Flor’s Mini Market Gets Fresh With National Health Foundation’s Community Health Liaisons

Flor’s Mini Market is a neighborhood corner store that is one block from Thomas Jefferson High School in Historic South Central Los Angeles. It’s a favorite among high school students who frequently stop by to purchase a bite to eat before class or during lunchtime. Her merchandise mix is typical of a ‘tienda’ with must have home and personal products as well as some food and beverage inventory. Until recently, the food for sale was mostly packaged with few healthy food options. In a community that is both a food desert (with few healthy food retail choices) and a food swamp (categorized by a prevalence of unhealthy food outlets), markets such as Flor’s have come to represent unique opportunities and key potential partners in the effort to improve access to healthy, affordable foods in South Los Angeles.

Recently, Flor joined the Community Markets Purchasing Real and Affordable Foods (COMPRA foods) program, an innovative food distribution system that caters to small businesses that want to offer healthy food and leverages their collective purchases to secure better prices and quality products from wholesalers. During the first delivery of fresh produce last week, Flor was approached by a dynamic group of high school students known as the Community Health Liaisons (CHL). As part of  National Health Foundation’s (NHF’s) BUILD Health L.A. Initiative, CHL youth   

work with neighborhood markets to help corner store owners introduce healthy produce, and better merchandise fresh fruits and vegetables. CHL’s help store owners make small, gradual changes by providing technical assistance that can help overcome the challenge of introducing new inventory and taking on new risk.

Two CHL youth, Ariana Vega and Melissa Villarruel, ‘adopted’ Flor’s Mini Market to help the store owner adjust to the demands of selling perishable healthy produce and help to ensure changes are profitable and sustainable, with the overall goal of increasing the availability of fresh, quality fruits and vegetables in their neighborhood. During this initial meeting, the CHL’s helped Flor inventory produce shipment and begin using marketing strategies to promote fruits and vegetables in-store.  Together they carved out space in the store for the produce and used baskets and other materials to entice consumers to consider adding fresh fruits and vegetables to their purchases. Within a week, the students will check back with Flor see how things are going and modify their strategies as needed.

The students are keenly aware of the alarming prevalence of obesity, heart disease and diabetes in their community. For NHF, the BUILD Health Initiative presents an opportunity for partners to come together and improve the health of the community from within. By working with local high schools, NHF is able to directly connect with the energy of youth from the community. NHF brings CHL youth together with community partners such as Leadership for Urban Renewal Network (LURN), Los Angeles Food Policy Council, and Los Angeles Department of Public Health among others to share knowledge and to craft innovative solutions to build a healthier South Los Angeles overall.  The students will continue to monitor their efforts to glean important outcomes, however, their efforts have already been well received by storeowners and the community alike.

For Ariana and Melissa, the experience of working with Flor left them inspired, “I felt really good knowing that we would be able to help her not only to sell her produce but also some of the other merchandise in her store,” shared Ariana. Melissa had this to say about her experience, “The level of excitement I had from helping Flor was inexplicable, it felt as if I were riding a roller coaster, or the feeling when you just learn to drive; it felt great!”

 To read Ariana’s account of her work with Flor, please click here.

Increasing Opportunities for Exercise in Historic South Los Angeles

On February 13^th, 2017, Central Avenue Jazz Park in Historic South Central Los Angeles was transformed into an outdoor fitness space with community members and instructors moving through workouts designed to increase cardiovascular capacity, boost energy levels and increase the feeling of wellbeing. For community member Claudia Durango, it was a welcomed event, “This is going to be really good for the community; we just need to continue having people show up.” The new program is part of the rollout of National Health Foundation’s (NHF) BUILD Health LA Initiative Community Action Plan for Historic South Central.

In 2016, NHF’s BUILD Health LA Community Health Liaisons, a group of local high school students and their mentors, surveyed the community to understand residents’ barriers to health. The results of the survey were captured in the Community Action Plan that aims to improve the health of the community through methods that have been identified by the community’s residents and that capitalize on partnerships and the assets available.

Historic South Central Los Angeles is 6 square miles, and is home to roughly 103,000 people. In this community, there are no gyms and there is only 0.4 acres of park space for every 100,000 people. Along with having limited access to open space, this community is considered both a food desert (with few healthy food retail choices) and a food swamp (categorized by a prevalence of unhealthy food outlets). Obesity and diabetes are common in this community, and while physicians recommend healthy eating and exercise, these lifestyle changes are challenging to practice with what is available in the community.

