This is the first installment of our ongoing series, The Grocery Gap, looking at how the lack of healthy food access impacts communities. This installment is authored by Sarah Treuhaft of PolicyLink, one of the authors of the recently released “The Grocery Gap: Who Has Access to Healthy Food and Why it Matters.”

Do Communities of color have less access to healthy food?

Over the past 20 years, dozens of researchers have asked this question. Some have assessed availability of nearby supermarkets (which provide the most consistent selection of healthy foods at affordable prices) or the mix of different food outlets (supermarkets, grocery stores, convenience stores) across neighborhoods based on their racial/ethnic composition. Increasingly, they survey the availability, quality, and prices of healthy foods within neighborhood food stores.

We thoroughly reviewed all of these studies for the Grocery Gap report released today, and found that the answer is yes: communities of color, and particularly African American communities, have disproportionately less access to healthy food compared to white communities. Here are some of the most striking findings:

• African American neighborhoods have four times fewer supermarkets than white neighborhoods.
• In Baltimore, 43 percent of stores in African American neighborhoods have low availability of healthy foods according to a survey, compared to 4 percent of stores in white neighborhoods.
• Schools attended by nonwhite students or located in communities of color are more likely to have at least one convenience store nearby.

Research has also linked better availability of supermarkets with improved eating behaviors. African Americans who have supermarkets in their neighborhoods are more likely to eat healthy diets: for each additional supermarket in a census tract, residents eat 32 percent more fruits and vegetables.

And evidence is accumulating that these communities can support new markets or expand existing ones. An assessment of the first supermarket to locate in Harlem in 1999 found that it devotes the same amount of shelf space to fresh produce, fish, and meat as a typical suburban store, at the same prices.

The Pennsylvania Fresh Food Financing Initiative has helped start or expand grocery stores, farmers’ markets, and converted corner stores (that now sell healthy food) in communities of color throughout the state.

These findings will come to no surprise to residents or community groups who have long been organizing to bring gardens, farmers’ markets, cooperatives, and supermarkets to these neighborhoods (see our Healthy Food for All report for case studies on Oakland and Detroit).

The proposed federal Healthy Food Financing Initiative could help these groups, and other entrepreneurs, develop new, effective food retail models communities of color – increasing access to healthy food while creating new jobs and entrepreneurial opportunities.

This post was written by PolicyLink Senior Associate Sarah Treuhaft.

Childhood obesity is a key dilemma of our generation. Since the early 1970s, obesity rates have doubled for 2 to 5 year olds, tripled for adolescents ages 12 to 19, and quadrupled for 6 to 11 year olds. Not surprisingly, rates are highest for low-income and nonwhite kids who are more likely to live in neighborhoods that seem to conspire against healthy choices.

What can be done? A theme issue of the journal Health Affairs released this morning asks this question, exploring trends, presenting lessons learned from state and local actions, and addressing the roles of neighborhoods, food policy, and schools in reversing the epidemic.

The new journal includes an article we wrote with colleagues at The Food Trust that describes the nuts and bolts of how one policy win can lead to many. In Pennsylvania, advocates successfully established a fund in 2004 that has since helped 83 grocery stores, farmers’ markets, and neighborhood stores open in underserved neighborhoods or expand their existing stores (all while creating or saving 5,000 jobs!).

Over the past several years, Illinois and New York state, as well as the city of New Orleans, launched similar programs based on the Pennsylvania model. The Obama Administration has proposed a $400 million investment in a national Healthy Food Financing Initiative. (We are working to make this happen, click here to find out more and sign on to our letter of support).

The article discusses how advocates moved the campaigns forward at the state and national level, presenting it as a five-step framework from understanding the problem through data and mapping analysis to policy implementation and evaluation. Hopefully, it can help policymakers, child advocates, health coalitions, and others advance their own childhood obesity campaigns.

(Video courtesy of the very cool Market Makeovers program in LA. Check them out)

This piece also appeared in the Washington Post’s Health Care RX online panel.

In all the arguing over incremental, sensible improvements to our nation’s health-care system, the voices of the people most affected by the current health-care crisis have been remarkably absent. Working families, self-employed small-business owners and uneasy workers fearful of losing their jobs have been heard from less and less as the debate has crawled on.

