Public Health Advocates Research Articles

Mapping the Lobbying Footprint of Harmful Industries: 23 Years of Data From OpenSecrets.

Commercial lobbying is often a barrier to the development and implementation of public health policies. Yet, little is known about the similarities and differences in the lobbying practices of different industry sectors or types of commercial actors. This study compares the lobbying practices of four industry sectors that have been the focus of much public health research and advocacy: tobacco, alcohol, gambling, and ultraprocessed foods. Data on lobbying expenditures and lobbyist backgrounds were sourced from the OpenSecrets database, which monitors lobbying in the United States. Lobbying expenditure data were analyzed for the 1998-2020 period. We classified commercial actors as companies or trade associations. We used Power BI software to link, analyze, and visualize data sets. We found that the ultraprocessed food industry spent the most on lobbying ($1.15 billion), followed by gambling ($817 million), tobacco ($755 million), and alcohol ($541 million). Overall, companies were more active than trade associations, with associations being least active in the tobacco industry. Spending was often highly concentrated, with two organizations accounting for almost 60% of tobacco spending and four organizations accounting for more than half of alcohol spending. Lobbyists that had formerly worked in government were mainly employed by third-party lobby firms. Our study shows how comparing the lobbying practices of different industry sectors offers a deeper appreciation of the diversity and similarities of commercial actors. Understanding these patterns can help public health actors to develop effective counterstrategies.

Public Health Advocacy in Times of Pandemic: An Analysis of the Medicare-For-All Debate on Twitter During COVID-19

Public Health Advocacy in Times of Pandemic: An Analysis of the Medicare-For-All Debate on Twitter During COVID-19

The Redox Stress Test: A novel technique reveals oxidative stress in Parkinson’s disease

A novel Redox Stress Test has been developed to identify symptoms of diseases associated with oxidative stress by observing symptom changes induced by short-term activation of the transcription factor Nrf2, to restore redox homeostasis. The Nrf2 pathway is triggered by a herbal preparation, Broccoli Seed Tea, developed to deliver a therapeutic dose of highly bioavailable sulforaphane, a potent activator of Nrf2. We discuss the rationale behind the tea and describe the methods used to optimise the bioavailability of sulforaphane to match the pharmacodynamics of Nrf2 activation. When consumed by people with Parkinson’s disease, the Redox Stress Test induced powerful and concurrent attenuation of a diverse group of Parkinson’s non-motor symptoms, including fatigue, constipation and urinary urgency. Motor symptoms were strictly unaffected. This observation indicates that oxidative stress may be a common factor contributing to non-motor symptoms involving sites in the CNS and peripheral organs. We tentatively interpret the results in terms of a hypothetical model for Parkinson’s Syndrome which we describe as a multisystem redox disorder with reservoirs of the disease in peripheral organs as well as in the brain. Eliminating the disease in peripheral organs is therefore a prerequisite to stopping disease progression in the brain. According to this model, the redox disorder in the brain provokes progressive neurological damage, which is not recognised as such in the early years. More specific neurological symptoms only come to light many years later, when damage to dopaminergic neurons creates a dopamine deficiency which eventually exceeds the threshold required for normal motor control, generating a new coherent group of neurological symptoms which define movement disorder. Given the apparent ease with which oxidative stress can be quenched in several locations simultaneously, we briefly discuss possible implications for public health, medical research, patients and patient advocacy groups. We note that the Redox Stress Test may have the potential to explore symptoms of other diseases where oxidative stress is believed to play a major role, although this remains subject to validation by further research.

Policies for Expanding Hepatitis C Testing and Treatment in United States Prisons and Jails

