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

2. What’s Health Got To Do With It?

4. Photo Courtesy of: http://www.chrisstroud.net/blog/fremont-union-city-farmers-markets/

5. Photo Courtesy of Google Images

7. / Photo Courtesy of: Don Dommer Associates at http://www.flickr.com/photos/dondommerassociates/3254703816/

8. HEALTH & SAFETY BEHAVIOR BEHAVIOR ENVIRONMENT

9. 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

10. 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

11. 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

12. 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

13. $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

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

15. Two Steps to Prevention Medical Care Exposures & Behaviors Environment

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

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

18. Photo courtesy of http://tycohealth-ece.com/files/d0003/ty_rn33d7.jpg

19.  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

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

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

24. What’s Sold and Promoted VS. IndustryLow-WealthHigh-Wealth Group Neighborhood Neighborhood Bars/Taverns 727 2624 3511 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.

25. What’s Sold and Promoted VS. IndustryLow-WealthHigh-Wealth Group Neighborhood Neighborhood Bars/Taverns 727 2624 3511 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.

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

27.  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

28.  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

29. Complete Streets Oakland, CA

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

32. “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

33. Fresh Food Financing

34. Alameda County CCNI West Oakland – Hoover District

35. Alameda County CCNI Sobrante Park Photo courtesy of: http://www.acphd.org/healthequity/ccni/docs/youth/SP_keeping_it_real_final_rpt.pdf

36. “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

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

38.  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

39. “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

40. www.preventioninstitute.orgwww.eatbettermovemore.org TOOLS

41. THRIVE Tool for Health and Resilience In Vulnerable Environments http://preventioninstitute.org/thrive/index.php

42. ENACT Environmental Nutrition & Activity Community Tool www.eatbettermovemore.org

43. 221 Oak Street Oakland, California 94607 phone: 510-444-7738 fax: 510-663-1280 www.preventioninstitute.org