One of the needs the Community Action Plan addresses is for programs to keep residents physically active. Many stated that the classes that were available were too expensive and that the free programs had extensive waitlists of residents eager to join. We learned that these residents want to exercise and they will – if the opportunity is there.

As a result, we partnered with 3WINS Fitness, an innovative program spearheaded by Dr. Loy and Kinesiology students from California State University, Northridge. 3WINS Fitness “adopts” parks in Los Angeles, and sends Kinesiology students to teach community members how to exercise while nurturing a community mentality that leads to friendships, accountability and results!

In addition to 3WINS Fitness, NHF also partnered with California Hospital Medical Center, LA County Department of Public Health, LA City Parks and Recreation, Newton Community Police Station, All People’s Community Center, and A Place Called Home, to launch the fitness program. Classes take place Mondays, Wednesdays, and Fridays at Central Avenue Jazz Park and All People’s Community Center.

Community members are thrilled with this new opportunity and have already built great rapport with the instructors from 3WINS. For NHF, the program represents a new way of delivering health to the community. “By creating an opportunity for the community to express their needs and actively engage in finding solutions to the health barriers they were experiencing, they are bringing about healthy changes from within,” shared NHF CEO Kelly Bruno.

Consistency is always the key with taking on a new behavior, but we are sure that with this new partnership and with the different components of the BUILD Health LA Initiative and Community Action Plan, the residents in Historic South Central Los Angeles will have new opportunities to live a healthier lifestyle.

Partnering for a Healthier South LA

National Health Foundation (NHF) and partners know firsthand that to improve the health of individuals and underserved communities the work cannot be done alone. Collaboration is necessary, and forming multi-sectoral partnerships to align resources, leverage partnerships, and synergize upstream prevention efforts -  is key to building a healthier community.

Under the BUILD Health LA initiative, NHF and partners have come together to address the health disparities and inequities faced by the South Central LA community. Together, BUILD partners envision Historic South Los Angeles as a community that defies the odds and becomes an oasis of fresh, healthy foods and inviting urban space. The BUILD initiative attempts to build on past efforts to create an inviting community where youth, families and adults can access healthy food, be physically active outside, and are supported in maintaining a healthy lifestyle that results in decreasing the prevalence of obesity and subsequently diabetes and cardiovascular disease. Furthermore, this partnership believes in the ambition and potential of the youth in this community. Central to this work, is the commitment and emphasis on youth involvement, empowering youth to take action towards improving social, environmental, and economic conditions in their neighborhood to impact community health.

At present, a new forged partnership with COmmunity Markets Purchasing Real and Affordable Foods (COMPRA Foods) has caused great excitement to the BUILD efforts. COMPRA Foods is a purchasing cooperative and produce distribution program designed to meet the needs of small grocers in low-income neighborhoods. COMPRA Foods was developed, and is lead, by Leadership for Urban Renewal Network (LURN), the Los Angeles Food Policy Council (LAFPC), and the Asian Pacific Islander Obesity Prevention Alliance (APIOPA). The COMPRA Foods team will provide leadership to the BUILD initiative in engaging small markets to offer fresh, healthy food options.

Other BUILD Health LA partners include: Santee Education Complex and Thomas Jefferson High Schools who are providing access to youth for participation; 3WINS program at California StateUniversity, Northridge, who are providing kinesiology student volunteers to facilitate fitness programming; All People’s Community Center, A Place CalledHome and L.A.U.R.A., who will each host new fitness programming and will conduct outreach to the community to expose neighbors to the positive changes being implemented; and South Central Family Health Center and St. John’s Well Childand Family Center, who will conduct outreach, disseminate marketing materials, and food vouchers to drive community members to embrace the implemented upstream healthy changes in the community.

Through BUILD, the project team is moving South LA toward supporting healthier lifestyles. In

addition, by training and supporting youth Community Health Liaisons to drive much of this change, the project creates a cadre of local leaders who will understand potential for upstream improvements and have the skills to influence them.

Together, NHF and partners are TAKING ACTION to decrease the prevalence of obesity, diabetes and cardiovascular disease in Historic South Central LA by creating new solutions to community health!