Hepatitis C virus (HCV) is highly prevalent in United States prisons and jails. In prisons and jails, rates of infection are ten to twenty times greater than national levels. And, more than thirty percent of all people living with HCV in the United States will spend time in prisons and jails in any given year. Rates are especially high among people who inject drugs (PWID), a population whose members are also likely to move between carceral settings and the community. Thus, addressing HCV among incarcerated populations would have a significant effect on the virus’s transmission both in and out of confinement and is a crucial part of any HCV elimination strategy. Safe and effective HCV treatment is available. Direct-acting antivirals (DAAs) offered in an eight to twelve week course of oral treatment cure HCV in more than ninety percent of cases. Widespread testing and treatment in prisons and widespread testing and treatment or linkage to community care in jails are essential public health approaches. But testing and treatment in confinement lags behind medical guidance and public health recommendations. People incarcerated in prisons and detained in jails are entitled to adequate health care, and the U.S. Constitution prohibits deliberate indifference to their serious medical needs. In recent years, lawsuits filed by people with HCV in carceral facilities across the country have alleged violations of federal law for failure to provide DAA treatment. Although litigation results have been mixed, settlement agreements in states across the country have expanded HCV testing and broadened access to DAA treatment. These settlement agreements reflect a growing understanding that widespread testing and treatment is cost-effective, avoid the harmful health consequences of disease progression, and meaningfully reduce community transmission. This paper recommends model policies for prisons and jails to expand HCV testing and DAA treatment. The policy recommendations draw from relevant settlement agreements and current medical guidelines, supplemented by input from public health experts, medical professionals, and advocates. The paper proceeds as follows: • Part I describes the HCV epidemic in United States prisons and jails, the recent sea change in treatment protocols, and relevant clinical guidance and public health recommendations. • Part II sets out the legal landscape, including governing federal law and judicial decisions interpreting that law in this context, and describes settlement agreements in class action lawsuits addressing DAA access. • Finally, Part III offers model policies for prisons and jails to expand testing and treatment and to support successful outcomes for people with HCV in their custody.

Impact of family history of cancer on colorectal cancer screening: a propensity score-matched analysis from the Health Information National Trends Survey (HINTS)

BackgroundEarly detection of colon cancer leads to better survival outcomes. This can be achieved through colorectal cancer (CRC) screening. People with a family history of cancer (FHC) have increased risk of developing CRC. Increasing screening in this group will reduce CRC mortality. This study evaluated CRC screening in people with FHC.MethodsThe study used data from the Health Information National Trends Survey (HINTS) 5, cycle 3. This is an annual cross-sectional survey with a nationally representative sample of American adults. The objective was to study the association between FHC and performing CRC screening. Propensity score matching was used to create a matched population with variables that constituted beliefs in cancer from the survey. Replication procedure, which is based on repeated sampling and allows for accurate computation of standard errors, was used for calculating statistical tests. Multivariable models were fitted in the matched population to assess the association between FHC and performing CRC screening.ResultsPeople with FHC were 14% (OR = 1.14; 95% CI: 0.81–1.60) more likely to perform CRC screening than those without FHC, even though not statistically significant. Age in years (OR = 1.14; 95% CI: 1.12–5.27) had increased likelihood of performing CRC screening, while other races such as American Indians/Alaskan Natives (except African Americans) compared to Caucasians (OR = 0.49; 95% CI: 0.29–0.84) had significantly decreased likelihood of performing CRC screening.ConclusionFHC was not significantly associated with having a colorectal cancer screening test. Public health advocacy should be directed towards increasing awareness of CRC screening among people with FHC.

Elevating organizational effectiveness: synthesizing human resource management with sustainable performance alignment

PurposeThis paper investigates the interactional relationships between sustainable human resource management (SHRM) and organizational performance (OP). Sustainable HRM is an approach that links HRM and sustainability. These studies focused on integrating HR with sustainable developments, such as economic and social aspects, in favour of focusing on the environmental aspect. Organizational change is an ongoing process that has to be managed effectively to keep the change in place for a long time.Design/methodology/approachA framework was offered to estimate the cause-and-effect relation of the SHRM and OP factors. Data is gathered from professionals from various pharmaceutical industries. This study applied two methods, Fuzzy AHP and DEMATEL Type II. These techniques are used to understand the cause-and-effect factors and their interactions.FindingsIt was observed from the findings that the factor of SHRM, such as Social Justice (F2), Green Job Design (F5), Green Training (F6) and Implementation of Green Policy (F8), was the most critical for the pharmaceutical sector that effects Financial performance (F13), Customer Satisfaction (F15) and Market performance (F14). Pharmaceutical firms ought to coordinate public health advocacy efforts, engage in healthcare initiatives and provide financial support for environmentally friendly efforts that improve social and economic conditions.Practical implicationsFor this sustainability, managers concentrate on creating an environment that is healthy and acceptable, and they work hard to mitigate the impact of natural factors and repair damage done to the environment; it is essential to move towards sustainable development to resolve environmental problems. Improving HR efficiency is among essential HRM responsibilities, as they expand the knowledge base of the workforce, enhance human capital, and eventually create valuable intangible assets and promote and encourage sustainable pharmaceutical products for some years.Originality/valueThis research paper has presented exclusive worth to the SHRM and organizational performance literature as it employs fuzzy FAHP and DEMATEL type 2. There is less research on SHRM in the pharmaceutical sector with these factors. In addition, FAHP and TYPE 2 DEMATEL are used in very few researches on SHRM approaches.

