Kick Butts Day in the Bronx!

Image: Province of British Columbia via Flickr

Today is Kick Butts Day, and we are featuring a guest blog post from Guillermo Flores, Bronx community engagement coordinator at NYC Smoke-Free.

Hello there!  Today, we’re celebrating Kick Butts Day in the Bronx!

My name is Guillermo Flores and I am the Bronx community engagement coordinator at NYC Smoke-Free, a program of Public Health Solutions made possible with the support of the New York State Department of Health’s Tobacco Control Program.  At NYC Smoke-Free, we work to protect the health of New Yorkers through tobacco control policy, advocacy, and education. Formerly the NYC Coalition for a Smoke-Free City, NYC Smoke-Free partners with community members, legislators, and health advocates to support local efforts to end the devastating epidemic of  tobacco use throughout New York City. We believe every New Yorker has the right to breathe clean, smoke-free air where they live, work and play.

Kick Butts Day is an international day of activism sponsored by the Campaign for Tobacco-Free Kids that empowers youth to stand out, speak up and seize control against Big Tobacco. There are over 1,600 tobacco retailers that populate our Bronx communities. This growing number of tobacco outlets in our neighborhoods re-normalizes tobacco use. And in far too many communities, youth are more likely to find tobacco on their neighborhood blocks than parks, schools, libraries, or toy stores.  We work with key stakeholders to bring awareness to this issue, to protect our youth from the over exposure to tobacco in their neighborhoods, and to find ways of stopping the proliferation of tobacco supply and use in the Bronx and New York City.

These initiatives as well as Smoke Free Housing, Tobacco Free Outdoor Air Policies, and other evidence based tobacco control policies are part of the New York State Tobacco Control Program. This program plays a crucial role in saving the lives of New Yorkers and preventing such chronic health conditions as heart disease, cancer and respiratory illness.  New York’s comprehensive tobacco prevention and cessation program prevent  youth from starting to smoke, helps adult smokers quit, and serves as a counter to the tobacco industry’s aggressive marketing and negative influence.  For more information, please visit our website.

High Cigarette Taxes Are a Start But Not the Whole Solution

High cigarette taxes are starting to have the impact that anti-smoking proponents have been hoping for. The latest National Survey on Drug Use and Health reported that 15.8% of young adults between the ages of 18 and 25 are daily smokers, down from 20.4% in 2004. The agency stated that substantial increases in cigarette taxes combined with increased education and enforcement efforts targeting younger smokers contributed to the decline. New York State has the highest state tax in the nation at $4.35. New York City tacks on an additional $1.50 tax making a pack of cigarettes almost $6 more than in other parts of the country. The high cost of cigarettes is a deterrent, but there’s still plenty of work that needs to be done to prevent our kids from becoming the next generation of smokers.

Among adults, the Bronx has one of the highest rates of smoking in NYC. Despite a 30% decline since 2002, southeast Bronx residents are nearly 40% more likely to be current smokers than NYC residents overall and other neighborhoods such as Fordham and Kingsbridge count almost a quarter of their residents as smokers. The danger smoking poses to Bronx youth is particularly worrisome. Research shows that 90% of all adult smokers begin before the age of 18. Although the Bronx has one of the lowest youth smoking rates in the city, 3,000 public high school students in the Bronx are regular smokers with data trends showing that 1/3 of these students will die prematurely because of the habit. These are 1,000 unnecessary and preventable deaths in a borough that already has too many of them.

Bronx Health REACH has been partnering with the Bronx Smoke-Free Partnership for the last few years on a number of campaigns to further lower youth smoking rates in the Bronx. One campaign explores the impact of tobacco marketing in stores on youth. Bodegas, pharmacies and other tobacco retailers are some of the last places in the United States where Big Tobacco can market its deadly products to our youth. The Partnership found that of the 11,500 tobacco retailers in NYC, 75% are located within 1000 feet of a school. A recent study suggests that the more tobacco products kids see, the more likely they are to smoke. The “point of sale” campaign aims to educate community leaders and local tobacco retailers about tobacco marketing and youth smoking and develop policies that promote healthier environments. With over two thirds of teens shopping in bodegas at least once per week, it is vital that we focus our efforts on this important issue. 

 On May 31^st, Bronx Health REACH joined the Bronx Smoke-Free Partnership, the NYC Coalition for a Smoke-Free City and youth from across the five boroughs in Washington Square Park for World No Tobacco Day to educate community leaders across the city about the importance of reducing youth exposure to tobacco marketing in stores. This event built upon the success of the “Take a Walk in Our Shoes” tobacco marketing tours held last October. In the Bronx, students from PS73 led Senator Gustavo Rivera and other community leaders on a walking tour of tobacco marketing inside and outside of the bodegas on Ogden Avenue in Highbridge to show them what they see on their walk to school (watch “Take a Walk in Our Shoes” here).

Going forward, Bronx Health REACH plans to work directly with bodegas, Merchant Associations, Business Improvement Districts, and Community Boards throughout the borough to gain a better understanding of the challenges store owners face around this issue and develop programs that benefit the health of our youth and businesses. Also, we hope to provide workshops for faith-based leaders, community-based organizations and other community leaders throughout the summer. We must continue to listen to and collaborate with these groups and individuals if we hope to create long-term, sustainable changes that better the health of Bronx communities.

Op-Ed: Bronx Residents Celebrate 1 Year Anniversary of Smoke-Free Parks and Beaches!

By Suneet Goraya

Bronx Health REACH

New York City was one of the first cities in the world to prohibit smoking in parks and on beaches. May 23rd marked the one-year anniversary of this historic policy that made it illegal to smoke anywhere in a city park, beach or pedestrian plaza, including Orchard Beach and Van Cortlandt Park! As a National Parks Service HealthCorps member for Bronx Health REACH, I am thrilled about this policy, because participants in our adult walking groups, girls running program, and zumba classes are no longer exposed to toxic secondhand smoke while exercising in the parks. With over 7,000 acres of parks space in the Bronx alone, smoke-free parks and beaches are vital for the health of Bronx residents and the maintenance of our beautiful parks and beaches. Many Bronx residents have noted that smoking in parks and on beaches has been a large deterrent from going to the parks and beaches to exercise and enjoy the outdoors.

While the Bronx is home to the largest amount of parks land in the city, it also fares the worst in health outcomes. According to the New York City Department of Health and Mental Hygiene, over 30 percent of children in Head Start programs and 40 percent of adults in the South Bronx are obese. Currently, 4 in 10 adults in the South Bronx report not exercising at all. In addition, Bronx County has one of the highest rates of asthma in the United States. In some areas of the Bronx, it is estimated that 1 in 5 children have asthma. Health experts have determined that there is no safe level of secondhand smoke exposure. Just 30 minutes of exposure to secondhand smoke can increase asthma attacks in asthmatic children. Prohibiting smoking at parks and beaches encourages Bronx residents to utilize the plentiful park space for physical activity and recreation, without inhaling secondhand smoke or increasing their risk of an asthma attack. 

Building healthier environments for Bronx residents is of great importance to Bronx Health REACH and our community partners. Thank you to our community leaders for supporting this important policy to improve the health of Bronx residents. This smoke free policy is a significant stride in reducing health disparities in the borough. It was a great first smoke-free year and we look forward to hosting Zumba, walking, running, and other activities this summer in smoke-free parks and beaches across the borough.

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.

Bronx Health REACH e-blast: May 4, 2011

The Bronx Forum: The Impact of Healthcare Reform on the Bronx – May 6th
CAUSE-NY and Hostos Community College is hosting a forum on how the Affordable Care Act will impact Bronx residents. Representatives from U.S. Dept of Health, Bronx Health Link, NYS Insurance Dept. and other community groups will be in attendance. The program will take place from 9 am to 12:30 pm on May 6th at Hostos Community College at 120 E. 149th St. in the Bronx. The registration fee is $20 and group discounts are available.


Teen Battle Chef Invitational – May 12th
FamilyCook Productions is holding its first benefit at the New York Institute of Technology’s auditorium on Broadway. The event kicks off at 6:30 pm with food prepared by NYC’s top chefs and the invitational will showcase the culinary talents and skills of high school students in FamilyCook programs across the Northeast. Tickets are on sale and start at $50 per person – the proceeds will benefit FamilyCook and help foster new culinary programs in schools and community centers.


The Faith and Earth Summit – May 13th
Faith Leaders for Environmental Justice and The Riverside Church of New York have designed a full day of workshops on May 13th from 9 am to 5 pm. Topics will include Greening Your Congregation, Practical Steps for Energy and Cost Saving, and Mobilizing Youth Groups. The summit will be held at Riverside Church (490 Riverside Drive). To register, go to: http://tinyurl.com/faithandearth or contact Sara Jones at sjones@nyfaithjustice.org or 212.870.1254.


