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.