Over the past two days in the nation’s capital, a powerful convergence of leaders came together to ponder the serious issue of obesity and its physical, social, and economic consequences.

At the Weight of the Nation conference, convened by the CDC, there was broad participation by local, state, and national researchers, policymakers, practitioners, advocates, academics and others seeking effective solutions. The big news to come of the conference so far was the startling study finding that obesity is costing us $147 billion in health-care costs — one in every ten dollars spent on health-care nationwide.

While it was exciting and encouraging to have champions such as Bill Clinton, Senator Harkin, and Health Sec. Kathleen Sebelius offer powerful declarations of support, I am still worried. Worried that this battle will take a very long time. Worried that many Americans still look at individual behavior as the primary place for change rather than exploring the harmful effects of place on the individual and family’s range of choices.  (Note the opening photo of an overweight person in the chair as opposed to the large number of fast food restaurants and unsafe place to play).

We are learning a lot at the conference. For example, studies showing that increased obesity is tied to cheap, easy availability of unhealthy, tasty foods. We are learning what’s working in other countries, such as in Amsterdam, with all their cycling and walking and high parking rates, there is still an obesity problem. We are hearing from economists that how we frame obesity intervention matters.

For example, polls taken in NY showed public suppport for having government involved in creating healthier policies to reduce obesity. But this support significantly declined when asked if they support taxes to make the changes happen. So there is still more to learn, more smart folks to talk to, more business cards to collect, more research to collect and evaluate.

But the real test is when we all return home, what do we do differently? What commitments will be made within our organizations and networks? How do we leverage and maximize this important moment to stay the course over the long haul to make the needed policy changes that can be sustained? How do we strengthen communities and families without blame and with resources? So these are the questions I will continue to ponder in the remaining half day of this amazing conference.

Mildred Thompson is the Director of the PolicyLink Center for Health and Place and the Deputy Director of the Robert Wood Johnson Foundation Center to Prevent Childhood Obesity.

The USDA released a much-anticipated study of food deserts today. The full study can be found here. Below are statements from PolicyLink and The Food Trust about the study.

Statement from PolicyLink President Judith Bell

“The new USDA food desert report provides yet another confirmation that access to healthy food is a significant problem for millions of Americans. The report shows that about one in every 13 Americans – 23.5 million people — live in low-income communities that are more than a mile from the nearest large grocery store.

As more than 70 studies have shown during the past decade, the lack of access to healthy food is a real challenge in many low-income urban communities, rural communities, and communities of color. This is a public health issue, plain and simple. As we demonstrated in the 2008 report, Designed for Disease: The Link Between Local Food Environments and Obesity and Diabetes, people living in neighborhoods crowded with fast-food and convenience stores but relatively few grocery or produce outlets have a significantly higher prevalence of obesity and diabetes. (The report was prepared by PolicyLink in partnership with the UCLA Center for Health Policy Research and the California Center for Public Health Advocacy).  Other studies demonstrate that in addition to providing access to healthy foods, supermarkets and large grocery stores are important neighborhood economic engines, bringing jobs and revitalization.

This USDA report adds to the growing body of research on the ways that where you live affects your health. Now is the time to implement proven, impactful policies to address America’s food desert crisis.”

Statement from John Weidman, Deputy Executive Director, The Food Trust

“Improving access to grocery stores in both urban and rural communities must be part of our national strategy to improve children’s health and prevent obesity and diabetes.  The Pennsylvania Fresh Food Financing Initiative has demonstrated that supermarkets can thrive in food deserts and offers a strong model for solving this problem nationally.   Expanding this program is one of the Top Ten recommendations of the Robert Wood Johnson Foundation’s Commission To Build a Healthier America.”

Excellent piece today in the Times’ business section about the Pennsylvania Fresh Food Financing Initiative…and the effort to replicate it in New York.

 The ShopRite owner, Jeffrey Brown, a fourth-generation grocer, said it would not have made economic sense to open the $14.5 million store, which is at 52nd Street and Parkside Avenue, if not for a Pennsylvania grant and revolving-loan program aimed at improving access to nutritious food in places with few, if any, good stores to choose from.

