Community Assets to Support Healthy Eating

1. Community Assets to Support Healthy Eating Health-Wealth Connection Symposium June 23, 2010 “A Holistic View of Assets: Family, Community, Equity” Leslie MikkelsenManaging Director www.preventioninstitute.org

2. What’s Health Got To Do With It?

4. Photo Courtesy of: http://www.chrisstroud.net/blog/fremont-union-city-farmers-markets/

5. Photo Courtesy of Google Images

7. Photo Courtesy of: Don Dommer Associates at http://www.flickr.com/photos/dondommerassociates/3254703816/

8. BEHAVIOR BEHAVIOR ENVIRONMENT EXPOSURES HEALTH & SAFETY

9. “ It is unreasonable to expect that people will change their behavior easily when so many forces in the social, cultural, and physical environment conspire against such change. ” Institute of Medicine

10. Current Health Care Spending $2.2 Trillion Behaviors & Environment Genetics Medical Care 70% 20% 10% Factors InfluencingHealth National Health Expenditures SOURCE: Centers for Disease Control and Prevention, Blue Sky Initiative, University of California at San Francisco, Institute of the Future, 2000

11. Current Health Care Spending $2.2 Trillion Behaviors & Environment 70% Genetics 20% Medical Care, 10% Factors InfluencingHealth National Health Expenditures SOURCE: Centers for Disease Control and Prevention, Blue Sky Initiative, University of California at San Francisco, Institute of the Future, 2000

12. Current Health Care Spending $2.2 Trillion Prevention, 4% Behaviors & Environment 70% Medical Services 96% Genetics 20% Medical Care, 10% Factors InfluencingHealth National Health Expenditures SOURCE: Centers for Disease Control and Prevention, Blue Sky Initiative, University of California at San Francisco, Institute of the Future, 2000

13. Return on Investment with Prevention Savings at 5 years $16 Billion Annual Savings In 5 Years $5.60 Return on Investment $1 Investment SOURCE: Prevention for A Healthy America: Investments in Disease Prevention Yield Significant Savings, Stronger Communities, Trust for America’s Health, July 2008

14. QUALITY Prevention is the Prescription • Comprehensive • Aimed at the community environment • Changes norms: makes the healthy choice the easy choice

15. TwoSteps to Prevention Medical Care Exposures & Behaviors Environment

16. Source: Actual Causes of Deaths in the US, 2000, Centers for Disease Control and Prevention, 2004

17. Medical care, costs, and inequities Heart Disease Cancer Stroke Diabetes Injuries & Violence Leading Causes of Death

18. Photo courtesy of http://tycohealth-ece.com/files/d0003/ty_rn33d7.jpg

19. Medical Care Alone Cannot Reduce Injuries and Inequities • Not the primary determinant of health • Treats one person at a time • Often comes late; can’t always restore health

20. Let’s take a step... Medical Care Exposures & Behaviors

22. Let’s take another step... Exposures & Behaviors Environment

24. VS. What’s Sold and Promoted Industry Low-Wealth High-Wealth Group Neighborhood Neighborhood Supermarkets 7 27 26 24 35 11 Carry-out eating places Bars/Taverns SOURCE: Morland K, Wing S, Diez Roux A, Poole C. Neighborhood characteristics associated with the location of food stores and food service places. Am J Prev Med. 2002;22:23-9.

25. VS. What’s Sold and Promoted Industry Low-Wealth High-Wealth Group Neighborhood Neighborhood Supermarkets 7 27 26 24 35 11 Carry-out eating places Bars/Taverns SOURCE: Morland K, Wing S, Diez Roux A, Poole C. Neighborhood characteristics associated with the location of food stores and food service places. Am J Prev Med. 2002;22:23-9.

26. Elements of Community Health PLACE • What’s sold & how it’s promoted

27. Elements of Community Health EQUITABLE OPPORTUNITY • Racial justice • Jobs & local ownership • Education PLACE • What’s sold & how it’s promoted • Look, feel & safety • Parks & open space • Getting around • Housing • Air, water, soil • Arts & culture PEOPLE • Social networks & trust • Participation & willingness to act for the common good • Acceptable behaviors & attitudes

28. Elements of Community Health EQUITABLE OPPORTUNITY MEDICAL SERVICES • Preventative services • Access • Treatment quality, disease management, in-patient services, & alternative medicine • Cultural competence • Emergency response • Racial justice • Jobs & local ownership • Education PLACE • What’s sold & how it’s promoted • Look, feel & safety • Parks & open space • Getting around • Housing • Air, water, soil • Arts & culture PEOPLE • Social networks & trust • Participation & willingness to act for the common good • Acceptable behaviors & attitudes

29. Complete Streets Oakland, CA

31. Healthy Food Retail and Access Rochester, NY Source: Partners Through Food

32. Increasing Access to Healthy Food Upper Falls Community: Rochester, New York “Life was there again. It transformed the neighborhood.” Hank Herrera, President/CEO Center for Popular Research Education and Policy

33. Fresh Food Financing

34. Alameda County CCNI West Oakland – Hoover District

35. Alameda County CCNI Photo courtesy of: http://www.acphd.org/healthequity/ccni/docs/youth/SP_keeping_it_real_final_rpt.pdf Sobrante Park

36. Focus on Safety “Violence is not the problem of one neighborhood or group…Coming together and owning this problem and the solutions are central.” -Dr. Deborah Prothrow-Stith, Harvard School of Public Health, UNITY Co-Chair

37. Health Reform Legislation • Community Transformation Grants • Prevention and Wellness Fund • Health Empowerment Zones • Workforce training in community prevention • National strategy and inter-agency efforts

38. Federal Funding: Other Opportunities • Stimulus (ARRA) • Health Equity and Accountability Act of 2009 (H.R. 3090) • Transportation Reauthorization • Child Nutrition Reauthorization • Preventing violence • The next Farm Bill

39. “It wouldn't have happened except for the fact that people worked to make it happen. Every time I go by that corner, I remember people saying ‘Face reality. There will never be a grocery store there,’ and I smile.” - Hank Herrera President/CEO, Center for Popular Research, Education, and Policy

40. TOOLS www.preventioninstitute.org www.eatbettermovemore.org

41. THRIVETool for Health and Resilience In Vulnerable Environments http://preventioninstitute.org/thrive/index.php

42. ENACT Environmental Nutrition & ActivityCommunity Tool www.eatbettermovemore.org

43. www.preventioninstitute.org • 221 Oak Street Oakland, California 94607 phone: 510-444-7738 fax: 510-663-1280