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.

High School Health Activist Has Sights Set on Health Career

Aracely Ortiz, 2nd from left, presenting Health Academy's Cafeteria Makeover Project during the 

Youth Summit hosted by LACDPH, April 2015

Aracely Ortiz first heard about the Health Academy during a recruitment presentation in class when she was in 9^th grade. It was also Health Academy’s first year at Thomas Jefferson Senior High. “I wasn’t really involved in anything else at that time,” she explains, “but Health Academy just sounded different from all the other groups I’d heard about, so I decided to go for it.”

She went on to submit an application and sat through an interview, and in the spring semester of 2014, Aracely became a member, or “youth leader,” of the brand-new Health Academy program. After attending a few meetings and experiencing first-hand what the program was about, she was hooked. “At first I was debating whether to continue or not, but everyone in the program was so nice and supportive. It felt like a good place to be.”

Through Health Academy, Aracely learned some unexpected things about her community. She learned how her neighborhood is often considered a food desert or food swamp because of the prevalence of fast food restaurants and liquor stores compared to full-service grocery stores that sell fresh fruits and vegetables. While discussing food swamps, she said, “it was definitely eye-opening. I thought that we already had a lot of things in our community, but now I’ve realized that we don’t have as much as we should.”

Since realizing this, Aracely has actively worked to improve access to healthy food for her school and her community. She often shares information she learns through Health Academy with her family and friends. “I always show my parents the healthy food recipes I get from Health Academy, and we’ve started making them at home… I’ve also taught my parents how to read nutrition labels, and it’s something we look at now when we shop for food”.

Aracely has also taken on leadership roles in several Health Academy initiatives, such as implementing Smarter Lunchroom strategies in the school cafeteria and the Mini Farm Stand project. Throughout her participation, Aracely has been an important voice for her fellow students and community members. One moment she feels particularly proud of was attending a youth summit hosted by the Los Angeles County Department of Public Health during her sophomore year, where she presented her team’s Cafeteria Makeover project to other high school students from across the County. “We made changes in the cafeteria that year that decreased the wait times for getting lunch and also got students more excited about the cafeteria food. More students started participating in the school lunch program, and I like to think our project helped… I felt really proud of how we presented our project and I think we were able to give other schools some good ideas.”

Her experience with Health Academy encouraged Aracely to be even more involved in school. Aside from Health Academy, she is now also an active member of her school’s Gay-Straight Alliance chapter, Student Leadership and ROTC. Now a senior, Aracely is in her fourth and final year in Health Academy, where her role has expanded to include Youth Social Media Manager. In this position, she will work with other Health Academy students to create and post content for the NHF Health Academy Instagram page. Aracely is also getting ready for college next year and has already received acceptance letters from California State University, Dominguez Hills and Loyola Marymount University. She aspires to become a nurse someday, and credits her involvement in Health Academy for inspiring her interest in the health field. 

Aracely is one of over a hundred students that has participated in Health Academy which is going into its fourth year through funding from the Los Angeles County Department of Public Health. Recently, National Health Foundation received another Department of Public Health grant, the Champions for Change – Healthy Communities Initiative, to expand Health Academy to another Los Angeles high school; allowing NHF’s Health Academy and its proven benefits to reach many more students like Aracely, their families and the community.

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.

Teens Bring Mini-Farm Stands to the Classroom, Reduce Food Waste in the Process

Youth engagement provides young people with the opportunity to develop leadership skills and address challenges they face head-on in their own communities. For the past three years, National Health Foundation’s Health Academy has been working alongside youth from Historic South Central Los Angeles to address upstream barriers to healthy weight such as access to healthy food in their community. NHF Health Academy’s “Legion of Health” youth team is one of four teams in the program that engaged in youth participatory action research to identify issues impacting access to healthy food and food waste and develop and implement solutions to tackle those barriers. Here is one example of their success.

In the fall of 2014, Los Angeles Unified School District implemented Breakfast in the Classroom (BIC), a program that enables students to eat breakfast provided by the school in their classrooms rather than before they get to school. This was especially important at Thomas Jefferson High School where the surrounding community is labeled a food desert¹ and access to healthy foods is an extreme challenge. Living in a “food desert” means that at least one third of the residents live more than one mile from a grocery store and in a dense urban environment, that is a significant barrier. In addition, those grocery stores serve significantly more people than in areas with better access. A 2010 Community Health Councils report indicated that South Los Angeles’s 60 full-service grocery stores serve approximately 22,156 residents each. In comparison, West LA’s 57 grocery stores each serve approximately half the number of residents. Layer onto this story the fact that 60% of South Los Angeles eateries are fast food restaurants. Clearly, BIC was an essential program providing increased access to fresh, healthy foods and students needed to take greater advantage of this opportunity. Within these statistics, the Legion of Health youth team saw an opportunity to make real impact.

As the Legion of Health team investigated the BIC program, they discovered that one of the unintended consequences was an increase in food waste, specifically the fruit accompanying the breakfast meal. A meeting and tour of the cafeteria with the Cafeteria Manager gave the youth real insight into the actual volume of food waste. The youth team began re-envisioning the BIC program as a way to encourage consumption by recovering the food and offering it as a snack to students throughout the day. This option would reducing food waste and minimize cost of healthy snacks. Legion of Health developed a pilot project to provide healthy snacks throughout the day at no cost to students by saving the surplus of fruit and/or non-perishable food items from the BIC program. Youth placed decorative baskets in classrooms and set uneaten food from BIC into the basket. Legion of Health named their project “Health Academy Mini-Farm Stand” and designed baskets to hold the fruit in classrooms. Legion of Health partnered with several of their high school teachers to implement the pilot project in select classrooms. Youth also developed a tracking system to record the number of students that grabbed a snack. Legion of Health hypothesized that students would consume all the items by the end of each school day.