A new approach to teaching public health advocacy

A new approach to teaching public health advocacy

Impact of the COVID-19 Pandemic on Childhood Lead Testing and Blood Lead Levels

ObjectiveTo evaluate the effect of the COVID-19 pandemic on childhood lead testing and blood lead levels. MethodsA retrospective analysis of lead tests and results was performed across 3 urban medical centers during the pre-COVID-19 (March 10, 2019–March 9, 2020) and COVID-19 (March 10, 2020–March 10, 2022) periods. Interrupted time series analysis with quasi-Poisson regression was used to evaluate changes in lead testing between study periods. The relationship between sociodemographic features with detectable (≧2 µg/dL) and elevated (≧3.5 µg/dL) blood lead levels (BLLs) was assessed with multivariable logistic regression. ResultsAmong a total of 16,364 lead tests across 10,362 patients, weekly testing rates significantly decreased during COVID-19 (relative risk (RR) 0.64, 95% (confidence interval) CI 0.53–0.78). Census tracts with the greatest proportion of pre-1950s housing had a stronger association with detectable BLLs during the COVID-19 period (pre-COVID-19 adjusted odds ratio (aOR) 1.73, 95% CI 1.35–2.20; aOR 2.58, 95% CI 2.13–3.12; interaction P value .014). When limited to 1 year following COVID-19 (March 10, 2020–March 10, 2021), the association between both elevated BLLs (pre-COVID-19: aOR 1.49, 95% CI 0.87–2.53; COVID-19: aOR 3.51, 95% CI 1.98–6.25; interaction P value .032) and detectable BLLs with pre-1950s housing were greater during the COVID-19 period (pre-COVID-19: aOR 1.73, 95% CI 1.35–2.20; COVID-19: aOR 2.56, 95% CI 1.95–3.34; interaction P value .034). ConclusionsThe COVID-19 pandemic led to a significant reduction in lead surveillance and magnified the effect of known risk factors for lead exposure. Concerted clinical, public health, and community advocacy are needed to address care gaps and excess cases of lead poisoning.

Addressing health equity in pediatric surgical care in the United States– Progress and challenges

There are notable inequities in health outcomes for children based on their social determinants of health (SDOH), including where they are born and live, their primary language, their race and ethnicity, socioeconomic status, and more. These health inequities are not restricted to resource limited settings; here we highlight three broad topics that are relevant to pediatric surgeons in the United States (US): access to care and disparities, and examples of inequities in firearm-related injuries and appendicitis.Most of our patients will at some point require operative interventions, yet there can be significant challenges in accessing this care and navigating our health systems, particularly around complex perioperative care. There are significant opportunities to improve equitable care by helping patients navigate our health systems and connecting them with additional resources, including screening for primary care services.Firearm-related injuries are now the leading cause of death in children in the US, with significant associated morbidity for non-fatal injuries. There are notable inequities in the risk of injury and types of injuries experienced by children based on their SDOH. Appendicitis is one of the most common pathologies managed by pediatric surgeons, with similar inequities in the rates of perforated appendicitis based on a child's SDOH.For both issues, addressing the inequities our patients experience requires moving upstream and working towards prevention. Key opportunities include better research and data to understand the drivers for observed inequities, multidisciplinary collaboration, community engagement, and public health advocacy among others. As a profession, we have a responsibility to work to address the health inequities our patients experience.