Instead, cable TV stations and op-ed pages are dominated by those who don’t have to worry about how to pay for an ambulance bill or a cancer test. Sunday morning talk shows feature almost exclusively those in the very highest echelons of national income. Just this week, the well-employed Rush Limbaugh even has the gall to claim that the health-care system is “working just fine, just dandy.”

The point of health reform was never to simply limit the red tape and cut down on the most egregious abuses of the insurance industry. It was to make millions of Americans more healthy and secure.

Without the voices of our most vulnerable communities, though, the provisions that could have helped those communities the most — a robust public option, expansion of Medicare, an improved children’s health insurance program, etc. — have lost out.

Specific provisions like ending discrimination based on pre-existing conditions are an enormous step toward a more just and more effective health-care system. But without the voices of struggling Americans at the heart of this legislation, it cannot do all that we need it to do.

After a year of a nearly non-stop national health-care debate, we sit on the precipice of significant — if incremental — progress. But we must remember this is not the end of the process. It is only the beginning. We will have countless opportunities to expand and improve on this foundation. The voices of those most in need are vital as we move toward implementation of this historic reform.

A couple years ago, a celebrity chef out of London convinced the city’s school district to allow him to remake the lunch menu (and kitchens) of a group of city schools. He argued the change could make the kids both healthier and more successful at school.

The results so far are incredibly encouraging:

Their answer – a provisional one, since they are still refining the research – is that feeding primary school kids less fat, sugar and salt, and more fruit and vegetables, has a surprisingly large effect. Authorised absences, the best available proxy for illness, fell by 15 per cent in Greenwich, relative to schools in similar London boroughs. And relative to other boroughs, the proportion of children reaching Level Four in English rose by four and a half percentage points (more than six per cent), while the proportion of children achieving Level Five in Science rose by six points, or almost 20 per cent.

(via the Washington Post’s Ezra Klein)

This post is written by Dr. Joe Thompson, the director of the Robert Wood Johnson Foundation Center to Prevent Childhood Obesity and the Surgeon General of Arkansas. 

Cereal and Saturday morning cartoons go together like peanut butter and jelly. The downside is what else our children are seeing when they turn on the television.

The Rudd Center for Food Policy and Obesity at Yale University on Monday released Cereal F.A.C.T.S. (Food Advertising to Children and Teens Score) earlier this week which reported on, and rated, how cereals are marketed, and specifically targeted, towards children.

According to the report’s executive summary, “The least healthy cereals are the ones most marketed to children, and overall, children are exposed to a vast amount of marketing for highly-sugared cereals, more than for any other category of packaged food.”

Their results found that seven of the 10 cereals with the poorest nutritional content are the same products most heavily advertised on television and the internet. One of the study’s key findings is that cereals marketed to children have 85 percent more sugar, 65 percent less fiber, and 60 percent more sodium. And although none of these cereals qualifies to be included in the USDA Women, Infants and Children (WIC) program, they all are designated as “smart choices” by the Council of Better Business Bureaus. These foods may proclaim to be “better-for-you,” but in actuality they are contributing to children’s poor health and the obesity epidemic.

With marketing targeting our young people, it creates a near toxic media environment that overwhelms kids with advertising on children’s networks and websites like Nickelodeon, Disney, and the Cartoon Network–networks that now bring the advertising into our homes 24 hours a day, 7 days a week..

However alarming the statistics in the study may be, they are also indications that environmental factors can be changed via policy change and governmental regulation.

In the long run, this kind of regulation is helpful for all of our children, especially those who are disproportionately impacted by overweight and obesity: children of color and children in low-income communities.

To read the full study visit Cereal Facts.org.

The health of the nation’s black and Latino communities stands to get a significant shot in the arm from the $650 million in health and wellness funding announced this afternoon by the Department of Health and Human Services, according to PolicyLink, a national research and advocacy organization.

The Prevention and Wellness Fund, funded by the American Recovery and Reinvestment Act (a.k.a. the federal stimulus bill), should go a long way toward creating healthier communities across America and, in particular, battling the pernicious racial disparities we see when it comes to obesity and diabetes rates.

“This new funding will throw a lifeline to millions of black and Latino children and their parents and help create healthier communities across America,” said Angela Glover Blackwell, CEO of PolicyLink and a principal advisor for the Robert Wood Johnson Foundation Center to Prevent Childhood Obesity. “Black and Latino Americans are hit hardest by the dual crises of obesity and diabetes. All people deserve to live in healthy communities - places with clean air, safe streets, clean parks, and easy access to healthy food options. These new funds will put us on a path toward healthy communities for all.”

The Administration’s funding approach appears to back three core policy principles PolicyLink and its partners have long called for:

• Healthy food in our schools
• Healthy food options in our communities
• Healthy and safe places to live and play

The funding plan also lines up well with recommendations provided to the White House by PolicyLink and the Prevention Institute. To read those recommendations, click here.

Fact and Resources after the Jump

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Health reform has officially become a test of character — the character of our nation and, perhaps more immediately, the character of our elected representatives.

Last night, President Obama laid out a strong, meaningful and moral health-reform platform. It is a sensible and fair approach that will help improve the lives, health and security of millions of American families.

Under the plan, hard-working Americans can be sure that an unexpected layoff or an effort to start your own business won’t keep you from getting the treatment you need. And strong prevention measures will help save money and reduce the terrible effects chronic diseases like diabetes and asthma are having on low-income people and communities of color.

It is time for leaders on all sides to put their heads down and do the work we elected them to do. The Obama plan represents a broad consensus, packed with the most promising ideas from experts, doctors and leaders on both sides of the Congressional aisle.

After a long, hot, loud August filled with disinformation and overheated rhetoric, it is time for the politics to cool. How Republican leaders react to this speech throughout September and October will show clearly whether they are in Washington to make the lives of everyday Americans better or if they are there to score cheap political points at the expense of the American people.

The perpetual campaign must stop. Our unfair, outdated, and unresponsive health-care system has dragged down families and businesses for far too long.

Obama stepped up to the plate last night, showing a willingness to bring any good ideas into the fold. But a willingness to compromise does not mean stepping away from essential elements and cannot represent a willingness to wait.

The time is now for real change. It’s up to our elected leaders to decide whether they want to play a constructive role — or merely hurl invective from the sidelines.

This article also appeared in the Washington Post’s “Health Care RX” experts panel. For more of Angela Glover Blackwell’s analyses, click here.

This post originally appeared on The Washington Post’s “Health Care RX” weekly panel discussion, in response to the question: “Recent polls show declining support for President Obama’s handling of the health-care issue. What should he do to get the effort back on track?”

What are we even arguing about again?

Though the volume of the health-care debate has never been louder, it has never been more silent on what really matters to the real lives and real struggles of everyday Americans.

During the campaign, President Obama and his team were geniuses at keeping an even keel and steadily pushing on a single narrative — hope — that was both powerful and flexible. But during the health-care fight, they have been unfocused. Of course, it’s hard to have a consistent message when you’re bargaining with 535 potential legislative partners at the other end of Pennsylvania Avenue (not to mention the dozens of TV and radio hosts who wield inordinate power in the modern media landscape).

Obama must take a step back and remind all Americans why we need to reform health care in the first place.

He needs to fill a town hall with people who have faced death or bankruptcy because of insufficient insurance or no insurance at all. Participants shouldn’t be hard to find — all of us have friends or neighbors or family members who have faced this harsh reality (or just go to Andrew Sullivan’s site where he has spent the past several weeks collecting dozens of heartbreaking “Views from Your Sickbed”)

Obama is a master of policy detail and — If he weren’t so politically savvy — would have made a terrific technocrat. But he must stress the big picture here.

We all know the health-care system is broken. We all know dealing with insurance companies is a maddening, often-frightening task. And we all know people will die needlessly unless we get some kind of reform now.

We need Obama to remind us of this fact. Every day. Every hour. The real pain of real Americans needs to become the center of this debate again, not the pitched voices of ill-informed mobs.

New York, NY - Leaders of six of the nation’s top health foundations today made an unprecedented joint call for prevention measures to be central to the reform of our national health systems.In a letter released today, leaders at The California Endowment, The Kresge Foundation, Nemours, Robert Wood Johnson Foundation, W.K. Kellogg Foundation, and Kaiser Permanente, wrote that prevention measures like early health screenings and improved access to healthy food will save both lives and money. Good health, they argue, doesn’t start at the doctor’s office - it starts where we live, work, learn and play.Beginning in 2006, the six foundations, along with technical advisor Centers for Disease Control and Prevention, partnered to form the Healthy Eating Active Living Convergence Partnership - a collaboration of funders looking to help healthy people live in healthy places. Today’s letter was released on behalf of the Partnership.

