NYC public schoolchildren are less obese than 5 years ago, but is everyone benefitting equally?

After years of relentless increase, New York City Mayor Michael Bloomberg announced last week that obesity rates for public schoolchildren in NYC have decreased over the past five years. The 5.5 percent decrease in obesity rates was the biggest decline in any large city in the country, where most rates are stagnant or rising. As NYC Health Commissioner Dr. Thomas Farley put it, “What’s impressive is that it’s dropping at all.”  

This announcement came after intensive city, state, and nationwide efforts to put childhood obesity on the public’s radar as a serious and urgent health issue. In NYC, the Department of Health, the public school system, and many community organizations have been implementing programs to reduce childhood obesity by increasing access to healthy food, teaching nutrition to schoolchildren, and increasing opportunities for physical activity.  While this decline is certainly a step in the right direction, over 20% of public schoolchildren in NYC are still considered obese and further drops in obesity rates will depend on the continuation and expansion of these efforts.

In addition, though drops were felt across all racial and ethnic groups and economic levels, it was not an equitable distribution. The results, published in a report by the Centers for Disease Control and Prevention, show that declines in obesity were sharply higher among middle-class children than low-income children. In terms of race and ethnicity, the greatest decreases were observed among white children and Asian/Pacific Islanders. Though black and Hispanic children also showed some decrease, it was to a much lesser degree. As this data indicates, there is a real need for concentrated and targeted efforts to reduce childhood obesity and improve health among low-income communities of color.

Bronx Health REACH has been working within schools and communities to reduce childhood obesity through classroom-based nutrition education, the creation of school wellness councils, and partnerships with local businesses to increase the availability and affordability of healthy food. (To read more about Bronx Health REACH’s efforts in this area, click here.) The communities in which we work are largely low-income and have majority black and Hispanic populations, which as the recent report shows, have the highest prevalence of childhood obesity in New York City. These are the areas that require the greatest intervention and increased resources. This recent report proves that lowering childhood obesity rates over a relatively short timeframe is possible, now we need to make sure that efforts to do so are equitable.

America’s Health at a Glance: Findings from the OECD report

Last week, we posted a blog entry about the observations of a group of visitors from the United Kingdom on the state of health care in the United States. Our country’s fragmented and inequitable health care system shocked our visitors and they expressed great concern that the UK’s conservative led government was leaning toward a U.S. style health care system. The recent release of Health at a Glance 2011, a report published by the Organization for Economic Cooperation and Development (OECD) on the health systems of its 34 member countries, affords another opportunity to see how the U.S. stacks up to other countries throughout Europe, North and South America, and the Asia-Pacific region.

The report looks at a variety of indicators in health status and the health workforce and breaks down key findings by country. Overall, medical care has improved in OECD countries and life expectancy has increased dramatically over the past 50 years. However, the United States suffers in comparison to other OECD countries in a number of ways. While the U.S. stands out in the area of cancer care, its rate of avoidable hospital admissions for chronic conditions, such as asthma or pulmonary disease, is much greater than the OECD average. For diabetes prevalence, only the U.S. and Mexico have more than 10% of the adult population living with the disease. The U.S. is also the most obese country in the group, with 34% of its adult population classified as obese in 2008, an increase from 15% in 1980. In childhood obesity, the U.S. ranks second only to Greece.

In health care expenditures, the U.S. ranks first by far, spending 17.4% of its GDP on health care in 2009. The next closest country is the Netherlands, which allocates 12% of its GDP to health care, but has much better health outcomes. Almost all the countries in the OECD rely on the public sector as the main source of health funding, but in the U.S. more than half of health spending in 2009 was through the private sector. In other words, the U.S. spends a larger portion of its GDP on health care than any other OECD country, but it also spends proportionately less from the public coffers than the other countries in the group. Despite these huge expenditures, health outcomes in the U.S. are mediocre at best and dismal at worst when compared to other developed nations. 

These reports should serve as a wakeup call that our health care system is failing the American people. Health spending per capita is much higher in the U.S. than any other OECD country, but yet our obesity and diabetes rates are skyrocketing. The already high hospital admission rate for chronic disease will only increase as diabetes and obesity related complications require medical intervention. And the troubling childhood obesity statistics are a dangerous omen for future generations and their impact on the system. The Affordable Care Act offers some remedies for these pressing issues, such as promoting a more integrated and coordinated model of care and providing more support and incentives for primary care doctors, but to get the U.S. to where it should be there need to be major changes in how health care is delivered. Being the richest country in the world doesn’t mean as much when its people can’t live a healthy life.

Learning Exchange with UK Communities for Health

Bronx Health REACH was selected by the Centers for Disease Control and Prevention to participate in an exchange with representatives from the United Kingdom’s Communities for Health program. The Communities for Health program intends to increase the role of local government in supporting health improvement and reducing health inequalities. Bronx Health REACH hosted visitors from the city of Nottingham, including the director of the health and well being partnership of the Nottingham City Council and a Nottingham city councilwoman, on November 16^th and 17^th.

As a community coalition dedicated to the elimination of racial and ethnic health disparities, Bronx Health REACH targets individuals through programs to promote healthy lifestyle change, as well as works with policymakers and stakeholders to effect policy change. Bronx Health REACH staff put together presentations to highlight programs that work with faith-based organizations, community groups, health care providers, elected officials, and others to improve health outcomes in the Bronx. We also invited our partners to speak about their work with the coalition and how they believe that Bronx Health REACH has impacted the health of the community. On the second day of the visit, we brought our visitors to the south Bronx and had them participate in a number of events. These included a “Can I Still Be Puerto Rican and Eat Healthy?” event at the MARC Academy and Family Center and the annual Thanksgiving dinner put on by the culinary committee at Walker Memorial Baptist Church for Bronx Health REACH’s Faith-Based Outreach Initiative. This annual event showcases the healthy dishes that have come about because of the nutrition training provided by Bronx Health REACH.

Throughout the learning exchange, we had a number of interesting conversations about the state of health care in the U.S. in comparison to the system in England. Because most citizens in the UK have public health insurance through the National Health Service, the UK visitors were struck by the differences in quality of care between publicly and privately insured patients in the U.S. They also repeatedly mentioned how shocked they were by the level of poverty in the south Bronx and, after hearing about the segregated system of care in New York, said they would go back to the UK with a renewed commitment to avert any efforts by the conservative leaning coalition government to introduce any aspect of a U.S. type health care system.

