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Module #3: Food 1
Module #3: Food
Overview: This training is designed to help participants better understand the environment in which they are working and the obstacles their patients and clients face when trying to sustain a healthy, nutritious diet in South L.A. This module challenges participants to come up with creative strategies to help patients meet their nutritional needs, build their immune systems and improve their overall health.
Objective: This workshop is designed to help participants draw connections between economic and socio-political policies, access to quality food, cultural norms and health outcomes in South LA.
By the end of the workshop, participants will: Understand the importance of healthy food and good nutrition to individual and
community health Understand how economic, social, spatial and racial systems limit the availability of
many healthy foods in South Los Angeles Be sensitive to cultural differences and understand the relationship between
culture, food and health Have a list of resources and concrete actions they can take to help their patients
meet their food and nutrition goals
Module Schedule At-a-Glance:
Time Topic Resources needed
3 min. Welcome/Introduction None
10 min. Icebreaker: Food memories Stopwatch
15 min. Maps and video An internet-connected laptop and a projector.
20 min. Virtual shopping trip One grocery bag for every four students, each with:
oA ZIP code profile sheetoFour mini-biosoA list of food outlets in the area
(See appendix)
5 min. Post-evaluation Post-evaluation questionnaire
List of resources
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Section Breakdown:
Preparation (In advance)
Distribute the pre-evaluation questionnaire at least 1 week ahead.
Prepare shopping bags for virtual shopping activity.
Welcome/Introduction
(3 min)
Have students drop off their pre-evaluations as they come in.
Once people are seated, introduce the day’s topic and briefly run through the objectives for the workshop.
Icebreaker Food memories (10 min)
Materials/Supplies Stopwatch
Procedure Have people pair up and share a food memory from childhood. Encourage people to describe emotions, smells, and other associations they have with the memory.
Pairs have 4 minutes to talk (2 minutes per person). The facilitator should keep time for everyone, letting them know when to start, when to switch who’s speaking, and when to finish.
After four minutes are up, bring the group back together and ask two or three people to introduce their partner and share something they learned about that person.
Discussion After four minutes are up, bring the group back together.
Ask two or three people to introduce their partner and share something they learned about that person.
Did anyone hear about a food or event that had cultural significance?
Transition Facilitator links the personal food memories people share to the context of South LA:
Food is many things, not just a biological necessity: it’s a part of cultural traditions and social activities. It can also be used for pleasure, as a distraction, a coping mechanism, or a stress reliever
Food is important to all of us as individuals, families and members of a given community and culture, but place matters. Where we
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work, live, play and shop for food often times serves as an indicator of what ends up on our “kitchen table” and therefore the health outcomes of that community
Maps and video Food outlets in South LA (15 min)
Materials/Supplies An internet-connected laptop and a projector
Procedure Use the projector to show the Community Health Council’s map of full-service grocery stores in South LA (see appendix)oBriefly highlight what stores are available in South LA, but
that they are too far apart to be easily accessible to many residents, and that the quality of the food can vary wildly
Show the 8-minute video, “A Tale of Two Women: Crossing L.A.'s Grocery Divide” http://youtu.be/4ke8bglaZWA and show the 8 minute video
Discussion Discussion questions:oDid this video seem like an appropriate representation of
grocery shopping in West and East LA? Would it be a good representation of shopping in South LA?
oAsk people how this environment compares to those environments they recalled in their food memories or where they live now:
- Where do you shop?- How do you get there?- When do you find time to shop and cook?
oWhat challenges do South LA residents face in feeding themselves and their families healthy food? Key points:
- few full-service grocery stores- long commutes and low rates of car ownership- irregular work schedules- low incomes- traditional diets not suited to modern sedentary life- the cheapest, most widely available food is often the most
unhealthy Terms you may want to introduce:
o food desert: an area where healthy, affordable food is hard to obtain
o food apartheid: sometimes used in place of ‘food desert’ to stress that food disparities are not a natural phenomenon, but rooted in discrimination
o food sovereignty: people’s right to have control over what they eat (including what food they buy and consume, where it comes from, and how it’s produced)
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Transition Now we’re going to put ourselves in the shoes of a South LA resident and explore the tradeoffs and decisions people are forced to make on a daily basis.