Integrated Knowledge Translation in the Food and Nutrition Security for Manitoba Youth study

Abstract Background There are concerns that many children do not have healthy diets, which may be related to dietary choices as well as lack of access to healthy foods. The Food and Nutrition Security for Manitoba Youth (FANS) study examined diet, nutrition-related behaviours and food security of 1587 grade nine students in Manitoba, Canada. Results show that while one in five students were food insecure, almost all need significant dietary improvements. Engaging stakeholders through multiple communication channels is key to disseminating research outcomes to drive action for policy change. Methods Principles of integrated knowledge translation were followed, including a breadth of dissemination activities, to maximize impact of study results. These included diverse partnerships, academic and non-academic research outputs, and use of media. Results Study partners including academic co-investigators, school authorities, government agencies and non-profit organizations advocating for child nutrition contributed to study design, interpretation and dissemination. Results were published in academic journals, as well as translated into a suite of non-academic outputs including a community report, infographics (circulated on social media), and a searchable data dashboard, available through a web-based portal. This approach allows for tracking of research output downloads, which number over 500 to date. Due to active outreach to traditional media, study results received widespread attention adding to the breadth of knowledge translation methods employed. This also led to uptake by provincial health education curriculum developers. Results will also be circulated during an upcoming provincial election as part of engaging candidates around child nutrition and food security issues and policies. Conclusions This broad approach to integrated knowledge translation has resulted in extensive distribution of FANS study results and has potential to influence public health nutrition policy. Key messages • Integrated knowledge translation and a breadth of dissemination strategies in the FANS study has led to extensive distribution of research outputs and media coverage. • The FANS knowledge portal, with diverse academic and non-academic research outputs including a data dashboard, is strategic for public health nutrition promotion and advocacy.

Establishing a Platform for Public Health Advocacy in the midst of a Pandemic

Abstract Issue/problem Prior to the COVID-19 pandemic, Doctors working in Public Health Medicine in Ireland lacked a platform to present a collective voice to advocate on issues of public health concern. The aim of this abstract is to describe the establishment of a platform for advocacy through the formation of the Irish Society of Specialists in Public Health Medicine (ISSPHM). Description of the problem An independent society for Public Health Doctors in Ireland was lacking. Models used by other medical specialties in Ireland and international practice was reviewed. The ISSPHM was developed to build capacity and capability for advocacy amongst Public Health Doctors in Ireland by providing indemnity for members and a forum to interact with the media. Results A constitution, mission statement and website for the society were developed. The formal launch of the ISSPHM took place in December 2021. Outputs to date include co-hosting of webinar entitled ‘Public Health and the Law'; contributing to the Irish Public Health Reform Expert Advisory Group; a position paper on pandemic preparedness; a statement on migrant health (published on the ISSPHM website and widely quoted in the media); letters published in Irish media; interviews on national radio and the formation of a Climate Change Working Group. Lessons The ISSPHM successfully creates an environment where Public Health Doctors can advocate on major issues. The establishment of an independent society requires diverse expertise and resources. Future plans for the ISSPHM are to further collaborate and build on existing partnerships and expand eligibility for membership to include other colleagues working in Public Health e.g. nurses, surveillance scientists, data analysts. Key messages • An independent national society for Public Health Doctors is an extremely useful vehicle for advocacy. • The establishment and development of an independent society is a significant undertaking requiring diverse expertise.

Gender differences in risk factors for smokeless tobacco use: Insights from the latest nationally representative cross-sectional demographic and health survey (2019–2021) and their potential implications for smokeless tobacco control in the WHO South-East Asia region

Introduction: The global prevalence of Smokeless Tobacco (SLT) use is estimated to be 4.72%, concentrated in South East Asia. Despite declining smoking rates, SLT usage remains high, resulting in 2.5 million DALYs and 90,791 deaths in 2017 due to cancers and heart diseases, with India contributing 70% of DALYs. This study examines risk factors for SLT use in Indian males and females aged 15–49 using 2019–2021 demographic and health survey data, also exploring gender differences. Methods: The study analyzed a substantial sample of 724,115 females and 93,267 males utilizing data from a nationally representative cross-sectional demographic and health survey conducted between 2019 and 2021. Gender-specific multivariable logistic regression analyses were performed to identify risk factors influencing SLT use. Results: The findings reveal gender-specific variations in SLT use risk factors. Among males, older age groups (35–49) were less likely to use SLT compared to those aged 30–34. In contrast, among females, SLT use increased with age, with the highest rates in the 40–44 and 45–49 age groups. Marital status played a significant role, with widowed, divorced, and separated females having higher odds of SLT use compared to currently married females. Tribe ethnicity was associated with increased odds of SLT use in females but not in males. Christian females had higher odds of SLT use than Hindu females, while Christian males had lower odds compared to Hindu males. Conclusion: These findings provide valuable insights for policymakers, healthcare professionals, and public health advocates in developing targeted interventions to combat SLT use in South-East Asia. By addressing gender-specific risk factors and tailoring strategies to different populations, progress can be made in reducing the burden of SLT use and improving public health outcomes in the region.

