1. Improving Food and Physical Activity Environments: What Local Health Departments Can Do Statewide Public Health Department Meeting (Annual Conference of the California Network for Healthy, Active Families) August 9, 2006 Kate Clayton, MPH, Chronic Disease Prevention Program Director Tanya Henneman, PhD, Senior Health Management Analyst City of Berkeley Public Health Division Kclayton@ci.berkeley.ca.us (510) 981-5314Kclayton@ci.berkeley.ca.us Thenneman@ci.berkeley.ca.us (510) 981-5351Thenneman@ci.berkeley.ca.us Public Health Services

2. Socio-Ecological Approach to Public Health Services Individual Social/Groups Community Institutional/Organizational Policy/Environmental

3. Public Health Services Successful Nutrition and Physical Activity Environmental Strategies Utilized by Local Health Departments Assessing what is currently being done How can Health Department best fill in gaps with resource limitations – CNN limitations, General Funds, Grants Health Department provides outreach and education for most strategies Note: These examples are being used by many health departments through out California.

4. Public Health Services Successful Environmental Strategies Utilized by Local Health Departments Increasing Food Access Grant writing assistance for neighborhood produce stands/mini-farmers’ markets Farm Fresh Choice

5. Public Health Services Successful Environmental Strategies Utilized by Local Health Departments Increasing Food Access Mini-grants for salad bars at Senior Centers Contracts to increase fresh produce in liquor stores/corner markets Work with School District to bring breakfast to Alternative High School

6. Public Health Services Successful Environmental Strategies Utilized by Local Health Departments Producing Food Locally Support of community and neighborhood gardens Spiral Gardens Urban Garden Center A Collective Food Production Garden Organic Urban Nursery Low-Cost Organic Produce Stand Outdoor education site

7. Public Health Services Successful Environmental Strategies Improving Physical Activity Environments Work with Community Residents/Groups Partnering with Parks and Recreation Departments in Cities Ex: Mini-grants, walking clubs Partnering with Planning Departments in Cities and Counties Ex: General Plan, zoning, etc. Partnering with Transportation Departments in Cities and Counties Ex: Grants for pedestrian/bicycle improvements

8. Public Health Services Successful Environmental Strategies Changing the Built Environment to Increase Physical Activity Bay Area Regional Health Inequities Initiative (BARHII) – 9 Bay Area Health Departments Built Environment Work Group Built Environment training for Public Health staff Association of Bay Area Governments (ABAG) to provide public health perspectives on regional planning addressing land use, housing, environmental quality, and economic development.

9. Public Health Services Successful Environmental Strategies Creating Small Scale Supportive Environments Creating small scale environments to support Healthy Eating and Physical Activity New Pilot Project funded by Robert Wood Johnson Foundation Work with a City Recreation Center on a full spectrum of activities: vending machine policy, weekly produce stand, weekly takeout meal, senior volunteers leading/teaching physical activities, training staff in promoting physical activity, “Students Run Berkeley”, Dance, Dance Revolution arcade game

10. Public Health Services Berkeley Environmental Approaches: Lessons Learned Access means different things to different people Environmental strategies can be replicated but not duplicated Environmental strategies may be driven by individuals, groups, or institutions If you build it, they won’t necessarily come-must have outreach and education

11. Public Health Services Communities of Excellence in Nutrition, Physical Activity and Obesity Prevention (CX 3 ) What is CX 3 ? A framework developed by the California Nutrition Network for evaluating communities in relation to a variety of community indicators and assets related to obesity prevention Currently being piloted at a few different Public Health Departments in California

12. Public Health Services Communities of Excellence (CX3) Assessing community indicators and assets 1. GIS Mapping Tool: Creates maps using indicators such as poverty, and location of large-chain grocery stores, small corner markets, schools, parks and fast food outlets 2. Surveys: Data collected on type of advertising in fast food outlets, grocery outlets and outdoor marketing Data collected on availability and pricing of healthy food items in grocery outlets

13. CX 3 map—West Berkeley % of Hispanic pop. < 185% FPL and grocery outlets

14. CX 3 map—West Berkeley % of Hispanic pop. < 185% FPL and fast food outlets

15. Public Health Services Communities of Excellence (CX3) An opportunity to build youth capacity A great tool to engage local youth on marketing and food access issues in their community Youth received trainings related to nutrition and health, administering surveys, and evaluating media messages related to healthy and unhealthy foods Students from the community can contribute their own knowledge and insight about different stores and neighborhoods Students will give a community presentation at the end of the summer

17. Public Health Services Communities of Excellence (CX3) A couple of observations "In general, it {produce} wasn't that great. People know that corner stores don't have great produce and they don't buy it, so it stays at the store to rot. It's like a bad cycle.” High school intern response when asked what was the overall quality of fruits and vegetables in the stores that were surveyed. "I expected a lot more {advertising}, but there was a lot hanging from the ceilings and some on the floors, a lot for alcohol” High school intern response when asked about the type of advertising seen "The corner markets were pretty expensive when it came to the grocery items compared to large chains” Graduate student intern

18. Public Health Services Communities of Excellence (CX3) Examples of how CX3 can be used The maps and surveys provide hard evidence to support what departments may know intuitively about the relationship between food access, media and poverty in their community An opportunity to examine cost differences and marketing strategies between small corner markets and large chain grocery outlets Surveying can offer an entryway to create conversations with store owners that may be interested in working with us to make store improvements Information can be used for program planning Ex. Technical assistance needed in corner markets around pricing of produce items