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Tuesday, August 9, 2016

Senator Gustavo Rivera – Legislating Health Equity for the Bronx

Bronx Health REACH continues its series on individuals who have made a significant contribution to not only the Institute for Family Health, but to the African-American, Black and Latino communities in the Bronx where they have been strong activists for needed change. A notable member of this group of change agents is Senator Gustavo Rivera, a New York state senator representing the 33rd Senate District, covering the Bronx neighborhoods of Kingsbridge Heights, Kingsbridge, Fordham, University Heights, Van Nest, Tremont, East Tremont, and parts of Morrisania and Parkchester.

You would think being a member of the New York State Senate would be enough of a commitment of time and energy, but to also publicly commit to shedding twenty pounds? That type of commitment was made by State Senator Gustavo Rivera. Elected in 2010 to represent Bronx District 33 in the New York State Senate, Senator Rivera was aware of the health disparities many Bronx residents faced in his district. "Dr. Christopher Malone, who had been my long-time policy director was doing research on District 33 in the Bronx, and it became clear that there was enough data, demonstrating that health was an issue impacting Bronx residents, not just in my District, but in the rest of the Bronx as well, and it needed to be addressed," says Senator Rivera.

One of the first steps Senator Rivera took after getting elected was introducing legislation that would impact the overall health outcomes of his constituency. "I asked to be appointed as the ranking member of the New York Senate’s Health Committee since health care issues not only in the Bronx, but across New York State interested me policy wise, and if I wanted to enact legislation, this was an important step for me to take on a leadership role in that Committee."

A recent legislative success he has championed is bill S779, known as the "Happy Meal Bill" that has passed the Senate Health Committee. This bill sets nutritional standards for restaurants distributing incentive items aimed at children. "The idea is simple, you have a ten year old child that wants one of the X Men toys that comes with the meal; that child is not thinking about the Big Mac, large fries, and super-size soda that comes with it, they just want the toy. We felt it was important that certain nutritional requirements in terms of the amount of fat, sugar, and caloric amounts be met when an incentive item is offered with a meal.”

Another bill Senator Rivera has been working to pass is a requirement for all sugar sweetened beverages sold in New York State have a warning label (Senate Bill S 6435 & Assembly Bill 2320-B). Unfortunately when legislation came up for a vote this past May, the bill failed to pass the Agriculture Committee. "It is rare for some pieces of legislation, when introduced, to be passed immediately. In this case, there are people who oppose the idea of labeling what they see as a benign product. Many do not understand that the reason the soda and fast food industry has had success in selling their products is that the salt, fat and sugar content go right to the pleasure centers of our brain - they make us feel good, but excessive consumption of sugar, fat, or salt causes serious negative health outcomes.”

Even though this bill has stalled for the moment, there has been some positive change since many fast food establishments are now under pressure to reconsider their food offerings. "McDonalds is now offering some healthy choices such as fruit and water with children's meals, and when one company starts doing that, all the others offer similar alternatives, creating smaller positive changes."

When Senator Rivera came together with Bronx Borough President Ruben Diaz Jr. in 2011 to form the Bronx CAN (Change Attitudes Now) Health Initiative, Senator Rivera decided to make a public commitment to lose weight. “I wanted to use myself as the model since I live in the same Bronx neighborhood as many of my constituents, and have the same access (or lack thereof) to healthy food options and places to exercise for free or low cost. Would I be able to lose weight and maintain a more healthy lifestyle given the choices in my community?” He lost 30 pounds back in 2011 but has since gained most of the weight back. “When I turned forty last November I had a small health scare which made me realize that the one thing I had not been doing on a regular basis was getting more physical activity, so I am committed to losing fifty pounds for this year by eating smaller portions and exercising on a daily basis.”

When asked what it would take to improve the Bronx ranking as the unhealthiest county in New York State, Senator Rivera replies, “From the Robert Wood Johnson Foundation County Health Rankings & Roadmaps report there is clear evidence that health disparities are directly connected to socio economic conditions. When you have consistently high unemployment rates, high poverty rates, food deserts, lack of access to fruits and vegetables as we do in the Bronx, all of these things are going to have a direct impact on the health and well-being of its residents. This is generational which means we cannot easily just snap our fingers and wish it away. However I believe with the work of the many community organizations partnering on Bronx CAN and other initiatives, combined with the work of elected officials, the needle can be moved.”