A COMPRA Foods van filled with healthy produce

Recently, NHF met up with Rudy Espinoza, LURN Founder and Executive Director, and his team at LURN Headquarters. Here’s what they had to say about the new partnership and how LURN’s work through COMPRA Foods, connects with the BUILD Health LA initiative.

What is it about the BUILD community action plan that is in line with LURN’s mission?

Alike the BUILD Health LA initiative, LURN is dedicated to binging people together to design, build, and promote sustainable communities that allow everyone to live to their greatest potential. For example, through the COMPRA Foods program, LURN is invested in finding creative opportunities to bring more fresh produce and healthier food options into underserved communities like South LA to build a healthier community, and a healthier Los Angeles overall.

What are the goals for COMPRA?

With little to no access to major grocery stores in neighborhoods like Historic South Central Los Angeles, COMPRA Foods aims to amplify the capacity of small convenience stores to carry affordable and healthy produce. Currently, COMPRA is a grant funded initiative, supported by funders such as USDA, the Department of Public Health, the Ahmanson Foundation, and the Kresge Foundation. “We have a vision that COMPRA can become the next stand-alone social enterprise, much like Amazon fresh, for local grocers and small convenience stores.” This would mean more access to fresh, quality, fruits and vegetables at a low-price for store owners, and residents alike, who frequent and shop at these local stores.

What has the community response to COMPRA been?”
Once in the COMPRA Foods program, small convenience store owners often see the value and cost savings of entering the cooperative. This is due by enlarge to the fact that small food retailers source their food products from "big-box" grocers, paying full price for these products and then marking them up for sale in their own establishments. This often occurs because entrepreneurs lack relationships with distributors who can deliver produce to their businesses at wholesale prices. Small and mid-size farmers who may be interested in selling their produce directly to these establishments also lack the relationships and efficient distribution systems that can connect them to the hundreds of stores in low-income, "food deserts”. This service gap between growers, distribution companies, and small food retailers impacts low-income consumers tremendously. Because there are few major grocery stores in some low-income communities, families are required to buy food at elevated costs found at small grocers who themselves lack low-cost alternatives to sourcing the produce they offer. In contrast, by entering the COMPRA Foods program, small market owners find support and are connected with small to large wholesale food distributors that provide them with the accessibility and affordability to sell fresh, healthy produce in their stores at a low-price to residents.

What does BUILD bring to LURN?
Through the BUILD Heath LA initiative, one part-time staff member will be hired to manage and expand the COMPRA Foods program to include 16 small markets within Historic South Central LA. Specifically, as a main focus in the first year, youth Community Health Liaisons and the project partners will conduct assessments of 22 local markets (out of the community’s 224 markets) to determine their viability and interest in participating in a food purchasing collaborative with expectations that a minimum of 16 will enter into the collaborative by the end of the first year. After three months of training, the anticipated goal is that each participating store will increase their healthy food options as measured by a cooperative order tracking system.

This supports LURN’s three-year program outcomes for COMPRA, which include: (1) engaging 60 small grocers and convenience stores in the Los Angeles Promise Zone area; (2) equipping 30 small stores to purchase produce and healthy snacks; (3) broker partnerships with 3 local farmers, produce wholesalers, and healthy snack purveyors; and (4) deliver food weekly to more than 30 small grocers and provide marketing and product placement assistance. This with an overall arching goal of reaching 30,000 residents and encouraging them to purchase health

A Community Comes Together for a Healthier Future

In 2015, National Health Foundation (NHF), CaliforniaHospital Medical Center (CHMC), and the Los Angeles County Department of PublicHealth (LACDPH) were awarded a BUILD Health Challenge planning grant to launch the BUILD Health LA initiative. The novel partnership had a specific goal: address the complex issues of obesity, diabetes and cardiovascular disease. Turning our attention to Historic South Central Los Angeles, the partnership sought to identify upstream solutions that address health disparities and inequities in the neighborhood by addressing the root causes of these issues. A team of nine emerging youth leaders from three South LA high schools was selected as community liaisons and led the comprehensive data collection efforts that informed the solutions identified by a community action plan.

Following 23 key informant interviews, 51 references and 515 community surveys, the Youth-Driven Healthy South LA (BUILD Health LA) team identified a lack of access to healthy food, a lack of access to open space for physical activity, and safety concerns as the barriers to a healthy lifestyle for their community. The community liaisons, together with community partners, are now moving to implement innovative and upstream solutions that tackle these issues.

