Look in any vending machine, and you can find plenty of snacks with dubious nutritional profiles. Take the ones in the state Capitol in Salem, Ore.
"We've got a lot of Cheetos and Pop-Tarts and candy bars and cookies and things like that," says state Rep. Alissa Keny-Guyer.
She notes that the obesity epidemic has a direct impact on the state, so she introduced a bill to have vending machines on state property switch to healthful options. Like many public health advocates, Keny-Guyer stresses that she's not trying to dictate what people eat — just make it easier for them to make a healthful choice when they're pressed for time or seeking a snack. But it turns out that this public health campaign impacts an unexpected group: the blind.
In 1936, Congress gave blind vendors priority to operate vending and concessions on federal property with the Randolph Sheppard Act. States then extended the same treatment to state buildings.
Why? To create jobs for the blind. And finding employment is still a struggle for the blind today: Their unemployment rate is 70 percent, which means that the jobs and income from the Randolph Sheppard Act still matter.
Kevan Worley, director of the National Association of Blind Merchants, says "2,300 blind entrepreneurs go to work every day to feed their families because of the Randolph Sheppard Act. That's significant. It's the most successful employment program for the blind ever conceived."
Worley says the program does about $700 million in annual sales, with participating vendors earning a $46,000 median salary. And now blind vendors are worried that if junk food in the vending machines is replaced with more healthful fare, they'll take their business elsewhere. But whether this actually happens is unclear — there's some evidence that mandating 50 percent or more healthful food in vending machines harms business.
The Centers for Disease Control and Prevention has been working together with blind vendors and vending machine companies to find ways to positively impact offerings and selections without affecting the blind vendors' bottom line. Together, they are finding snacks that are affordable and actually fit in the existing vending machines, and looking at ways to highlight these options (such as little green tags that can inform and motivate consumers).
"Do vending machines contribute negatively to the overall diet?" asks Joel Kimmons, a nutrition scientist who worked on the Centers for Disease Control and Prevention's vending machine recommendations. "I think the question can be turned around, and you should ask, 'Can vending machines contribute positively to the overall diet?' "
The Oregon Healthy Vending legislation has gone through an overhaul: Instead of mandating 100 percent healthful snacks, the bill now calls for the creation of a task force to gather all interested parties together.
And blind vendors, like Worley, hope this collaborative approach will be the best way forward. "You know, I understand, if we don't reduce health costs, that's going to be a huge economic impact. But I don't want to balance the health of the nation on the backs of blind Americans," he says. "We can develop ways to have our cake and eat it, too."
RENEE MONTAGNE, HOST:
There's a movement afoot to get healthier snacks into public vending machines. In fact, some states and cities are trying to pass laws that mandate that. People who make their living running these machines say dried apples and soy nuts are no match for a Snickers bar.
And as Deena Prichep reports, those worried about losing profits on the machines have an unusually powerful voice in this debate.
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DEENA PRICHEP, BYLINE: The vending machines here in Oregon State Capitol Building don't have the healthiest selection of snacks.
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STATE REPRESENTATIVE ALISSA KENY-GUYER: We've got a lot of Cheetos and Pop-Tarts and candy bars, and, you know, cookies and things like that.
PRICHEP: Alissa Keny-Guyer is a state representative with a background in public health.
KENY-GUYER: It looks like obesity may overtake tobacco in the leading cause of disease and morbidity. So it's a really big concern. In Oregon alone, we lose about $1.2 billion because of obesity-related issues in our healthcare system. And we lose over $200 billion in work-loss productivity.
PRICHEP: So Keny-Guyer introduced a bill to have vending machines on state property - switch over to all healthy options.
KENY-GUYER: This is not telling people what they have to eat. It's really just trying to change the environment so that we make the personal choice an easier one to make.
PRICHEP: But it turns out changing that environment has an unexpected impact.
KEVAN WORLEY: Randolph Sheppard Act allows for a priority to be given to blind entrepreneurs to operate vending and concessions on federal property and some state properties are often included.
PRICHEP: Kevan Worley is head of the National Association of Blind Merchants, a division of the National Federation of the Blind.
WORLEY: Twenty-three hundred blind entrepreneurs go to work every day to feed their families because of the Randolph Sheppard Act. Twenty-three hundred, that's significant. It's the most successful employment program for the blind ever conceived.
PRICHEP: The Act passed in 1936, back when it was the rare blind person who had a job. But even now, unemployment among the blind is over 70 percent. And healthy vending initiatives - like in Oregon, California, and several other places - are seen as potential threats.
WORLEY: If they want, you know, chocolate-wrapped jelly doughnuts, they're going to find a way to get them. And so, to take them away, so we can't offer them, is going to kill our businesses.
JOEL KIMMONS: Do vending machines contribute negatively to the overall diet?
PRICHEP: Joel Kimmons is a nutrition scientist with the Centers for Disease Control and Prevention.
KIMMONS: I think the question can be turned around, and you should ask: Can vending machines contribute positively to the overall diet.
PRICHEP: Kimmons has been working with blind vendors to find ways to meet CDC recommendations; cutting trans fat, limiting sodium - without hurting the bottom-line. In Oregon, Representative Alissa Keny-Guyer has gone in a similar direction. Instead of mandating healthy snacks, the bill now calls for a task force, bringing together health advocates and blind vendors.
KENY-GUYER: I think the Randolph Sheppard Act, a fabulous program that started many decades ago, but it started decades ago when we didn't have this obesity epidemic. And so, like so many industries, I think it's really important that we all change with the times.
WORLEY: You know, I understand. If we don't reduce health costs, that's going to be a huge economic impact.
PRICHEP: Again, Kevan Worley with the National Association of Blind Merchants.
WORLEY: But I don't want to balance the health of the nation on the backs of blind Americans. We can develop ways to have our cake and eat it too.
PRICHEP: Worley hopes that with this collaborative approach, blind vendors and health advocates can find ways to meet the market and move it together.
For NPR news, I'm Deena Prichep.
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(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.