2012 ASFS/AFHVS/SAFN Conference Global Gateways and Local Connections: Cities, Agriculture, and the Future of Food Systems Carolyn Zezima, Director of Food and Nutrition Initiatives, Communities IMPACT Diabetes Center at Mount Sinai School of Medicine Despite increasing recognition that fresh, healthy, local foods are scarce in low-income communities, and the creation of a number of healthy food initiatives targeting these communities, historically underserved communities still lack novel, profitable, and sustainable businesses that supply healthy, affordable and taste-satisfying foods. Bringing together the business and public health sectors, Communities IMPACT Diabetes Center at Mount Sinai School of Medicine invited business students to submit concepts and plans for viable, market and community-driven business solutions to one of our most pressing public health needs: healthy, affordable food in underserved communities. The proposed enterprises must have served communities with limited availability to healthy foods, be tailored to the particular assets and challenges in the communities, and must be developed in consultation with target communities. Proposals were judged by a panel of experts in business, food and local government. Teams competed for $25,000 in start-up funds and other business support services.

1. Food For Health Business Plan
Competition
Engaging social entrepreneurs in community-
based participatory solutions to food system
and public health challenges
June 21, 2012
Global Gateways and Local
Connections: Cities, Agriculture, and
the Future of Food Systems
NYUSteinhardt

2.  1 of 18 Racial and Ethnic Approaches to Community Health (REACH)
centers in the nation, funded by the Centers for Disease Control &
Prevention
 Emphasis on reducing and eliminating racial/ethnic health disparities
 Rooted in community-based participatory approaches; a collaboration
between academic researchers, representatives from local organizations, and
community residents
 Goal: To address diabetes disparities among African Americans and Latinos
with or at risk for diabetes first locally in East Harlem, then more broadly in
similar urban communities
 Mission: To prevent and control diabetes by empowering multicultural
communities to live healthy lives, create a healthy environment, and mobilize
change.
Communities IMPACT
(Inspired and Motivated to Prevent And ConTrol)
Diabetes Center

3. Health Disparities and Access to Healthy Foods
Poor neighborhoods have higher rates of obesity and
more diabetes-related deaths and heart disease than
more affluent neighborhoods
• Children from low-income families are twice as likely to be
overweight as those from higher-income families.
• Almost 1 in 5 African American children, and almost 1 in 4
Mexican American children is obese, compared to one in ten
white children.
• Approximately 1 out of every 6 adults in East Harlem has
diabetes compared to the national rate of 1 in 12.
Source:“Healthy Food, Healthy Communities: Promising Strategies to Improve Access to
Fresh, Healthy Food andTransform Communities,” PolicyLink (2010)

4. Health Disparities and Access to Healthy Foods
Adults living in counties
without supermarkets were
23% less likely to meet
guidelines for daily fruit and
vegetable consumption than
adults living in counties with
supermarkets.
Source: “Healthy Food, Healthy Communities: Promising Strategies to Improve Access to
Fresh, Healthy Food and Transform Communities,” PolicyLink (2010)

5. Health Disparities and Access to Healthy Foods
• African Americans living in an area with a supermarket are more likely
to meet federal guidelines for fruits and vegetable consumption--and for
each additional supermarket, produce consumption increased by 32
percent.
• Adding a new grocery store to a neighborhood translated into an
average weight loss of three pounds for adults in that community.
• NewYorkers and Californians living in areas with more fresh food
retailers, along with fewer convenience stores and fast food restaurants,
have lower rates of obesity.
Source:“Healthy Food, Healthy Communities: Promising Strategies to Improve
Access to Fresh, Healthy Food andTransform Communities,” PolicyLink (2010)

6. Case Study: East Harlem
EH UES
Non-White 90% 6%
Living in Poverty** 38% 7%
Less Than HS Education** 46% 5%
Medicaid Recipients 41% 3%
Think Neighborhood is Unsafe* 58% 7%
Rate Health Poor/Fair** 30% 10%
No Physical Activity 27% 18%
Obesity Prevalence* 31% 7%
Diabetes Prevalence** 15% 2%
Diabetes Death Rate/1000* 54% 10%
Preventable Hospitalization/1000* 45% 7%
All Cause Mortality/1000* 10% 7%
* = EH Has Highest Rate in NYC
** = EH Has Highest Rate in Manhattan
Source: NYC DOHMH NYC Community Health Profiles, 2003; 2nd Edition, 2006

