Valley Up: Creating Healthier Communities in California’s Central Valley


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Presentation given by Genoveva Islas-Hooker at the Session: "Raising A Healthier Valley: The Future Is Now" at the Great Valley Center's Annual Conference on May 6, 2010 in Modesto, CA.

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  • Good Morning, I am Genoveva Islas-Hooker. I am the regional program coordinator for the Central California Regional Obesity Prevention Program
    It’t my honor to be here to talk with you about CCROPP. The slides on this page are of our School farm stand in Pixley, the Greenfield Walking Group and the Farmer’s Market at Buroughs elementary.
  • Rural areas are remarkably poorer than these averages reveal….and many are primarily Latino.
  • In order to be successful CCROPP must work in context to the issues specific to our region.
    Food Insecurity
    Diverse Cultures and Languages
    Limited Resources
    Urban and Rural needs
  • In 2003, the percent of overweight and obese Valley teens was 15.2%. This is 3 times greater than the national objective of 5%.
    In 2003, the percent of overweight and obese Valley adults was 63.4%. This is more than 4 times higher than the national objective of 15%.
  • In 2003, the percent of overweight and obese Valley teens was 15.2%. This is 3 times greater than the national objective of 5%.
    In 2003, the percent of overweight and obese Valley adults was 63.4%. This is more than 4 times higher than the national objective of 15%.
  • Large scale situational inducement
  • 2008 zoning ordinance change
    Fresno City Ordinance on Farmer’s Markets revision now permits farmers markets in neighborhoods.
    Merced and Atwater Flea Markets (combined there are more than 6,000 visitors per weekend)
    Ceres Farmers Market
    Madera Farmers Market (has the highest WIC redemption rate in the state)
    Kern County Department of Public Health farmers market (first market to be certified on public health department grounds)
  • Farmers Market at Burroughs (first ever to open on Fresno Unified school grounds)
    Pixley Fruit and Vegetable Stand
  • Greenfield Walking Group transformed it’s now safer and more accessible for residents to enjoy recreational activities
    Cesar Chavez Leadership Program youth documented Stiern Park challenges, wrote a grant for new play equipment and received healthier, safer playground
  • Youth rebuilt park arbor to make their local park more inviting and more accessible
  • CCROPP sites have built partnerships with city and county planning departments
    CCROPP partners inform key stakeholders about the role public health plays in the built environment
    Inclusion of health elements in general plans
    Restricting fast food businesses
    Residential development to remain walkable/bikeable
  • George: Networking with peer cbo's and PH departments / technical experts / web / topical conferences / CA Convergence /
    The goal is to share a common understanding of what CCROPP as a policy and environmental change intervention, occurring in a natural environment entails in terms of its implementation and program impact expectations. It reports and draws on the experience of CCROPP Phase I.
    It includes
    The soft complex systems theory as its theory base
    An intervention model that involved several iterative steps
    c) An evaluation approach which emphasizes both process and short-term outcomes It also suggests process and short-terms outcome measures and starts a discussion on levels of change.
    It demonstrates community driven approaches, need to understand local institutions and suggests that several local conditions may have shaped program implementation at each site.
  • Improve Daily Living Conditions
    Tackle the Inequitable Distribution of Power, Money and Resources
    Equity and Justice
    Promoting the sales and consumption of more fruits and vegetables is linked to economic development for our region – green jobs.
    Increasing healthy food outlets and access to physical activity space is linked to greater community safety, increase community cohesion and community ownership.
    Designing communities for walking/biking and not driving supports air quality improvement and abates climate change.
    The social determinants of health are mostly responsible for health inequities - the unfair and avoidable differences in health status seen within and between countries.
  • for me, the most striking thing in our research, is that the inequalities in health and quality of life we observe through mortality data, chis, systematic observation....
          the communities at greatest risk for obesity face a compilation of health challenges: infrastructure, housing, air, water, rec potential, job prospects, unfair marketing etc.....and a consistent pattern of worse health outcomes...
          white, affluent, suburban neighborhoods dont....the solution isnt to build more of these suburban neighborhoods....but in recognizing that building them is a major contirbutor to the poor health elsewhere
    our poor overall health performance compared to CA and nation: about how we live and how we get care......
    may 26 event Place Matters: SJV Regional Equity Forum
    basically, i think we have been making the same its hard to think what to say
  • Valley Up: Creating Healthier Communities in California’s Central Valley