In the letter, the foundation leaders point to several proven examples where community-level prevention measures improved health, saved money, and cultivated community leadership.

“This is a strong national platform for the nation to build on,” they write in the letter, available in full at www.convergencepartnership.org. “With additional resources, it could bring considerable improvements in health for all Americans. It is time to scale up these efforts by including robust financial support for community prevention in any health systems reform.”

The letter’s signatories are:

• Robert K. Ross, MD, President and CEO; The California Endowment
• Raymond J. Baxter, PhD, Senior Vice President; Kaiser Permanente
• Rip Rapson, CEO; The Kresge Foundation
• David J. Bailey, MD; CEO and President; Nemours 
• Risa Lavizzo-Mourey, MD, MBA; President Robert Wood Johnson Foundation   
• Sterling K. Speirn; President and CEO; W.K. Kellogg Foundation

The letter is released at a crucial time, as Americans and Congress debate how to reform our national health care system.

The foundation leaders stress that prevention can save money and improve the long-term population health. A study last year from the Trust for America’s Health showed that for every dollar we invest in proven community-based disease prevention programs, we save $5.60. If we invested $10 per person in prevention, we could yield savings of more than $16 billion nationwide annually within five years.

The American people also want a health care system built around smart prevention measures. A recent Greenberg Poll showed prevention was the most popular potential health care fix, with nearly half of respondents rating it a 10 out of 10 in terms of importance.

Successful programs highlighted in the letter include:

• In Bakersfield, Calif., a small group of local mothers - many of them Spanish-speaking farm workers - formed a walking group to improve their fitness and build community. With the help of police, parks officials, and the local Chamber of Commerce, the group cleaned up a long-neglected park and reported meaningful improvements in their health.
• In Somerville, Mass., the citywide Shape Up Somerville campaign helped bring the city healthier school food, safer routes to school, farmers markets, community gardens, and more nutritional restaurant options. Weight gain among first- through third-graders has already slowed.
• In Delaware, the statewide Make Delaware’s Kids the Healthiest in the Nation campaign ensured that policies and practices in early education focus on healthy eating and physical activity as part of a comprehensive approach to positively impact childhood obesity where children live, learn, and play. For every dollar invested in the initiative, Delaware saw a $4 savings in healthcare costs.

“Over time,” the foundation leaders wrote, “a focus on community prevention will improve health, save money, reduce demands on our health system and, most important, lead to a nation of healthier people and healthier places to live.”

About The Convergence Partnership In 2006, a collaboration of funders came together to create the Healthy Eating Active Living Convergence Partnership, with the shared goal of changing policies and environments to better achieve the vision of healthy people living in healthy places. The steering committee includes representatives from The California Endowment, Kaiser Permanente, Nemours, The Kresge Foundation, The Robert Wood Johnson Foundation, and the W.K. Kellogg Foundation.

The Centers for Disease Control and Prevention serve as critical technical advisors on the committee. PolicyLink, a national research and action institute advancing economic and social equity, serves as program directors for the partnership. Prevention Institute, a national non-profit organization dedicated to improving community health and equity through effective primary prevention, provides policy research and analysis along with strategic support.

For more information, please visit www.convergencepartnership.org

Leaders of six of the nation’s top health foundations today announced an unprecedented joint call that community-level prevention measures must be central to national health systems reform.

In a joint letter released today, leaders at The California Endowment, The Kresge Foundation, Nemours, The Robert Wood Johnson Foundation, W.K. Kellogg Foundation, and Kaiser Permanente, wrote that community-level prevention measures like improved access to healthy food will save both lives and money.

The letter was released on behalf of the Healthy Eating Active Living Convergence Partnership, a collaboration of funders working to change policies and environments to better achieve the vision of healthy people living in healthy places

As Americans and Congress debate how best to reform our health systems, the foundation leaders show how vital community-level prevention measures are to making Americans healthier for the long-term.

To read the full letter, please visit www.convergencepartnership.org.