Time and time again the visitors voiced their awe at how much communities, through the efforts of Bronx Health REACH and others, have undertaken to meet their health challenges from the ground up. At the same time, they also voiced their consternation at the lack of a systemic effort to address health inequities, be it at the city, state, or the national levels. However impressed our visitors were with the work that Bronx Health REACH is doing to improve health in the south Bronx area, their lasting impressions of the broken health care system in the U.S. and the pervasive inequity in our country are profound. It shocked them that the richest country in the world could have such glaring poverty and inequity.

For those of us that work in this field, these realizations are nothing new, but it’s an eye-opener when outsiders so easily see the problems in our system. The learning exchange allowed Bronx Health REACH to showcase our efforts around nutrition, fitness, and health inequity in the community, but it also provided an opportunity to think critically about how health in our country stacks up against others. Unfortunately, we learned that we don’t stack up too well. In order for health to improve in underserved communities in a lasting way, policy and systems change must be at the forefront of our efforts. We all have a part to play to improve health outcomes and the Bronx Health REACH coalition will continue to drive change in its community to achieve health equity.

Addressing the Social Determinants of Health Disparities

As those of us who work in public health know, improving health outcomes has a lot to do with improving the environment in which people live, work, and learn. Addressing the social determinants of health, such as education and income, is critical in order to create healthier communities.

At the New York REACH US Health Disparities Summit a few weeks ago, Dr. Robert Fullilove gave a keynote address on the social determinants of health disparities, exhorting the audience to look at a variety of factors when working within communities to improve health. Dr. Fullilove, the Associate Dean for Community and Minority Affairs and a Professor of Clinical Sociomedical Sciences at the Mailman School of Public Health at Columbia University, has an extensive background working on minority health issues, especially in urban environments. He spoke about rebuilding communities as a way to improve health and referenced the breakdown of family cohesion in crime-blighted neighborhoods as an impediment to public health.

Though Dr. Fullilove touched upon many social determinants of health, one of his major points was the need to engage formerly incarcerated people, especially men, in the public health field. He examined the health needs of the so-called “million dollar blocks”, single city blocks with residents whom the state spends over a million dollars per year to incarcerate. Dr. Fullilove spoke about efforts to engage these men as partners in improving the health of their community upon their reentry into society. He also addressed the plight of at-risk populations, positing that risky behavior is not always a personal decision, but a factor of the environment. He called on the audience to realize that it was necessary to rebuild communities and the social fabric in order to improve health outcomes. As Dr. Fullilove said, “We don’t need a mass movement, we’re looking for people and for communities.”

The push for a community-based solution to eliminate health disparities remains a central component of Bronx Health REACH’s mission. As a number of Bronx Health REACH’s projects have shown, building support within a community to improve health outcomes does lead to positive results. Our work in churches and schools to promote healthy eating and increased physical activity has led to behavior change, as well as changes in the environment. To take one example, Bronx Health REACH’s Culinary Initiative, which aims to introduce healthy options in church meals, has led to less fat and salt being used by church culinary committees in preparing meals. Our efforts to engage all facets of the community also resonate with Dr. Fullilove’s call to action. In the fight to achieve health equity, it’s necessary to reach out to new partners and work with them to improve health outcomes.

First Annual Food Day: A Success in NYC!

On October 24, thousands of Americans across the country came together and planned events in celebration of Food Day, recognizing that food in its most natural, unprocessed state is healthiest for us. There were 300 Food Day events in New York State alone, some of which were hosted by organizations in the Bronx. Notable among these were Lehman College / CUNY Institute for Health Equity; NY State Senator Gustavo Rivera in partnership with the Committee of Interns and Residents and the Mary Mitchell Family and Youth Center; Morrisania WIC; and PS 218.

At Lehman College, students stopped by tables in between their classes to learn about healthy eating, sample healthy snacks, and take a survey asking about healthier options they would like to see in the school’s vending machines. In keeping with the theme of Department of Health’s new ‘sugary free’ drink campaign, Bronx Health REACH promoted awareness of the high amounts of sugar in commonly consumed beverages. Water was promoted as the healthy alternative. Several students expressed great surprise as to the amount of sugar in such beverages as Mountain Dew, with its 77 grams of sugar in a 20-oz bottle. The event was hosted by Lehman College’s Department of Health Sciences, The Office of the Dean of Natural & Social Sciences and the CUNY Institute for Health Equity.




























At Mount St. Ursula School in Bedford Park, Borough President Ruben Diaz, Jr. and State Senator Gustavo Rivera celebrated Food Day by kicking off a Family Health Challenge. This health initiative, developed alongside the Mary Mitchell Family and Youth Center and the Committee of Interns and Residents, asks students and their families to set small weekly goals for themselves, such as drinking only water and low-fat milk (no soda or juice), eating one piece of fresh fruit a day, and eating whole grains. The Challenge is the last component of Senator Rivera's Bronx CAN Health Initiative. Students at Mount St. Ursula, as well as 50 sites participating in Montefiore’s School Health program and a number of additional public schools such as PS 218, will be taking the Challenge. At the kickoff, Dr. Jane Bedell of the Bronx District Public Health Office spoke about the national obesity epidemic and how it will grow if we do not do something now. Heidi Hynes, Executive Director of the Mary Mitchell Family and Youth Center spoke on the right of every person to have access to fresh, healthy, affordable food. Dr. Appel of Montefiore Medical Center's School Based Clinics spoke about food accessibility, and a Montefiore nutritionist took the auditorium full of students through a presentation on eating colorful foods. Both the Senator and Borough President stressed the importance of taking small steps and making small changes over time to achieve a healthy lifestyle.

At the Morrisania WIC clinic on Gerard Avenue, participants were invited to: prepare and sample a soup made with locally grown winter squash, learn about community supported agriculture (CSA), locate a community garden in their neighborhood, learn about foods that grow in New York, view trailers of local food movement films, and more. Across the street at PS 218, third grade students participating in Bronx Health REACH’s obesity prevention program were given samples of a vegetable and pasta dish, one of the Office of School Food’s plant-based menu options.

















In the evening, Veggiecation and the Columbia Grammar and Preparatory School hosted “EatNYC,” an event offering tastings of food from some of NYC’s finest restaurants committed to serving healthy food from local growers. There were also talks by several distinguished keynote speakers, and streaming of LUNCH NYC episodes, a television series exposing health conscious individuals, organizations, and events in NYC. The event was a fundraiser for organizations in NYC promoting school wellness. This is a fundraising initiative of the Bird’s Nest Foundation, which recently donated 100 garden boxes to NYC elementary schools through its Ground Up Campaign in collaboration with the NYC Strategic Alliance for Health.





























For Food Day, the NYC Department of Health & Mental Hygiene launched a new webpage, www.nyc.gov/nycfood, with all of the city resources New Yorkers need to know about food.
Several other useful websites were also launched, such as a tumblr page with recipes contributed by New Yorkers, and a Vimeo channel compiling videos about accessing and eating healthy food in NYC.

