If Braun wants to make Indiana healthy again, here's how to do it
Obesity is one of Indiana's most urgent and costly public health challenges. Nearly 38% of Hoosier adults and 19% of children live with obesity, placing us among the most affected states in the nation.
Nationally, this chronic condition costs the U.S. health care system an estimated $173 billion each year and is linked to a wide range of serious illnesses, including heart disease, type 2 diabetes, cancer and premature death. Though often diagnosed in adulthood, obesity begins much earlier — shaped by a lifetime of exposure to the environments where we live, learn, eat, and play. Yet, our policies rarely reflect that reality.
Gov. Mike Braun on Tuesday issued a series of executive orders aimed at addressing nutrition and diet-related disease. The orders include plans to expand access to local foods, revise school wellness programs, increase transparency around food additives and develop a statewide strategy to reduce chronic disease. One order also proposes restricting what can be purchased through the Supplemental Nutrition Assistance Program (SNAP), preventing families from using benefits to buy certain foods like sugary drinks or snacks.
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Addressing obesity in Indiana is essential. But while these executive orders signal intent, the strategies fall short of the bold, evidence-based policies needed to make a measurable difference.
Take the proposed SNAP restrictions. SNAP is our nation's largest federal food assistance program, and it plays a key role in shaping food access for low-income households — especially children, who live in more than half of SNAP households.
Improving nutrition through SNAP is a worthy goal. But focusing on what people shouldn't be allowed to buy is a narrow and incomplete solution. In fact, research shows little consistent impact of such restrictions on dietary quality or obesity.
Worse, these policies can reduce autonomy, reinforce stigma, and weaken support for one of our most important safety net programs. This policy also leans heavily on outdated assumptions that obesity is the result of poor individual choices, despite decades of research showing that structural factors — poverty, food access, marketing, and community design — play a much larger role.
A better approach? Invest in what works.
The U.S. Department of Agriculture's Healthy Incentives Pilot, conducted in Hampden County, Massachusetts, tested what would happen if SNAP participants received a financial reward — an extra 30 cents for every dollar spent on fruits and vegetables. The results were clear: Participants increased their produce intake, without sacrificing food security or other household needs.
Combine incentives like this with culturally relevant nutrition education and reliable access to affordable, healthy food, and the result isn't just short-term behavior change — it's a path toward sustained, community-driven progress.
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To be clear: Improving school meals, expanding food access, and increasing labeling transparency are all important. But, on their own, they aren't enough. Obesity is a population-level problem, and it demands a population-level response — one that spans sectors and addresses the full ecosystem that shapes health, including housing, transportation, education, and economic opportunity.
Some communities are already showing what this looks like. In Somerville, Massachusetts, the Shape Up Somerville initiative took a multi-sector, community-wide approach to childhood obesity. The city revamped school lunches, repaired sidewalks and parks, partnered with restaurants to offer healthier options, and provided nutrition education for families.
It worked. After just one school year, children in Somerville experienced a notable decrease in BMI z-scores compared to those in similar communities without the intervention. Moreover, a 2019 study assessing the program's economic impact found that for every dollar invested, there was a return of $1.51 in healthcare savings and productivity gains over a 10-year period.
Other models across the U.S. reinforce this systems-level approach. Produce prescription programs — operating in states including California, Michigan, and Massachusetts — give patients vouchers to buy fruits and vegetables at farmers markets and grocery stores. Studies show that these programs not only increase fresh produce consumption, but also improve food security and diet-related health outcomes.
Medically tailored meal programs, where individuals with diet-related illnesses receive customized meals through healthcare or community-based organizations, show similarly compelling outcomes. Research has linked these programs to fewer hospital admissions, shorter hospital stays, and lower healthcare costs — demonstrating that when food is treated as a core part of care, health improves.
Even history points us toward what works. A recent study of sugar rationing during World War II found that when sugar availability declined in the United Kingdom, deaths from diabetes dropped by more than 20%. The takeaway: When we make systemic shifts in how food is distributed and supported, population health improves.
Obesity is not a failure of individual responsibility. It's a reflection of the systems we've built and the priorities we've set. If we want to reverse course, we need more than symbolic gestures. We need long-term investments in early-childhood nutrition, universal access to affordable healthy food, safe and walkable neighborhoods and the political will to confront the commercial and policy interests that perpetuate this crisis.
Braun's executive orders are a start, but they fall short of what the science tells us is necessary. Indiana has an opportunity to lead with evidence, empathy and common sense. Let's not waste it.
Erika R. Cheng is an epidemiologist, public health researcher and associate professor at the Indiana University School of Medicine, where her work focuses on health equity, child health and systems-based solutions to chronic diseases including obesity.
This article originally appeared on Indianapolis Star: RFK, Dr. Oz, Braun want to make Indiana healthy. Here's how. | Opinion
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