“In neighborhoods like this, people have less money and the first thing they cut out are all the high-margin items,” said Mr. Brown, citing prepared foods and fancy breads as examples. Costs, like extra security, tend to be higher in poorer neighborhoods, he said.

Through the Pennsylvania Fresh Food Financing Initiative, Mr. Brown, who owns 10 other supermarkets in the Philadelphia area, got a $1 million grant and $7 million in federal New Markets tax credits, which are aimed at stimulating investment in low-income communities. Several customers said the prices at Mr. Brown’s store were fairer than what they had been used to.

Inspired by Pennsylvania’s example, New York City officials have developed an initiative of their own to bring new neighborhood markets selling fresh food to areas of the city where they say the need is greatest.

PolicyLink, The Reinvestment Fund and The Food Trust are also working to bring this idea national. Check out a great two-page primer on the federal possibilities here.

Gallup and America’s Health Insurance Plans (an industry group) just released this really interesting, in-depth new study/map showing the shocking “well-being” disparities in America. They have been surveying 1,000 new people every day since January 2008 to come up with “well-being” scores for each state and congressional district. The score takes into account general happiness, access to care, work quality, physical health and emotional health.

The disparities it shows are striking – though not necessarily surprising.

If you have a minute, visit this page, go to the Quick Report builder in the center of the page, create a map filtering by congressional district, then zoom in on any region you know well. You can see clearly that the poorer congressional districts all have far lower “well-being scores.” The proximity of wealth, healthy communities to poor, unhealthy ones is shocking.

Click through to the jump to see the well-being map of New York City. Nearly all of the low-scoring districts are overwhelmingly low-income communities and communities of color (like the 11th District, my district):

(more…)

A recap of this week’s equity news.

“One Step Off The Superhighway,” - Washington Post
Push to Expand Internet Access Leaves Behind the Urban Poor

President Obama made his first major push for the Web this month when he signed off on the stimulus bill, which includes $7.2 billion to bring high-speed Internet to rural America. But some critics say the administration’s plan largely overlooks the biggest group of disconnected people: the urban poor.

One provision in the stimulus plan could provide about $250 million for service and training in urban areas. Some of that money is likely to go toward boosting efforts at community centers, but interest groups say the amount is not enough to help an estimated 21 million low-income people get online.

“He’s the Angel of Harlem,” - NEWSWEEK
Geoffrey Canada leads a nonprofit that helps thousands of poor city kids
The secret: conquering one block at a time

One day my chief operating officer, George Khaldun, and I were walking to lunch. We were on Park Avenue at 137th Street, in kind of a beat-up area. We’re in suits and ties and we see these other two African-American men in suits and ties, which is very unusual over there. And so we’re just walking and talking, and George says, “Geoff, those are our kids.” They were two of our college kids who were heading to their jobs down in midtown. George looked at me and he said, “You know, this is what we dreamed about.” And we just watched those two kids heading towards a good life and thought, that’s what this is about. We’ve leveled the playing field

- Geoffrey Canada

“Healthy Foods Harder to Find in Poor Neighborhoods,” - Forbes.com

New research suggests that stores in poor neighborhoods are much less likely to offer healthy foods than those in wealthier parts of town.

“Where you live matters in terms of your diet,” said study author Dr. Manuel Franco, an associate professor at Johns Hopkins Bloomberg School of Public Health in Baltimore. “If you live in a neighborhood with no healthy options, it’ll be tough for you to change your diet.”

PolicyLink President Judith Bell addresses the importance of access to healthy food during a panel discussion focused on hunger at the Center for American Progress. ” Judith focused on many innovative and urgent policies for spreading healthy food access to all communities — especially low-income communities and communities of color.

You can watch the entire video (courtesy of CAP) below:

A recap of this week’s equity news

“Nutrition grant will refresh local ‘food deserts’,” - The Courier-Journal
Grant to boost nutrition at two corner stores

They’re called “food deserts” — poor, urban neighborhoods where residents lack cars to drive to distant supermarkets, prompting many to rely on nearby fast food or convenience-store fare.

Now, after months of delays, a project is about to bring healthful food to two such “deserts” in Louisville by helping two corner stores in disadvantaged neighborhoods begin selling fresh fruits and vegetables.