On Sunday, October 23, people of faith from across NYC came together at Riverside Church for a Faith, Food Justice and the Farm Bill event. The focus was on the lack of access to fresh, healthy, affordable food faced by low-income neighborhoods such as South Bronx, Central Brooklyn and East and Central Harlem. Rev. Derrick Boykin from Bread for the World and Walker Memorial Baptist Church spoke about the Farm Bill as a “stewardship bill of our nation’s bounty, with both domestic and international ramifications.” He highlighted the need to reform the food system while also protecting safety nets. Wenonah Hauter, Executive Director of Food & Water Watch, spoke about the problems with the current food system: namely, that corporate lobbyists’ tremendous influence on Congress enables big agribusiness and food corporations to dominate the market. She also stressed that while corporations spend billions of dollars advertising processed foods, many farmers are not even paid fair wages for their work.

There were two panel discussions. The first set of panelists spoke about the impact of the food system on those who must rely on food aid and those who live in areas that lack direct access to fresh, healthy, affordable food. The second panel presented Solutions for Change, with information about programs offered by local and international organizations, and how funding for these programs could best be leveraged through allocations in the Farm Bill. Organizations represented included Just Food, the NYC Community Gardening Coalition, Corbin Hill Rd Farm, East New York Farms, Rural Migrant Ministry, WHY Hunger, American Jewish World Service, Sojourners, New York Faith and Justice, and the NYC Food and Farm Bill Coalition. More information about the Farm Bill and how to take action can be found at http://foodbillnyc.wikispaces.com/.

Food Day – October 24, 2011

It’s time for America to eat real, healthy, sustainably grown food again. October 24, 2011 will be the first annual Food Day.  Food Day will be a celebration of real food: food that’s grown from the Earth with minimal, if any, processing.  It will bring together all Americans—parents, teachers, and students; health professionals, community organizers, and local officials; chefs, school lunch providers, and everyone else who cares about food—to push for healthy, affordable food produced in a sustainable, humane way. People are encouraged to attend events at their schools, churches, farmers markets, city halls, and state capitals, or host an event at their home. The initiative is being launched by the Center for Science in the Public Interest, a non-profit advocacy group started in 1971 that supports policies which make our food healthier and safer.

The Food Day website has many resources, such as a school curriculum, a newspaper, recipes, videos, petitions, and a map of Food Day events happening all over the country. These events aim to educate Americans about the food system and what we can do to change it. Actions we can take range from making healthier choices when buying food for ourselves and our families to asking Congress to support the Food Day goals.

Food Day’s stated goals are:

1)      To reduce diet-related disease by promoting safe, healthy foods.

2)      To support sustainable farms and limit subsidies to big agribusiness.

3)      To expand access to food and alleviate hunger.

4)      To protect the environment and animals by reforming factory farms.

5)      To promote health by curbing junk-food marketing to kids.

6)      To support fair conditions for food and farm workers.

New York City will be home to dozens of Food Day events. On Sunday, October 23, there will be a Faith, Food Justice, and the Farm Bill event to highlight the crucial role of the faith community in the food justice movement and the potential to reform local and national food policy. The event is being organized by the Farm Bill Working Group of NY Faith & Justice, one of Bronx Health REACH’s Legacy grantees.  There will be particular emphasis on the Farm Bill and how it affects the choices we make about the food we consume. The event will be held at The Riverside Church (490 Riverside Drive) in the Assembly Hall from 2:00 pm – 4:30 pm.

New York State Senator Gustavo Rivera is launching the Bronx CAN Family Health Challenge on Food Day. Senator Rivera has been partnering with Bronx Borough President Ruben Diaz Jr. and other community partners as part of the Bronx CAN (Change Attitudes Now) Health Initiative. The Bronx CAN Family Health Challenge was designed by the Mary Mitchell Family and Youth Center and Committee of Interns and Residents. One of the first challenges is to limit consumption of sugary drinks, which coincides with the launch of the NYC Department of Health’s new sugary drink campaign. The Family Health Challenge guidebooks will be distributed to students and their families throughout the neighborhoods of Kingsbridge Heights, East Tremont, Crotona Park, Fordham, and Bedford Park in the Bronx.  The guidebooks will be distributed through Montefiore Medical Center's school-based health clinics, as well as other participating schools.

Find an event to attend or learn more about Food Day at www.foodday.org.

Introducing Bronx Health REACH's 2011-2012 Legacy Grantees!

As a Center of Excellence in the Elimination of Disparities (CEED), Bronx Health REACH provides seed grants to fund new projects which aim to eliminate health disparities related to diabetes prevention, management, and treatment. Grants are made to non-profit organizations on behalf of community coalitions serving primarily African American and/or Latino populations. Funding ranges from $25,000-$30,000 with 3-5 grants made per year. In addition to funding, grantees receive technical assistance from Bronx Health REACH to implement year long projects.

Bronx Health REACH awarded three grants for 2011-2012. Please read about these great organizations - we look forward to seeing their projects move forward!

THE POINT Community Development Corporation, Bronx, NY

THE POINT is a non-profit organization dedicated to youth development and the cultural and economic revitalization of the Hunts Point section of the South Bronx. THE POINT’s Legacy Project aims to reduce the high prevalence of diabetes in Hunts Point by educating youth and community members about health and nutrition and improving community access to affordable and nutritious foods. Teens participating in THE POINT’s community leadership group, A.C.T.I.O.N. (Activists Coming To Inform Our Neighborhood), will take part in education sessions on diabetes prevention and be trained as peer educators. Sessions will include hands-on workshops to construct new bed gardens and will distribute produce to the Hunts Point community through the Corbin Hill Farm Share. To share knowledge throughout the community, A.C.T.I.O.N. will lead education sessions at MS 424’s after-school program to increase awareness of healthy eating for diabetes prevention. THE POINT also plans to produce a Hunts Point gardening manual, do community outreach on healthy eating, and promote the Corbin Hill farm shares to families in the Hunts Point area.

Seeds in the Middle, Brooklyn, NY

Seeds in the Middle fights childhood obesity by taking an integrated approach to health and creating a sustainable infrastructure that engages the entire community: children, parents, and educators. Seeds in the Middle’s Legacy Project will further establish its Hip2B Healthy program in PS 221 in Crown Heights, Brooklyn and develop a model for replication to expand to neighboring schools. The Hip2B Healthy program incorporates a school garden, a school-run healthy market, chef’s nights, in-school cooking classes, and fitness opportunities including Zumba, soccer, and track, to create a healthy and nourishing environment for the school community. Seeds in the Middle also works with teachers to develop an integrated curriculum on health and gardening.

