Healthy Food Access John Weidman, Deputy Executive Director, The Food Trust www.thefoodtrust.org Facebook: facebook.com/thefoodtrust Twitter: @thefoodtrust Hello everyone, My name is John Weidman and I’m the Deputy Executive Director at The Food Trust. Before I continue on with my presentation, I’d like to thank John Glenn School of Public Affairs for having me here today, and the Ohio Regional Convergence Partnership for supporting this event. It’s great to be here in Ohio with you all, and its great to be in a room with so many passionate people dedicated to improving communities across Ohio Before I continue I’d like to show you all a video that discusses the work of The Food Trust:

Video: Everyone Deserves Access This video depicts healthy food access problems experienced by a resident of New Orleans, and highlights the work of a number people trying to improve healthy food access in communities across the country Link to video: http://vimeo.com/73245404 Roadmap Video: Everyone Deserves Access

Ensuring that everyone has access to affordable, nutritious food. For more than 20 years, The Food Trust has been working to ensure that everyone has access to affordable, nutritious food and information to make healthy decisions. The Food Trust's comprehensive approach includes improving food environments and teaching nutrition education in schools, working with corner store owners to increase healthy offerings and helping customers make healthier choices, managing farmers' markets in communities that lack access to affordable produce and encouraging grocery store development in underserved communities. 9/16/2018

Source: Robbins, et al. Prevalence, Disparities, and Trends in Obesity and Severe Obesity Among Students in the Philadelphia, Pennsylvania, School District, 2006–2010. Prev Chronic Dis, Sept 2012. http://www.cdc.gov/pcd/issues/2012/12_0118.htm

The Comprehensive Approach Authors cite Philadelphia's comprehensive approach to obesity prevention as a potential contributor to the decline The Food Trust and many partner organizations worked to: Bring more grocery stores to Philadelphia through PA’s Fresh Food Financing Initiative Improve access to healthy, affordable food through corner stores as part of our Healthy Corner Store Initiative Expand our network of farmers' markets in low-income communities Provide nutrition education to 60,000+ SNAP-eligible students Develop a comprehensive school nutrition policy that included removal of sugary drinks from vending machines Advocate for a city-wide menu labeling law

Get Healthy Philly 10 new farmers’ markets Philly Food Bucks 650 healthy corner stores Work with Schools School food reforms Wellness councils Youth engagement After-school programs Healthier snacks and meals Increase physical activity

Obesity Trends in the US 1995 1985 One of the reasons why access to healthy food is so important is because of the level of obesity across the united states. These three maps show the upward trend of obesity over the years. Some recent statistics from the 2011 Trust for America’s Health F as in Fat Report - Twenty years ago, no state had an obesity rate above 15 percent. 12 states now have obesity rates more than twice that, with more than half the country approaching 30%. Totally new categories. -In Florida, more than a quarter of population is obese, more than half overweight. - Adult diabetes rates increased in 11 states and the District of Columbia over the past year - Households that make less than $15,000 have the highest obesity rates (33.8%) In addition to the health consequences associated with obesity (heart disease, diabetes, etc.), the cost of this epidemic is astronomical – with an estimated medical costs related to adult obesity exceeding $147 billion a year (in 2008). Source: Behavioral Risk Factor Surveillance System, CDC 2010 No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30% 7

But obesity and health is not the only problem that is created by a lack of food access. Over the past thirty years, changes in the grocery industry have left many communities without access to healthy food. The picture above depicts a shuttered grocery store. When a grocery store leaves a community, it loses and economic anchor and can create a downward spiral on jobs and economic opportunity for low-income communities.

The alternatives in many places In the absence of grocery stores, many low-income community residents are surrounded by unhealthy food options like fast food and convenience stores. These stores and restaurants are likely to have items abundant in calories, sugar, and fat, and low in nutritive value. And of course your environment impacts your behavior.

