Community Assets to Support Healthy Eating Leslie Mikkelsen Managing Director Health-Wealth...
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Community Community Assets to Assets to Support Support Healthy Healthy Eating Eating www.preventioninstitute.o www.preventioninstitute.o Leslie Leslie Mikkelsen Mikkelsen Managing Director Managing Director Health-Wealth Health-Wealth Connection Connection Symposium Symposium June 23, 2010 June 23, 2010 “ “ A Holistic View of A Holistic View of Assets: Family, Assets: Family, Community, Equity” Community, Equity”
Transcript of Community Assets to Support Healthy Eating Leslie Mikkelsen Managing Director Health-Wealth...
Community Community Assets to Assets to
Support Healthy Support Healthy EatingEating
www.preventioninstitute.orgwww.preventioninstitute.org
Leslie MikkelsenLeslie MikkelsenManaging DirectorManaging Director
Health-Wealth Health-Wealth Connection Connection SymposiumSymposium
June 23, 2010June 23, 2010
““A Holistic View of A Holistic View of Assets: Family, Assets: Family, Community, Equity”Community, Equity”
What’s Health Got What’s Health Got To Do With It?To Do With It?
Photo Courtesy of: http://www.chrisstroud.net/blog/fremont-union-city-farmers-markets/ Photo Courtesy of: http://www.chrisstroud.net/blog/fremont-union-city-farmers-markets/
Photo Courtesy of Google ImagesPhoto Courtesy of Google Images
Photo Courtesy of: Don Dommer Associates at http://www.flickr.com/photos/dondommerassociates/3254703816//
HEALTH HEALTH & &
SAFETYSAFETYBEHAVIORBEHAVIORBEHAVIORBEHAVIOR
ENVIRONMENTENVIRONMENT
It is unreasonable to expect It is unreasonable to expect
that people will change their that people will change their
behavior behavior easilyeasily when so many when so many
forces in the social, cultural, forces in the social, cultural,
and physical environment and physical environment
conspire against such change.conspire against such change.
““
””Institute of MedicineInstitute of Medicine
70%70%
10%10%
20%20%
$2.2 Trillion$2.2 Trillion
Current Health Care SpendingCurrent Health Care Spending
Factors InfluencingHealth
National Health Expenditures
SOURCE: SOURCE: Centers for Disease Control and Prevention, Blue Sky Initiative, Centers for Disease Control and Prevention, Blue Sky Initiative, University of California at San Francisco, Institute of the Future, 2000University of California at San Francisco, Institute of the Future, 2000
Behaviors & Behaviors & EnvironmentEnvironment
GeneticsGenetics
Medical CareMedical Care
Behaviors & Behaviors & EnvironmentEnvironment
70%70%
Medical Care, 10%Medical Care, 10%
GeneticsGenetics20%20%
$2.2 Trillion$2.2 Trillion
Current Health Care SpendingCurrent Health Care Spending
Factors InfluencingHealth
National Health Expenditures
SOURCE: SOURCE: Centers for Disease Control and Prevention, Blue Sky Initiative, Centers for Disease Control and Prevention, Blue Sky Initiative, University of California at San Francisco, Institute of the Future, 2000University of California at San Francisco, Institute of the Future, 2000
Behaviors & Behaviors & EnvironmentEnvironment
70%70%
Medical Care, 10%Medical Care, 10%
GeneticsGenetics20%20%
Prevention, 4%Prevention, 4%
Medical ServicesMedical Services96%96%
$2.2 Trillion$2.2 Trillion
Current Health Care SpendingCurrent Health Care Spending
Factors InfluencingHealth
National Health Expenditures
SOURCE: SOURCE: Centers for Disease Control and Prevention, Blue Sky Initiative, Centers for Disease Control and Prevention, Blue Sky Initiative, University of California at San Francisco, Institute of the Future, 2000University of California at San Francisco, Institute of the Future, 2000
$1$1
Return on Investment with PreventionReturn on Investment with Prevention
Investment
SOURCE: SOURCE: Prevention for A Healthy America: Investments in Disease Prevention Yield Significant Savings, Prevention for A Healthy America: Investments in Disease Prevention Yield Significant Savings, Stronger Communities, Trust for America’s Health, July 2008Stronger Communities, Trust for America’s Health, July 2008
$5.60$5.60
Return on Investment
Savings at 5 years
$16 Billion $16 Billion Annual SavingsAnnual Savings
In 5 YearsIn 5 Years
QUALITYQUALITYPreventionPrevention
is the Prescriptionis the Prescription ComprehensiveComprehensive
Aimed at the community Aimed at the community environmentenvironment
Changes norms: Changes norms: makes the healthy choice the makes the healthy choice the easy choiceeasy choice
TwoTwo Steps to Steps to PreventionPrevention
Medical Care
Exposures &
BehaviorsEnvironment
Source:Source: Actual Causes of Deaths in the US, 2000, Centers for Disease Control and Prevention, Actual Causes of Deaths in the US, 2000, Centers for Disease Control and Prevention, 20042004
Leading Causes of DeathLeading Causes of Death
Heart Heart DiseaseDisease
CancerCancer
StrokeStroke
DiabetesDiabetes
Injuries & ViolenceInjuries & Violence
Medical care, costs, and Medical care, costs, and inequitiesinequities
Photo courtesy of http://tycohealth-ece.com/files/d0003/ty_rn33d7.jpgPhoto courtesy of http://tycohealth-ece.com/files/d0003/ty_rn33d7.jpg
Not the primary determinant of healthNot the primary determinant of health
Treats one person at a timeTreats one person at a time
Often comes late; can’t always restore Often comes late; can’t always restore healthhealth
Medical Care Alone CannotMedical Care Alone Cannot Reduce Injuries and InequitiesReduce Injuries and Inequities
Let’s take a step... Medical
CareExposures
& Behaviors
Environment
Let’s take anotherstep...
