anticipated by each County department. Since 2011, DPH has partnered with 7 County departments. DPH provided technical assistance to each department, conducted site visits and menu reviews, recommended and integrated DPH nutrition standards in County contract solicitation and operational processes, and established a monitoring and compliance system.
An adapted version of the validated Nutrition Environment Measures Survey for Vending Machines (NEMS-V) tool and an internally developed environmental scan tool for cafeterias were used to collect baseline and follow-up data on the food and beverage options offered in vending machines and cafeterias at select facility locations. Baseline data on food and beverages that are offered in 45 County hospitals and multiple worksite cafeterias were collected.
Vendor quarterly revenue, product sales records, and nutritional information of vending machine snacks and beverages were collected to examine the level of adherence and impact of 100% healthy vending policy at a large urban agency in Los Angeles County.
Findings: A key finding was that policy adherence increased for snacks and beverages sold in County vending machines at the start and 23 months after implementing the policy; from ~32% to ~61% for snacks and ~50% to ~98% for beverages. However, average snack and beverage revenues appeared to decrease during the sampled period for snacks and beverages by ~37% and ~34%, respectively. DPH also conducted an environmental scan sub-assessment, and found a 32% price increases for vended snacks and beverages occurred shortly after the implementation of the policy.
DPH plans to continue technical assistance through the dissemination of healthy food procurement toolkits, and promotion of model procurement guidelines for a variety of venues and institutions. The DPH evaluation team has published several articles pertaining to healthy food procurement work and has several manuscripts in development that document the challenges and successes of creating healthier food environments. Contribution to this evidence base provides valuable information for informing similar efforts in other sectors (e.g., cities, private companies, community-based organizations with food services).
This study uses California Health Interview Survey (CHIS) 2020 data.
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