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.