In a densely populated community unhealthy ‘junk’ food is available at an alarmingly disproportionate rate, prompting some to label South LA as a “food swamp.” A strategy to provide 16 corner store owners the opportunity to enroll in the Leadership for Urban Renewal Network’s (LURN) CommunityMarkets Purchasing Real and Affordable (COMPRA) Foods Program will infuse more healthy food options into the neighborhood. The purchasing program will allow market owners the opportunity to purchase fresh produce at a low-cost and thereby increase access to fresh fruit and produce for the community. The youth community health liaisons will identify the 16 markets and, with the support of the LACDPH, will help the markets to promote healthy food messaging at the stores.

With only .4 acres of park space per 100,000 residents, South Los Angeles stands in stark contrast with the recommended 3 acres per 1,000 people. Furthermore, residents report that the 10 parks and 4 pocket parks that do exist are often not maintained and are centers of crime making them unsafe for residents. The youth community health liaisons will take the lead in developing and advocating for park safety. With a keen eye on pedestrian and bicycle accessibility, the youth will conduct assessments to determine what types of infrastructure are needed to ensure all parks are safe and inviting to the community. The youth will then present their recommendations to local stakeholders to advocate for action.

The environmental scan further discovered that recreational facilities offer a limited number of affordable physical activity programs, and that the programs that are offered often have long waiting lists. Providing residents opportunities to engage in physical activity is crucial especially given the high numbers of obesity, diabetes and other disease related to sedentary lifestyles and inactivity. The project team will expand the capacity of a few local community-based organizations to offer additional physical activity programs for community members, specifically in park-poor areas of the neighborhood and areas with limited fitness programming, by connecting these organizations to California State University Northridge’s3WINS Fitness Program. These trained kinesiology students will teach free fitness classes that will be held outside in local parks near the host organizations. A Place Called Home and All People’s Community Center will outreach to residents to participate in these new programs.

With the plan in place, the youth and the community partners share a common goal: getting the word out about the healthy changes in the neighborhood. Currently, the community is saturated with unhealthy food messages on billboards, buses and street corners but the youth and the project partners have identified more than 70 service organizations that have regular contact with residents and could help maximize the awareness of and participation in this program. The youth will develop a comprehensive marketing campaign and, together with the project partners, will raise awareness of the health-related improvements in their community. The sustainability of policy, systems and the health of their neighbors are depending on their ability to connect residents to the fresh produce, safe parks and opportunities for fun physical activity sprouting up in their community.

NHF Seeks KaBOOM! Funding to Further their BUILD Health Challenge Efforts

 

Playing is an essential part of development for young children. Its benefits go beyond learning to include better health and improved social skills. However, not every child lives in a community with enough accessible, safe, outdoor space to play.

The national nonprofit KaBOOM! is dedicated to bringing balanced and active play in the daily lives of all children. Their latest “play challenge” will award $1 million in prizes to communities that provide the best ideas to increase the playability of their neighborhood. For this challenge, there is one caveat, the idea to increase playability must be implemented in a nontraditional space, such as a sidewalk, vacant lot, bus stop, or street.

Like KaBOOM!, National Health Foundation (NHF) realizes that in some communities, a nontraditional approach is often necessary. Over the last year, NHF, in partnership with the California Medical Center and the Los Angeles Department of Public Health, has conducted an environmental scan of the Historic South Los Angeles community. Among a wide range of identified health disparities and poor social determinants of health this community faces, lack of safe, open play space is one of community residents’ greatest concerns. After carefully evaluating the needs of the community and receiving input from a team of South LA high school youth leaders, a robust community action plan was created to address this lack of safe, open space in Historic South LA, along with the lack of access to healthy food.

The community action plan will address the lack of safe, open space through a tested method, partnership with the 100 Citizens program, which places kinesiology students from local universities in local communities to facilitate exercise programs. There is demonstrated need for this partnership. Local organizations that offer physical activity programming have long waiting lists and too few resources to meet the demand. Implementation of these partnerships would take place in small pocket parks that currently have no programming. Through this action plan, NHF and its partners will support residents in taking advantage of their parks. 