Manhattan Middle School for Scientific Inquiry (MS 328), New York, NY

MS 328 is a public school in Washington Heights, a neighborhood with high rates of obesity and diabetes. The middle school’s Legacy Project adds a focus on diabetes and food access to a school wide sustainability curriculum.   MS 328 will expand an organic school garden and greenhouse and create a garden curriculum to make connections between growing and eating healthy food. The school will also develop three units of study focused on diabetes for use in biweekly student advisory classes and will work to change the school food system at MS 328 by increasing the amount of fresh fruits and vegetables and decreasing the processed foods served in the cafeteria.

 

Racial Justice: Why we need to be talking about race

Are we living in a post-racial society? That question has been bandied about frequently since the election of President Barack Obama, the assumption being that electing an African-American to our highest office was proof enough that America’s complicated, and often ugly, past was long behind it. But for people of color and the activists and community groups that work to achieve racial equity in health, education, employment, housing, and everything else the answer is simple: no.

Confronting race to achieve health equity was the theme of a racial justice training that Bronx Health REACH and staff from REACH communities around the country received earlier this week in Washington, DC. Presented by the Applied Research Center, a racial justice think tank, the group learned how to frame issues with a racial equity lens and to recognize the different ways that racism can appear (internal, interpersonal, institutional, structural). The major takeaway was that we need to be explicit in addressing race as a key component in our work. If we shy away because we are afraid of being accused of playing the “race card”, we may unintentionally derail the policies necessary to address structural and systemic racism.

In an earlier blog post, we wrote about a recent study that found that race and ethnicity was the primary barrier to proper follow-up after an abnormal breast cancer screening. Another study, published in May in the Journal for the Poor and Underserved, looked at Emergency Room wait times based on race. The researchers found that African-Americans coming to the ER with chest pains were 1.42 times more likely to wait longer than 60 minutes than whites. Similar trends occurred with Hispanic patients. Race, whether intentionally or not, is a factor in this decision-making and it needs to be addressed head-on.

Taylor Branch, Dr. Martin Luther King’s biographer, said that King saw race as part of everything, but not all of anything. In Bronx Health REACH’s work to achieve health equity in communities of color, we know this is true. Race is a major factor in our work, but it’s not all of it. Like everything else, health equity requires a multi-faceted approach and, as the ARC trainers taught, we should be race explicit, but not race exclusive. Though bringing up race can be uncomfortable and often unwelcome, these are necessary conversations. If we don’t keep having them, study after study will continue to show the blatant disparity in access to health care between whites and people of color and the people we work with will continue to experience unfair treatment. Advancing the premise of America being a colorblind society benefits no one and doesn’t move our country any further along in realizing the equity for all that we so need.

Race/ethnicity, not health insurance, as primary barrier to quality care

As a community-based organization committed to the elimination of health disparities, Bronx Health REACH works closely on access to health care issues in underserved communities. One of our signature issues is advocating against the segregated health care system in New York City, which separates patients into two systems based on their health insurance status. This two-tiered system discriminates on the basis of health insurance, steering patients on Medicaid or with no insurance toward the clinic system while those with private insurance are seen in faculty practices. We have found that public insurance or no insurance can be a barrier to accessing quality care due to the poor follow-up, lack of continuity of care, and long wait times that plague the clinic system. However, a recent study published in the journal Cancer, found that lack of health insurance may not be the primary barrier to proper diagnostic care for minority women.

The objective of the study was to determine the impact of race, ethnicity, and health insurance on follow-ups from breast cancer screenings in Washington, D.C., an area that has high mortality rates from breast cancer compared with national rates. The researchers’ hypothesis when they began the study was that patients with health insurance would have a shorter diagnostic time (defined as the number of days from a suspicious finding from a breast cancer screening to a definitive diagnosis for the patient) than patients without health insurance. However, after analyzing the diagnostic times of over 1500 women, the researchers found that health insurance was not the main determinant in longer wait times. On average, the diagnostic wait times for white, black, and Hispanic women were half a month, 1 month, and 2 months respectively. For white women on government insurance the average diagnostic time was 12 days; however for black women with the same insurance it was 39 days and for Hispanic women it was 70 days. Similar trends occurred when comparing women with private insurance from the three different racial/ethnic groups (16 days for whites; 27 days for black; and 51 days for Hispanics). The huge difference in diagnostic time between the different racial/ethnic groups suggests that health insurance status may not be the primary barrier to care.

This research highlights the alarming disparity in quality health care between minority groups and whites. While having health insurance does mediate this issue somewhat, the fact that women on the same insurance but of a different racial/ethnic background would have such varied waiting times shows that the system does discriminate against minority groups. In this particular case, the women were waiting to hear whether a breast abnormality identified by a clinician was benign or malignant. Depending on the stage of the cancer, a difference in diagnostic time between 12 and 70 days could be a serious impediment to proper treatment and halting the spread of the cancer. Other studies have shown similar disparity in treatment between white and minority patients. One well-known study by Dr. Kevin Schulman looked at the effect that race and gender had on physicians’ recommendations for cardiac catheterization and concluded that African-Americans and women were less likely to receive a referral than whites and men, with black women being the least likely group to get a referral.  Another study conducted by the Department of Veterans Affairs found disparities in health care between black and white veterans across all clinical areas. The study also suggested that disparities in health care delivery between the two groups are contributing to disparities in health outcomes.

This research all points to the conclusion that racial and ethnic disparities in health care access and delivery are a critical problem in our health care system. Through community outreach and education efforts, such as the health disparities education conducted by Bronx Health REACH, community members are becoming more aware of their patient rights and learning how to advocate for proper care. However, policy and system change must take place both in the training of physicians and in how care is delivered in order to affect lasting change.  

Take Action and Protect Healthier School Lunches!

Over 31 million children receive lunch through the National School Lunch Program. In New York City alone, public school kitchens serve 860,000 meals each day and service 1.1 million kids. School food is a critical piece in keeping children fed and alert throughout the school day, but it also provides a key opportunity to get children eating healthy. The federal government’s Healthy Hunger-Free Kids Act of 2010 authorizes funding and sets policy for the U.S. Department of Agriculture’s core child nutrition program. Under this legislation, the USDA has proposed nutrition guidelines to improve school lunches and breakfasts by including more fruits, vegetables, whole grains, and low-fat milk, as well as cooking with less salt and fat. Despite support from tens of thousands of parents and organizations, some members of Congress are trying to stop these guidelines from being finalized. 