    1. 1. Valley Up: Creating Healthier Communities in California’s Central Valley Presented by: Genoveva Islas-Hooker, MPH Regional Program Coordinator, CCROPP Great Valley Center Annual Conference
    2. 2. California’s Central Valley  Central California stretches almost 300 miles.  It’s home to more than 3.8 million residents. The population is expected to more than double 2050.  Our families represent over 70 ethnicities and speak over 105 languages making it one of the most culturally diverse areas in California and the nation.
    3. 3. Poverty in Central California  Annual unemployment rate is almost 2x greater than the unemployment rate for California.  21.7% of our population live below 100% of the FPL, the average rate in California is 15.5%  More than 1 in 4 of our children live in a household whose income is below 100% of the FPL.
    4. 4. The Paradox  Within our valley lies one of the largest and richest agricultural regions in the world.  Families still struggle to put food on their tables. "It's ironic that those who till the soil, cultivate and harvest the fruits, vegetables, and other foods that fill your tables with abundance have nothing left for themselves." -Cesar Chavez
    5. 5. Overweight & Obesity  1 out of 3 children, <12 years of age, are overweight and obese  17.2% of adolescents, ages 12-17, are overweight and obese  64.3% of adults, ages 18-64, are overweight and obese  62.9% of adults age 65 and over are overweight and obese Source UCLA Center for Health Policy Research, 2003; 2007; 2009
    6. 6. Overweight & Obesity by Age Group, San Joaquin Valley and California, 2001, 2005 and 2007 County Ages 12-17 Ages 18-64 Age 65+ 2001 2005 2007 2001 2005 2007 2001 2005 2007 Fresno 14.1% 19.8%* 24.7% 65.0% 56.7% 63.3% 55.3% 64.7% 66.2% Kern 7.7%* 9.6%* 6.5%* 61.4% 66.9% 60.1% 50.8% 62.1% 62% Kings 16.3% 7.5%* 17.7%* 63.5% 62.9% 64.9% 58.0% 70.3% 68.7% Madera 11.5%* 4.8%* 27.1%* 66.1% 64.5% 67.6% 58.6% 60.8% 68.5% Merced 18.2%* 12.5% 17.1%* 67.4% 66.8% 67.6% 67.2% 65.5% 65.6% San Joaquin 17.9% 12.2%* 15.0%* 66.9% 71.6% 65.7% 62.3% 59.7% 61% Stanislaus 12.9%* 17.0%* 17.0%* 62.8% 67.2% 64.7% 53.4% 63.0% 51.7% Tulare 7.6%* 21.10% 20.7%* 71.0% 66.5% 68.3% 56.1% 63.8% 69.5% San Joaquin Valley 12.8% 15.5% 17.2% 65.1% 65.0% 64.3% 56.5% 63.0% 62.9% California 12.2% 14.2% 13.3% 55.% 56.2% 57.2 54.3% 55.7% 58.3% Healthy People 2010 Objective 5.0% 5.0% 5.0% 15.0% 15.0% 15.0% 15.0% 15.0% 15.0% Source UCLA Center for Health Policy Research, 2003; 2007; 2009 * Statistically unstable
    7. 7. Working Together  Grassroots Community Members, including youth  Community Based Organizations including Fresno Metro Ministries, Kern County Network for Children, Livingston Medical Group, Community Partnership for Families of San Joaquin, Ceres Partnership for Healthy Children and Tulare County Nutrition Collaborative  Public Health Departments in Fresno, Kern, Kings, Madera, Merced, San Joaquin, Stanislaus and Tulare counties  California State University, Fresno
    8. 8. Central California Regional Obesity Prevention Program Kern Kings Tulare Fresno Madera Merced Stanislaus San Joaquin Regional
    9. 9. Our Approach We believe that in order for community members to eat healthier and be active they need the environmental context and policy support to practice these behaviors.
    10. 10. Assessment  How easy is it to eat healthy?  How easy is it to be physically active? Challenges  Limited access to healthy foods. • Cost, availability and convenience of fast food, distance/transportation  Limited opportunities for physical activity. • Safety, air quality, heat, closed green space, no park or limited use parks, loose dogs
    11. 11. Community Driven Logic Models & Work Plans State Region County Local Community-Driven
    12. 12. Access to Healthy Food Maximizing EBT & WIC at Alternative Food Outlets  Merced and Atwater Flea Markets  Ceres Farmers Market  Madera Farmers Market  Kern County Department of Public Health farmers market
    13. 13. Access to Healthy Food School Farm Markets/Stands  Farmers Market at Burroughs Elementary School  Pixley Elementary School Fruit and Vegetable Stand
    14. 14. Access to Healthy Food Small Store Conversion  Youth in Kettleman City transformed their only small store , the Hla Hla Market. Good quality affordable produce is now available.
    15. 15. Opportunities for Physical Activity Making Parks Safer  Stiern Park, Bakersfield, CA • Greenfield Walking Group • Cesar Chavez Youth Leadership Program
    16. 16. Opportunities for Physical Activity Improving Park Amenities  Pixley Park Pixley, CA • Soccer Goal Posts • Youth rebuilt park arbor
    17. 17. Opportunities for Physical Activity Built Environment  Inclusion of health elements in general plans • Include accommodations for complete streets; walking, biking, etc…
    18. 18. Institutional Change Worksite Wellness  Policies center around the • Healthier food choices (removal of unhealthy items from vending machines) • Promotion of increased physical activity • Promotion of breast- feeding
    19. 19. Unexpected Successes  San Joaquin Valley voice & identity influencing/informing statewide & national work in the field.  Grassroots Community Leadership (Assets not liabilities)  Increase Community Cohesion  Immigrant Integration  Increased Civic Participation
    20. 20. Some Lessons Learned Obesity Prevention through policy and environmental change:  is intensive and takes time – don’t rush it.  necessitates relationship building across stakeholders – find your allies, transform your opposition.  requires a deep level of community engagement – kitchen table work by candlelight  grassroots leadership development is fundamental to sustainability.  requires educating decision makers and persuading them to act - grassroots advocacy & mobilization.  should be community driven- they are the experts!
    21. 21. Social Determinants of Health The social determinants of health are the conditions in which people are born, grow, live, work and age, including the health system. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels, which are themselves influenced by policy choices. – Commission on Social Determinates of Health
    22. 22. For more information… Genoveva Islas-Hooker, MPH Regional Program Coordinator 1625 E. Shaw Avenue, Suite 106 Fresno, CA 93710 p: 559.228.2142 f: 559.228.2149 visit us at
    23. 23. Thank you! This project is funded by
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