Addressing Obesity and Disease in an Environment with Junk Food

The drug store business has evolved from just dispensing prescriptions. Many pharmacies now host retail health clinics that provide basic primary care services and pharmacists now immunizations, too.

Retail settings also sell junk food, sugary drinks, tobacco products, and alcohol. Annual alcoholic beverages and soft drinks sales at drug stores has skyrocketed, reaching approximately $3.9 billion in 2017. Selling these products replete with empty calories in a health care setting, like selling cigarettes, is counterintuitive.

A recent review published in theHealth Marketing Quarterlyaddress the dual role pharmacies play as health care and prescription medication providers and beverage and food retailers. The authors also propose opportunities for change and policy-making to improve the retail drug chain food environment.

Most Americans live within a 5-mile radius of a retail drug store. Retail drug stores also serve numerous underserved and low-income communities with high rates of diet-related chronic diseases and childhood obesity. Obesity is linked to several chronic conditions: hyperlipidemia, cardiovascular disease and hypertension.

Robust prescription drug sales increase the opportunities to market and sell unhealthy food and sugary drinks to this population. Availability of healthy food choices, counseling from all of the pharmacy’s health care personnel, medication therapy management, immunizations, health-related information, and promotion and presence of retail health clinics can serve as positive cues toward better health outcomes.

The authors propose 5 measures to limit the exposure to unhealthy food choices in a retail setting

1. Pharmacies that sell food and beverages could implement food-free or healthy-food-only checkout lanes; place healthier foods in preferred locations; maintain minimum stocking requirements for healthy foods; and offer nutritional education programs. Pharmacy benefit managers (PBM) could consider nutritional standards as a prerequisite for inclusion in the pharmacy benefit network.
2. Pharmacists can offer medication synchronization and help patients avoid making multiple trips to pharmacy and exposure to unhealthy foods. (If this service is offered, retail health care providers should encourage their patients to use it.)
3. Retail clinicians can offer nutrition and wellness information and direct patients to healthy foods and beverages.
4. Health systems operating retail health clinics can require a food-free entrance path, waiting areas, pharmacy counters, and endcaps adjacent to clinics.
5. Unlike alcohol or tobacco regulation to protect the public against chronic illness, retail food environment is unregulated. Presence of health clinics in a retail setting makes a convincing case for formal regulation.

Reference

Cara Wilking, Mark A. Gottlieb & Nathaniel Rickles (2019): The role of chain pharmacies to promote healthy food retail: Current trends, legal limits, and policy opportunities, Health Marketing Quarterly, DOI: 10.1080/07359683.2019.1575058