7. Healthy Food Availability
East Harlem vs. Upper East Side
18
58
0
20
40
60
80
100
EH UES
% Stores with 5
healthy food items
Source: Horowitz et al, “Barriers to Buying Healthy Foods for People With
Diabetes: Evidence of Environmental Disparities. “ American Journal of Public Health, Sept. 2004.
Availability of recommended foods
EH UES
Total # of Stores 173 151
% low-carbohydrate
or high-fiber bread 32 74
% with low- or nonfat milk 49 92
% with fresh fruit 74 90
% with fresh green vegetables 60 76
% Desirable stores
(stores that carry all
five recommended food items) 18 58

8. Food For Health Business Plan Competition
Despite increasing recognition that fresh, healthy, local foods are scarce in
low-income communities, and the creation of a number of healthy food
initiatives targeting these communities, few successful examples of healthy
food businesses exist that:
 meet current local demands,
 market to expand demand and market share, and
 demonstrate financial feasibility and success.
 To date, many well-meaning healthy food efforts have not successfully
appealed to cultural needs and preferences, or the economic realities that
go into making daily food choices and feeding a family.

9. Food For Health Business Plan Competition
Public health initiatives need robust engagement with the business
community to tap into its entrepreneurial agility to tailor businesses
to the specific tastes, needs and demands of a local underserved
community.
We looked for food enterprises that:
1) Serve communities with limited availability to healthy foods
2) Are tailored to the particular assets and challenges in the communities,
and
3) Are developed in consultation with target communities.

10. Food For Health Business Plan Competition
Challenge
To transform how healthy foods are marketed,
distributed, and sold in underserved communities

11. Food For Health WinningTeam
• $25,000 in start up funds
• A suite of strategic management, marketing
and other consulting services from leading
business and food systems experts to further
develop their business plan.

12. Our Partners
 Centers for Disease Control and Prevention/REACH
U.S.
 Wallace Center/Healthy Urban Food Enterprise
Development
 James Beard Foundation
 CRT/tanaka
 Karp Resources

13. >Year-long Process
Pre-Contest
Engagement
Engage business schools/save
the date
Develop guidelines/criteria
Web site/promote
Recruit judges and mentors
Develop Webinar for
prospective entrants
Contest
• Contest “begins” with
submission of Food
Enterprise Summary
• Elimination/attrition
• Full Business Plan Round
• Five finalists chosen
• Finals
presentation/winning team
chosen
Incubation
• Mentorship
• Deliverables
• Payment of start up funds

14. Food Enterprise Summary Components
1. Business Name
2. Contact Information
3. Food Business Concept (25 percent)
a. Target location or community
b. Current food options
c. Proposed product or service
d. Potential customers
4. Business Model (15 percent)
a. Capital
b. Revenue
c. Growth and replication
5. Community Partnership (5 percent)
a. Government and community-based
organizations
b. Business or trade associations,
marketing programs, government or
neighborhood incentive programs
6. Analysis of Competition (20
percent)
a. Competitors
b. Competitive advantage
7. Impact on Healthy Food Access (15
percent)
a. Assessing food access
b. Measuring impact
8. Management (20 percent)
a. Management team
b. Qualifications
c. Key skills to acquire and strengthen
d. Entry strategy

15. Business Plan Components
1. Business Name
2. Contact Information
3. Executive Summary
4. Food Business Concept and
Impact (20 percent)
a. Product and service description
b. Location
c. Pricing
d. Target Customers
e. Impact
5. MarketAnalysis and Plan (20
percent)
a. Market size
b. Potential customer and community
feedback
c. Bringing your product or service to
market
d. Partnerships – Letter of Support
6. Competition (15 percent)
a. Competitors
b. Competitive advantage
7. Financial Projections (20
percent)
a. Capital
b. Sales projections, Operational
P&L, 5Year Cash Flow
c. Growth plan
8. Operations and Management
Plan (20 percent)
a. Management team
b. Success and risk factors
c. Key milestones
9. Appendices

16. Expert Reviewers
Sarah Brannen, Vice-President for Research and Policy, Pattern for Progress
Erica Dorn, Business Development Officer,ACCION USA
Larry Feldman, Workshop in Business Opportunities (WIBO)
Jeff Merrill, Associate Director, Northwestern University, School of Education
and Social Policy
Debbie Myers, ExecutiveVice President , CRT/Tanaka NewYork
Cathy Nonas, Director, Physical Activity and Nutrition Programs, New
York City Department of Health and Mental Hygiene
Ellen Simon, former Executive Director, Union Settlement Association
AlexaVan DeWalle, Lighthearted Locavore
Zac Zeitlin, President, ZZVentures

17. Three Rounds
Food Enterprise
Round
Using school kitchens after
lunch-hours to prepare
ready-to-eat, take home
meals for students and their
families
Make-at-home meal kits for
grocers and convenience
stores
Healthy corn chips
Casual egg restaurant
Cooperative grocery
Whole grain baking
company
Mobile markets of various
stripes
Business Plan
Round
Who was
eliminated/fell by the
wayside?
Finals Round
Actual Food
BellTower Foods
Fresh Routes
Respect For Life
Twice-Spiced Grill

18. Viability – likelihood to succeed based on concept, market,
model, and management
 Innovation – the concept, model, and partner engagement show
innovation in healthy food business planning and implementation.
 Impact – likelihood of positive short- and long-term impacts on
the availability of healthy food options and consumption of healthy
foods in the target community
HowTeams Progressed

19. Food for Health Finals
April 12, 2012
Mount Sinai School of Medicine

20. The Judges

21. Actual Food

22. BellTower Foods

23. Fresh Routes

24. Respect for Life Gardens

25. Twice-Spiced Grill

26. Congratulations, Fresh Routes!

27. Food for Health Mentors
 Legal concept basics/due diligence
 Entrepreneurship and business planning:
 Governmental affairs and economic incentives
 Community engagement
 Microfinance and crowd-funding
 Organizational change and business plan development
 Food marketing and P.R.
 Food enterprise technical assistance
 Financial opportunities, attracting capital and socially-
minded investors

28. Food for Health Mentors
Mentorship guidelines
 Attend Finals Competition, if
feasible.
 Read Food Enterprise Summary
and Business Plan
 Draft list of questions for team
and any assignments that may be
helpful to move along
 Define the parameters of the
mentor-mentee relationship and
what you are willing to commit to in
terms of time and knowledge-
sharing.
 Execute Mentoring Agreement
Form with winning team.
 Participate in at least one
conference call with IMPACT staff to
discuss progress of business and
teams’ efforts.
 Contact IMPACT staff, as needed,
for technical assistance and any
issues that require troubleshooting.

29. Incubation/ “Deliverables”
 Attend Kick off and monthly meetings (in person or by conference call) with IMPACT staff
 Execute mentoring agreement with Food for Health mentors, as applicable, and submit signed copy of
agreement to IMPACT
 Create 3-month and 6-month progress goals towards implementing business plan and creating viable
food enterprise
 Initiate and schedule regular meetings with Food for Health mentors and community partners as
appropriate to move project forward;
 Create agenda for all meetings with mentors and community partners, including any pending or new
tasks and target dates for completion, questions for mentors, drafts of documents for their review;
 Take advantage of any opportunities and resources presented by the mentor and complete any
commitments and goals set during the mentoring sessions;
 Submit monthly progress reports to IMPACT, including:
 Agenda and minutes or summaries of any meetings with Food for Health mentors and
community partners
 Any change in organization team and name and contact information of any new team members
 Summary of business research and planning materials
 Copies of pertinent documents,such as agreements, corporate filings, letters, and
 An accounting of award funds spent to date.

30. Lessons Learned
 More direct contact with business schools
 Funding one business but fostering multiple social
entrepreneurs
 How to screen out token business students—is goal to
finance businesses or to engage future entrepreneurs in
public health and food system?
 Judges reading more business plans
 Shorten criteria
 Community partnership is the common denominator
supporting viability, innovation and impact – it may not be a
viable idea if you can’t get community buy-in.
 Build in an evaluation/impact component

31. Progress to Date
Monthly reporting on track
Three and six month goals drafted
All mentors engaged
First funds released
More from Fresh Routes on their perspective on
process and success next

32. Evaluation Ideas?

33. Thank you and Good Luck to
Fresh Routes!

34. Food for Health Presentation
April 12, 2012
Sarah Frank, Rachel Koffman, Margaret Tung, & Josh Wessler

35. Concept to Reality
IdeationCompetition Realization
• Fall 2011: Food for Health
announces competition
• Josh Wessler and Margaret Tung
begin to discuss ideas, decide to
work towards competition goals
• Rachel Koffman and Sarah Frank
join the team
• Each member of the team brought
different prospectives and various
levels of business and subject
expertise:
•Josh: Food Bank of NYC, food pantry
developer and coordinator for Memorial
Sloan Kettering
•Margaret: small business/startup operations
and food policy experience
•Sarah: nutrition educator at HealthCorps,
experience w/Harlem teenagers
•Rachel: MPH and in process business degree
at Brandeis
•What are we passionate about?
•Fresh Routes!!!
• Food for Health = $25,000 and
mentor development
• Marketing and business startup
guidance
• Resources to prototype and
test our MVP
• Launch/pivot

37. The fresh routes model

38. Shopping experience