Fourteen quick tips for crowdsourcing geographically linked data for public health advocacy.

This article presents 14 quick tips to build a team to crowdsource data for public health advocacy. It includes tips around team building and logistics, infrastructure setup, media and industry outreach, and project wrap-up and archival for posterity.

Viewpoint diversity in public health.

Schools of public health are often situated within universities but not infrequently also function as public health advocacy organizations. Viewpoint diversity on many issues is often limited within schools of public health and does not reflect the diversity one finds in society more generally. It is argued that welcoming, and even seeking out, viewpoint diversity within public health would contribute to understanding and knowledge, to the training public health leaders and academics who can serve the whole of society, and to working together across ideological lines to better contribute to population health.

Perspectives From Public Health Practitioners and Advocates on Community Development for Active Living: What are the Lasting Impacts?

Evidence suggests differential impacts of community development, including gentrification and displacement. Public health practitioners and advocates are key stakeholders involved in the community development process related to active living, yet little is known about their perceptions of its impacts. We explored the perspectives of relevant leaders of public health departments and key community and advocacy organizations on community development, gentrification, and displacement. Purposive key informant interviews. CDC State Physical Activity and Nutrition (SPAN) funding recipients. CDC SPAN recipient leadership (n = 10 of 16) and advocacy organizations they partnered with (n = 7 of 16). Interviews were recorded, transcribed, coded, and thematically analyzed with direct quotes representing key themes. Both groups felt community development held important benefits, specifically by creating healthy living opportunities, but also potentially leading to the displacement of long-time residents. Practitioners reported the benefits were for all community members, whereas advocates noted the benefits were seen in those with privilege, and the consequences were disproportionately seen in disadvantaged communities. Both mentioned the importance and difficulty of getting diverse representation for community engagement. Learning how key stakeholders perceive and navigate the community development process can help inform recommendations for better equity in active living community improvements. More work is needed to further elucidate best practices for health and social equity in the community development process.

Targeted Invitations to Tailor: Establishing Fertility as Relevant in U.S. Sex Education

ABSTRACT The United States faces troubling fertility trends that include high percentages of unintended pregnancies, as well as record-low fertility rates and individuals having fewer offspring than they desire. To address these problems, scholars and public health advocates have argued for the implementation of fertility information into existing sex-education curricula. In this study, we draw from 32 semi-structured interviews with secondary school sex educators to gain insight into their experiences on this front. They contended that one of the greatest barriers to their successfully teaching fertility related material was that students do not find fertility information relevant. Participants described three appeals that they employ to communicate fertility information as persistently relevant to the adolescents in their classes. Our interviews revealed that all three of these relevance appeals employ targeted invitations for students to tailor fertility information in ways that fit them personally. These findings suggest a need to re-conceptualize targeting and tailoring research in ways that connect with the goals of in situ, relevance-oriented communication, and they indicate how a focus on teaching health educators to establish fertility as relevant would help to situate future generations for better sexual and reproductive health over a lifetime.

Commercial lobbying and political contributions: an Australian scoping review

ObjectiveMany of the most effective and equitable policies to reduce the burden of non-communicable diseases threaten the interests of powerful corporations. A first step for public health advocates seeking to challenge powerful corporate interests is to understand the nature and extent of corporate political practices. This scoping review explored public health research on two political practices in Australia: lobbying and political donations. MethodsWe searched six databases, two Google Advanced searches and 11 Australian public health websites. We screened 2866 documents in total, and extracted information about political practices, industry actors and datasets. Results62 studies published between 1980 and 2021 were identified, analysing public health advocacy, policy submissions, direct engagement with government representatives and political donations. We extracted data from 14 studies that focused on direct engagement and/or political donations. Most focused on ‘unhealthy commodity industries.’ ConclusionsAnalysis of lobbying and political contributions in Australia is a nascent but expanding area of public health research. We discuss opportunities for future research to strengthen the evidence base and support public health advocacy to counter harmful corporate practices and promote and protect population health. Implications for Public HealthCountering powerful commercial interests requires greater investment in understanding corporate political activities.

