Thursday, November 29, 2012

Churches – still a beacon of hope as communities undergo changes both good and bad.

In an open letter from President Obama addressed to African American families in the November 2012 issue of Ebony magazine, the President begins thus, “ As a young man , I got my first start working with a group of churches on the South Side of Chicago, helping families who had no place to turn when the local steel plants shut down.  I worked with local leaders to rebuild neighborhoods, improve schools and, most of all, to broaden opportunities for people who felt like it was slipping away.”  In reading this I was reminded of the fact that time and time again it is the churches in so many hard hit communities that are the mainstay of those communities.  They stock and staff the food pantries that feed the hungry. They educate the children of the poor or at least supplement the diabolically inferior education provided by many of the local public schools (read any of Jonathan Kozol’s seminal works such as Savage Inequalities to get a first-hand description).  They rehabilitate neighborhoods that more look like the bombed out neighborhoods of Beirut than cities which are part of the greatest city in the world – New York.  It is ironic that it was the churches in New York through such efforts as the Nehemiah low cost housing program that kept many of those neighborhoods now being transformed by gentrification sufficiently intact to be now so desirable that they are the site of a feeding frenzy by vulture real estate developers. Many of these same vulture developers had bought buildings and boarded them up for decades, not caring how much it decimated the lives and real estate value of those who couldn’t flee and who clung to their American dream of home ownership. And, it was churches that operated the front lines in the battles against the scourge of crack/cocaine in those neighborhoods.

The church as an engine of change or, at least, a bulwark against the bleak social and economic forces that attempt to disembowel many of our neighborhoods is one we know well in Bronx Health REACH.  Within our community coalition we have a group of 47 churches of different denominations and sizes.  It is these churches that have been the mainstay of our efforts as we grapple with 18% of south Bronx residents diagnosed with diabetes. Many more are at risk for diabetes with the obesity prevalence rate at 31%.  Bronx Health REACH is founded on the partnerships that its parent organization, the Institute for Family Health, built with churches (as well as other community based organizations) to establish health centers in the south Bronx at a time when Medicaid Mills were the main access to health care ( I use ‘healthcare’ very, very loosely here).

Over the last decade, church leaders working with Bronx Health REACH have sought to embed health ministries in their churches.  They have either incorporated these ministries into such existing ministries as their men’s ministry, women’s ministry, youth ministry, nurses’ ministry, or have created new ministries with a singular focus on health.   A few weeks ago in San Francisco at the annual American Public Health Association (APHA) conference we presented on some of our faith based initiatives that have had demonstrable impact on some of the bleak statistics I cited earlier.

During the past year we have had visitors from the University of New Mexico, the UK and even from the Netherlands who wanted to come hear and see for themselves the work that the churches are doing in community health development.  They have explicitly remarked on the leadership role of the churches not only in the work they are doing in their respective congregations but in strongly advocating for systemic changes, most notably in ending segregated care based on health insurance status in academic medical institutions.

When the day arrives that the Bronx Health REACH slogan, “Making Health Equality a Reality’ is a fact of life it will in no small part be because of the movement that the churches in the Bronx led, and because they taught and fought to hold on to the promise of possibilities even when everything seems to point to away from that.  Their faith will have made us whole.

Charmaine Ruddock, Project Director of Bronx Health REACH

This post was previously posted on HealthCetera, the Center for Health Media & Policy at Hunter College's Blog, on November 27, 2012.


Tuesday, November 20, 2012

Healthy Holiday Meals – A New Tradition for Bronx Families

Turkey…mac and cheese…collard greens…cranberry sauce… sweet potato pie. Who’s excited for Thanksgiving and the holiday season?!  In three days, family, friends, and neighbors will come together for a wonderful day of amazing food, family stories, and football. After Hurricane Sandy, this holiday full of warmth and good food is definitely welcomed.
 
However, maintaining our weight and keeping our blood sugar down is not easy over the holiday season. For those of us who have diabetes, it is even more challenging. I discovered that the average American gains 3-5 pounds during the holidays. With over 11 percent of adults in the Bronx being diabetic, we cannot afford the extra weight.
 
In honor of Diabetes Awareness Month, I am taking up the challenge to prepare favorite family holiday recipes with healthier ingredients and to eat smaller portions during the holiday season. I hope my fellow Bronxites will take up the challenge as well. I know it is hard, but I believe it is possible. Many of us have been preparing healthier meals and reducing the amount we eat each meal for the last few years – and that’s great! But the holiday season does not mean it is time to go back to old habits.
 