The Grocery Gap: Key Research Findings Accessing healthy food is a challenge for many Americans – particularly those living in low-income neighborhoods, communities of color, and rural areas. Better access corresponds with healthier eating Access to healthy food is associated with lower risk for obesity and other diet-related chronic diseases. New and improved healthy food retail in underserved communities created jobs and helps to revitalize low-income neighborhoods. The good news is that research shows that increasing access to grocery stores and healthy food in low-income communities can improve health and create jobs. The Food Trust and PolicyLink jointly released a report in 2013 titled “Access to Healthy Food and Why It Matters”, a review of nearly 300 studies from the last 2 decades on the connections between food access, health, income, and local economies. This report confirmed what we were hearing from communities across the country. You can see the key findings on this slide, but I’ll highlight a few examples. Accessing healthy food is a challenge for many Americans – particularly those living in low-income neighborhoods, communities of color, and rural areas. Better access corresponds with healthier eating African Americans living in a census tract with a supermarket are more likely to meet dietary guidelines for fruits and vegetables, and for every additional supermarket in a tract, produce consumption rose 32 percent. In New Orleans, proximity to stores stocking more fresh produce is associated with higher vegetable consumption. Each additional meter of shelf space devoted to fresh vegetables is associate with an additional 0.35 servings of vegetables per day. will talk about corner stores shortly > this is a pertinent example Access to healthy food is associated with lower risk for obesity and other diet-related chronic diseases. Adults living in neighborhoods with supermarkets have the lowest rates of obesity (21%) and overweight (60-62%) and those living in neighborhoods with no supermarkets and only access to convenience stores and smaller grocery stores had the highest rates (32-40% obesity; 73-78 percent overweight) according to a study of more than 10,000 adults. New and improved healthy food retail in underserved communities created jobs and helps to revitalize low-income neighborhoods. Grocery stores are known by economic development practitioners to be high-volume anchors that generate foot traffic and attract complementary stores and services lie banks, pharmacies, and restaurants. An assessment of the impact of new supermarkets on neighborhood housing values in Philadelphia found that the values of homes located within one-quarter to one-half a mile of a new supermarket increase by 4 to 7 percent (an average of $1500) after the stores open. We agree that putting a grocery store in an underserved area is not magic bullet, one part of comprehensive approach, most research shows there is some kind of relationship Available at: http://www.thefoodtrust.org 10

A Critical Public Health Issue Fresh Food Access: A Critical Public Health Issue Public health experts agree: Increasing fresh food access is a necessary strategy to combat obesity Growing evidence – Connection between increased access and better health outcomes As a result of the research findings I just discussed, many leading government agencies and organizations including the American Heart Association, Center for Disease Control, American Public Health Association and Institute of Medicine have issued policy statements that support improving healthy food access as one necessary piece of a comprehensive approach to reducing rates of childhood obesity. Mention AHA and RWJ Voices for Healthy Kids Campaign – national campaign on state and local food access policies 11

This map of Philadelphia was developed in 1999 to highlight communities that needed better access to grocery stores

Success Story: PA Fresh Food Financing Initiative 88 approved stores in PA urban/rural areas $190 million total invested 1.7 million sq. ft. of grocery retail developed/refreshed 5,000 jobs created/retained Named “Top 15 Innovation in Government” by Harvard The initial healthy food financing model was launched in PA in 2004, a public-private partnership between the PA Department of Community & Economic Development and 2 non-profit partners: The Food Trust and The Reinvestment Fund. Innovative new model, not a traditionally run government program. The program offered one time grant and loan funding to eligible operators in low-income, underserved communities. Not continuing subsidy, one time costs. The State of PA appropriated $30 million over 3 years to create the program. These funds were given to The Reinvestment Fund, a CDFI in the room with us today, who then leveraged this money to a HUGE extent > brought total to over $190 million in grocery retail investment. In just 5 years, the initiative has funded 88 fresh food retail projects reaching almost half of the counties in PA. Very flexible, all sizes and types: stores include everything from a brand new 69,000 sq ft supermarket to a small food coop and rural markets. store size range from 900 to 70,000 sq. ft. We worked to build new stores from the ground up, and also to support existing stores who wanted to renovate or expand their fresh food offerings. The program was also flexible in terms of the fund uses: could be used to buy land, for construction, also for job training. Pictured above is one of the supermarkets that opened under FFFI in North Philadelphia. Progress Plaza is famous; it's the nation oldest African-American owned and developed shopping center. But in the recent past had been in decline, and it hadn’t housed a supermarket in 10 years. Was a huge economic boon to that shopping center > In addition to the health benefits achieved from increasing access to fresh fruits and vegetables, economic benefit to the community in terms of jobs and sparking other business in the neighborhood. Fresh Grocer opens at Progress Plaza in North Philadelphia December 2009

Healthy Food Financing: The Basics Business financing programs that provide grants and loans for new and expanded grocery retailers in underserved communities Administered by a variety of community development entities, especially CDFIs Funded with federal, state, local, and philanthropic dollars Healthy food financing programs around the country have had several key features: -Structured as business financing programs that provide grants and loans for new and expanded grocery retail in underserved communities. -Administered by community development financial institutions in partnership with food access organizations—since they often have a history of investing in low-income areas -Often programs are set up with some initial seed funding from the public sector and then leverage significant private investment

Healthy Food Financing Program Model Fresh Food Retail Projects in Underserved Communities Supermarkets Small grocery stores Co-ops, farmers markets, and other “non-traditional” formats Community Development Financial Institution & Food Access Organization Raise private capital Provide financing Determine applicant eligibility Market program, advocate for community Government or Foundation Provide seed funding Oversee program implementation The diagram here outlines how healthy food financing programs are structured. Governments and foundations provide seed funding and monitor program implementation Community development financial institutions raise private capital, provide financing for grocers, and work in partnership with food access organizations that screen applicants for geographic eligibility, and market the program to grocers and communities Supermarkets, small grocery stores, and a variety of non-traditional food retailers receive financing from the program, and build or expand operations in low income communities.