Developing evidence for building sanitation justice: A multi methods approach to understanding public restroom quantity, quality, accessibility, and user experiences.

Access to basic sanitation is a human right and a critical environmental determinant of health. In this paper, we detail the development of three tools to investigate sanitation justice: (1) our public restroom spatial database, (2) our field assessment tool, and (3) survey of restroom access experiences. We document our process to collect these data in a consistent, health equity-driven framework. Together, these tools comprise a suite of methods for the examination of public restrooms from the macro- to the micro-level, and highlight key opportunities to promote health and well-being among restroom-reliant populations (e.g., people experiencing homelessness) by advancing sanitation justice in the built environment. With an illustrative case study, we demonstrate how methods triangulation, using the tools in concert, can provide a comprehensive assessment of basic sanitation access in a given region-San Diego, CA. We also detail how each tool can also be used separately to assess key sanitation justice and health equity questions that may be of interest to researchers, public health practitioners, policymakers, and advocates, including: (1) where do public restrooms exist (mapping)?; (2) how accessible are public restroom facilities, and what health-supportive features do they have (field assessment)?; and (3) what are the experiences of people most reliant on the available public restroom facilities (survey)? The results of our case study demonstrate that these adaptable tools can be used to provide meaningful data on and a holistic picture of public restroom quantity, quality, accessibility, and the experiences of public restroom users in a given region.

Global leadership in paediatric and congenital cardiac care: education and empowerment to improve outcomes in low- and middle-income countries - an interview with Krishna Kumar, MD, DM FAHA.

Dr Krishna Kumar is the focus of our sixth in a series of interviews in Cardiology in the Young entitled, "Global Leadership in Paediatric and Congenital Cardiac Care." Dr Kumar was born in Raurkela, India. He attended medical school at Maulana Azad Medical College in New Delhi, graduating in 1984. Dr Kumar then went on to complete internal medicine, emergency medicine, and adult cardiology training at All India Institute of Medical Sciences in 1988, 1989, and 1990, respectively. He then pursued paediatric cardiology training at Harvard Medical School in Boston, MA, USA. Dr Kumar began his clinical position as a paediatric cardiologist at Amrita Institute of Medical Sciences in Kochi, Kerala, India.During his impressive career, Dr Kumar has made significant contributions to educational advancement, research and innovation, public health advocacy, and clinical care. Dr Kumar is credited for distinguishing paediatric cardiology as a distinct subspecialty in India. He was a founding member of the Pediatric Cardiology Society of India and the original editor of the society's academic journal. Recognising the deficit of paediatric cardiology-trained physicians in low- and middle-income countries, Dr Kumar helped establish formal structured training programmes for paediatric cardiology in India. More recently, he established the Children's HeartLink Fellowships in paediatric cardiac sciences at Amrita Institute of Medical Sciences in Kochi and Institut Jantung Negara in Malaysia. Through educational programmes, Dr Kumar has taught countless caregivers and paediatricians, in India and neighbouring countries, the early identification and management of children with CHD. Dr Kumar has established a premier paediatric heart programme at Amrita Institute of Medical Sciences. As department Chief, he emphasises the importance of teamwork, advocacy, and continuous quality improvement. He has developed numerous low-cost strategies for the management of CHD. He has established large community-based studies on rheumatic heart disease and CHD in South India. Dr Kumar's focus on advocacy and policy change in India has made a substantial impact on early identification and treatment of CHD in the subcontinent. He has made a global impact on the care of paediatric cardiology patients through his educational programmes, research and innovation, large-scale research registries, and advocacy for public health policy changes. He is an incredibly humble and generous leader, and his patients and community are the source of his unending motivation.

History Lesson

History teaches us that while public health advocates can do much, a country needs well informed and courageous members of Congress to put useful public health measures into law. In the late 20th century, the work of one such individual, Congressman Joseph Moakley (D-MASS), helped to revolutionize the laws on food advertising and labeling and resulted in major gains in information for consumers. Given the recent modernization of nutrition labeling, this article attempts to highlight the initiatives led by the unsung hero of recent past, Congressman Moakley. Specifically, in the practice of nutrition, the behind-the-scenes initiatives that have helped standardize food labels and better educate the consumers to improve public health often go underrecognized. This article presents a brief overview of Moakley's contributions in these domains and identifies gaps for future works in the field of nutrition labeling.