Below are some healthy cooking and eating tips and healthy, diabetic-friendly holiday recipes that the Bronx Health REACH team has gathered over the years to help us create a meal plan for ourselves and our family and friends.
 

Healthy Cooking Tips
  • Make eggnog with low-fat milk.
  • Instead of using butter, lard or salt to give flavor to meat and vegetables, use canola or olive oil, lemon and orange juice, lemon peel, and herbs such as rosemary, basil and tarragon.
  • Bake turkey breasts instead of the whole turkey. Remove the skin and fat from the turkey when eating.
  • Try making lighter gravy using the turkey broth and herbs.
  • Serve a salad with low-fat salad dressing as a first course.
  • Serve 100% whole grain pasta, bread, brown rice and crackers.
  • Serve cut up vegetables as a snack before dinner with low-fat ranch dressing or dips with low-fat sour cream.
  • Make stuffing healthy by adding more vegetables like celery, peppers, and onions. Leave out the sausage.
  • Make sweet potatoes without marshmallows. Sprinkle on extra cinnamon instead for flavor.
  • Use non-fat milk, chicken or vegetable broth in mashed potatoes instead of butter or cream. Add garlic for flavor.
  • Serve collard greens or spinach with very little or no oil. Use lemon juice instead of salt.
  • Serve fresh fruit salad or low-sugar gelatin before serving pies and cakes.
  • Arrange a buffet table so that the vegetables, fruits and whole grains are first.
 
Healthy Eating Tips
  • Eat lunch. Have a small sandwich, fruit or crackers and lots of water before leaving home so as not to be tempted to eat three servings of your Grandma’s mac and cheese!
  • Fill up on lots of vegetables and salad, but avoid large amounts of salad dressing, especially if it’s not low-fat! Filling up with vegetables will reduce the amount of meat, stuffing, and other high-calorie foods.
  • Control the amount of each type of food you eat. By making healthy choices, we reduce our risk of diabetes and heart disease. For diabetics, healthy eating will help control blood sugar level.
  • Drink water with a touch of lemon or seltzer instead of soda and fruit juice. High calorie sodas and sweet drinks can add hundreds of calories to the meal. If I must have a soda, I will drink diet soda.
  • Don’t eat to make someone else happy. If someone offers more sweet potatoes with marshmallows or asks, “Did you taste my pie?” I plan to politely say, “I’m sure it’s delicious but I’m already full!” or only have one small taste.
 
Healthy and Diabetic-Friendly Recipes
 
Mac and Cheese Lite
Courtesy of Now Eat This! By Rocco DiSpirito
 
Ingredients
Nonstick cooking spray
Salt
4 ounces whole wheat macaroni
1/2 cup onion-garlic puree
1/2 teaspoon dry mustard
Pinch cayenne pepper
1 cup shredded 50 percent reduced-fat cheddar
1/3 cup nonfat Greek yogurt
1/4 cup whole wheat panko bread crumbs
1/4 cup grated Parmesan
 
Directions
Preheat the oven to 425 degrees. Mist an 8-by-8-inch baking dish with cooking spray; set it aside. Bring a large pot of salted water to a boil. Add macaroni and cook according to package directions, drain. Meanwhile, bring onion-garlic puree, mustard, and cayenne to a simmer in a small saucepan over medium heat, stirring often. Whisk in cheddar until melted. Remove from heat and whisk in yogurt. In a medium bowl, toss the macaroni with the cheese sauce. Season with salt to taste. Pour the mixture into the prepared baking dish and sprinkle panko over the top. Top with Parmesan. Bake until Parmesan is melted and macaroni is hot throughout, about 10 minutes.
 
Serves: 4
Serving Size: 2/3 cup
Per serving: 237 calories, 17g protein, 31g carbohydrate, 7g fat (4g saturated), 3g fiber
 
Cranberry Sauce with Splenda
Courtesy of www.diabetesdaily.com
 
Ingredients
1 teaspoon cornstarch
1 cup Splenda
1/2 cup water
3 cups fresh or frozen cranberries
1 Tbs orange peel
1 tsp fresh grated ginger
 
Directions
Combine cornstarch, Splenda and water in a medium saucepan, stirring until Splenda and cornstarch dissolve. Stir in cranberries, ginger and orange peel; bring mixture to a boil, stirring constantly, over medium-high heat. Reduce heat, and simmer, stirring often, for 5 minutes or until cranberry skins begin to pop and mixture begins to thicken. Set aside to cool. Cover and chill at least 3 hours.
 
Serving Size: 1/4 cup cranberry sauce
Serves: 6
Carbohydrates per serving: 14g
 
Lite Pecan Pie
Courtesy of www.diabetes.org
 
Ingredients
 
Crust:
1 1/4 cups of graham crackers, crushed
1 tablespoon light margarine
1 tablespoon cold water
 
Filling:
3/4 cup egg substitute, such as Egg Beaters (or 3 eggs)
1 cup sugar substitute for baking, such as Splenda
1/2 cup light margarine, melted
1 teaspoon vanilla
2 cups pecan pieces
 
Directions
Pre-heat oven to 350 degrees. To prepare crust, combine crushed graham crackers, margarine, and water and press into bottom and sides of a 9-inch pie plate. Bake crust for 5 minutes, remove from oven and set aside. To prepare filling, mix egg substitute, sugar substitute and melted margarine and vanilla. Add pecan pieces and mix. Pour filling into crust and bake for 35 minutes. Let cool and serve at room temperature.
 
Serves: 8
Per serving: 297 calories; 20g carbohydrates; 23 fat
 
We would love to add more healthy recipes to our list!  Please send your favorite healthy holiday dishes to erodgers@institute2000.org or post them on the Bronx Health REACH Facebook page  www.facebook.com/BronxHealthREACH.
 
Have a healthy and safe Thanksgiving!
 
For more information about diabetes, please visit our website.

Monday, October 22, 2012

Healthy Living in the Bronx -- A Call to Action from the Notorious PhD

On September 22nd, community residents and organizations from across the Bronx participated in the “Just in the Bronx – Our Voice, Our Choice” summit at the Bronx Museum. The day was a testimony to famous anthropologist, Margaret Mead’s belief, “that a small group of thoughtful, committed citizens can change the world.” We heard from community residents, students, teachers, faith based groups, food advocates, elected officials, and Department of Health officials talk about the myriad of exciting projects they are involved in to make the Bronx a place where people are creating opportunities to eat healthier and be more physically active. The event reminded us that while there is a lot of work that still needs to be done; we’ve come a long way as a borough in improving the health of the Bronx. From Play Streets to growing healthy food in classrooms and in community gardens and window sills to community-led fitness groups, Bronxites can hold their heads up high; amazing work is being done across the borough and things are moving in the right direction. During the Action Forum community residents shared their views and indicated their willingness to continue creating this healthier Bronx that we all want.

One of the highlights of the summit was Professor Mark Naison’s keynote address which challenged us to look and understand many of the systemic causes of the unhealthy nature of our Bronx community. Professor Naison is a Professor of African-American Studies and History at Fordham University, Director of Fordham's Urban Studies Program, a community activist and remarkable rapper. Below is his speech. We hope that you enjoy it as much as we did.

Thank you to all of our community partners for making the summit a huge success. To get more involved, please check out the Call to Action from the day on the event’s Wikispace page. You may also be interested in learning more about the organizations that participated in the Action Forum, which you can do with the Action Forum Directory.

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Keynote Address – Professor Mark Naison

Since everybody in the Bronx knows me as Notorious PhD, I have to begin my speech with a line from one of the Bronx’s greatest rappers, Big Pun, whose life and early passing symbolizes the issues we are confronting here today. The line--”Iverson crossover, cheese doodles, grape soda” is one part of a litany of cultural practices which Pun found on the streets of the Bronx, some of which condemned people to an early death. This is certainly true of eating practices in Bronx neighborhoods, many of them places where it is almost impossible to find fresh fruits and vegetables, and where residents would have difficulty affording them even if they could find them. The Bronx is not only the poorest of New York’s 62 counties, it has been rated the unhealthiest, and has the highest rates of both hunger and obesity among New York’s five boroughs. Despite all the heroic efforts of people in this room, and throughout the borough, to bring healthier food to the people of the Bronx, and promote healthier lifestyles, the forces activists are up against, some of them political, some of them market driven, are making that task extremely difficult. In the remarks that follow, I will argue that the health problems of the Bronx are not primarily a result of poor choices on the part of its residents, but of policies which accentuate the poverty of Bronx residents and make their lives more difficult and stressful. And while I fully support community based health programming, I also urge people to turn their attention to policies shaped by powerful forces outside the borough which undermine the health of Bronx residents.

There are three different dynamics currently affecting the health status of Bronx residents in a negative way, each of which is rarely discussed in the medical literature—gentrification, housing and urban planning policies which promote hyper-segregation; and test driven education policies which undermine health and fitness of public school students. I will discuss how each of these shape life in Bronx neighborhoods, and intensify health problems that were serious even before their effects became visible.

First, let us look at Gentrification. The Bronx has been the site of a demographic revolution in the last 20 years, with people from West Africa, the Dominican Republic, and Mexico moving to the borough in large numbers. But this has not been an entirely voluntary migration. According to Greg Jost, Deputy Director of the University Neighborhood Housing Program, “New York’s poorest renters are being priced out of other boroughs and are moving to the West Bronx one of the last bastions of affordable housing in the borough.” When in the Bronx, Jost adds, many of these new residents are paying over half their income in rent, putting a huge dents into funds available for things like health care, food and recreation. And that is not all. According to community activists I have spoken to, the exodus from gentrifying neighborhoods like Harlem, Washington Heights, the Lower East Side and Williamsburg, has resulted in immense housing overcrowding in many sections of the Bronx, with families doubling and tripling up in apartments, people renting out rooms, and even couches to boarders, and spanking new townhouses being subdivided into illegal rooming houses where immigrants can rent rooms with communal bathrooms and kitchens at prices they can afford. These crowded conditions accentuate the risk of fires and communicable diseases, while the income pressures inhibit families abilities to purchase health food. You cannot realistically address healthy conditions in the Bronx, in my judgment, without looking at housing overcrowding, and housing affordability; both of which are at crisis levels in the Bronx The second factor is housing and planning policies which promote hyper-segregation and accentuate the concentration effects of poverty.

During the last ten years, almost every vacant lot in the South Bronx has been the site of new housing construction, some of it in the form of town houses, some of it in the form of large apartment complexes. This has definitely increased the supply of affordable housing in the borough, not enough to offset the impact of gentrification related migration, but still an impressive contribution. But while all of this new housing has gone up, it has not been accompanied by the construction of new youth or recreation centers, raising the question, where are the young people living in these new buildings going to go to get exercise or supervised recreation? If the local public schools were open to the community for this purpose, that would be different, but because of budget cuts, some of them stemming back to the fiscal crisis of the 70’s some of them more recent; those gymnasiums are almost entirely unused in after school hours. And the result is a recreation crisis- felt most acutely by youth= fostered by planners who concentrate affordable housing in already poor-segregated neighborhoods without providing the new recreation resources these residents will need. Most Bronx neighborhoods are not only FOOD DESERTS, they are RECREATION and EXERCSE DESERTS. The dangers of the double whammy should be apparent to everyone in this room. And they can only be corrected by changes in city policy regarding the relationship between housing and recreation space in all new development.

The final force, shaped by political interests outside the borough, negatively affecting the health of Bronx residents, is school policies shaped at the City, State and National level which rate teacher performance, and the fate of entire schools, on the basis of student results on standardized tests. In New York City today, both as a result of Bloomberg Administration policy, and as a condition of accepting Race to the Top Money, schools who do not meet certain performance targets on standardized tests must be closed and half of their teaching staffs removed. More than 144 such school closing have taken place already, many of them in the Bronx, despite the protests of students, parents and community members, with more slated for the future. Along with this, new procedures have been approved at the state level requiring public ratings of teachers, 40 percent of which is based on students test scores, with several years of bad ratings requiring that the teacher be removed. These two policies have created an atmosphere of near panic in the schools of the Bronx, where many of the students are children of immigrants, and a high portion have special needs. And the results have been devastating for the physical and emotional health of these students. To make sure students test well, many schools have taken time once used for gym or recess and use them for test prep; while converting after school recreation programs into study halls.

The result is that already recreation starved youngsters in the Bronx get almost no physical activity in their schools and sit at their desks all day. This in my judgment is a public health disaster, but you cannot address it without reducing the impact of high stakes testing on the careers of Bronx educators. It is a policy problem that has to be addressed at its source, City Hall, the State Capital in Albany, and the US Department of Education.

