Healthy Base Initiative Mr. Chuck Milam Principal Director Deputy Assistant Secretary of Defense

1. Military Community & Family Policy Healthy Base Initiative Mr. Chuck Milam Principal Director Deputy Assistant Secretary of Defense (Military Community and Family Policy) 28 October 2014

2. Healthy Base Initiative Inception National Prevention Strategy 2

3. Healthy Base Initiative14 Pilot Sites USCG AIRSTA Cape Cod Mountain Home AFB Ft Meade Camp Dodge Yokota AB Defense Logistics Agency NAVSUB Base New London March ARB MCB Quantico Defense Health Headquarters Ft Sill KEY Ft Bragg Army MCAGCC 29 Palms Marine Corps Navy Air Force Coast Guard JB Pearl Harbor- Hickam Agency National Guard 3 Reserve

4. Healthy Base InitiativeBurning Platform Obesity in the US has risen dramatically and is a threat to our national security 36% of American adults are obese of potential military candidates cannot qualify for the militarydue to their weight 27%

5. Healthy Base InitiativeBurning Platform Tobacco is the leading cause of death in the United States Smoking in the US In the US military of personnel younger than 25 smoke 37% 40% of enlisted personnel smoke of enlisted smokers initiated tobacco use while on active duty 40% http://www.cdc.gov/VitalSigns/AdultSmoking 5

6. Healthy Base InitiativeHBI Initiatives at a Glance Focus on Addressing Obesity and Tobacco use Children, Schools & Families Physical Activity • Share Our Strength • Alliance’s Healthy Schools Program & Healthy Out of School Time • Fitness on Request • 24-hour Fitness Physical Activity Children, Schools & Families Healthy Food Options Physical Environment Health and Wellness Tobacco Use Healthy Food Options Tobacco • Smarter Food Movement • Go For Green • Better-for-You • Menu Renovation • Farmers Markets • mNEAT • Fit-Pick (vending) • Increase Designated Tobacco Free Areas • Counter Marketing • HollyGraham • Fight the Enemy THE HEALTHY BASE Health and Wellness Physical Environments • UltimateMe • Group Lifestyle Balance • Community Health Promotion Council • Operation KidFit • mPAC

7. 2013 – 2014 Percentage Point Change Legend >+1.0 Green +1.0 to -1.0 Yellow >-1.0 Red Healthy Base Initiativem-NEAT Scores: 2013 – 2014 Comparison • m-NEAT = military Nutrition Environment Assessment Tool • Designed to provide a snapshot of availability of healthier food on a military installation 7

8. Healthy Base InitiativeOutcome Measures - Obesity *Source: Information pulled from clinical record available from outpatient visits at Military Treatment Facilities

9. Healthy Base InitiativeOutcome Measures - Tobacco *Source: Information pulled from clinical record available from outpatient visits at Military Treatment Facilities

10. Healthy Base Initiative Initial Observations • Dining Facilities provide some healthy options, however, most have limited hours of operation and are only open to authorized patrons • Many have closed due to budgetary constraints and low utilization rates; overall customer satisfaction remains low • Food portfolio requires significant changes in order to make healthy options easily available; based on results of m-NEAT • Requires engagement with all food services providers including Dining Facilities, Exchanges and MWR • Vending/fast food outlets scored very low and require attention • Initiated comprehensive food study to determine future options • Defense Advisory Committee on Tobacco established to provide SECDEF range of options going forward 10

11. Healthy Base Initiative DeCA/Exchange Initiatives • DeCA • Piloting Cornell University’s Smarter Food Movement • Utilizes “choice architecture” (how/where food is displayed) to influence customers buying habits • Testing “better for you” product labeling • Sponsoring Share our Strength healthy shopping tours • Exchanges • Marine Corp Exchange tobacco counter-marketing campaign • Increased availability of fresh foods in convenience stores • Posting nutritional information at food concession outlets 11

12. Healthy Base Initiative DoD Food Study • Burning Platform: • Launched in response to concerns raised during Quality of Life Working Group as well as lessons learned from HBI • Services provide subsistence feeding and essential dining services through a variety of delivery systems • 404 appropriated fund dining facilities, galleys and open messes • 653 nonappropriated fund restaurants and snack bars • DoD spends approximately $2B annually to provide essential dining services • Goal: • Develop potential courses of action to improve service, availability, and efficiency 12

13. Healthy Base InitiativeWay Ahead • HBI Demonstration: January 2014 - Aug 2015 • Collect baseline measurements • Launch selected HBI initiatives • Monitor/report initiative results • Evaluate/refine initiatives • Determine impact of initiatives • Report findings and recommendations • HBI 1.0 After Action Items: • Codify lessons learned through • Policy changes • Creation of toolkit/resources • Comprehensive communications strategy 13