Pop-ed Exercise Virtual shopping trip (20 min)
Materials/Supplies One grocery bag for every four students, each with:
oA ZIP code profile sheet taped or stapled to the outsideoFour mini-bios paper clipped to the top of each bagoA list of food outlets in the area, cut so that each food outlet is
on its own strip of paper
(Note that except for bags, all materials can be found in the appendix and should be printed and prepared before the workshop.)
Preparation Before the workshop, prepare one grocery bag for each group of four students:
Print one zip code fact sheet for each group of four students and tape or staple it to the bag
Print the mini-bios, cut them into individual handouts, and clip four bios to the top of each bag
Cut the list of food outlets into strips (so that each outlet is on its own strip of paper) and place one set of food outlets inside each bag
Procedure Divide the students into groups of four. Have the students sit with their groups, and hand each group a bag
Instructions:
oThe goal of the activity is to put ourselves in the shoes of our patients, and to think through some of the tough decisions that South LA residents have to make on a daily basis as they shop, prepare food, feed their families and eat
oEach student should take a mini-biography, describing the role she or he should assume for the activity
oEveryone should read the profile of their ZIP code and their mini-biography
oOnce everyone in the group is done reading, go around the circle and introduce yourself to your teammates. Explain who you are, your health condition, and what the doctor told you to eat, and/or your challenge to obtain the food that you seek.
oOnce everyone has introduced him or herself, take turns drawing the name of a food outlet from the bag. The first
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outlet you draw is the closest food store or restaurant to your house. Explain to the group whether you might choose to eat there, and what factors (location, cost, taste, convenience, affordability, health, etc.) led you to your decision
oContinue taking turns drawing the names of food outlets from the bag until you have drawn all the outlets in your neighborhood. If you finish before time is called, discuss how this activity does (or does not) reflect the decisions facing your patients
Discussion Reconvene as a group and ask a few people to share who they were, what tradeoffs they faced, and why they made the decisions they did.
Shift the discussion to doctors and patients:oHow might these sorts of situations affect their patients week
after week?oHas anyone encountered a similar situation?oHow are our personal food choices constrained by the
neighborhood and economic context?oWhat resources are available to our patients to help them get
healthy, affordable food?oWhat obstacles keep people from accessing those resources,
and how can we help them overcome those obstacles?
Post-Evaluation (5 min)
Materials/Supplies Post-evaluation questionnaire (one per student)
List of resources (one per student)
Procedure Ask everyone to take two minutes to think about what they’ve learned about the food and nutrition challenges facing their patients, and to write down one outstanding question and one concrete action they will take
Hand out the post-evaluation questionnaire and the list of resources
Ask students to complete the questionnaire and drop it off as they leave. They can keep the list of resources
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Resources How you can use it (eg background info; community resource; way to take action)
Services & Referrals
Los Angeles County Dept. of Social ServicesHealth and Nutrition Hotline: (877) 597-4777 dpss.lacounty.gov/new_portal/dpss_foodstamps.cfm
Agency responsible for providing CalFresh benefits (formerly known as food stamps and SNAP) to qualified families and individuals.
PHFE WIC Program(888) WIC-BABY (888) 942-2229www.phfewic.org
The largest local WIC (Women, Infant and Children) program in the country. Provides supplemental food program for pregnant, breastfeeding and postpartum women, infants and children up to 5 years old in low-income families.
The Los Angeles Regional Food Bank1734 East 41st StreetLos Angeles, CA 90058(323) 234-3030www.lafoodbank.org/about-us/how-the-foodbank-works.aspx
Temporary food assistance available to patients with a financial hardship.