Monday, August 8, 2016

Bronx Health REACH Debuts Vegetable and Fruit Prescription Food Demonstrations

Bronx Health REACH debuted its first cooking demonstrations of the Vegetable and Fruit Prescription program on Tuesday, August 2nd at the Institute for Family Health Center’s Mt. Hope Family Health Center. Tania Lopez, the chef and founder of Coqui the Chef is collaborating with Bronx Health REACH to lead cooking demonstrations of healthy delicious dishes that patients can easily make at home. Tania provides a wealth of knowledge about healthy cooking and has shared her recipes on The Chew, BronxNet’s Open, and What Not to Wear!

For the Mt. Hope cooking demonstration she made a “Fiesta Salad” which is chock full of vegetables such as cucumbers, avocadoes, tomatoes, and bell peppers as well as fruits. Tania demonstrated step-by-step in Spanish and English how easy it was to make the salad. Over thirty patients and Mt. Hope staff tasted the Fiesta Salad and received the recipe and nutrition facts about the vegetables and fruits in the salad. The food demonstration was well received and created a buzz about the Vegetable and Fruit Prescription Program and its benefits! The next food demonstration will be held at the Institute for Family Health’s Stevenson Family Health Center on August 11th.

Click here for the Fiesta Salad recipe.

Update on the Bronx Health REACH Vegetable and Fruit Prescription Program

A supermarket tour at Key Foods, part of the Vegetable and Fruit Prescription Program.

As of July 2016, one hundred and seventy patients have participated in Bronx Health REACH’s Vegetable and Fruit Prescription program at three Institute for Family Health centers in the Bronx (Mt. Hope, Walton, and Stevenson). Patients that have a Body Mass Index (BMI) of 30 or more (considered obese) are given a Vegetable and Fruit Prescription by their doctor. The patient “fills” the prescription by purchasing fruits and vegetables at one of the eleven supermarkets and bodegas participating in the program. Once the patient receives a Vegetable and Fruit Prescription, a Bronx Health REACH Community Health worker provides information about the program and nutrition education.

Patients also get an opportunity to go on tours of supermarkets and bodegas. Conducted in English and Spanish, the tours consist of an aisle by aisle review of healthy vs. unhealthy food, lessons in understanding food labels, and determining which food items provide the best value through unit pricing. At the end of the supermarket tour participants get to purchase $10 worth of healthy food. Three tours are scheduled for August. In addition to these tours, there will also be farmers markets tours. On those tours, patients may redeem their prescriptions for Health Bucks that they can use towards the purchase of fruits and vegetables at the farmers market.

Friday, July 22, 2016

The Building Blocks for the Grant Avenue Elementary School Playground

This post comes to us from Bronx Health REACH public health intern, Diana Litsas.

Active Design is an exciting new approach to renovate spaces that encourages children in school to enjoy the physical, emotional, and social benefits of play and exercise1. In an effort to increase physical activity, Bronx Health REACH uses Active Design in Schools to engage students and other non-profit organizations in developing a plan for children to be active and play. Each of these projects is unique, adapting to school needs of space and budget.

Bronx Health REACH (BHR) is excited to be working on an Active Design Project to create a more engaging play yard at Grant Avenue Elementary School. Currently the outdoor space is a barren, narrow strip of concrete—a play area that seems especially inadequate as it faces a full-functioning playground which belongs to a neighboring school (the other school is overcrowded as it is, and unable to share facilities with Grant Avenue). Grant Avenue’s planned solution is an Imagination Playground2, which features movable pieces (“big blue blocks”) that allow for more dynamic and creative play compared to the fixed structures of a typical playground.

BHR joined a recent visit with Grant Avenue elementary school as they explored the Imagination Playground flagship in Burling Slip. Upon their arrival to the park, the students immediately began playing, despite the unfamiliar set of playground elements. These foam pieces encourage students to move in safe and creative ways, as they are made in a variety of shapes and sizes that give students versatility while they play with them2. While some blocks can be carried, others are bigger than some students themselves! The students built large “house” structures, as they referred to them, or use the blocks as a place to sit and socialize. Some students even arranged two rectangular blocks to construct a seesaw! The pieces were made out of a hard foam material is durable enough to withstand outside elements while being soft enough for students to stay safe when they fell on them. Few students used the blocks by themselves; most preferred to collaborate with classmates while building.

It was clear that using the blocks necessitated communication and patience among students, as they had to share and negotiate the use of certain blocks. Teacher Diana Castillo expressed her confidence that the blocks would be well received at Grant Avenue Elementary School based on the limited space they require, and how much the kids enjoyed using them.

1The Partnership for a Healthier New York City