According to the most recent estimates by the U.S. Census Bureau, over 20 percent of America’s children live in poverty. In New York City, the number of children living in poverty ranges from 25 to 33 percent depending on age group. Overall, 76% of elementary and middle school children in NYC receive free lunch and in some neighborhoods that number is much higher. (In the South Bronx, almost 95% of elementary and middle school children receive free lunch). For many of these children, school meals provide one of the few available opportunities for a nutritious meal. The food deserts in which many of these children live only compound the problem by providing few options to access healthy, affordable food. By insuring that school food follows common-sense nutrition guidelines, these children can eat healthy twice a day, which will lower risk factors associated with childhood obesity. Other national efforts to fight childhood obesity, including the Partnership for a Healthier America’s recent initiative to bring healthy, affordable food to 10 million people over the next five years, are crucial. However, the USDA guidelines are a critical weapon in the fight to combat childhood obesity in high need, vulnerable communities and they must be protected.

The House of Representatives has already included a rider on its agriculture spending bill to urge USDA to start over and propose a new set of school meal standards. The Senate will vote on its own agriculture appropriations bill on September 7^th. To keep healthy school lunches, please send an email to both of your Senators asking them to support USDA’s efforts to improve school meals. Go to https://secure2.convio.net/cspi/site/Advocacy?cmd=display&page=UserAction&id=1251 and take action!

Preaching Healthy Living from the Pulpit

This week The New York Times published a story highlighting the efforts of pastors in the Mississippi Delta to get their congregations to eat healthier. In a state with the second highest adult obesity rate and ranking dead last in life expectancy, the Delta is especially hard hit. Fried and heavily-salted foods dominate the culinary scene and, if there are greens, they are often boiled with ham hocks. Pastors, alarmed by the health of their congregants, began to promote healthier food options at church events and encourage physical activity. Like many attempts to change long-standing traditions, these efforts were initially met with skepticism, if not outright resistance, but over the years more Delta churches and their congregations have begun to change the way they think about food.

Preaching healthy living from the pulpit is not unique to the Mississippi Delta. For the past decade, Bronx Health REACH’s Faith-Based Outreach Initiative has been working with faith-based leaders to incorporate health messages into church activities and provide programming around nutrition and fitness, diabetes prevention and management, and health disparities. Currently, Bronx Health REACH works with 47 churches throughout the Bronx and upper Manhattan. These programs include a Culinary Initiative, which works with church culinary committee members to serve healthier meals at church events, and Fine, Fit, and Fabulous, which teaches nutrition and fitness within a spiritual context. These programs and others have contributed to both behavior change and weight loss in participating congregants.

Faith-based institutions are key partners in the effort to counteract obesity and prevent diabetes. Pastors, as leaders in their community, have a unique ability to speak to their congregations about the importance of eating healthy and exercising. Because churches engage in many community events, as well as provide meals to their congregants, they are able to influence what kind of food is served and encourage churchgoers to use healthy cooking methods at home. In a similar way, exercise and/or diabetes management programs conducted in a church setting or with spiritual elements provide a familiar background or context to people starting a new activity. The built-in support of the church community is a crucial part of encouraging congregants to continue to eat healthy and to follow exercise regimens.

Battling the obesity epidemic in our communities requires a multi-pronged approach and investment from all parts of the community. Faith-based institutions and their leaders are a critical piece in bringing the message of healthy living to community members. The example that the pastors in the Mississippi Delta and those in Bronx Health REACH’s Faith-Based Outreach Initiative have set is one that can and should be followed in faith communities throughout the country.

Farm to Table: Supporting CSAs in Our Community

Not too long ago having access to farm fresh produce in urban areas meant driving upstate and picking apples or paying high prices at gourmet grocery stores. But the recent advent of Community Supported Agriculture (CSA) programs, which have been popping up throughout the Bronx and other underserved communities, are now bringing the farm to the city. CSAs give communities direct access to high quality, fresh produce grown by local farmers, who bring their wares to a designated drop-off site once a week for a reasonable cost. Participants buy a farm share, usually enough for a family of four, and can often use food stamps or pay on a sliding scale depending on income. At last count, there were approximately 12,000 CSAs in the U.S. and 350 in New York State alone.

The growing importance of CSAs in urban areas and food deserts (discussed in a recent blog post here) is underlined by the introduction of the Community Supported Agriculture Promotion Act by Senators Gillibrand, Leahy, Sanders, and Tester. This proposed legislation would create a competitive grant program within the U.S. Department of Agriculture (USDA), which would award federal funds to support new and current CSA farmers, develop innovative methods of delivery and distribution, and promote participation through outreach and education activities. The program would give preference to CSAs that expand their reach into food deserts or low-income communities.

This legislation is good news for fresh food advocates, who have been working to connect farmers with community members in underserved areas. Bronx Health REACH has been an active partner in supporting CSAs throughout the community and provided funding to the NYC Coalition Against Hunger to start a Bronx-based CSA that brings produce from Fresh Radish Farm in Goshen, NY to the Seventh Day Adventist Temple on the Grand Concourse in the Bronx. Kelly Moltzen, Bronx Health REACH’s nutrition coordinator, is a member of the South Bronx CSA and recently visited Nolasco Farms in Sussex County, New Jersey where she learned about the 50 kinds of produce grown on the farm (see photo below). If you’re interested in joining a CSA or starting one in your neighborhood, the organization Just Food keeps a running list of CSAs in New York City and provides information to people interested in starting a program.

The Community Supported Agriculture Promotion Act will give crucial support to CSAs throughout the country as they connect underserved communities with local farms. Farm to table is not just a restaurant fad, but a true movement that is being recognized by our legislators. Let’s keep the momentum going!

More money, less preventable deaths

Public health activities, which are designed to promote health and prevent disease and disability, are a crucial component in reducing health disparities and improving community health. However, despite the increased focus on community-based health interventions (discussed in an earlier Bronx Health REACH post available here), national health spending on public health activities accounts for less than 5 percent of the total. The Affordable Care Act authorized a major expansion of federal public health spending ($15 billion over the next 10 years), but critics of health reform still argue that evidence linking public health activities to positive health outcomes is lacking. Public health professionals and community health advocates can attest that community-based interventions have been successful in changing unhealthy behavior, but a new study provides even greater evidence of the link between public health activities and better health. The study found that increasing public health spending lowers mortality rates from preventable causes of death. Though many of us in the field aren’t surprised by this news, it gives strong support to public health efforts in communities across the country.

The study, published this month in the journal Health Affairs, analyzed changes in spending patterns and mortality rates within the service areas of nearly 3000 local public health agencies over a 13 year period (1993-2005). The authors found that the degree of change in per capita spending varied widely across communities and only 65 percent of agencies experienced positive growth in the study period. However, in areas where public health spending increased, there were statistically significant reductions in mortality in four of the six mortality rates examined. Infant mortality and cardiovascular disease mortality were particularly affected: infant mortality fell by 6.9 percent and cardiovascular disease mortality fell by 3.2 percent for each 10 percent increase in spending. Diabetes mortality and cancer mortality also fell. The study’s authors concluded that public health spending was one of the most consistent determinants of community-level preventable mortality, even after accounting for differences in demographic and socioeconomic conditions.

