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Public Health & Food Access Disparities

Disparities poster

Highlights from the SUMMIT, Day One, May 11th:

•    Considerable discussion about the need to be inclusive as we address the issue of increasing access to local food

  • For example, while WIC and Food Stamp programs target low income populations there are a lot of working poor that should not be left out
  • And there are sub-groups of the population, such as seniors, that whether they are poor or not, have difficulty accessing local foods.

•    Need to education everyone about how to cook with local, seasonal , whole foods.  Everyone, whether you’re rich or poor, has largely forgotten how to cook.  Need to engage in skill-building activities and increase awareness about the benefits of local food and HOW TO use them.

•    Concern – we’re not very well prepared to deal with non-English speaking citizens and we need to build this into our work.

Original WIT meeting facilitators and SUMMIT breakout leaders:

  • Alice Ammerman, UNC at CHapel Hill, Center for Health Promotion and Disease Prevention, and
  • Diane Beth, NC Division of Public Health

staff: Warren Miller

 

Background

Improving access to healthy local foods is a way to address hunger and poor nutrition in underserved communities throughout our state. Improving the quality, freshness, and diversity of food may also help prevent obesity and other diet-related diseases. In NC and across the US, many initiatives have focused on ways to identify and reduce disparities in food access and public health through food banks, community gardens, and other programs. These efforts are not often coordinated through centralized mechanisms, thus missing opportunities to collaborate and gain efficiencies through local food sourcing.

 

North Carolina Perspective

In 2007, the adult poverty rate in NC was 17 percent, compared with 15 percent at the national level. North Carolina ranks 17th among the states in terms of adult obesity and is 5th highest in youth obesity. Individuals living in poverty often live in areas with limited access to retail grocery stores and public transportation. As a result, lower income communities often lack access to healthy foods. Fruits, vegetables, and whole grains are also typically more expensive than foods high in fat and sugar. People with lower income levels in NC have a higher risk for diet-related diseases such as diabetes, obesity, heart disease, and many cancers. Not only do people with lower incomes suffer from these diseases at higher rates but they experience the outcomes more severely.

 

Issues Under Discussion

A great opportunity exists in NC to deliver fresh local foods to hungry people. There are periods of time when healthy local food is available in fields to be harvested, but no one is available to glean it nor is there the transportation, storage or processing infrastructure in place to take advantage of it. While these issues are being resolved on a small scale, or on a case by case basis, there does not yet exist a coordinated statewide response. Consumer education and outreach is needed to help vulnerable populations understand the importance of eating nutritious, fresh food and the means to access it. This includes how to shop for local produce and how to prepare it in healthy ways. Another critical issue is affordability of fresh, local foods. While supporting local farmers with fair and equitable pricing is essential, so is ensuring that fresh, local foods are affordable for people with lower incomes. Food access is a problem for many low income communities. There is increasing awareness of “food deserts,” in NC where residents have difficulty buying food, let alone, healthy fresh food.

The initial WIT meeting produced the following ideas, to discussed, developed, and expanded further at the SUMMIT:

 

Game Changer

We propose to develop a “Local Foods Community Outreach Coalition.” This Coalition will work statewide on a coordinated effort to improve private and public sector efforts to expand access to and nutrition education about fresh, local, healthy foods in low income communities. Key elements of this Coalition are to develop the necessary partnerships to:

1) Significantly increase nutrition education and outreach to underserved communities by leveraging an existing and under-utilized source of federal dollars (SNAP-ED) available for this effort; and

2) Enhance the capacity of North Carolina’s emergency food providers to grow, harvest, glean, store, process, prepare, and distribute local foods in a manner coordinated with existing food system businesses, infrastructure, and volunteer power.

 

Other Statewide Action Plan Ideas

  • Establish farmers markets and community gardens at county health departments and other local agencies where people are already accessing services (e.g., WIC, Food Stamps)
  • Advance EBT use at farmers markets, following the impetus gained through the model program, the 21st Century Farmers’ Markets, with their established collaboration with the Dept. of Health & Human Services, Division of Social Services, Durham Co. Health Dept, the NC Dept of Agriculture and the NC Senate, among others.

Local Action Ideas

  • Capitalize on parental energy to establish wellness policy committees & create funding for implementation to address healthy foods & snacks (other than those served through School Lunch program
  • Utilize Farm Bureau help to establish school gardens
  • Encourage farmers markets and other direct market venues to apply for EBT
  • Pursue mini-mobile markets in low income areas.
  • Use community-based research tools to evaluate local situation (e.g., food deserts)

 

Notes on Public Health and Access Disparities WIT SUMMIT Breakout Session:

Game Changer:  Develop a “Local Foods Community Outreach Coalition.”  This Coalition will work statewide on a coordinated effort to improve private and public sector efforts to expand access to and nutrition education about fresh, local, healthy foods in low income communities. Key elements of this Coalition are to develop the necessary partnerships to:

1)    Significantly increase nutrition education and outreach to underserved communities by leveraging an existing and under-utilized source of federal dollars (SNAP-ED) available for this effort; and

2)    Enhance the capacity of North Carolina’s emergency food providers to grow, harvest, glean, store, process, prepare, and distribute local foods in a manner coordinated with existing food system businesses, infrastructure, and volunteer power.