In July, NHF’s KaBOOM! playability idea was selected as one of the top 200 ideas submitted to the Play Everywhere Challenge. In line with the strategies of the action plan, NHF proposed to, in collaboration with Council District 9 and five youth leaders from a local high school, design a maze that will highlight historic events of South Central on the sidewalk in frontof the Constituent Center located on Central Avenue. Additionally, creative seating will be installed that will be abstract in shape, such as concrete orbs, or cylinders. The project will provide an opportunity to play and learn in a space that is safe and close to community resources, the Council District’s Constituent Resource Center on Central Avenue.  Here there is high pedestrian traffic. As a main corridor of the community, high pedestrian traffic will bring many children through the maze to play. NHF’s KaBOOM! submission is building on the work already underway to enhance the local community’s physical environment and invite children and adults alike to get more physically active.

Zip Codes as Indicators ... of Actively Engaged Communities

 

By Danielle Cameron, Chief Strategy Officer for National Health Foundation

Too many times we have heard how zip codes have a greater impact on individuals’ health than their genes; usually in the negative sense. Social determinants of health – conditions in the places where people live, learn, work, and play – can have wide ranging impact on health risks and outcomes.[i] But these zip codes facing troublesome social determinants of health have an opportunity to rise up and tackle these challenges head-on so that these zip codes are no longer synonymous with poor health, but rather signify some of the most willful, engaged communities working together to improve their environment and collective health.

Rather than viewed for their economic policies, environmental circumstances, social norms, or educational experiences that poorly impact health, these zip codes often indicate the presence of a powerful community of organizers, advocates and change agents. They are shifting the tide in terms of population health – in their own neighborhoods. It’s these zip codes where hospitals, health plans and community-based organizations should be looking to establish multi-sector partnership that leverage local resources and ambition to create the most impactful change.

NHF has had just that experience in South Los Angeles.

According to the ‘Mapping LA’ project of the Los Angeles Times, South Los Angeles is a 51 square-mile region encompassing 28 neighborhoods that are home to more than 749,000 residents and some of the most troublesome zip codes in Los Angeles County.

For the past four years, NHF has been working in a handful of these zip codes with a generation of engaged teens, learning to bring about dramatic changes in their community and succeeding! In particular, they are changing the way South Los Angeles residents view their physical environments, personal health practices, the healthy development of their children, as a means of improving their overall health and wellbeing.

Through a series of student-led programs that emphasize information gathering as well as peer and public input, healthy changes are afoot in a zip code that otherwise has many negative associations.

At Jefferson High School, National Health Foundation’sHealth Academy, a student-led, healthy change initiative has, over the past three years, implemented such ground breaking ideas as a hydration station offering fresh water as an alternative to sodas and juices, reconfigured the lunch room so that all students have time to get lunch and eat it, versus having to go to the snack shop to buy sugary treats to replace meals, and have tested and introduced healthy meal options that are now on the lunch menu. Perhaps the biggest victory was the creation of classroom-based mini farm stands where students can help themselves to a piece of fresh fruit when needed. The initiative caught the eye of the Los Angeles Unified School District’s food services director who acknowledged the thoughtful use of fruit left over from breakfast service, the reduction of food waste, and the increase in opportunity for students to snack on healthy fruits. The district is considering expanding the program to other LAUSD school sites.

Through another project, NHF’s BUILD Health Challenge grant in collaboration with California Hospital Medical Center and the LA County Department of Public Health, student ”Community Health Liaisons” spent several months interviewing residents about their perceptions and needs as they relate to their physical environment. Residents voiced concerns ranging from a need for safe, open spaces for play and exercise, to a desire to walk more and have more opportunities to purchase fresh fruits and vegetables. The partnership took the information gathered and formulated a Community-Driven Action Plan for Historic South Central. The purpose of the plan will be to implement upstream, meaning preventative rather than curative, solutions to the health issues faced by the community. By lowering or even eliminating some of the social and environmental barriers to health, the team hopes that the community will defy the current statistics that point to lower life expectancy and a higher than average rate of preventable illnesses.

As part of Mayor Eric Garcetti’s Great Street’s Initiative, another group of inspired students championed the creation of a Walking Corridor along Central Avenue. Through the use of clever wayfinding signage, the community can now see how far the nearest transit, entertainment, shopping and recreational facilities are located on foot. The signage, unveiled during a community event in May, has been met with the resounding approval of the community and visitors alike.

The community is seeing first-hand that change is most meaningful when it comes from within and is possible when it is led by the energy and passion of one of its most valuable assets: its youth. The remarkable success of these empowered and engaged youth is a reflection of a new and brighter outlook in the zip codes of South Los Angeles.

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[i] World Health Organization