This column is a mea culpa.
In this week's issue of Modern Healthcare, we highlight the leaders whom our readers and the editorial staff consider the most influential people in healthcare.
We go through a form of crowd-sourcing to determine who gets on the list. It begins by asking readers to nominate candidates. Over 9,000 suggested one or more names this year.
Stunningly, not one of our readers this year thought to nominate the first lady of the United States—Michelle Obama. And Modern Healthcare's editors—including me—never added her name to the list despite the fact that she arguably has had a bigger impact on public health than any first lady in American history.
Shortly after her husband—our No. 1 most influential this year—entered the Oval Office, she initiated a personal and political campaign aimed at reducing childhood obesity. “Let's Move” didn't just focus on getting America's youth to engage in more physical activity. She also initiated a policy-driven agenda to overhaul the foods kids eat at home and at school.
Don't let her push-ups with Ellen DeGeneres, mom-dancing with Jimmy Fallon or tearing up the White House lawn to install a vegetable garden fool you into thinking this was a soft public relations campaign. Working through Sam Kass, a family friend and Chicago chef who proved to have Rahm Emanuel-like arm-twisting skills once in Washington, she played an instrumental role in implementing some far-reaching changes in the information Americans get about what they eat.
“Michelle Obama's sophisticated and strategic campaign has transformed the American food landscape in ways considerably deeper than the public appreciates, even now,” Politico concluded last March after interviewing 60 people who were intimately involved in the process of making those changes.
As early as June 2009, at a public event displaying the first fruits of her vegetable garden, Mrs. Obama pledged the upcoming struggle for healthcare reform would include a focus on nutrition and prevention. The Affordable Care Act that passed a year later included a section mandating that restaurants list calorie counts on menu items.
She pressed a healthier foods agenda with the private sector. The American Beverage Association, which includes major companies like Coca-Cola and PepsiCo, agreed to list calorie counts on the front of their beverage labels. Wal-Mart reduced the sodium content—a major cause of hypertension—in its processed foods. Chains such as Olive Garden began substituting fruits and vegetables for french fries.
A White House policy team under her direction pushed for overhauling the school lunch program, where many low-income kids get half their calories. For those efforts, she earned opprobrium on social media from many kids who prefer to dine on pizza, fries and a Coke, and from the School Nutrition Association, whose members saw their profit-center turn into a money-loser.
The team led by Mrs. Obama pushed the FDA to update the food Nutrition Facts box. The new regulations require a line for added sugars and give greater prominence to the lines for the calories and servings in each container.
The Agriculture Department overhauled its food pyramid to give more room for fruits, vegetables and whole grains, and designed a better symbol—My Plate—for public education.
Has the “Let's Move” campaign been an overnight success? Of course not. The latest data suggest the obesity epidemic, though no longer growing, persists—along with its $150 billion a year in healthcare costs.
But her emphasis on physical fitness and food content transparency has changed public consciousness in a major way. Smoking didn't decline the moment the surgeon general issued his famous report. But transparency eventually led to understanding and understanding eventually led to behavioral change.
Michelle Obama during her nearly eight years in the White House succeeded in changing the national conversation about diet and exercise, and gave a major boost to food transparency. That's pretty darn influential in my book, and I'm sorry we missed it.