Learning and information tools
Healthy Citywww.healthycity.org
This website is an information and action resource for service referrals and social change. The site’s tools include: Find a service : Search through a wide range
of resources and services like housing assistance, healthcare, job training and education. View your results in a list or on a map.
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Maps and data : View maps, charts and tables showing key a broad range of health indicators such as particulate matter exposure, civic engagement and rent as a percentage of income.
Nutrition in Medicinewww.nutritioninmedicine.net/portal
A comprehensive online medical nutrition curriculum for training future and current health professionals.
Multimedia
“A Tale of Two Women: Crossing L.A.'s Grocery Divide” (short video)http://youtu.be/4ke8bglaZWA
Follows two women on grocery shopping trips, one in Santa Monica and one in Boyle Heights.
Further reading
“Teaching Doctors about Nutrition and Diet,” by Pauline W. Chen, M.D. New York Times, September 16, 2010.http://www.nytimes.com/2010/09/16/health/16chen.html
Op-ed advocating for better nutrition training for physicians.
Local advocacy organizations
Community Health Councils (CHC)3731 Stocker Street, Suite 201Los Angeles, CA 90008 (323) 295-9372www.chc-inc.org
A research and advocacy organization dedicated to increasing access to quality healthcare and improving the environment for under-resourced communities. CHC’s reports include:
Fast Food Restaurant Report: Promoting Healthy Dining in South Los Angeles:www.chc-inc.org/downloads/PB%20Fast%20Food%20Report.pdf
Transforming the Urban Food Desert from the Grassroots Up: A Model for Change: www.chc-inc.org/downloads/PB%20Family%20Community%20Health.pdf
Food Desert to Food Oasis: Promoting Grocery Store Development in South Los Angeles: http://www.chc-inc.org/downloads/Food%20Desert%20to%20Food%20Oasis%20July%202010.pdf
Does Race Define What’s in a Shopping Cart?: www.chc-inc.org/downloads/Food%20Desert%20to%20Food%20Oasis%20July%202010.pdf
Los Angeles Alliance for a New Economy (LAANE): Good Grocery Stores Project464 Lucas Avenue, Suite 202Los Angeles, CA 90017(213) 977-9400
LAANE links customers’ need for high quality food with workers’ need for high quality supermarket jobs.
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www.laane.org/projects/good-grocery-stores
Los Angeles Food Policy Council1600 Campus Road, MS M-1Los Angeles, CA 90041(323) [email protected] www.goodfoodla.org
The Food Policy Council is a coalition of private, public and nonprofit partners dedicated to creating systemic change in the Los Angeles region’s food system.
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List of attachments: Module #3 (Food and Nutrition)
1. Pre-evaluation questionnaire
2. Post-evaluation questionnaire
3. Map of full-service grocery stores in South Los Angeles
4. Mini-biographies (4)
5. ZIP code profiles (4)
6. List of markets in each ZIP code (one page per ZIP code)
Module #3: Food 10
Pre-Evaluation Questionnaire
Module: Food and Nutrition
Please fill out these 10 questions to the best of your ability. All feedback is appreciated and used to improve future iterations of this module. Turn in completed questionnaire at the beginning of module.
1. The module is relevant to my clinical work:
Strongly Disagree Disagree Agree Strongly Agree
2. The assigned readings were informative:
Strongly Disagree Disagree Agree Strongly Agree
3. I feel knowledgeable and comfortable with this module topic and know how to respond in these situations:
Strongly Disagree Disagree Agree Strongly Agree
4. I am open to training and guidance on this module topic to change how I conduct my work where applicable:
Strongly Disagree Disagree Agree Strongly Agree
5. I know how to address health inequity in our hospital system:
Strongly Disagree Disagree Agree Strongly Agree
6. Are you familiar with the food inequalities in South Los Angeles?
Strongly Disagree Disagree Agree Strongly Agree
7. Are you interested in learning more about this topic?
Strongly Disagree Disagree Agree Strongly Agree
Comments:____________________________________________________________________
Module #3: Food 11
Post-Evaluation Questionnaire
Module: Food and Nutrition
Please fill out these 10 questions to the best of your ability. All feedback is appreciated and used to improve future iterations of this module. Thank you for participating.
1. The module was relevant to my clinical work:
Strongly Disagree Disagree Agree Strongly Agree
2. The format/style of the presentation was effective; I gained new insights about the issue in relation to my work:
Strongly Disagree Disagree Agree Strongly Agree
3. After participating in this module, I feel knowledgeable and comfortable with this topic and know how to respond in these situations:
Strongly Disagree Disagree Agree Strongly Agree
4. As a result of this module, I am likely to change how I conduct my work where applicable:
Strongly Disagree Disagree Agree Strongly Agree
5. As a result of this module, I am likely to begin to address or change how I address health inequity in our hospital system:
Strongly Disagree Disagree Agree Strongly Agree
6. Are you familiar with the food inequalities in South Los Angeles?
Strongly Disagree Disagree Agree Strongly Agree
7. Are you interested in learning more about this topic?Strongly Disagree Disagree Agree Strongly Agree
8. Which parts of the training did you find most valuable? Least?
9. Which things would you like to learn more about?
Module #3: Food 12
Comments:
Module #3: Food 13
Source: Community Health Councils. Food Desert to Food Oasis: Promoting Grocery Store Development in South Los Angeles: http://www.chc-inc.org/downloads/Food%20Desert%20to%20Food%20Oasis%20July%202010.pdf
Mini-biographies
90003 Profile
Desmond Moore is eighteen years of age
Has recently transition out of foster care
Enrolled at Community College
Works part time at school (work study)
Takes public transportation
Food budget $150.00
Currently staying in a motel until is housing application is approved
He has a mini refrigerator and no stove
-----------------------------------------------------------------------------------------------------------------
Health Challenge – Overweight borderline diabetic
Doctors recommends that he lose 50lbs
Eat more fruits and vegetables
Cut down on the sugary drinks, fried food and carbohydrates
Exercise 1 hour a day 5 days a week
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90061 Profile
Ms. Martha Rodriguez is 30 years of age and undocumented
Lives in the Harbor North Gateway
Uses public transportation
Speaks very little English
Has three children ages, 6 month, 3 & 7 (children are bi-lingual)
Husband recently died in an auto accident
Works 2 part jobs 1) daycare making minimum wage 2) part-time nail salon maintenance minimum wage
Food budget $50.00 a week
Afraid to apply for public assistance, fear of deportation
No insurance
-----------------------------------------------------------------------------------------------------------------
Health Challenge – Hypertension, Asthma
Doctor recommends that she decrease salt-in-take and fried foods
Recommends that she stops working at the nail salon because of her asthma
Eat more fruits and vegetables
Exercise 3-5 times a week
Prescribes - Hypertension medicine $100.00 per month Asthma medicine $40.00 (month)
Module #3: Food 15
90059 Profile
Antonio Timo 42 years of age
Divorced father of four children ages, 19, 17, 13, 8
Recently laid off school bus driver
Transportation: Unreliable automobile
Waiting for Cal Fresh food assistance program decision
Currently $175.00 cash for food for the month
-----------------------------------------------------------------------------------------------------------------
Health Challenge:
Family recently became vegetarian before Mr. Timo was laid off
Family history high blood pressure, obesity and diabetes
The two youngest children are lactose intolerant
Module #3: Food 16
90044 Profile
Dorothy Dandridge 74-year-old African-American female homeowner living in Westmont
Live on her own after husband passed away two years ago after a sudden heart attack
Most of her neighbors of 40 years have either moved or passed away
New neighbors are mostly immigrants from Mexico or Central America who speak little to no English
Communication cordial yet limited
Has one daughter who may come to visit twice a month from Lancaster
Has vision problems so doesn’t drive anymore
The nearest full service market is a mile away
Where are you primarily going to go to get food?
