National Health Foundation Awarded Nearly $1 Million to Address High Obesity Rates in Historic South Central Los Angeles

National Health Foundation (NHF) was awarded $880,000 from the Los Angeles CountyDepartment of Public Health with funding from the California Department of Public Health and the United States Department of Agriculture. The grant will support the Champions for Change - Healthy Communities Initiative, which aims to reduce the prevalence of obesity among low-income Supplemental Nutrition Assistance Program-Education eligible populations by providing nutrition education, physical activity promotion, and working to create healthier environments for low-income individuals and families where they live, learn, work, play, pray, and shop.

Key efforts under the initiative include teaching fundamental skills such as cooking, reading food labels, shopping on a budget, growing fruits and vegetables, and introducing low-cost and fun ways to be physically active. In addition, champions in communities throughout the County will be identified to help improve access to healthier foods and increase opportunities to be physical active in a variety of settings, including early childcare centers, schools, faith-based organizations, corner stores, parks, worksites, and cities.   

“National Health Foundation is pleased to be a part of this County-wide initiative, as we are committed to improving underserved communities by taking actions on the social determinants of health,” explained Kelly Bruno, MSW, President/CEO, National Health Foundation. “We are working toward making notable changes in the community by working with students in schools, local corner stores and community partners to make healthier foods more affordable and available as well as identify ways to integrate physical activity into the day to improve the overall health for families in South Central LA.” 

According to the LA County: A Cities andCommunities Health Report, obesity-related chronic illnesses continue to rank among the top ten leading causes of premature death, including heart disease, stroke, and diabetes. While the obesity epidemic continues to impact virtually all population groups, roughly 29% of children and 37% of adults in South Central LA are obese, which is significantly higher than the rest of Los Angeles County. LA County black and Latino resident’s fair worse when it comes to obesity and obesity-related illnesses compared to whites and Asians. Thirty-two percent of Latinos and thirty one percent of blacks are obese in LA County, compared to 18% of whites and 8% of Asians. When it comes to South Central Los Angeles black and Latino residents, who make up 10% and 87% of the population respectively, the situation is no different. 

“Reducing obesity is a priority of Public Health and a key objective of the Champions for Change - Healthy Communities Initiative,” said Jeffrey Gunzenhauser, Interim Health Officer of Los Angeles County. “By investing in our communities and the people that we serve, we are hopeful that we can make impactful, long-lasting changes for better health outcomes.”

 

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.

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