I’m sorry I didn’t see this one earlier but thanks to Khanna on Health for spreading the gospel on a recent March report from CDC: The Effect of Price Reduction on Salad Bar Purchases at a Corporate Cafeteria. The study tried to determine the effect of reducing the cost of the salad bar in a cafeteria, reducing the price by 50% during March 2012 and analyzing sales data by month for February through June 2012. The study found that reducing the price of salad drove up consumption by 300%. Amazing.
This is exactly the type of choice architecture that is needed to help create a healthier population. In the context of a corporate office, this sort of nudge could have serious positive consequences in terms of reducing health care costs, especially when combined with effective wellness programs. Yet, at the same time, as Khanna astutely points out in his own work:
Health system leaders I met with last year all raised their hands when I asked if they had wellness programs and kept them up when I asked if they also sold sugar-sweetened beverages in their cafeterias at highly profitable prices. The irony was completely lost on them. They had to be walked through the inconsistency of telling their employees to take (worthless) HRAs and biometrics, but then facilitating access to $0.69 22 oz fountain sodas.
This is the type of nudge that Bloomberg attempted here in New York City with the ‘soda ban’, but of course that was government dictating the choice architecture and not the employer. Regardless of who is doing it, subsidizing healthy foods makes all sorts of sense, especially in light of the fact that so much of the unhealthy choices are already severely subsidized. Soda is cheap because corn syrup is cheap because the US government subsidizes it. Leveling the playing field for healthy food should be an easy solution, but of course it is not. Corporate cafeterias are run in a way that incentivizes putting the soda machines in front while hiding the water or lowfat milk in back. However, if all the dots could be connected, corporate leaders would realize that the long-term benefits of helping keep employees healthy far outweigh the short term gains in the current paradigm. Who is paying attention?