Building Healthy Communities

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Building Healthy Communities. Erin Hagan PolicyLink Center for Health Equity and Place. NASCSP 2012 Mid-Winter Training Conference March 2, 2012. PolicyLink. PolicyLink is a national research and action institute advancing economic and social equity by Lifting Up What Works® - PowerPoint PPT Presentation

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Building Healthy CommunitiesErin HaganPolicyLink Center for Health Equity and Place

NASCSP 2012 Mid-Winter Training ConferenceMarch 2, 2012

1PolicyLinkPolicyLink is a national research and action institute advancing economic and social equity by Lifting Up What Works

PolicyLink Center for Health Equity & Placeis informed and driven by the recognition that a neighborhoods environment including economic, social, and physical characteristics all affect our health.2Building Healthy Communities3ParksGrocery StoresFinancial InstitutionsEmployment OpportunitiesSafe & Affordable HousingBetter Performing SchoolsGood Public TransportationFast Food RestaurantsLiquor StoresUnsafe/Limited ParksPoor Performing SchoolsHigh unemploymentIncreased Pollution and Toxic Waste SitesLimited Public TransportationInadequate Child Care & After School Programs

Communities of OpportunityDisinvested CommunitiesGood Health StatusPoor Health StatusContributes to health disparities:ObesityDiabetesAsthmaInfant mortalityThis visual provides an opportunity to think about the variety of strategies to achieve the qualities present in communities of opportunity.

A healthy community is not just one with low rates of disease it is one where there is access to goods and services, high-performing schools, employment opportunities, an affordable housing market AND all of these things also contribute to community health and wellness.

Policies are intertwined although we sometimes work in silos, impacts are not confined to one sector.Food policy is not just about food policy it is also economic policy and Transportation policy is also food policy Think about the entire food system production, distribution, retail, consumptionTransportation matters on both ends of the supply chain - how food gets to the retail outlets and how people get to retail outlets low income people and people of color are much more likely to utilize public transit to access food retail. Introducing a new grocery store doesnt just bring healthy food into a community, it also brings jobs, spurs economic development. The best strategies can are flexible and can be tailored to the needs of the community. For permission to use any or all of the slides in this presentation, please email info@policylink.org3Designed for Disease

Designed for Disease: The Link Between Local Food Environments and Obesity and Diabetes

The Retail Food Environment Index (RFEI) is an indicator of the relative density of food outlets that are less likely to stock fresh fruits and vegetables and other healthy foods, to those where such healthy options are more likely to be available. A higher RFEI indicates that a respondent lives near a larger number of fast food restaurants and convenience stores relative to the number of grocery stores and produce vendors. For example, an individual with an RFEI of 2.0 has twice as many fast food restaurants and convenience stores as grocery stores and produce vendors nearby.

The average low-income community has four times as many fast-food restaurants and convenience stores as grocery stores and produce vendors.

People who live near an abundance of fast food restaurants and convenience stores, compared to grocery stores and fresh produce vendors, (PEOPLE WITH HIGER RFEIs) have a higher prevalence of obesity and diabetes.

4The Grocery GapAccessing healthy food is a challenge for many Americansparticularly those living in low-income neighborhoods, communities of color, and rural areas.

Better access corresponds with healthier eating and lower risk for obesity and other diet-related chronic diseases.

New and improved healthy food retail in underserved communities creates jobs and helps to revitalize low-income communities.

One nationwide study found that low-income zip codes have 25 percent fewer chain supermarkets than middle-income zip codes. Compared to predominantly white zip codes, majority African American zip codes have about half the number of supermarkets, and mostly Latino zip codes have about a third as many.

In Washington, DC, the citys lowest-income and almost exclusively African American wards (Wards 7 and 8) have one supermarket for every 70,000 people while two of the three highest-income and predominantly white wards (Wards 2 and 3) have one for every 11,881 people.

Barriers to entry:Lack of access to sufficient capital. National supermarket chains can either self-finance their growth or have access to capital markets. But smaller independent and regional supermarket operators, who may be more willing to locate in underserved communities, may not have this capacity.

