Community Assets to Support Healthy Eating Leslie Mikkelsen Managing Director Health-Wealth Connection Symposium June 23, 2010 “A Holistic View of Assets: Family, Community, Equity”

What’s Health Got To Do With It?

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/ Photo Courtesy of: Don Dommer Associates at

HEALTH & SAFETY BEHAVIOR BEHAVIOR ENVIRONMENT

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

70% 10% 20% $2.2 Trillion Current Health Care Spending Factors Influencing Health National Health Expenditures SOURCE: Centers for Disease Control and Prevention, Blue Sky Initiative, University of California at San Francisco, Institute of the Future, 2000 Behaviors & Environment Genetics Medical Care

Behaviors & Environment 70% Medical Care, 10% Genetics20% $2.2 Trillion Current Health Care Spending Factors Influencing Health National Health Expenditures SOURCE: Centers for Disease Control and Prevention, Blue Sky Initiative, University of California at San Francisco, Institute of the Future, 2000

Behaviors & Environment 70% Medical Care, 10% Genetics20% Prevention, 4% Medical Services 96% $2.2 Trillion Current Health Care Spending Factors Influencing Health National Health Expenditures SOURCE: Centers for Disease Control and Prevention, Blue Sky Initiative, University of California at San Francisco, Institute of the Future, 2000

$1 Return on Investment with Prevention Investment SOURCE: Prevention for A Healthy America: Investments in Disease Prevention Yield Significant Savings, Stronger Communities, Trust for America’s Health, July 2008 $5.60 Return on Investment Savings at 5 years $16 Billion Annual Savings In 5 Years In 5 Years

QUALITYPrevention is the Prescription  Comprehensive  Aimed at the community environment  Changes norms: makes the healthy choice the easy choice

Two Steps to Prevention Medical Care Exposures & Behaviors Environment

Source: Actual Causes of Deaths in the US, 2000, Centers for Disease Control and Prevention, 2004

Leading Causes of Death Heart Disease Cancer Stroke Diabetes Injuries & Violence Medical care, costs, and inequities

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 Not the primary determinant of health  Treats one person at a time  Often comes late; can’t always restore health Medical Care Alone Cannot Reduce Injuries and Inequities Reduce Injuries and Inequities

Let’s take a step... Medical Care Exposures & Behaviors

Environment Let’s take another step... Exposures & Behaviors

What’s Sold and Promoted VS. IndustryLow-WealthHigh-Wealth Group Neighborhood Neighborhood Bars/Taverns Supermarkets Carry-out eating places SOURCE: Morland K, Wing S, Diez Roux A, Poole C. Neighborhood characteristics associated with the location of food stores and food service places. Am J Prev Med. 2002;22:23-9.

What’s Sold and Promoted VS. IndustryLow-WealthHigh-Wealth Group Neighborhood Neighborhood Bars/Taverns Supermarkets Carry-out eating places SOURCE: Morland K, Wing S, Diez Roux A, Poole C. Neighborhood characteristics associated with the location of food stores and food service places. Am J Prev Med. 2002;22:23-9.

 What’s sold & how it’s promoted Elements of Community Health PLACE

 Social networks & trust  Participation & willingness to act for the common good  Acceptable behaviors & attitudes  Racial justice  Jobs & local ownership  Education  What’s sold & how it’s promoted  Look, feel & safety  Parks & open space  Getting around  Housing  Air, water, soil  Arts & culture Elements of Community Health PEOPLE PLACE EQUITABLEOPPORTUNITY

 Social networks & trust  Participation & willingness to act for the common good  Acceptable behaviors & attitudes  Racial justice  Jobs & local ownership  Education  What’s sold & how it’s promoted  Look, feel & safety  Parks & open space  Getting around  Housing  Air, water, soil  Arts & culture Elements of Community Health PEOPLE PLACE EQUITABLEOPPORTUNITY  Preventative services  Access  Treatment quality, disease management, in-patient services, & alternative medicine  Cultural competence  Emergency response MEDICAL SERVICES

Complete Streets Oakland, CA

Source: Partners Through Food Healthy Food Retail and Access Rochester, NY

“Life was there again. It transformed the neighborhood.” Hank Herrera, President/CEO Center for Popular Research Education and Policy Increasing Access to Healthy Food Upper Falls Community: Rochester, New York

Fresh Food Financing

Alameda County CCNI West Oakland – Hoover District

Alameda County CCNI Sobrante Park Photo courtesy of:

“Violence is not the problem of one neighborhood or group…Coming together and owning this problem and the solutions are central.” -Dr. Deborah Prothrow-Stith, Harvard School of Public Health, UNITY Co-Chair Focus on Safety

Health Reform Legislation  Community Transformation Grants  Prevention and Wellness Fund  Health Empowerment Zones  Workforce training in community prevention  National strategy and inter-agency efforts

 Stimulus (ARRA)  Health Equity and Accountability Act of 2009 (H.R. 3090)  Transportation Reauthorization  Child Nutrition Reauthorization  Preventing violence  The next Farm Bill Federal Funding: Other Opportunities

“It wouldn't have happened except for the fact that people worked to make it happen. Every time I go by that corner, I remember people saying ‘Face reality. There will never be a grocery store there,’ and I smile.” - Hank Herrera President/CEO, Center for Popular Research, Education, and Policy President/CEO, Center for Popular Research, Education, and Policy

TOOLS

THRIVE Tool for Health and Resilience In Vulnerable Environments

ENACT Environmental Nutrition & Activity Community Tool

221 Oak Street Oakland, California phone: fax: