Food as Medicine: A “Prescription” for Fresh Fruit and Vegetables

 

This article was written by Kenny Escobar, Nutrition & Physical Activity Coordinator, Jamila Outlar, Produce Prescription Coordinator, and Intern Stephanie Garcia.

In the winter of 2023, Bronx Health REACH and Corbin Hill Food Project Inc. (CHFP) launched the Food as Medicine Produce Prescription Program (FAM) for patients at three Bronx-based Institute for Family Health (IFH) centers to promote the consumption of healthy food.

The FAM project is funded by the Gus Schumacher Nutrition Incentive Program (GusNIP) grant from the National Institute of Food and Agriculture (NIFA) of the USDA.  Project participants must be an IFH patient over 18 years of age and screen positive for food insecurity. Once enrolled, participants receive a box of high quality, fresh local fruits and vegetables on a bi-weekly basis for a minimum of six months. The average price for the box of produce is roughly $35 but through FAM the cost to patients is only $2.50. The participants can pay with SNAP, cash, debit, or credit card. Participants who have SNAP can also pay with Health Bucks.

The FAM project also provides participants with recipes at each distribution in order to encourage the eating of fruits and vegetables. These recipes include creative and helpful ways to use the produce from that week’s distribution. Food demonstrations accompany the distribution of the recipes at least once a month at each health center introducing participants to  fruits and vegetables they may not have known or previously eaten. 

Chef Yadi leading a food demonstration. 

Bronx native Chef Yadira Garcia, also known as, the “Happy Healthy Latina” or Chef Yadi, is the chef enthusiastically creating delicious and nutritious dishes for patients to try. She makes sure that patients are educated on the multiple ways to prepare the different produce and is always open to answering any questions that the participants may have. 

As of February 2024, when enrollment ended, 374 patients were enrolled in the program and 130 have completed their 6-month commitment. We will conduct a program evaluation to assess patients’ overall opinions and feedback of the program to determine the effectiveness of this intervention and the impact it has had on the participants. To date feedback from some participants indicate that the program, for them, is a resounding success. An Urban Horizons patient shared that they are “very happy as a lot of us need this program, we get healthy food and we need this in the neighborhood. You’re doing a very good thing for us." A Stevenson patient said she “enjoys this program so much as I am learning how to cook and eat different things.” A patient from Walton stated, “by receiving these produce box two times a month, I am able to eat healthier which is contributing to my weight loss.”

The Boogie Down Walking Club: Implementing Walking Programs as a Sustainable Form of Physical Activity

 

Members of Grand Concourse Seventh Day Adventist Church Walking Club.

This post was written by Immaculada Moronta.

With the high rates of obesity and overweight in many South Bronx neighborhoods, a low impact activity such as walking provides a great opportunity for residents to get physical activity. But being able to safely engage in physical activity in many Bronx neighborhoods is no simple walk in the park. Many areas of the Bronx are densely populated urban areas where open, green spaces are limited, and many public areas have conditions that discourage residents to get out and walk. There are unsafe walking conditions such as unpaved and uneven or dirty sidewalks, construction activities, unsafe crosswalks, busy vehicular traffic and areas with criminal activity. 

Bronx Health REACH, in collaboration with Equity Design, an organization that uses physical activity to motivate and transform the lives of youth, adults and communities, launched a walking program, with seven participating faithbased organizations. Bible Church of Christ, Cathedral at Greater Faith in the Bronx, Church Alive Community Church, Grand Concourse Seventh Day Adventist, Every Day is a Miracle, New Life Rehoboth Church and St. Jerome Church completed the program with 80 participants in the summer of 2023. From June to September, the partners collectively walked 128.23 miles/296,801 steps.  

Members of Cathedral at Greater Faith in the Bronx Walking Club.

The walks not only provide a low-impact physical activity and social connectedness, but also create a safe environment for the community of walkers by activating spaces deemed unsafe or unfit for walking, and to help narrow existing health inequity gaps that remain for Black and Latino residents in many Bronx communities.

The partners designed their walking routes with technical assistance provided by Equity Design and tailored their goals to the needs and capacity of the people leading the clubs and the participants. For example, the goal for one of the walking clubs included a one-mile walk in 20 to 30 minutes, while another it was 1,000 steps per participant. The walking clubs also set a collective goal of completing one million steps. Prospective members of a walking club completed a survey to determine what days and times they preferred to walk, how many times a week to meet and if they had any health issues that would impact their ability to walk.  Each walking club partner completed a walking assessment of their proposed walking route to determine walkability, taking into account: sidewalk conditions, pedestrian traffic, the number of trees and seating per block along a route, cleanliness of routes, vehicular traffic and accessibility to public transportation. 

Members of Christian Bible Temple Walking Club.

A major success of this project was that each walking club created their own timeline and action steps to ensure the sustainability of their program. A tool developed for the walking clubs was a walking course map highlighting and identifying the degree of ease vs. difficulty for each route i.e. steep places vs. flat surfaces and distance. The tools could be accessed through Google Earth on users’ smartphones. A captain and co-captain were selected by the members of each walking group. To promote their walking club and church affiliation some walking clubs printed their own t-shirts for each participant to wear and provided them with visors, water bottles, pedometers, captain t-shirts, and whistles. 

