1. CLEVELAND HEALTHY KIDS’ MEALS CAMPAIGN
CREATING PATHWAYS
TO HEALTH EQUITY
CLEVELAND HEALTHY KIDS’ MEALS CAMPAIGN
LEADERSHIP INSTITUTE
July 23 & 24, 2019

2. Commitment to Health Equity
Our opportunity: To advance health equity by ensuring that public policy language prioritizes implementation and funding first in areas of greatest need, then expands to benefit all children.
One of the American Heart Association’s top priorities is ensuring that all Americans have access to healthcare and lifesaving information that can prevent heart disease and stroke. That’s why we often talk about eliminating health disparities and creating health equity.
Earlier today, you heard Christine Compton talk about the broader Voices agenda. Healthy Equity is a priority for Voices for Healthy Kids, and it’s why the American Heart Association received funding to do this work in Cleveland.
We recognize that Health Equity is also a priority for the organizations represented here today, so the information that will be shared on the following slides won’t come as a surprise but will emphasize the critical need for the work that we’re discussing during the training.

3. Life Expectancy
You may have seen this map or a similar representation. Cleveland residents have up to a 12-year gap in life expectancy compared to their suburban counterparts. The next few slides identify contributing health factors.

4. Adult Obesity
Highest rates are indicated by the dark brown areas. You’ll see similar representation of the following health factors.
Diabetes….NEXT SLIDE

5. Diabetes
(Note: specific search parameters need to be entered)
AND STROKE..Next Slide

6. Stroke (Note: specific search parameters need to be entered)
NEXT SLIDE…

7. Racial/Ethnic Disparities
Racial/Ethnic disparities are almost 2 to 3 times larger within the City of Cleveland compared to Cuyahoga County for the following:
Infant Mortality
Newly diagnosed cases of HIV and AIDS
Violent Crimes
Births to adolescents and teens years
As outlined on this slide, residents within the City of Cleveland are not experiencing the same level of health and well-being compared to residents of Cuyahoga County.
Racial/Ethnic disparities are almost 2 to 3 times higher within the City of Cleveland for the following:
Infant Mortality
Newly diagnosed cases of HIV and AIDS
Violent Crimes
Births to adolescents and teens years

8. Population Change
As represented on this slide. There has been a major shift in the demographics in Cleveland since The African-American population in Cleveland has increased from 47.7% in 1980 to nearly 70% in 2015.
Why does this matter?
The United States is undergoing a dramatic transformation. It is predicted that people of color will represent the majority population within the next 25 years.

9. Baseline Health Stats from YRBS
Obesity
7th and 8th graders in Cleveland are about 10% more likely to live with obesity/overweight than their peers across Cuyahoga County
Racial/ethnic disparities persist in youth
Dietary Behavior
Nearly ¾ of Cleveland 7th and 8th graders ate fast food on one or more of the past seven days
Middle schoolers in Cleveland are 15-20% more likely to have had a soda/pop in the previous day than middle schoolers elsewhere in Cuyahoga County
This slide represents baseline health statistics from the 2017 Youth Risk Behavior Survey conducted by the Prevention Research Center at Case Western Reserve University.
I will highlight a few points:
The survey found that 1 in 3 middle and high school students are considered obese or overweight
Physical activity declined from the 7th t0 12th grade
Nearly ¾ of the Cleveland 7th and 8th graders surveyed ate fast food on one or more of the past seven days
Middle schoolers in Cleveland are 15-20% more likely to have had a soda/pop in the previous day than middle schoolers elsewhere in Cuyahoga County
*From Prevention Research Center, based on 2017 YRBS

10. Food Deserts
50% of residents live farther than a half mile from a grocery store compared to the Cuyahoga County (25%)
1 out of 2 people live in areas that lack access to healthy food options, referred to as “food deserts”
Food deserts are a concern for many Cleveland residents.
50% of residents live farther than a half mile from a grocery store compared to the Cuyahoga County (25%)
1 out of 2 people live in areas that lack access to healthy food options, referred to as “food deserts”
I would like to acknowledge the great work that’s being done to address this health concern.
The Prevention Research Center at Case Western Reserve University received a REACH grant that focuses on:
Engaging residents to improve access to healthy foods (through the healthy retail project)
Increasing opportunities for physical activity (through shared use agreements)
Facilitating linkages between health clinics and community resources (through referrals to the Produce Prescription Program and the Chronic Disease Self-Management Program)

11. Prevalence of Fast Food
This slide represents the top 10 cities by population with the most and least restaurants per 10K residents.
Cleveland ranks #9 for most fast food restaurants per capita.

12. PARTNERSHIP FOR IMPROVED
HEALTH & WELLBEING

13. We all have a shared goal to foster cross-sector collaboration in an effort to ensure that all Cleveland residents have full and equitable access to opportunities and resources that allow them to lead healthy lives.
As you can see, there are many organizations across the region that are committed to creating pathways to health equity.