Circle Food Store, New Orleans, 2005 Based on the success of the PA program, this model began to get attention around the country, including in New Orleans, which launched its Fresh Food Retailer Initiative in 2011. Here is one project that we’re very excited about: Circle Food Store—first African-American owned grocery store in New Orleans. After Katrina, was under 6 feet of water. Owner Dwayne Boudreaux wanted to re-open (people passing by every day to ask for Creole tomatoes), but was difficult to secure financing that would cover his costs. NOLA FFRI provided $1 million in financing, half forgivable. TRANSITION: And just a week and a half ago (click) Will employ 75 people, not including construction jobs. Economic boon for the 7th ward/Treme. The benefit of a city-wide program, can fund several other projects, plans to impact several neighborhoods across the City.

Circle Food Store, New Orleans, 2014 On January 17th, Circle Foods Store hosted a ribbon cutting, and hundreds of people came out, excited to shop, especially for the 4 for a dollar green bell peppers. These pics barely begin to express the excitement of New Orleanians that day. Circle Foods was a historic site, and EVERYONE knew this store. The store will employ 65 people, not including construction jobs. It’s an economic boon for the 7th ward/Treme. The New Orleans program is city-wide, and is funding several other projects across the city.

Federal Healthy Food Financing Initiative $118 Million awarded to CDFIs and CDCs from the U.S. Treasury and Dept of Health and Human Services $400 Million in New Markets Tax Credits Now there is also a program at the federal level, funded through the Treasury and HHS, and it was modelled after the Pennsylvania program we just described. Numerous projects funded over the last few years, about 60 grantees across the country. This is a nice place to mention any local organizations that may have received funding. Federal awards are limited, spread across many states, but can help to support existing initiatives or help community development groups explore opportunities, can be leveraged by local efforts at a city or state level. For permission to use any or all of the slides in this presentation, please email info@policylink.org

And now there are a lot more places invested in healthy food financing, with seed funding coming from federal, state, local and philanthropic sources. As you can see, Ohio is

Healthy Food Financing In Ohio Cincinnati Fresh Food Financing Retail Fund Finance Fund and The Food Trust Advocacy Efforts As you can see, the is a great deal of momentum around the country related to this work. Cincinnati has launched a program led by The Center for Closing the Health Gap and the Cincinnati Development fund. With support from ORCP and Finance Fund, The Food Trust is in the process of assessing Ohio’s need for a statewide healthy food financing program. Together we’re continued to researching the issue of food access in Ohio and host conversations with key stakeholders.  Program staff partnered with a GIS specialist to create maps that survey food access in Ohio, and are currently working with local partners to locally verify these maps prior to their publication in a formal report in June The Food Trust is working with Activate Allen County and local partners in Allen County, Ohio to develop a plan to bring healthier and Ohio-grown foods into the numerous small stores throughout the county. Our vision is that this project will lay the groundwork for a new initiative that represents a "triple win" in the community -- for residents, by supporting their local stores in offering a good variety of healthier foods to help make it easy for people to make better choices for themselves and their families... for small businesses, by providing them with the resources and expertise needed to support healthier in-store changes in a way that makes sense for their businesses... and for local farmers, by increasing demand for their products and providing new markets in which to sell their goods.

Healthy Food Access Portal HealthyFoodAccess.org Healthy Food Access Portal Here is a screenshot of the portal website, the first comprehensive source for information and resources related to Healthy Food Retail. It was first launched in February of 2013 and continues to be updated and evolve. We encourage you to explore the many great resources, included news about different policy efforts happening across the country, information on funding opportunities, and new research related to healthy food retail. Free Webinars are offered every 4-6 weeks through the portal and our partners, so be sure to check the Portal for news and updates about these events and others. Also, please let us know if you’re working on a healty food retail project not featured on this site and you would like it to be. And we have time for questions and I would also just love to hear about the work any of you are doing in the area of food access.

Thank you! John Weidman jweidman@thefoodtrust.org www.TheFoodTrust.org