I am not pointing out these larger forces to undermine the valuable work everyone here is doing to improve health opportunities and health choices for Bronx residents. Everything you are doing builds communities and saves lives. But we also have to try to change policies at the city and national level which make this work more difficult- and build the kind of alliances necessary to do that. The people of the Bronx did not create the conditions they live in; and while they can organize to make their lives better it they will need help from both markets and government who thus far have done more to accentuate their hardships than relieve them.

Tuesday, October 9, 2012

The Fitness Divas Transforming Their Community One Park at a Time

Darlisa Evans, Betty Robertson and Wendy Williams are community residents who participated in exercise classes offered this past spring by Bronx Health REACH and the Institute for Family Health, and who achieved significant improvements in their health, stronger friendships and a new passion for healthy living. They remained so committed to healthy living that this summer they formed their own group – the “Fitness Divas.” In addition, to regularly providing exercise classes for their friends and neighbors in nearby parks and a local housing complex, they’ve become amazing public health and parks advocates in their own community.
 
Last Thursday, the Fitness Divas joined Bronx Health REACH for a meeting with the NYC Department of Parks & Recreation to discuss the poor conditions of the parks in the Bronx and how community residents and organizations can partner with the NYC Parks & Recreation Department to make improvements to Bronx parks. Attending the meeting from the Bronx Office of the NYC Department of Parks and Recreation were Robert Wright, Chief of Recreation and Deputy Chiefs of Recreation Neil Harmon and Pete Jones. During the meeting, Darlisa, Betty and Wendy discussed the poor condition of Galileo Park, where they exercise. They pointed to the fact that the park is dirty, the equipment is old and poorly maintained, the benches are waterlogged and that there is a sinkhole. Beyond the unappealing state of the park, they talked about their concern for the lack of park space for children with disabilities, especially in Plimpton Park, which is right across from a school for children with special needs. In the grand scheme of things, the Fitness Divas pointed out that the parks should not only be seen as places for physical activity but for healthy eating as well. Ideas were shared about placing Green Carts in the parks and encouraging bodegas neighboring the parks to set up outdoor stands offering water and fruits.
 
The Parks Department staff agreed that there are a number of challenges to using parks in the Bronx, especially in Community Board 5, which has the least amount of green space in the Bronx and does not even have a recreation center. However, they discussed and emphasized the important role of community members in reporting these concerns and getting involved in their local park to improve its conditions. Deputy Chief Harmon recommended a number of activities that people can to do improve the conditions of their parks:
  • Contact your local Community Board and/or call 311 to make complaints. When you call 311, the claim goes directly to the Parks Manager and then he/she has 48 hours to fix the problem in the park. Also, make sure to request a meeting with the Parks Manager to meet you at the park to review the problem and see how it was fixed.
  • Work with the Partnership for Parks to create a “Friends of Group” for parks that don’t have them. “Friends of” groups become part of a citywide network of people connected with and interested in improving their local parks. Anthony Martinez is the coordinator for the Bronx.
  • Join the Parks Committee of your local Community Board.
  • Work with your Community Board to get the Community Affairs Department of the nearby precinct to increase police patrolling near the parks.
  • Set up a meeting with your local City Council member to discuss the capital funds for your local parks and increasing the number of Park Enforcement Patrol officers.
  • Attend the Parks Department budget consultation/“scopes” meeting to voice concerns about local parks. Anyone from the community can attend.
In addition to this invaluable information from the Parks Department, one of the major takeaways from this meeting was the importance of community involvement in all work that we do. In order to make significant, sustainable improvements to our parks in the Bronx, community residents must be at the forefront of all activities and discussions, because they know their community best -- they know the people, the concerns, and the solutions better than anyone else. For these reasons, we strongly encourage our partners and colleagues to make sure that community residents are sitting front and center when developing and implementing programs and policies that aim to improve the health of the Bronx and reduce health disparities.
 
We can’t thank Darlisa, Betty, and Wendy enough for their energy, enthusiasm, hard work, and commitment to the health of the Bronx and our parks. There is no doubt in our mind that there will be major improvements in the parks in the Bronx in the near future because of these amazing women and others like them!
 
For more information about how you can get involved in your Community Board, click here.
 
For more information about how you can create a “Friends of Parks” group at your park, click here.
 
 
 
 

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