14. “The Healthiest City in the Nation”
Championed by former Councilman Joe Cimperman
February 2011: Council passage of Healthy Roadmap 
Currently known as the Healthy Cleveland Initiative
Partnership on tobacco cessation 
Smoke free expansion on city property- Stronger than state
2011: passage of Trans Fat Elimination
2015: Tobacco policies Introduced - Flavors, Hiring and Tobacco 21 
Many of you may be familiar with former council member Joe Cimperman’s efforts to make Cleveland the Healthiest City in the country. He worked on a series of policy efforts.
Here are a few efforts that supported his vision:
The City of Cleveland has shown a commitment to improving the health of city residents. In February of 2011, city council passed a resolution as a commitment and roadmap to improve the health of city neighborhoods and residents. From this resolution, the Healthy Cleveland initiative was created with support from the major health systems, including the Cleveland Clinic, MetroHealth, Sisters of Charity Health System and University Hospitals. 
After the state abolished the Tobacco Use Prevention and Cessation Foundation and its funding, city leaders worked with the hospital systems and the health department to establish a program to provide free tobacco cessation to all residents. Additionally, the city passed a policy stronger than the state’s smoke free law and eliminated smoking on all city property, including in parks, playgrounds and garages.
In 2011, the city removed sugary drinks from vending machines and passed a policy to remove trans fat from food items throughout the city. At each step, the city urges local businesses to follow their lead to expand the impact of the policy.
In 2015, the city passed an ordinance to increase the age to purchase tobacco to 21.  Cleveland was an early adopter and was the first large city to pass such legislation. 

15. It Takes a Collective Approach
HIP CUYAHOGA/CUYAHOGA COUNTY BOARd of HealtH
AWARDED 5-YEAR Reach (Racial and Ethnic Approaches to Community Health) GRANT IN 2018
HEALTHY CLEVELAND INITIATIVE/HEALTHY EATING COMMITTEE
HARVARD Technical Assistance GRANT FOR community ENGAGEMENT AROUND SUGARY DRINKS
CLEVELAND-CUYAHOGA COUNTY FOOD POLICY COALITION
Ongoing efforts to promote just, equitable, healthy and sustainable food systems in Cleveland and Cuyahoga county.
PREVENTION RESEARCH CENTER – CASE WESTERN RESERVE
FOSTER PARTNERSHIPS WITHIN CLEVELAND’S URBAN NEIGHBORHOODS FOR DEVELOPING, TESTING, AND IMPLEMENTING STRATEGIES TO PREVENT AND REDUCE THE BURDEN OF CHRONIC DISEASE.
EARLY AGES HEALTHY STAGES/OHIO Healthy programs
TRAINING, Policy work and PROGRAMmING For CHIldREN 0-8 YEARS OLD in HOME AND EARLY EDUCATION CENTERS
This slide doesn’t reflect all the great work that’s being done across the area but provides a snapshot of a few current efforts that align with improving access to the conditions and resources that strongly influence better health and wellbeing.
HIP CUYAHOGA/CUYAHOGA COUNTY BOARd of HealtH
AWARDED 5-YEAR Reach (Racial and Ethnic Approaches to Community Health) GRANT IN 2018
HEALTHY CLEVELAND INITIATIVE/HEALTHY EATING COMMITTEE
Received a Technical Assistance GRANT from harvard law food policy clinic FOR community ENGAGEMENT AROUND SUGARY DRINKS
CLEVELAND-CUYAHOGA COUNTY FOOD POLICY COALITION
Ongoing efforts to promote just, equitable, healthy and sustainable food systems in Cleveland and Cuyahoga county.
PREVENTION RESEARCH CENTER – CASE WESTERN RESERVE
FOSTER PARTNERSHIPS WITHIN CLEVELAND’S URBAN NEIGHBORHOODS FOR DEVELOPING, TESTING, AND IMPLEMENTING STRATEGIES TO PREVENT AND REDUCE THE BURDEN OF CHRONIC DISEASE.
Freshlink
Produce prescription
Healthy retail program
EARLY AGES HEALTHY STAGES/OHIO Healthy programs
TRAINING, Policy work and PROGRAMmING For CHIldREN 0-8 YEARS OLD in HOME AND EARLY EDUCATION CENTERS

16. Questions? LISA WHEELER-COOPER Jamie Meerdink Cresha Auck
Community Impact Director
Jamie Meerdink
Coalition Manager
Cresha Auck
Ohio Community Advocacy Director
The information that I just shared can help inform our discussion as we begin to form our strategy for approaching local policy and decision makers.
Before we transition to the next item on the agenda, I’ll pause for questions and comments.