“How Obama can partner with philanthropy,” - San Francisco Chronicle
 
With violence in the Mideast, the spreading economic crisis, the tragedy in Mumbai and the risk of state failure in troubled regions, President-elect Barack Obama has had a glimpse of the in-box that awaits him. Already on his checklist had been the problems of new poverty at home; uneven access to health care and quality education; the climate crisis; and the need for post-war reconciliation and reconstruction abroad.

Yet the president-elect was quick to acknowledge on election night that, “government can’t solve every problem.” He will need to tap all available sources of innovation, including from the nonprofit and philanthropic sectors. In the case of the social sector, its most important asset may be its independence, not only from governments but from the snap judgments of markets or electoral politics, influenced by the 24-hour news cycle. In a world of complex problems, the social sector - philanthropy and those it supports - may be the only sector able to take risks, withstand criticism and make long-term investments in the public interest.

“A Pitch for Mass Transit,” - New York Times

Unlike President Bush, Barack Obama is going to enter office with a clear appreciation of the urgent problems of climate change and America’s growing dependency on foreign oil — and a strong commitment to address both.

One way he can do this is to give mass transit — trains, buses, commuter rails — the priority it deserves and the full financial and technological help it needs and has long been denied.

In New York City, summer doesn’t officially start until we hear the sweet calliope music pumping from the scratchy speakers of a Mister Softee ice cream truck. Kids bounce out of brownstones and off of playgrounds to grab a chocolate-vanilla twist.

But upstate, they’re looking at a whole new paradigm. The Veggie Mobile is bringing locally grown, healthy and AFFORDABLE produce to the people of Albany. Run by Capital District Community Gardens, the Veggie Mobile looks to serve folks not served by full-service grocers. The results look promising:

When compared to New York Supermarket — a small grocery in the poor Arbor Hill neighborhood of Albany — the Veggie Mobile offered dramatic savings, more selection and fresher options. Bananas sold for $0.99 a pound at the supermarket, but went for $0.59 a pound from the Veggie Mobile. Iceberg lettuce was $1 each at the mobile grocery, and $1.99 at the New York Supermarket. Cucumbers sold for $0.89 each at the neighborhood market, but were 3 for $1 from the Veggie Mobile.

The difference means that poor families cannot only afford and access fresh produce, but can buy more than if they relied on the neighborhood options.

Instead of going to a big chain grocery store each week, where volume sales and competition mean lower prices, families in urban food deserts and rural communities tend to rely on gas station convenience stores, or corner stores where milk, bread and other staples cost more.

For more ideas on how to put an end to food deserts and increase access to healthy foods, check out the PolicyLink Center for Health and Place.

For decades, advocates have been spinning their wheels trying to reduce health disparities. Health-care is a necessary but insufficient weapon in this battle, leading many to pursue environmental or place-based approaches to promoting health such as increasing access to healthy foods, improving air quality, and contributing to land use planning.

Now, lawyers across the country are joining this pursuit. A Boston hospital is using lawyers to demand accountability and fight for healthier living conditions for poor families. In Los Angeles, organizers are helping tenants living in unhealthy housing find legal counsel and press landlords to improve their rental properties. Strategies such as these are gaining traction and have been shown to reduce illness as well as time spent in a clinic or hospital for those who can least afford to be there.

Check out the embed player below for a recent story on Marketplace about the practice:

[MP3]

Below is an excerpt from a post I wrote for the Robert Wood Johnson Foundation’s Commission to Build a Healthier America Leadership Blog. To read the full post, click here.

The type of community we live in clearly has a tremendous impact on our health. That is why I am so excited and inspired to be a part of the Robert Wood Johnson Foundation’s Commission to Build a Healthier America. By shining a light on the way our economic, social, and physical environments affect our health, the commission is helping to expand our national discussion on health beyond just health care.

Those key environmental effects are never more clear than in the neighborhoods loaded with unhealthier food options. In an era when we are acutely aware of the effect of our diets on our overall health, we are leaving millions of Americans adrift in neighborhoods where healthy eating is next to impossible. For many people, food “choices” are really nothing of the sort. People must first have a broad and healthy set of food options in order to be able to make healthy choices.

To learn more about the Commission and its mission, visit www.CommissionOnHealth.org