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

2. Healthy Base Initiative Inception National Prevention Strategy 2

3. Healthy Base Initiative 14 Pilot Sites Mountain Home AFB Yokota AB MCAGCC 29 Palms JB Pearl Harbor- Hickam Ft Sill Ft Bragg MCB Quantico NAVSUB Base New London Defense Logistics Agency Army Navy Marine Corps Coast Guard Agency Air Force KEY USCG AIRSTA Cape Cod National Guard Reserve March ARB Camp Dodge Defense Health Headquarters Ft Meade 3

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

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

6. Healthy Base Initiative HBI Initiatives at a Glance Focus on Addressing Obesity and Tobacco use Children, Schools & Families Healthy Food Options Physical Environment Health and Wellness Tobacco Use Physical Activity THE HEALTHY BASE 6

7. Healthy Base Initiative m-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 20132014 Percentage Facility Type Score Point Change DFAC* 82%81%-1% MWR Food 31%44%13% Exchange Food 39%44%5% MWR Contract Food 40%41%1% Convenience Store 36%39%3% Commissary 88% 0% Vending 17%16%-1.3% * 2014 DFAC assessments for MCB Quantico and Fort Meade pending 2013 – 2014 Percentage Point Change Legend >+1.0 Green +1.0 to -1.0 Yellow >-1.0 Red

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

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

10. Healthy Base Initiative Initial Observations 10 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

11. Healthy Base Initiative DeCA/Exchange Initiatives 11 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

12. Healthy Base Initiative DoD Food Study 12 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

13. 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 Healthy Base Initiative Way Ahead