The University of North Carolina at Chapel Hill

Public Health Innovation


Turning the tables on unhealthy products

06.03.19


UNC public health venture Counter Tools gives communities and policy makers insights to reduce the impact of tobacco and other harmful products

Counter Tools tracks and collects data to help policy makers pass legislation to better control tobacco sales

Why Innovators Care

Social and public health innovations like Counter Tools create change where it’s needed most. Counter Tools helps retailers like local corner markets make healthier decisions when deciding which products to stock in their stores. 

10

Employees working at Counter Tools

22

States where Counter Tools works and helps shape public health policies

80

Point-of-sales policies passed in Minnesota alone based on Counter Tools data

The communities in which we live are vital contributors to how daily habits and behaviors are formed. Where we live, work, learn and play can have a profound impact on our health. And in many communities, the corner store is a mainstay – a place where local residents gather. But often, corner stores do not offer the healthiest choices. Counter Tools, a social venture launched by public health faculty at the University of North Carolina at Chapel Hill, is looking to change the trend.

Counter Tools empowers communities to become healthier places by helping them put policies in place that affect the retail environment. The organization collaborates with communities and state and local government agencies to improve tobacco control, food access and/or alcohol control, no matter where they are in the policy change continuum.

Counter Tools collects data related to unhealthy products and the proximity to youth.
Nina Baltierra, Counter Tools Executive Director

“We have a vision for a nation where everyone has the opportunity to live a healthy life in a healthy place,” 

– Nina Baltierra, Counter Tools Executive Director

Nina Baltirra conducting a group training

“We have a vision for a nation where everyone has the opportunity to live a healthy life in a healthy place,” says Nina Baltierra, Counter Tools Executive Director. “We know that communities have a profound effect on lives – and the retail environment, the built environment, is what we can focus on for change.”

Counter Tools helps public health practitioners and community members collect data on their local retailers, visualize disparities using maps and mobilize for policy change. The organization educates communities about the findings, helps them formulate policy solutions, engages strategic partners and raises awareness of challenges and solutions – all through its proprietary software tools and technical assistance. Counter Tools even works with local communities to persuade decision makers to enact solutions as well as implement, enforce and evaluate those solutions.

“Counter Tools provides software tools and technical assistance to help communities pass policies that improve the retail environment in their community,”

“The biggest challenge we face – even in the public health community – is that we are focusing on upstream innovation,” says Baltierra. “Many people are focused on individual behavior and education, and it can be hard to make system changes.”

The organization is already seeing results. For example, Counter Tools—along with other partners–implemented a unique program in Philadelphia, working with retailers to eliminate tobacco product sales. To help participating retailers supplement those tobacco product sales, a healthy foods catering service was born, delivering healthy foods to local businesses. The catering service helped to supplement any income retailers would have received if they had continued to sell tobacco products.

With its team of 10 employees, Counter Tools works for a variety of states. From Colorado, Oklahoma and Indiana to Alabama, North Carolina and Vermont, Counter Tools collaborates with state departments of health as well as individual cities and counties.

“Counter Tools provides software tools and technical assistance to help communities pass policies that improve the retail environment in their community,” says Kurt Ribisl, Counter Tools co-founder, who works as a professor and chair of the health behavior department at the UNC Gilling School of Global Public Health. “Counter Tools works in 22 states and helps shape policies that will restrict the sale of harmful products, such as menthol cigarettes, and promote the sale of healthier food options at stores so people can choose to use healthier products.”

“Counter Tools has contributed to the passing of more than 80 point-of-sales policies in Minnesota,” says Baltierra. “In addition, it is exciting to see Florida recently pass its very first tobacco retailer licensing policy in Alachua County which we were able to help with. Ultimately, our success is measured in policies passed and lives saved.”

Counter Tools now uses a mobile data collection tool as part of its toolkit

Counter Tools offers several software tools that allow states and localities to collect, manage, visualize and analyze data to show decision makers the need for change: the Store Audit Center is their mobile data collection tool, and the Store Mapper shows retailer locations in relation to schools, parks, and other retailers, with demographic overlays like median household income to visualize disparities. Its Point-of-Sale Toolkit focuses on enforcement efforts and combines data collection and GIS (geographic information systems) visualization. In addition, the organization has created the Arizona Tobacco Enforcement System to coordinate and implement tobacco enforcement checks.

Counter Tools was born from an online resource destination for tobacco research support called CounterTobacco.org, which was created in 2011 by Drs. Kurt Ribisl and Allison Myers at the University of North Carolina at Chapel Hill. They participated in programs offered by the Kenan Flagler School of Business to help promote entrepreneurship. At the outset, Ribisl, a professor and chair of the Health Behavior department at the UNC Gillings School of Global Public Health, and Myers, an adjunct associate professor, created the website as a resource focused on tobacco point-of-sale history, impact and policy solutions.

As part of the CounterTobacco.org site, Myers and Ribisl created software to research geographic disparity: the Store Audit Center and the Store Mapper. The team quickly discovered these tools could be used for a wider purpose to serve the greater good. They created Counter Tools and first offered the Store Mapper and Store Audit Center tools to public health practitioners.

And Counter Tools still maintains strong ties to the University, working with interns from the UNC Gillings School of Global Public Health as well as receiving evaluation help from the UNC School of Nursing.

“We have sent students and alumni from the Department of Health Behavior at UNC’s Gillings School to work at Counter Tools or participate in an internship,” says Ribisl. “The software developed at UNC that is used by Counter Tools also has created royalties paid to the department that has been used to support four students doing their summer practicum. The relationship between UNC and Counter Tools has been very mutually rewarding.”

As the leading voice in place-based public health, Counter Tools will continue to make a positive difference in communities across the nation.

“Being the national name in point-of-sale policies that affect public health, Counter Tools is the go-to organization that connects you to others that can help you with those initiatives,” says Baltierra. “We are the experts, the connectors and translators of science and best practices that communities can put into practice.”

To learn more about Counter Tools, visit the organization’s website.

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