Costly site assembly. Assembling a site large enough for a grocery store requires pulling together smaller parcels, typically held by multiple landowners. Site assembly significantly increases the time and complexity of development. Urban sites, unlike suburban sites, typically require an urban developer to demolish existing buildings or clean environmentally contaminated sites.

Higher development costs for urban areas. Urban area development requires increased construction cost, which includes: labor costs associated with union workforces and an often cumbersome approval and permitting process.

More expensive workforce development. Recruitment and retention of personnel contributes to high operating expenses in low-income urban and rural communities. Full-service grocery stores require highly skilled and trained employees in their specialty meat and bakery departments. Also, in communities with limited car access, residents may make smaller purchases per trip, which creates a need for additional check-out staff.

No existing public incentives. Economic development and financing programs are often not available to, or not marketed to, food retailers.

56USDA Food Environment Atlas

#Low income & > 1 mi to store, 2006 0 - 5,000 5,001 - 10,000 10,001 - 25,000 25,001 - 257,616 The Grocery Gap PolicyLink and the Food Trust reviewed 132 studies and to examine the research findings about access to healthy foods spurred the development of this map. 23.5 Million people in the US lack access to healthy food within a mile of where they live.

67Community Strategies to Increase Access to Healthy FoodGrocery store development/attractionFarmers marketsCorner storesUrban agricultureSchool food reform

Regional food systemsMobile marketsFood-based business/ microenterprise developmentCommunity-supported agriculture

78A Case in Improving Food Access

Source: Baltimore Office of SustainabilityIn Oct. 2011, Baltimore Mayor Rawlings-Blake announced that Howard Park will receive $759,000 from the national Healthy Food Financing Initiative to build a long deserved grocery store in their community. The project is one of only 12 Community Development Financial Institutions nationally to receive a share of $25 million.8Healthy Food Financing InitiativeA national campaign initiated by PolicyLink, The Food Trust, and The Reinvestment Fund

Goal: To improve access to healthy food in low-income, underserved rural, suburban, & urban communities

PolicyLink has been working with The Food Trust and The Reinvestment Fund to scale up the PA FFFI program to the national level.

Bipartisan legislation introduced in 2011:Lead Senate Sponsor: Senator Gillibrand (D NY)Lead House Sponsors: Rep. Schwartz (D - PA)Rep. Burgess (R - TX)Rep. Blumenauer (D - OR)

The Healthy Food Financing Initiative (HFFI) is a viable, effective, and economically sustainable solution to the problem of limited access to healthy foods, and can reduce health disparities, improve the health of families and children, create jobs, and stimulate local economic development in low-income communities.

HFFI would attract investment in underserved communities by providing critical loan and grant financing. These one-time resources would help fresh food retailers overcome the higher initial barriers to entry into underserved, low-income rural, suburban, and urban areas. It would also support renovation and expansion of existing stores so they can provide the healthy foods that communities want and need. The program would be flexible and comprehensive enough to support innovations in healthy food retailing and to assist retailers with different aspects of the store development and renovation process

9Healthy Food FinancingPennsylvanias Fresh Food Financing Initiative93 new or renovated stores5,023 jobs created or retainedImproved food access for 400,000 residentsCommercial revitalization$194 Million in total projects leveraged from $30 Million state seed money4 - 7% increase in nearby home values National Healthy Food Financing InitiativeUSDAHHSTreasury10

The success of the PA program has sparked interest around the country. Harvard University recently named the initiative one of the top 15 government innovations in the country, and the Centers for Disease Control and Prevention recognized the FFFI with an award at its recent Weight of the Nation conference in Washington, DC.

Achieves multiple objectives especially for low-income communitiesBetter access (both through proximity and price) corresponds with healthier eating and lower risk for obesity and other diet-related chronic diseases.New and improved healthy food retail in underserved communities creates jobs with career paths and helps to revitalize low-income communities. Also leverages private capital.

Replication efforts underway in many states:ArizonaCalifornia Unique philanthropic modelColoradoGeorgiaIllinoisMarylandMichiganMinnesotaMississippiNew JerseyNew YorkTennesseeTexasWashington, DC

For permission to use any or all of the slides in