By finding a clear association between spending and mortality, this study suggests that additional spending, such as that under the Affordable Care Act, would generate improvements in population health over time. It also warns against severe cuts in the health budgets of state and local governments. While health spending continues to be a frequent target for those against “big government”, this study provides the necessary evidence that our nation’s public health is a wise investment. Lowering mortality rates from preventable causes should be a top priority for the legislators and policymakers that are deciding how the federal government spends its money.

Health Care Organizations Issue Call to Action to Eliminate Health Disparity

For over a decade Bronx Health REACH has been working within underserved communities to eliminate health disparity. In that time, government agencies, hospitals, and health systems have become more willing to address health disparities and work toward solutions to achieve health equity. This partly stems from ethical obligation, but it also enhances performance and makes good financial sense. (Chronic diseases account for the largest health gap among ethnic and minority populations and are responsible for 75 cents of every dollar spent on health care in the U.S.) Even so, the Call to Action to Eliminate Health Care Disparities, issued by leading national health care organizations last week, is notable for its commitment in providing a foundation to accelerate efforts to achieve health equity.

Led by the American Hospital Association (AHA), the “Call to Action” brought together five major health care organizations, including the American Association of Medical Colleges (AAMC) and the National Association of Public Hospitals and Health Systems, to focus their efforts on eliminating health disparity. “We’re in a new era of health care,” says Dr. Maulik Joshi, senior vice president of the AHA. “Collaboration is a key part of the process.” The group will focus on three building blocks: increasing the collection and use of race, ethnicity and language data; increasing cultural competency training for all staff; and increasing diversity in leadership and governance. The organizations will pool resources and tools and have created a website (www.equityofcare.org) as a portal for information on how to implement these initiatives within hospitals.

A main impetus for joining this effort, says Dr. Marc Nivet, chief diversity officer at the AAMC, was the recognition that medical schools and teaching hospitals need to do a better job in communicating the importance of health disparity. “We’re creating future physicians and we’ve known for a long time that we’re not providing a workforce that is culturally competent,” says Dr. Nivet. “We need to have the concept and understanding of health disparity woven into the curriculum.” Collecting and sharing data is also a key component so that people understand the issues and better policy can be made. The goal, says Dr. Joshi of the AHA, is not just systematic data collection, but a better understanding of the community and how the right data can be used achieve equity of care.

The importance of integrating the entire hospital structure with the community is also a key part of this effort. “Community organizations have been in the right place for decades in terms of trying to improve health by not just paying attention to health care, but paying attention to other social determinants of health,” says Dr. Nivet. “It’s important that all of that knowledge is transferred through shared learning between major medical institutions and community groups to figure out how we can all work together more closely going forward.” Dr. Joshi agrees, saying that hospitals are often role models in the community and collecting better data allows hospitals to know their communities in a more comprehensive way. “We need to move away from this mentality that we sit in the community to that we are part of this community,” concludes Dr. Nivet.

The chasm between public health and medicine is a frequent roadblock in collaboration between community groups and hospitals, but the “Call to Action” may be the crucial opportunity needed to bridge the gap. We applaud these health care organizations for taking a decisive step forward in outlining steps to achieve health equity and providing resources so that hospitals can implement better practices. As a community-based initiative, Bronx Health REACH looks forward to increased collaboration with hospitals and hopes that this effort galvanizes hospitals across the country to heed this Call to Action and become active in the national effort to eliminate racial and ethnic health disparities.

Building an oasis in the desert

According to the Partnership for a Healthier America, 23.5 million Americans live in areas where finding affordable, healthy food is difficult. These so-called food deserts make healthy eating a true challenge, even if the population is willing to make lifestyle changes. To combat this issue and the rising tide of childhood obesity (of the 23.5 million Americans living in food deserts, 6.5 million are children), the Partnership for a Healthier America has announced an initiative to bring healthy, affordable food to 10 million people over the next five years.

The Partnership for a Healthier America, a key partner in First Lady Michelle Obama’s Let’s Move Initiative, received commitments from six leading grocery retailers, including Walgreens and Walmart, to open or expand over 1,500 locations in low-income areas. Walgreens alone has committed to expand a minimum of 1000 stores by 2016 to serve 4.8 million people in low-access areas. The New York Times reported that Walgreens will turn these locations into “food oasis stores” that will sell fruits, vegetables, and other items they do not normally stock.

This effort comes at a crucial time. One in three children is overweight or obese and the White House has said that, according to some research, today’s youth may be the first generation to have shorter lives than their parents. The lack of access to healthy food is a key contributor to the ever increasing weight of America’s children, as is the concentration of fast food outlets in low-income areas. The Bronx, to take one example, has 43 McDonald’s alone – if you were to add the Taco Bell, Burger King, Wendy, and KFCs that number would be significantly higher.

Some cities have taken their own steps to ban unhealthy foods. In 2008, South Los Angeles issued a moratorium on building new fast food outlets in the area. The ban, advocated for by Community Health Councils, a REACH grantee, allowed existing restaurants to stay, but no new outlets have opened since it was passed. A few years ago, New York City issued a ban on trans fats and Bronx Health REACH led a successful effort to eliminate whole milk in NYC public schools.  

These are all important steps, but an overhaul of how food is distributed in this country is necessary. Though nutrition education is a big part of the effort, people cannot practice what they learn if there is not an affordable and convenient place to buy healthy food. Now is the time to turn our deserts into oases.

Does having health insurance make you happier and healthier?

Does providing health insurance to the poor actually make them healthier? While a critical question in the long-running health care debate, the impact of health insurance on the poor has been difficult to determine as studies comparing the insured versus the uninsured typically have too many variables (income, education, health habits, etc.) to be completely successful. However, a recent study on the impact of Medicaid in Oregon provides the first rigorously controlled look at the costs and benefits of having health insurance.

This study, published by the National Bureau of Economic Research, took advantage of an unusual situation in Oregon, which decided to expand its Medicaid program by selecting 10,000 uninsured people by lottery. This allowed economists to compare those selected by lottery to receive Medicaid with those who had not been picked. Because it is considered unethical for researchers to deny coverage to some people for the benefit of a study, nothing like this had ever been done before.