The project findings proved the Legion of Health’s hypothesis to be correct: all food from the farm stand baskets were consumed by the end of each school day. Legion of Health presented these findings to school administration and advocated for school-wide implementation. School leaders agreed to implement the project school-wide so that every classroom would have a “Health Academy Mini-Farm Stand” basket and students would have access to healthy food anytime of the school day in any classroom on campus. Since school-wide implementation, the Cafeteria Manager is reporting a near complete reduction of food waste from BIC.

Legion of Health recently expanded the “Health Academy Mini-Farm Stand” project to Nava College Prep Academy. Legion of Health presented the benefits of the baskets to students and staff along with delivering baskets to each of the classrooms. This past school year, Legion of Health met with Laura Benavides Co-Director of LAUSD Food Services who applauded the youth’s efforts. In the coming year, Health Academy’s Legion of Health will seek out partnerships at other schools to expand the program in hopes of ultimately meeting with the LAUSD School Board to advocate for district-wide implementation.

^[1] ‘Free and Reduced Meal,’ Analysis, Measurement, & Accountability Reporting Division. California Department of Education, 2013; http://www.cdph.ca.gov/programs/cpns/Documents/SNAP-Ed%20FFY%2015%20Att%201%20FRPM%202013%2005%2024.pdf

Rethinking School Nutrition: National Health Foundation’s Health Academy Increases Access to Healthy Options Through Innovative Youth-Led Projects

Health Academy 'Legion of Health' team with LAUSD Food Services Director, Laura Benevides.

The school cafeteria has been the subject of plenty of derision over the years given such negative perceptions of the food served and limited resources to meet the demands of a diverse student body. In the Los AngelesUnified School District (LAUSD), home to 640,000 students in more than 1,187 schools, the subject of school nutrition is a high priority. It is a priority shared by National Health Foundation’s innovative “Health Academy,” a youth-led, community research and advocacy program.

Since December 2013, teams of students have been researching and identifying challenges to accessing and consuming healthy foods and beverages, as well as obstacles for physical activity in their South Los Angeles community. One of their focus areas has been school nutrition. For many LAUSD students, the meals they consume at school are their primary meals of the day, and in some cases, their healthiest meals.

One of the Health Academy’s youth-led teams, Legion of Health, has been addressing the issue of healthy lunches and snacks at Jefferson High School and the students have made important headway since the program’s inception. Last year, students conducted menu sampling in an effort to introduce tastier and healthier menu options. According to LAUSD Food Service Director Laura Benavides, some of the new choices would be available as early as this April. She noted that given the sheer size of the district, changes take time, but she extended an invitation to the team to participate in the LAUSD Menu Committee meeting next year where critical decisions on menu development would be made.

One of the key findings of student research has been that with only 30 minutes for lunch and the increased wait times, many students are avoiding the cafeteria and are relying on alternative venues that promote sugary snacks, such as the student store and vending machines. Research has also shown that consuming a healthy meal takes more time, time that most students simply will not take. In an effort to have more students eat lunch in the cafeteria, the district is taking a serious look at reducing wait times. The Health Academy students, for their part, took a practical approach to solving the lunchtime crunch: a cafeteria makeover. By reorganizing the layout of the cafeteria, they were able to create a more efficient flow of traffic, thereby reducing wait times. This improvement has helped increase school lunch participation and the number of students eating at the cafeteria every day.

An LAUSD program called Breakfast in the Classroom (BIC), implemented in fall 2014, was widely touted as one way to ensure students were starting their day with a healthy meal and the nutrition needed to get through the morning. An unintended consequence of the program has been an increase in food waste. Last year, the Health Academy team tackled the food waste issue, as well as their limited access to healthy food, by creating the Health Academy Mini Farm Stand. Students redirected the fresh fruit left over from the BIC program to individual baskets in several test classrooms. Students in need of a snack could help themselves to a piece of fruit from the basket in their classrooms. The results were overwhelmingly positive. Teachers were pleased, students consumed more fruit, and food waste from BIC was significantly reduced. The project was expanded school-wide in February of this year. There are plans to expand the project to more schools in the district, but the students have set their goals even higher: They are hoping LAUSD will adopt the concept district-wide!

The Mini Farm Stand filled with fresh fruit is now a feature in 2 LAUSD schools!

These students have also been instrumental in addressing access to water in Jefferson High School by working to install one of the first Hydration Stations in the district. The filtered water station was unveiled Fall 2015 and is designed for students to refill their water bottles as opposed to reaching for sugar-sweetened beverages in the vending machines. Sugar-sweetened beverages alone are responsible for a large number of unhealthy calories that lead to obesity and the associated health risks such as diabetes. The Health Academy students championed the Hydration Station effort after their research revealed that students wanted access to more fresh water and to consume less sugary drinks.

The Health Academy students have, through their research, project design, and implementation, created lasting changes in one of the largest school districts in the nation. Moreover, they have been exposed to real-world learning that has included meetings with school officials, community stakeholders, and elected officials, all in an effort to realize lasting, equitable policy change with respect to the health and wellbeing of their South Los Angeles community. These young community advocates have already left a mark on the health of their community, a mark that will hopefully inspire others to do the same.