The impact of this initiative can be seen at both the community and individual level. One notable example of community level impact is Bible Church of Christ. During their environmental assessment of their proposed walking route, members observed that substance abusers and homeless people occupied an open space along their walking route. Instead of finding an alternate route, they invited all those that were there to join them. Several community members subsequently joined them in their weekly walks. As a result, those residents who joined, are helping the walking club create a safer space. Individual walking club members have been touting the benefits from walking. Christian Bible Temple completed a community clean-up day surrounding the blocks around the church that were was part of their walking route. Equity Design connected them with the New York City Department of Sanitation and received tools to continue with the cleanup. On the individual level, one woman, a senior citizen, had been using a walker when she started walking with the walking club, and now she no longer needs to use a walker.

The faith-based walking clubs not only provide physical activity but social connectedness as well for participants, which many sought following the devastating isolation brought on by the COVID-19 pandemic. The level of commitment from the walking clubs is powerful. Many times over these walking clubs have brought people together with the goal of making healthier versions of themselves. Our walking clubs always find a way to bring out the best in each of their members with the goal of getting physically active in the Boogie Down Bronx!

Food Education Roadmap: Building a Healthier Relationship with Food in Schools

 

This blog post was written by Diana Bernal, Program Coordinator for the Creating Healthy Schools and Communities program at Bronx Health REACH.

When it comes to health outcomes, nearly 40% of New York City public school children are overweight or obese and this disproportionately affects Black and Latino students.  Children living in the Bronx have the highest prevalence of being overweight at 43% compared to 38% in Manhattan, 39% in Queens, 40% in Staten Island, and 41% in Brooklyn. Being overweight or obese increases the risk of developing chronic diet-related disease, such as diabetes, obesity, and hypertension. 

Through our Creating Healthy Schools & Communities (CHSC) program, Bronx Health REACH works with Bronx schools to help improve their school wellness, nutrition, and physical activity. In doing so we learn the struggles schools face when it comes to the students’ health and nutrition. School leadership and teachers have told us that their students do not like the food being served to them during their school lunch period, and that many would rather eat chips, like Takis (spicy corn chips made of rolled tortillas, similar to taquitos), and other unhealthy foods. These are known as “competitive foods”, which includes all food and beverages outside of the reimbursed meals provided by schools. New good nutritious food changes, like Plant Powered Fridays, which is when students are served meatless meals, have been made in an effort to introduce more plant-based foods to children. Bronx Health REACH, through its CHSC work with schools, have discussed with school leadership  how to improve nutrition in schools. The leaders  shared, that  Plant Powered Fridays has not been well received in schools and that  the kids do not eat the food. Teachers pointed out that students are more likely to try new things when they are being engaged and taught about it, thus highlighting the need for food education. According to the Food Ed report: 

“Food education describes any combination of educational strategies, accompanied by environmental supports, designed to motivate and facilitate voluntary adoption of food choices and other food and nutrition-related behaviors that are conducive to the health and well-being of individuals, community, and the planet.” 

On June 6, 2023, Mayor Eric Adams, along with New York City Department of Education (NYCDOE) Chancellor David Banks, and the Mayor’s Office of Food Policy’s Executive Director, Kate MacKenzie, announced the Food Education Roadmap to promote healthier school communities across New York City. “Prioritizing Food Education in Our Public Schools: A Path to Developing a Healthy Next Generation” provides goals, strategies and key performance indicators to ensure that students have the tools and knowledge to lead healthy lifestyles. The Roadmap Goals and Strategies focus on building on the knowledge and accessibility of healthy eating and wellness among students, as well as for those in the community who serve as advocates.  

Food education takes a wider approach and focuses on more than what healthy and non-healthy foods are. It focuses on our relationship with food and how this relationship is connected to, and affected by, other influences such as culture, economy, and communities. By implementing food education in schools, students will be able to understand why certain foods are healthier than others which will enable them to form a better relationship with food, and in turn help to guide them to making healthier choices. 

Bronx Health REACH’s many years of experience working to change the food culture of schools helping children embrace new healthy food underscores the need for food and nutrition education in  making such a change happen.   There are many resources and organizations getting kids to try new foods that are introduced in the schools through the Farm to School program that the NYCDOE Office of Food and Nutrition Services participates in. 

References:

1. FoodEdReport_010.pdf (nyc.gov) 

2. databrief1.pdf (nyc.gov) 

Join us this FRIDAY SEPT 15 for Racism and Our Families’ Health: Connecting the Dots…Why the Conversation Matters from 10AM to 12PM

 

Join us this FRIDAY SEPT 15 for Racism and Our Families’ Health: Connecting the Dots…Why the Conversation Matters from 10AM to 12PM. The presentations and discussions will offer lessons in how to effectively respond to our most pressing social issues employing a lens of anti-racism. 

Click HERE to Register. 

Questions? imoronta@institute.org.

Click here to view Part 1 of a recent discussion with Stay Alive with Church Alive (hosted by Bishop Timothy Birkett) featuring Immaculada Moronta from The Institute for Family Health/Bronx Health REACH, Rev. Dr. Calvin R. Kendrick, Pastor of Grace Baptist Church in the Bronx, and Father David Powers from RC St. Helena Church as they discuss the Racism and Our Families Health series of webinars as they discuss: What is racism? What are the types of racism? Where do we find racism? Why does the conversation about race matters to all?

Click here to view Part 2 of a recent discussion with Stay Alive with Church Alive (hosted by Bishop Timothy Birkett) featuring Immaculada Moronta from The Institute for Family Health/Bronx Health REACH, Rev. Dr. Calvin R. Kendrick, Pastor of Grace Baptist Church in the Bronx, and Father David Powers from RC St. Helena Church as they discuss the Racism and Our Families Health series of webinars as they discuss the following: How is racism making us sick? How is racism affecting our wellbeing? How do you achieve equity goals as an organization and/or individuals?