Exposures &
Behaviors
What’s Sold and PromotedWhat’s Sold and Promoted
VS.VS.
Industry Low-Wealth High-Wealth Group Neighborhood Neighborhood
Bars/Taverns
7 27
26 24
35 11
SupermarketsCarry-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 PromotedWhat’s Sold and Promoted
VS.VS.
Industry Low-Wealth High-Wealth Group Neighborhood Neighborhood
Bars/Taverns
7 27
26 24
35 11
SupermarketsCarry-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 What’s sold & how it’s promotedit’s promoted
Elements of Community HealthElements of Community Health
PLACEPLACE
Social networks & trustSocial networks & trust Participation & willingness to act Participation & willingness to act
for the common goodfor the common good Acceptable behaviors & attitudesAcceptable behaviors & attitudes
Racial justiceRacial justice Jobs & local ownershipJobs & local ownership EducationEducation
What’s sold & how What’s sold & how it’s promotedit’s promoted
Look, feel & safety Look, feel & safety Parks & open spaceParks & open space Getting aroundGetting around Housing Housing Air, water, soil Air, water, soil Arts & cultureArts & culture
Elements of Community HealthElements of Community Health
PEOPLEPEOPLE
PLACEPLACE
EQUITABLE EQUITABLE OPPORTUNITYOPPORTUNITY
Social networks & trustSocial networks & trust Participation & willingness to act Participation & willingness to act
for the common goodfor the common good Acceptable behaviors & attitudesAcceptable behaviors & attitudes
Racial justiceRacial justice Jobs & local ownershipJobs & local ownership EducationEducation
What’s sold & how What’s sold & how it’s promotedit’s promoted
Look, feel & safety Look, feel & safety Parks & open spaceParks & open space Getting aroundGetting around Housing Housing Air, water, soil Air, water, soil Arts & cultureArts & culture
Elements of Community HealthElements of Community Health
PEOPLEPEOPLE
PLACEPLACE
EQUITABLE EQUITABLE OPPORTUNITYOPPORTUNITY
Preventative servicesPreventative services AccessAccess Treatment quality, disease Treatment quality, disease
management, in-patient management, in-patient services, & alternative medicineservices, & alternative medicine
Cultural competenceCultural competence Emergency responseEmergency response
MEDICAL MEDICAL SERVICESSERVICES
Complete StreetsComplete StreetsOakland, CAOakland, CA
Source: Partners Through FoodSource: Partners Through Food
Healthy Food Retail and AccessHealthy Food Retail and Access
Rochester, NYRochester, NY
““Life was there Life was there again. again.
It transformed the It transformed the neighborhood.”neighborhood.”
Hank Herrera, President/CEOHank Herrera, President/CEOCenter for Popular Research Education and PolicyCenter for Popular Research Education and Policy
Increasing Access to Healthy FoodIncreasing Access to Healthy FoodUpper Falls Community: Rochester, New YorkUpper Falls Community: Rochester, New York
Fresh Food FinancingFresh Food Financing
Alameda County CCNIAlameda County CCNI
West Oakland – Hoover DistrictWest Oakland – Hoover District
Alameda County CCNIAlameda County CCNI
Sobrante ParkSobrante Park
Photo courtesy of: http://www.acphd.org/healthequity/ccni/docs/youth/SP_keeping_it_real_final_rpt.pdf Photo courtesy of: http://www.acphd.org/healthequity/ccni/docs/youth/SP_keeping_it_real_final_rpt.pdf
“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 SafetyFocus on Safety
Health Reform LegislationHealth Reform Legislation
Community Transformation GrantsCommunity Transformation Grants
Prevention and Wellness Fund Prevention and Wellness Fund
Health Empowerment ZonesHealth Empowerment Zones
Workforce training in community Workforce training in community preventionprevention
National strategy and inter-agency effortsNational strategy and inter-agency efforts
Stimulus (ARRA)Stimulus (ARRA) Health Equity and Accountability Act of Health Equity and Accountability Act of
2009 (H.R. 3090)2009 (H.R. 3090) Transportation ReauthorizationTransportation Reauthorization Child Nutrition ReauthorizationChild Nutrition Reauthorization Preventing violencePreventing violence The next Farm BillThe next Farm Bill
Federal Funding: Other OpportunitiesFederal Funding: Other Opportunities
““It wouldn't have happened except for the It wouldn't have happened except for the fact that people worked to make it happen. fact that people worked to make it happen. Every time I go by that corner, I remember Every time I go by that corner, I remember people saying ‘Face reality. There will people saying ‘Face reality. There will never be a grocery store there,’ and I never be a grocery store there,’ and I smile.”smile.”
- Hank Herrera - Hank Herrera
President/CEO, Center for Popular Research, Education, and PolicyPresident/CEO, Center for Popular Research, Education, and Policy
www.preventioninstitute.orgwww.preventioninstitute.org
www.eatbettermovemore.orgwww.eatbettermovemore.org
TOOLSTOOLS
THRIVETHRIVETool for Tool for Health and Health and Resilience Resilience In Vulnerable In Vulnerable EnvironmentsEnvironments
http://preventioninstitute.org/thrive/index.phphttp://preventioninstitute.org/thrive/index.php
ENACTENACTEEnvironmental nvironmental NNutrition & utrition & AActivityctivityCCommunity ommunity TToolool
www.eatbettermovemore.org
221 Oak Street221 Oak StreetOakland, California 94607Oakland, California 94607
phone: 510-444-7738 fax: 510-663-1280phone: 510-444-7738 fax: 510-663-1280
www.preventioninstitute.org
