Presentation to Inclusive Dubuque Network partners on 8/10/2016 about Double Up Food Bucks as strategy to reduce health disparities

1. What We Want
An informed community where all people are respected,
valued, engaged and treated fairly
INCLUSIVE DUBUQUE HEALTH EQUITY SECTOR GROUP IS
Working to bring an equity and inclusion lens to the health space in
Dubuque. Focusing on community-wide health conditions and resources that
support getting, being, and staying well

2. REDUCING HEALTH DISPARITIES
WHAT WORKS
Introducing Double Up Food Bucks as a tactic to reduce Health Inequity in Dubuque
Presented August 10, 2016 by Carolyn Scherf
Inclusive Dubuque Health Equity Working Group
Local Food Coordinator – ISU Extension & Outreach, Dubuque County

3. How it works

4. Bring your SNAP EBT Card to the Market Money Booth
On the corner of 12th & Iowa Street
Saturday morning Farmers’ Market
Open 7am-12pm
FREE BUS RIDES FOR SNAP CARD HOLDERS TO MARKET AVAILABLE

5. Buy any SNAP-eligible foods at the market with your
SNAP EBT dollars.

6. Double Up Food Bucks will match what you spend
with FREE Double Up tokens – up to $10, every
market day.
Use them right away or later on to buy locally
grown fruits and vegetables

8. Background: Equity & Health conditions in Dubuque
• Diet-related chronic diseases disproportionately effect low income individuals
• 57% of Inclusive Dubuque survey participants do not think healthy food is
affordable
Double Up Food Bucks: How it works & How it’s working
• Impacts so far in Dubuque (Pilot began in July 2016)
Will this really move the needle?
• Results in other communities
Call to action
How can network partners contribute to program success?

9. What We Know
Community Equity Profile
Diet Related Illnesses
Disproportionately
effect Iowans with
low household
income

10. WHAT WE KNOW About being and staying well
A diet rich in vegetables and fruits
can lower blood pressure, reduce
risk of heart disease and stroke,
prevent some types of cancer, lower
risk of eye and digestive problems,
and have a positive effect upon
blood sugar which can help keep
appetite in check.
-Harvard T.H. Chan School of Public Health
Dietary Guidelines For Americans 2015-2019

11. WHAT WE KNOW
Over 70% of Americans do not consume
the recommended amount of fruits &
vegetables
Dietary Intakes Compared to Recommendations. Percent of the U.S.
Population Ages 1 Year and Older Who Are Below, At, or Above Each
Dietary Goal or Limit
Local surveys have produced similar results – that
the majority of people in Dubuque are not eating a
healthy amount of fruits and vegetables
In 2010 77% of Dubuque County Survey respondents
reported eating fruit less than 3x per day in the
previous week. In 2012, 70% reported the same.
With vegetables in 2010 and 2012 79% of
respondents indicated eating vegetables less than 3x
per day.

12. What We Know
Iowa is now ranked dead last –
50th out of 50 states in fresh fruit and
vegetable consumption.
Gallop-Healthways Well-Being Index, 2016
Iowa is ranked 38th and 42nd in fruit
and vegetable production,
respectively.
USDA National Agricultural Statistics Service, 2009

13. Childhood Obesity Rate
Strongly correlated with povertyHas climbed from 12 to 27%
In schools with a majority of students eligible for free
& reduced priced lunch (and which are located in
USDA Food Desert Neighborhoods):
33-44% of students are overweight
(median 37%)
In schools with less than 65% of students eligible for
free and reduced price lunch:
11-33% of students are overweight
(median 28%)

14. INCLUSIVE DUBUQUE HEALTH EQUITY SECTOR GROUP IS
Working to bring an equity and inclusion lens to the health space in Dubuque
Community Equity Profile
FROM THE SURVEY
• While 76.21% of respondents believe that
fresh and healthy food is accessible in
Dubuque, 57% do not believe it is
affordable
FROM THE DIALOGUES
• Since it began accepting SNAP benefits as a
payment, the farmers market has become more
inclusive and has made healthy, local food more
accessible by all populations.
• While there is an abundance of fresh, healthy food
available, it may not be easy to access or affordable
for those with limited income or access to
transportation.

15. INCLUSIVE DUBUQUE HEALTH EQUITY SECTOR GROUP IS
Focusing on community-wide health conditions and resources that support getting, being, and staying well
STRATEGY
Increase availability and affordability of fresh healthy foods

16. How it works

17. Bring your SNAP EBT Card to the Market Money Booth
On the corner of 12th & Iowa Street
Saturday morning Farmers’ Market
Open 7am-12pm
FREE BUS RIDES FOR SNAP CARD HOLDERS TO MARKET AVAILABLE

18. Buy any SNAP-eligible foods at the market with your
SNAP EBT dollars.

19. Double Up Food Bucks will match what you spend
with FREE Double Up tokens – up to $10, every
market day.
Use them right away or later on to buy locally
grown fruits and vegetables

21. How it works – Behind the scenes
2015 – Dubuque created capacity for SNAP at Market with centralized EBT
Station – Over 50 vendors began accepting tokens (avg. 9 transactions
$160/week)
2016 – Local DUFB pilot programs coordinated by Healthiest State Initiative
in 6 Iowa Communities with technical support from Fair Food Network and
funding from the World Food Prize; Coordinated by Healthiest State Initiative
This Fall: FINI application will be submitted
2017- 2020 – Iowa communities eligible for up to $500K in matched federal
dollars – limited by what is promised as a local/state match. Can be used to
build capacity in existing pilot communities or expand to new markets.

