Building a Policy Roadmap to Advance Organizational Practice Change and Public Policy for Healthy Eating and Active Living Virginia Lee, MPH, CHES American Public Health Association November 5, 2007

Building momentum for quality primary prevention Characterized by a strong commitment to community participation, social justice, and equitable health outcomes among all social and economic groups Groundbreaking work and looking at prevention in new ways. PI’s focus is putting primary prevention at the focus of community health and wellbeing. strong commitment to community participation, social justice, and equitable health outcomes among all social and economic groups

Supersizing America It also doesn’t help when we are living in a culture where the norm is “the bigger the better.” This is my son Ezekiel. Don’t worry, I didn’t let him eat the whole hotdog. We shared it among three of us, but I indulged him a little so that I could get a picture of him. It is however, frustrating as a mom…. TRANSITION: Let’s compare our culture to another….

Is it just individual choice? The first shift in thinking is moving away from this notion of individual choice and trying to engage in healthy behaviors. For example, we’re told that we need to exercise 30 minutes or more each day, but then this person can’t even walk around in her neighborhood safely.

“ 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. “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

The same injuries and illnesses only more so HEALTH DISPARITIES: The same injuries and illnesses only more so And unfortunately, low income communities and communities of color suffer from the same injuries and illnesses ONLY MORE SO

Building a Movement for Healthy Eating & Active Living

ENACT Local Policy Database Our Learnings ENACT Local Policy Database

Inter-Sectoral Collaboration Education Transportation Health Care Public Health Sustainable Agriculture Government Level 4: Fostering Coalitions and Networks I like the notion of a jigsaw puzzle because each piece is important in and of itself, and yet, interlocked, the pieces make a more complete picture. The important thing to consider about coalitions is who do you need at the table to accomplish your goals. Example: Faith Business Environment

Collaboration Math Health Education Social Services Nutritionists Data Concepts Funding Training Partners Key Issues Outcomes Sum Remainder: Average: Sum: Product: Exponential Product: Health Education Social Services Nutritionists Business Media Public Planning TOTALS

Convergence of Interests Preliminary Findings Sectors Built Environment Strategies Land Use Planning Active Transportation Environment   Planning Advocates Public Health Education Sustainable Agriculture Healthcare

Policy Criteria Consider whether proposed policies have the potential for significant impact and whether they are politically feasible. Ensure the right elements are in place for successful implementation and to inform future policy

Cross-Cutting Strategies for Healthy Activity Medical care is not the primary determinant of health Of the 30-year increase in life expectancy since the turn of the century, only about five years of this increase are attributed to medical care interventions. Blum asserts that the most important determinant of health is environmental conditions, followed by lifestyle. Medical care ranks third as a determinant of health. Medical care treats one person at a time By focusing on the individual and specific illnesses as they arise, medical treatment does not reduce the incidence or severity of disease among groups of people. Treatment does not always restore health Medical care is usually sought after people are sick. Many common chronic health problems, such as heart disease, diabetes, asthma, and HIV/AIDS, are never cured. There are disparities in medical treatment A growing body of evidence shows that people of color experience disparities in treatment across all socioeconomic levels. Therefore, even if the medical care infrastructure could address the sheer number of people being sick, it is unlikely that the outcomes would be as positive for people of color as for the general population.

Cross-Cutting Strategies for Healthy Eating

Taking Action for a Healthier California Strategic Alliance recently crafted a set of recommendations to articulate the specific changes that industry and government leaders can take to re-shape California’s eating and activity environments. Businesses, community and government leaders can use their resources to ensure that all Californian’s have convenient, affordable and safe access to quality, healthy food and opportunities for activity.

Opportunities to Take Action Transportation Equity Act Childhood Nutrition Reauthorization No Child Left Behind Farm Bill

TOOLS www.preventioninstitute.org www.eatbettermovemore.org

CHAPTER 2 Achieving Health Equity and Social Justice By Wayne H CHAPTER 2 Achieving Health Equity and Social Justice By Wayne H. Giles & Leandris Liburd

CHAPTER 13 Creating Healthy Food Environments, Preventing Chronic Disease By Leslie Mikkelsen, Catherine S. Erickson, & Marion Nestle

THRIVE Toolkit for Health and Resilience In Vulnerable Environments Eliminating Health Disparities Through a Focus on Community Resilience

The Built Environment and Health: 11 Profiles of Neighborhood Transformation Changes to the neighborhood environment can improve community access to healthy food options. In the Upper Falls community of Rochester, New York, a dynamic collaborative of community members increased access to healthy food by organizing for over five years to bring a full-service supermarket into a community which had had none. Profile: Partners Through Food increases access to healthy food by bringing a full-service supermarket into the community (Rochester, New York) Funded by: Centers for Disease Control and Prevention, Division of Emergency and Environmental Health Services (EEHS), National Center for Environmental Health (NCEH)

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