The ABC’s of Change: Health Advocacy for Everyone

For many of us who care about preventing obesity and keeping our families healthy, the idea of advocacy can be difficult. We understand that it has a role to play, but day-to-day, it’s tough to step up to the plate.

For those of us in public health, the barrier can be that the other side often looks bigger, badder and better-funded. For the rest of us – moms, dads, teachers – it can be hard to even know where to start. But at every level, from nation to neighborhood to corner store, action and advocacy are the keys to health.

Margo Wootan: Truth, Justice and the American Breakfast

On the national level, Margo Wootan is one of a rare breed who seem to say – more often than not – “bring on the bigger and the badder.” Strategic advocacy seems to be Margo’s middle name.

As the director of nutrition policy at the Center for Science in the Public Interest (CSPI), Margo has had a profound impact on our nation’s health. With her leadership, CSPI has achieved several significant obesity prevention victories for children and families. These wins have included the requirement that fast-food and chain restaurants post calorie counts and that packaged foods include trans fat information. They’ve included improvement in school foods, and the reduction in misleading junk food marketing aimed at kids.

In the public health arena, Margo is a true hero: An advocate who seems motivated by the seeming inequity of a fight. Margo’s detractors accuse her of supporting a nanny state where personal decisions are dictated by the government. They position the public health initiatives she advocates as an attempt to eliminate free choice. But that argument only stands up in a house of mirrors: Margo’s efforts are all about giving families choices. Parents may or may not choose to feed their kids sugar-sweetened cereals. What Margo argues is that they should know what they’re doing rather than being tricked by packaging or predatory marketing practices. What Margo argues is that the public should be armed with the truth.

Ofelia Zapata: A Champion for Change

On the local level, I’ve met influencers and leaders (even grocers) who have become passionate change agents. Here in Austin, Ofelia Zapata is a remarkable and inspiring health advocate. For years, Ofelia wasn’t a fighter. Life got in her way – specifically, a vision impairment that rendered her legally blind. She also believed, like many of us, that her opinion didn’t count, that those with decision making power were better educated and too busy to be bothered with her ideas. For a long time, Ofelia though she had nothing to contribute to important conversations. She struggled to hold her own in the face of authority. She was silent.

No longer. Today, Ofelia is a champion. She may be visually impaired, but she sees her community for what it is, what it needs, and what it has the potential to be. She chairs meetings. She raises issues; she organizes for change; she collects data; she shares it; she speaks up with community opinions; she helps community members engage in efforts to improve their neighborhood.  Ofelia develops community agendas, strategic planning, mobilization efforts. She is looked to as an authority– by those who live in her immediate neighborhood as much as by city government.  She is a local legend, and her voice is heard.

The Power of the Purse: An Apple a Day

Which brings me back to my larger point: We must all be advocates. We owe it to our kids, who, thanks to living in a world that makes obesity harder and harder to avoid, face the prospect of living sicker and dying younger than their parents’ generation.

Those of us in public health have it easy. We entered our field because we wanted to speak on behalf of those with whose voices are compromised or unheard. Our job is simply to stay in the game and on point, even when the going gets tough and our detractors get loud. But there’s a place along the continuum for everyone to stand up and be counted: Moms, dads, kids… in neighborhoods, in schools, even in supermarkets, where buying the apple (and the carrot and the broccoli) instead of the cookie (and the Pop-Tarts and the soda) can convince owners that healthier options are smart business.

Here in Austin, there is a large supermarket chain with a strong commitment to improving the health of its consumers.  Yet when we visited their location in one of our partner neighborhoods, healthy options were lacking and unhealthy choices abounded. “Why?” we asked. Would they be willing to partner to increase healthy options in the store?  “Certainly,” they countered.  “If customers in the neighborhood showed their support by demanding healthier options and by purchasing those already offered.”

The fact is that, in some cases, health advocacy has nothing to do with using our voices; we advocate with our wallets, too.  We can be demand agents, purchasing, using and frequenting healthy options (be they parks or sidewalks or fresh fruits and vegetables) with abandon.

Not all of us will make as dramatic a transformation as Ofelia. Not all of us will be as bold as Margo. Not all of us have to. But in our own ways, in our own settings and our spheres of influence, we must act.

Now, who’s ready to go buy that apple?


Together with the Alliance for a Healthier Generation, the Michael & Susan Dell foundation just released A Year of Being Well: Messages from Families on Living Healthier Lives. The book is a 13-month action guide featuring practical, step-by-step strategies to kick-start and stick to a healthier lifestyle. It’s available at no cost in both Spanish and English at