22. 2015 – Dubuque created
capacity for SNAP at Market
with centralized EBT Station –
Over 50 vendors began
accepting tokens (avg. 9
transactions $160/week)

24. 2016 – Local DUFB pilot programs coordinated by Healthiest State
Initiative in 6 Iowa Communities with technical support from Fair
Food Network and funding ($25k) from the World Food Prize;
Coordinated by Healthiest State Initiative

25. 2016 – Local DUFB pilot program
July Impacts so far – (Spencer IA not included*)
Impacts: Month 1 (July 2016) Dubuque
Avg. 2015
Dubuque
Avg July 2016
Iowa
July 2016
Total # SNAP Transactions/week 9/week 24.4/week ~51.25/week
Total Value SNAP Transactions $167.12/week $206.40/week ~$721.8/week
Total Double Up Food Bucks
distributed
$0 $1,032 ~$2,163+
Total: July 2015:
$882
July 2016:
$2,064.00
July 2016
~$5,106.00+

27. 2017- 2019 – Iowa communities eligible for up to
$500,000 in matched federal dollars – limited by what
is commited as a local/state match for 2017-2019.
* Note to sponsors: Letters of Commitment needed by November 2016 *
Food Insecurity Nutrition Incentives Program (FINI)
Supports projects to increase the purchase of fruits and vegetables among low-income consumers participating in the
Supplemental Nutrition Assistance Program (SNAP) by providing incentives at the point of purchase. There are three
categories of projects:
(1) FINI Pilot Projects (awards not to exceed a total of $100,000 over one year);
(2) Multi-year, community-based FINI Projects (awards not to exceed a total of $500,000 over no more than four years);
and
(3) Multi-year, FINI Large-Scale Projects (awards of $500,000 or more over no more than four years).

28. Includes $31.5 million for FINI
Pilots of DUFB in 140+ communities across the U.S. were so successful
USDA is investing over $30 million in expanding similar programs

29. ?

30. Dubuque
Farmers’ Market
Goal:
$36,000
Statewide
fundraising goal
for Iowa:
$500,000

31. Will this really make a difference?
Diet
Related
Illnesses
Disproportionately
effect Iowans with low
household income
A diet rich in vegetables
and fruits can lower blood
pressure, reduce risk of
heart disease and stroke,
prevent some types of
cancer, lower risk of eye
and digestive problems, and
have a positive effect upon
blood sugar which can help
keep appetite in check.
-Harvard T.H. Chan School of Public Health

32. National Success Stories: Michigan

37. National Success Story: New Mexico
State funds help ensure program sustainability,
capture federal match
• 2015 $400K state funds allocated
towards food incentives + $100 K
federal funds
• 2016 – 2020: With the $400K
recurring state funds as committed
federal match, it is projected NM
DUFB will receive $500K of federal
funding per year, or $2 million total
• More than 75% shared that DUFB
was a strong incentive to shop at
farmers’ markets and that they
increased their purchase of fruits
and vegetables as a result.

39. Iowa is now ranked dead last –
50th out of 50 states in fresh
fruit and vegetable
consumption.
Gallop-Healthways Well-Being Index,
2016

42. Become a Program Sponsor
• Local and Statewide recognition opportunities
available
Join the DUFB Outreach &
Promotion working group
• Monthly meetings held to plan creative community
engagement

43. Sponsorship Needs
• This year: $5,500
• Promised by November - $30,000
• Opportunity to have this matched by USDA to = $60,000

44. Outreach & Promotion Needs
• How can we reach SNAP participants to make them aware of the
program?
• How can we make the Farmers’ Market welcoming to first time
market-goers?
• How can we ensure people are supported in learning to cook with
new foods?
If you’re interested in creative solutions to these questions – Join us!

45. Performance Measures
“Developing a shared measurement system is essential to collective
impact. Collecting data and measuring results consistently on a short list of
indicators at the community level and across all participating organizations not
only ensures that all efforts remain aligned, it also enables the participants to hold
each other accountable and learn from each other’s successes and failures.”

46. The Iowa Double Up Food Bucks program (DUFB) uses existing infrastructure
- farmers’ markets and the Iowa EBT card - to:
1. Improve access to and affordability of fresh fruits and vegetables for low-
income families;
2. Grow the local economy by supporting purchases from local farmers;
3. Shift public policy so that future federal (and state) nutrition assistance
programs can simultaneously address health, hunger, and nutrition and
support a more sustainable food system.

47. Things to consider:

48. { Shameless Plug }

49. Other upcoming events - Inclusive
Dubuque Health Equity Working Group