In short, the findings from the first year are encouraging. The researchers found that when the previously uninsured were given Medicaid they saw doctors more often, felt more financially stable, reported better physical and mental health, and undertook more preventative health measures. For example, Medicaid coverage increased the likelihood of using outpatient care by 35% and of having a regular doctor by 55%. Women on Medicaid were 60% more likely to receive a mammogram than the uninsured group and the likelihood of people having to borrow money or skip other bills to pay for health care decreased by 40%. However, having Medicaid coverage did not reduce the number of emergency room visits and increased utilization of health care services by the insured added up to an extra 25% in annual medical expenditures, making cost still a significant factor.

With the debate on the expansion of public insurance raging, this study is expected to be a strong argument for insuring the poor. However, feeling healthier doesn’t necessarily mean that people are healthier. The study also didn’t assess the quality of care for those on Medicaid, which is a frequent criticism of public insurance. The second phase of the study will attempt to answer at least one of these questions by measuring the health effects of having Medicaid versus being uninsured. The researchers interviewed 12,000 people (6,000 from each category) and measured variables like blood pressure, cholesterol, and weight. Those results will be released once they have been analyzed.

Insuring the poor is a critical component to reducing the chronic disease burden and eliminating health disparity. Relying on “safety net” hospitals, free clinics, and charity care is not a sustainable option, nor a preferable one. However, expanding public insurance on its own is not enough. Without improving the quality of care of those on Medicaid or raising reimbursement rates so that more doctors accept it, the cycle of poor health outcomes for underserved populations will continue. As this study shows, if people are offered the option to live a healthier life they take it. This should be proof enough.

To read the entire study, click here.

Kids’ LiveWell: Healthier Options for Children at Restaurant Chains

In the past ten years, obesity rates have doubled in the United States. According to the New York City Department of Health, New Yorkers are also piling on the pounds, and quickly. More than half of all adult New Yorkers are overweight or obese and their children aren’t faring much better. Today, nearly half of the kids in NYC are not at a healthy weight and 1 in 5 kindergarteners is obese.

Spurred by these high numbers and the government’s commitment to reduce childhood obesity, community groups, non-profits, and government agencies are combating this epidemic by promoting healthier food in classrooms, teaching nutrition to parents and children, advocating for safe spaces for physical activity, and increasing the availability of healthy food options in low-income areas. Now, chain restaurants are getting in on the action.

This week, the National Restaurant Association introduced a voluntary initiative called Kids’ LiveWell to promote a selection of healthy menu choices for children at chain restaurants around the country. The inaugural group of 19 restaurants includes big names like Burger King, Friendly’s, and Chili’s, though other popular fast food outlets like McDonald’s, Taco Bell, and Wendy’s have not signed on. The nutrition criteria specifies that each Full Kids’ Meal, which includes one entrée, a side order, and a beverage, would be under 600 calories, contain less than 35% total fat, and have at least two sources of fruits, vegetables, whole grains, lean proteins, or low-fat diary.

With more than 15,000 restaurants participating in the launch of the program, Kids’ LiveWell has the potential to reach a great number of kids at America’s popular eateries. In order for its impact to be felt, however, parents and caregivers need to promote healthy options when dining out and teach their children the benefits of healthy eating. As the number of children at risk for diabetes, heart disease, and hypertension continues to increase rapidly, fast food chains and restaurants must take responsibility and accelerate their efforts to halt and reverse childhood obesity. Kids’ LiveWell is a good first step in a long road.

Community Transformation Grants: How Transformational Will They Be?

For community advocates and local non-profits, community-based health interventions have long been considered a critical component to reducing chronic disease and eliminating health disparity at the ground level. With the passage of the Affordable Care Act, the policy world has also recognized the importance of community in preventative health activities. The Affordable Care Act created Community Transformation Grants, which aim to help communities implement projects proven to reduce chronic diseases and promote healthy lifestyles. Over the five year project period, the Community Transformation Grants (CTGs) will support two categories of activity: building community capacity to implement change and implementing evidence-based and practice-based programs to achieve change. The implementation grants, which are open to States, local governments, and non-profits, range between $500,000 and $10 million for the first budget year.

As envisioned in the Affordable Care Act, these grants would emphasize community in all aspects of the process. County applicants (including New York City, which got a special dispensation to apply under this category) must allocate at least 50 percent of their award to local community entities or local governments. The applicant must also provide evidence of a community coalition committed to the planning, implementation, and evaluation of the CTG. This community-focused approach is crucial, but many community groups are concerned about how much “transforming” these grants will actually spur. In the past, collaborations with agencies such as the NYC Department of Health have employed a more top-down approach. The agency planned the project and the community groups implemented it. This method has worked sporadically at best, with community groups unable to provide the necessary feedback to make the projects applicable and workable in their neighborhoods.

Under the proposed CTG, the Department of Health (considered by many a strong candidate to receive a large grant) has to make changes in its approach to community-based interventions. The Bronx Health REACH coalition, and other coalitions in New York City, have spent years building relationships in their communities to address widespread health issues. These relationships will give the DOH a considerable advantage if they build on these partnerships and employ the capabilities of community groups in the planning process. Some in the Health Department seemingly recognize the value of community efforts and have indicated an interest in partnering with community coalitions in each borough to plan and implement the grant if it was awarded. However, many community groups view with understandable skepticism any suggestion from the Health Department that does not indicate its leadership’s commitment to a strong community presence in the shaping of an initiative intended to transform communities and improve health for its residents.

Bronx Health REACH e-blast: June 17, 2011

** Legacy Project Funding Opportunity for Projects Addressing Diabetes Related Health Disparities – proposals due July 8**

Bronx Health REACH, a Centers for Disease Control and Prevention, (CDC) designated National Center of Excellence in the Elimination of Disparities (CEED), announces a request for proposals for projects which aim to eliminate diabetes related health disparities affecting African American and/or Latino populations. Bronx Health REACH/New York CEED will award 3 grants of $25,000-$30,000 for a period of one year beginning September 30, 2011. Proposals for funding are due by July 8, 2011. For application or if you have any questions regarding this announcement, contact: Jill Linnell, jlinnell@institute2000.org (212) 633-0800 ext. 1305 or Yvette Holland, yholland@institute2000.org (212) 633-0800 ext. 1232.

Good Health Bronx Initiative – June 18^th

The Bronx Multi Faith Advisory Group and NYC Department of Health Office of Minority Health is hosting a full-day Good Health Bronx Initiative on June 18^th in Crotona Park. The event will feature a 3 mile faith walk, health screenings, and information about health concerns affecting Bronx residents. Registration for the faith walk is required and each person will receive a free t-shirt. For information on registering please contact Lisa White at 646-253-5800 or email her at lwhite@health.nyc.gov.

Green Bronx Machine – launch party June 22^nd and help a classroom get computers!