Comments on Game Changer

  • INCLUDE WORKING POOR, not just those eligible for Food Stamps, etc…
  • REMEMBER RURAL AREAS (and transportation issues to access healthy food), senior, ESL, farmers, farm workers and all those folks not near a market, not necessarily accessing food assistance, and not comfortable in local food market setting.
  • ADDRESS LANGUAGE BARRIERS
  • ENGAGE COMMUNITY in discussions and planning; identify key community leaders; listen more; use existing networks; empower people.
  • A coalition in of itself is not the useful unless there is funding and staff; would need to be very diverse group.
  • Don’t forget innovative, community-based projects already up and running in NC and don’t overlook them in excitement to see state level action/efforts to maximize agency resources.
  • CONSIDER PUBLIC HEALTH AND FOOD ACCESS ISSUES WITHIN ALL WITS; run risk of compartmentalizing by pulling it out as a separate rather than integrated issue.

Comments on Other State Action Ideas & New Ideas

  • ESTABLISH FARMERS MARKETS AT OTHER SITES than just health departments, including senior sites, libraries, worksites; build it where people are getting services and where people frequent, including churches.
  • Expand utilization of CSAs for WIC/Senior FM program.
  • Public Education and outreach – need to increase demand at all sites with the people we are trying to reach – build it and they MAY come but not necessarily; make sure to have or instill demand; remember to examine languages used in order to reach out to broad & diverse constituency; this speaks to considering cultural accessibility; consider mandatory TV & radio time for PSAs.
  • Looking at agencies and NGOs for models & figuring out how to connect & increase awareness
  • FOCUS ON COOKING SKILLS & EDUCATION – all of us have forgotten how to cook, not just low income; need public education about seasonal, local eating & cooking.  Nutrition education, knowledge & skills.
  • Need to incorporate local foods education into existing food assistance programs
  • Create incentive program for low income groups to be able to purchase local foods
  • Break paradigm that local food is expensive not accessible and only for yuppies
  • Train farmers to educate customers on cooking, using produce
  • Need to explore alternative funding avenues for food distribution agencies and how to link existing resources?
  • DON’T REINVENT THE WHEEL; focus on coordinating existing efforts.
  • Need a web database to share information about what is going on but also PSAs and other forms of communication to reach groups who do not get online.
  • Can we subsidize CSAs, food share programs, etc….
  • Incentive EBT users to purchase local & seasonal?  Ideas include discounted costs, reward points, etc…
  • Address issue of limited state funding for SNAP-Ed program – policy proposal to make an exception in this case?
  • MAPPING—location of food deserts and areas in need of greater access.
  • EXPERIMENT WITH MINI-MOBILE MARKETS
    • Meals on Wheels establishing gardens on their site
    • Use vehicles that run on biodiesel and look like ice cream trucks and play music!
    • They can be PTA fundraisers.
  • WORK ON COMMUNITY GARDENS – huge opportunity but need to be managed, which takes funding.
  • FOCUS ON SENIOR CENTERS—provide markets, CSA drop-offs, gardens at senior centers and assisted living facilities.
  • FOCUS ON WORK IN SCHOOLS – this is a huge opportunity; link with kids to bring home the messages
    • Establish school gardens and then advocate for the garden’s food to be used in school cafeterias; collaborate with non-profits such as Communities in Schools to obtain funding to build school gardens.
    • Parents may not be the most important for working on School Wellness Policy.
    • Remember gardens are hard to maintain in the summer; who will do it when school is closed?
  • NCSU should set up a community garden on campus as a way to engage students and promote community gardens statewide.
  • We need more discussion of organic, environmental and social justice issues.
  • Consider connecting with Head Start for parent trainings.
  • Apply idea of Neighborhood Watch to food access issues; include ideas such as community cook-offs; “talking councils,” and tapping community knowledge and traditions regarding local food.
  • Urban foraging; harvesting fruit from urban fruit trees.
  • Consider projects for prisons.
  • Encourage grocery stores to sell local fruits and vegetables consistently in all their stores, even low-income areas.

Local Action Ideas

  • Options for all to contribute include children, schools, farms
  • Mapping system to locate excess food
  • More community gardens on public land, increase involvement
  • Collaborate with Farm Bureau/nonprofits to start school gardens
  • Prison projects to grow food
  • Senior projects to grow food – both contribute to increased PR
  • Match farmers & interested community groups/consumers
  • Bus lines from low income to grocery stores/farmers markets
  • Get more local food into chain stores in low income communities
  • Mobile markets and kiss n go lines at schools

Questions

What is the technical definition of mini-mobile market?

Is the Farm Bureau the “key” for helping develop school gardens?

Is this coalition the same as food policy council or something separate?