New York Road Runners Youth Jamboree – May 15th
New York Road Runners invites kids ages 4 to 15 to join them for a fun and FREE day of running, jumping, and throwing at Icahn Stadium on Randall’s Island between 7:45 am and 4 pm. There is no cost of admission for youth or adults and every child who participates will receive a Youth Jamboree t-shirt and event ribbons. Boys and girls 5-10 years old will compete in the morning and events for youth 11-15 years old will take place in the afternoon. There will be a 55-meter race for 4-year-olds at 12:30 p.m. For more information on the Youth Jamboree or to download the registration forms and schedule, please go to www.nyrrf.org, e-mail jamboree@nyrr.org, or call 646.758.9675.


Walk with a Doctor – May 17th
The Committee for Interns and Residents is sponsoring an obesity themed walk-a-thon and health fair on Tuesday, May 17th between 4 pm and 7 pm at 2330 Eastchester Road in the Bronx. This is an opportunity to build relationships with healthcare providers and doctors and there will also be free giveaways, health screenings, and activities. Please contact Nagiane Lacka at nlacka@cirseiu.org for more information.


Fit City 6th Annual Conference – May 17th
The NYC Department of Health & Mental Hygiene and the American Institute of Architects New York Chapter is holding its 6th annual Fit City conference that will look at ways to address the childhood obesity epidemic through transformations in the built environment. This conference will bring together architects, planners, designers, developers, and public health professionals to address how building design and policy decisions can improve health outcomes in communities and help prevent chronic diseases such as obesity, diabetes, heart disease, some cancers and asthma. The full day event will take place at the Center for Architecture at 536 LaGuardia Place. Advance registration is required, please go to http://cfa.aiany.org/index.php?section=calendar&evtid=2523 to register and for the full schedule.

American Community Gardening Association and Robert Wood Johnson Foundation Fighting Obesity Grant – due May 30th
ACGA and Robert Wood Johnson Foundation are offering four $250 grants to programs that are fighting childhood obesity through their gardening program. The applicant is to submit a news article of three hundred words or less about what they are doing in their school/community garden to combat childhood obesity (can include up to three photos). The articles are due May 30th and will be published in the 2011 ACGA Greening Review. Please send or email articles to Bobby L. Wilson 1757 Washington Rd East Point, Georgia 30344 or bobbyw@uga.edu.


New York City smoking ban for parks and beaches goes into effect May 23
The smoking ban passed by the New York City Council in February will go into effect on May 23, prohibiting smoking in New York City parks, beaches and playgrounds. The ban will cover 1,400 parks and 14 miles of beaches citywide. Fines for smoking in these areas will start at $50.

Join Bronx Health REACH for World No Tobacco Day on May 31
Bronx Health REACH has been working with the Bronx Smoke-Free Partnership in an effort to curtail the aggressive tobacco marketing to youth taking place in Bronx neighborhoods through signage and product placement in convenience stores. Read more about our recent activities here. Also, we invite all Bronx youth to take part in the World No Tobacco Day press conference and rally on Tuesday, May 31, at 3pm in Union Square Park in Manhattan. There, they can make their voices heard and tell Big Tobacco they have had enough.


New York 2 New Orleans
New York 2 New Orleans (NY2NO) is a youth-led non-for-profit that creates meaningful service-learning opportunities for NYC high school students in both New Orleans and New York. This summer NY2NO is launching its second consecutive "Food Justice Summer," that will include up to 5 trips to New Orleans, 5 New York based service-learning initiatives, as well as two summer sessions of their programs “Growing Youth Organizers', and the “Community Action Project”. The trips are still being planned but if interested please contact Alex Goldman at 917-656-1558.


Volunteer with City Harvest
City Harvest is looking for a long-term (4 month) volunteer to assist low-income residents in the South Bronx in accessing healthy seasonal food options as part of its Healthy Neighborhoods programming. City Harvest is New York’s only food rescue organization and is looking for a student, community resident, or anyone looking to gain some experience in the food systems change field to start in June. Please contact Tatiana Orlov at torlov@cityharvest.org if interested in applying.


NYC Green Cart Photo Exhibit - through July 10
The Museum of the City of New York is displaying a photo exhibit titled “Moveable Feast: Fresh Produce and the NYC Green Cart Program” that documents the Green Carts throughout NYC neighborhoods. The resulting photographs, in styles ranging from portraiture to landscape to street photography, capture not only the carts themselves, but also the stories of the vendors, customers, and their communities. The exhibit is running through July 10.