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Module #3: Food 17
Zipcode
Population: 58,187
Hispanic/Latino: 66.4%White*: 0.8%Black*: 31.5%Native American*: 0%Asian*: 0.2%Hawaiian/Pacific Islander*: 0%
Other*: 0.2%Multiracial*: 0.6%
* Does not include individualsin this racial group who identify as Hispanic/Latino.
Unemployed 7.4%
Below Poverty Line 40.3%
Median Household Income: $22,346
Map data @ 2012 Google Source http://zipskinny.com
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Zip Code
Population: 87,366
Hispanic/Latino: 52.4%White*: 1.1%Black*: 44.7%Native American*: 0%Asian*: 0.3%Hawaiian/Pacific Islander*: 0.1%Other*: 0.2%Multiracial*: 0.9%
* Does not include individualsin this racial group
who identify as Hispanic/Latino.
Unemployed 7.5% Below Poverty Line 37.3%
Median Household Income: $22,091
Map data @ 2012 Google
Source http://zipskinny.com
Module #3: Food 19
Zip Code
Population: 38,123
Hispanic/Latino: 52.6%White*: 0.8%Black*: 45.1%Native American*: 0%Asian*: 0.2%Hawaiian/Pacific Islander*: 0.1%Other*: 0.2%Multiracial*: 0.7%
* Does not include individualsin this racial group
who identify as Hispanic/Latino
Unemployed 9%
Below Poverty Line 41.8%
Median Household Income: $22,151
Map data @ 2012 Google Source http://zipskinny.com
Module #3: Food 20
Zip Code
Population: 24,503
Hispanic/Latino: 53.1%White*: 0.9%Black*: 44.6%
Native American*: 0%Asian*: 0.2%
Hawaiian/Pacific Islander*: 0.1%Other*: 0.2%
Multiracial*: 0.7%* Does not include individuals
in this racial groupwho identify as Hispanic/Latino.
Unemployed 7.9%
Below Poverty Line 33.5%Median Household Income: $26,449
Map data @ 2012 Googlehttp://zipskinny.com
Module #3: Food 21
MARKETS IN 90003
3 MINUTES MARKET8861 S BROADWAYLOS ANGELES, CA 90003
99 CENTS & TOBACCO8221 S AVALON BLVDLOS ANGELES, CA 90003
CHAPARRASTIQUE WAREHOUSE5841 S SAN PEDRO ST #ALOS ANGELES, CA 90003
L MILAGRO MINI MARKET6607 S SAN PEDRO STLOS ANGELES, CA 90003
Module #3: Food 22
MARKETS IN 90059
HAPALA MARKET1774 E 92ND STLOS ANGELES, CA 90059
CVS / PHARMACY #9507650 E EL SEGUNDO BLVDLOS ANGELES, CA 90059
FOOD 4 LESS11840 S WILMINGTON AVELOS ANGELES, CA 90059
JOSEPH'S MARKET11019 S ALAMEDA STLOS ANGELES, CA 90059
Module #3: Food 23
MARKETS IN 90044
CHONG'S MEAT AND FISH MARKET10713 S VERMONT AVELOS ANGELES, CA 90044
AVERY MARKET8919 S VERMONT AVELOS ANGELES, CA 90044
BUDLONG MARKET10216 S BUDLONG AVELOS ANGELES, CA 90044
EL RANCHO FRESH MARKET11805 S VERMONT AVELOS ANGELES, CA 90044
Module #3: Food 24
MARKETS IN 90061
99 CENT MINI MARKET11229 1/2 S BROADWAYLOS ANGELES, CA 90061
CALIFORNIA NUTRITION CENTER11305 S AVALON BLVDLOS ANGELES, CA 90061
LIQUORANA MARKET12800 S SAN PEDRO STLOS ANGELES, CA 90061
ZACATECAS MARKET10962 S BROADWAYLOS ANGELES, CA 90061