Green Bronx Machine is a new youth initiative focused on generating authentic voices in health, wellness, and academic and vocational career readiness. The United Federation of Teachers is hosting a launch party for the program on June 22^nd from 6 pm to 9 pm at Café Iguana on West 54^th Street in Manhattan. The Green Bronx Machine will receive a set of computers for a school classroom if they receive 1,000 “likes” on Facebook and/or followers on Twitter by June 22^nd, so please visit http://www.facebook.com/green.BX.machine orhttp://twitter.com/greenBXmachine and help out! You can also watch a video starring Bronx Borough President Ruben Diaz Jr. and State Senator Gustavo Rivera about the Green Bronx Machine here: http://www.youtube.com/watch?v=Cww_dUh5FUI.

Bronx Health REACH Nutrition and Fitness Committee – June 23^rd

Bronx Health REACH is holding its monthly nutrition and fitness committee on Thursday, June 23^rd from 10 am to noon at Walker Memorial Baptist Church in the Bronx (120 E. 169^thStreet). The topics discussed will be the school health policy work of HEA+LTHY Schools NY and resumption of the three working groups on physical activity, nutrition and tobacco. Also, there will be updates on the Johnson & Johnson initiative and the social marketing project. All are welcome to attend.

Bronx Health REACH Coalition Meeting – June 24^th

Bronx Health REACH is holding its quarterly coalition meeting on Friday, June 24^th at Walker Memorial Baptist Church in the Bronx (120 E. 169^th Street). The meeting will take place from 9:30 am to 12 pm and all are welcome to attend.

Hunts Point Farmer’s Market – Wednesdays and Saturdays starting June 29^th

Starting Wednesday June 29^th, the Hunts Point Farmer’s Market will be open twice a week (on Wednesdays and Saturdays) through November. The market will be open from 8:30 am to 5 pm rain or shine at Msr Raul Del Valle Square at Southern Blvd. and E.163rd St. Alex’s Tomato Farm located in Carlisle, N.Y. will sell fresh and local fruits, vegetables, culinary herbs, and plants. The farmers market will accept state issued Electronic Benefit Transfer (EBT) cards and there will be nutrition education lessons and cooking demonstrations conducted every Wednesday by NYC Department of Health. Free HealthBucks will be distributed at the workshops for people to spend at the farmers market. Please contact Dagmar Kostkova at dkostkova@communitymarkets.biz for more information.

Bronx CAN Health Initiative

Bronx Health REACH and the Institute for Family Health are proud sponsors and partners of the Bronx CAN Health Initiative, a borough-wide community health initiative promoting healthy behaviors throughout the Bronx community. The Bronx CAN Health Initiative, led by New York State Senator Gustavo Rivera (33^rd District) and Bronx Borough President, Ruben Diaz, Jr.,  is a collaborative effort with community groups, residents, faith-based institutions, health care providers, and others to encourage healthier lifestyles in our communities. For more information about the Bronx CAN Health Initiative and to see a calendar of events, visit: http://www.bronxcan.com/.

Bronx Health REACH featured in UFT-ACTS Spring Newsletter!

The United Federation of Teachers Alliance for Charter Teachers and Staff highlighted Bronx Health REACH’s obesity prevention program at the Bronx Academy of Promise Charter School in its Spring newsletter. The program, funded by the Johnson & Johnson/John Hopkins Community Health Care Scholars Program, is part of a national effort to provide elementary school children with nutrition education. Bronx Health REACH staff member Diana Johnson taught two third grade classes at Bronx Academy of Promise about healthy eating over six sessions and has brought this program to other schools in the Bronx. Bronx Health REACH plans to expand the program to reach 600 students and will also train teachers to teach the whole curriculum on their own.

The Virginia Faith-Based Outreach Initiative featured in local newspaper!

The Virginia Faith-Based Outreach Initiative, a Bronx Health REACH legacy grantee, was featured in the Suffolk News-Herald about its five-week fitness program in local churches. The Virginia program started when a Bronx Health REACH coalition member relocated to Suffolk, Virginia and asked if she could start a fitness program at her church modeled after Bronx Health REACH’s Fine, Fit and Fabulous program. The Virginia-based program combines faith with physical activity and nutrition information and runs for five weeks. Read the article here: http://www.suffolknewsherald.com/2011/06/11/faith-%E2%80%94-and-five-weeks-to-fitness/

Bronx Smoke-Free Partnership Newsletter – June 2011

The Bronx Smoke-Free Partnership highlights its partnership with Bronx Health REACH in its June newsletter. Bronx Health REACH staff members Sigrid Aarons and Bernice McFarline have worked closely with the Smoke-Free Partnership on protesting tobacco marketing toward youth in stores and in organizing the World No Tobacco Day held last month in Union Square. 

Excellence in School Wellness Awards

Bronx Health REACH is pleased to announce that four of our HEA⁺LTHY Schools NY partner schools received recognition from the NYC Strategic Alliance for Health for Excellence in School Wellness. PS 218 and Sheridan Academy received Gold Medals, PS 43 received a Silver Medal, and PS 64 received an honorable mention. The award ceremony for schools in the Bronx will take place on Wednesday, June 22^nd at the Bronx Museum of the Arts (1040 Grand Concourse) from 3 pm to 5 pm. Congratulations and keep up the good work!

The Prevention Institute discusses how “overweight is the new normal”

In its weekly e-newsletter, the Prevention Institute explores how changes in our environment, such as larger food portion sizes, have transformed our cultural norms surrounding food and physical activity, and our behavior. The Institute examines how what surrounds us shapes our behavior toward nutrition and fitness and provides tips on how to inform legislators about community prevention and creating healthier environments. Read more here: http://org2.democracyinaction.org/o/5902/t/0/blastContent.jsp?email_blast_KEY=1168072

Women Helping Others Foundation Invites Grant Applications

The Women Helping Others Foundation is inviting grant applications from grassroots organizations for programs that serve the overlooked needs of women and children in the United States. The Foundation is particularly looking for projects or programs that address health or social service needs. The grants will range from $1,000 to $40,000 and are open to 501(c)(3) organizations that have been incorporated for at least three years. To learn more about funding guidelines, eligibility restrictions, and application procedures, please visit: http://www.whofoundation.org/.

BeFitNYC.org

The New York City Departments of Parks & Recreation and Health & Mental Hygiene have launched BeFitNYC.org – a search engine to find FREE and low-cost fitness opportunities in New York City. Visit BeFitNYC.org to find and join free or low-cost fitness activities, such as lunchtime walking groups, after-work runs, yoga meet-ups or zumba classes, as well as organize a fitness activity and invite friends and family to join using Facebook.