Tobacco Marketing to Youth in the Bronx

According to the Food and Drug Administration (FDA), nearly 4,000 youth under age 18 try their first cigarette each day in the United States and an additional 1,000 become daily smokers. In the Bronx, 3,000 public high school students are current smokers (NYC Department of Health, 2009) and a third of them are likely to die prematurely from the effects of cigarette smoking, based on statewide data from the Centers for Disease Control and Prevention.

Tobacco companies market heavily to youth with the goal of finding and securing “replacement smokers.” The Campaign for Tobacco-Free Kids notes that tobacco industry internal documents identify children as young as 11 years old as a “key market.” A newly published FDA report indicates that 80% of black and 50% of Hispanic teens smoke menthol cigarettes such as Newport. This is particularly relevant to the Bronx, which is 91% black and Hispanic, according to the 2010 census. According to a report published this year by the Tobacco Products Scientific Advisory Committee (TPSAC), menthol cigarettes reinforce smoking behavior through their cooling “throat grab”, which reduces the aversion to nicotine among new smokers, thus promoting continued use leading to addiction. One manufacturer of a menthol-containing brand that is extremely popular among black and Hispanic teens, notes: “[T]he base of our business is the high school student.”

Although cigarette companies claim that they have discontinued intentional marketing to youth through targeted ads and promotional items, they have found another powerful venue for the promotion and sale of their products—the local neighborhood store. The corner store is a favored stop off point for youth on their way to and from school. A recent Bronx community mapping survey showed that 85% of these establishments are located within a five block radius of a school. Cigarette and spit-tobacco companies continue to advertise heavily at these stores with large ads and signs clearly visible from the outside.

On June 22, 2010, the FDA issued a new ruling designed to limit the effect of tobacco advertising on youth.

Among other things, the rule:

• Prohibits the sale of cigarettes or smokeless tobacco to people younger than 18,
• Prohibits the sale of cigarette packages with less than 20 cigarettes,
• Prohibits distribution of free samples of cigarettes or smokeless tobacco, and
• Prohibits gifts or other items in exchange for buying cigarettes or smokeless tobacco products.

To ensure compliance, the FDA has promised to conduct unannounced inspections of local retail establishments and to impose “enforcement action,” which could include warning letters, civil money penalties, and orders prohibiting the future sale of tobacco products.

While these provisions are important, they do not address the key issue of tobacco signage in local neighborhood stores. In the Bronx, this is a major issue, due to their proximity to schools, and the tendency of many to violate the FDA ruling by selling small quantities of cigarettes and other tobacco products to youth, and failure to verify their age at the time of sale.

What can communities do? Bronx Health REACH (BHR) has spent the last few months as a community contractor with the Bronx Smoke-Free partnership under a grant funded by the New York City Department of Health. We have met with local members of the Assembly, Senate and City Council to encourage their continued advocacy and support of smoking prevention and cessation efforts in the Bronx, which has one of the city’s highest overall smoking rates and highest pediatric asthma hospitalization rate. In addition, we have met with Community Boards 3 and 5, representatives from our key target schools in Districts 7 and 9, and members of our Faith-Based Outreach Coalition to inform and sensitize them to the issue of youth-focused tobacco marketing in the local retail market.

Bronx Health REACH is currently working with eight schools under the New York State Department of Health-funded HEA+LTHY Schools NY program to bolster school wellness policies focusing on nutrition, physical fitness and tobacco prevention. It has also encouraged its faith-based coalition to actively engage their youth groups in tobacco prevention advocacy, since youth are the target of tobacco marketing efforts. Several youth groups in member churches have already been sensitized to the importance of healthy eating through participation in the God’s Health Squad program, a multi-unit participatory curriculum that covers key concepts related to nutrition, fitness, good health and positive body image. REACH staff and members of the Bronx Smoke-Free Partnership will work with these same youth groups in targeting local retailers to encourage them to remove tobacco signage outside their stores and reduce tobacco product visibility inside.

Finally, Bronx Health REACH invites all Bronx youth to join the Bronx Smoke-Free Partnership on World No Tobacco Day, Tuesday, May 31, 2011, at Union Square Park in Manhattan at 3 pm for a rally and press conference. There, they can tell Big Tobacco that they've had enough of the aggressive marketing designed to get them hooked on cigarettes.