Public Procurement of Food and Healthy Communities

By Greg Cook

Public purchasing by institutions such as schools and hospitals is big business. It is also a crucial part of strategies to roll back increasing levels of chronic diseases.

Leaders from both the public and private sectors have begun to consider the role public procurement of food plays in nutritional health among populations of students and others fed through publicly-funded means. The Kaiser Permanente Institute for Health Policy (IHP) puts it this way: “The food system is a key pathway to individual, public and global health—above and beyond basic nutrition.” Re-assessing the procurement process can have many benefits, including improved nutrition for consumers, reduction of public health scares involving pathogens such as salmonella, decreased pollution, and a decrease in health inequalities for at-risk populations and minorities.

Companies in the private sector are showing some ways in which procurement can be re-thought. Walmart has been making efforts to purchase more locally-sourced and organic foods. Chipotle Mexican Grill is guided by its corporate philosophy of “food with integrity” in reaching outside the existing supply chain to buy humanely-raised and drug-free meats.

There is also movement in the public sector. Washington State has instituted a farm-to-school food program that encourages schools to purchase food from nearby producers. Another aspect of this program is a set of pilot projects at state prisons to serve food grown by inmates.

Current issues of procurement arise, ironically, from past success in standardizing and efficiency. The massive scale of much procurement has led to small and/or local suppliers being shut out of the process. The growth of huge supply chains has also interacted with fluctuating transportation costs.

The Healthiest State Campaign and the Washington State Department of Health are working to bring together concerned private and public advocates from business, philanthropies, non-profits, and government to talk about ways to improve the public procurement process and work on other issues. This Healthiest Communities Partnership seeks to enlist interested partners from throughout the state to make our state a healthier state and our communities healthier places to live, raise families, and do business.

For more information on the Healthiest Communities Partnership click here.

After the School Day

By Greg Cook, WHF Associate

For far too many students across our state, the end of the school day means the start of problems such as overeating, lack of exercise, excessive media exposure, and use of tobacco products. All these negative behaviors can lead to health problems among our young people—tomorrow’s leaders, work force and defenders. But there are efforts underway in both the private and public sectors to push back against unhealthy trends and ensure Washington communities are places fro healthy kids.

Last month in Tacoma, the Boys and Girls Clubs opened the Donald G. Topping Regional HOPE Center, a place for children to learn and play outside the school day. The HOPE Center, along with a new East Side satellite branch and existing facilities, offer opportunities for youth to get after-school tutoring and enrichment, participate in healthy physical activity, and take advantage of the presence of trained listeners. HOPE was funded in large part by private philanthropies and businesses: “the Ben B. Cheney Foundation, the Gary E. Milgard Family Foundation, and. . .Tacoma businessman Henry T. Schatz (and his General Plastics Manufacturing Co.) and the late Donald G. Topping,” according to The News Tribune.

In the public sphere, the Department of Health and Human Services (HHS) offers its afterschool.gov site to bring together resources for after school programs. It offers guidance on setting up and running after school programs, activity ideas, resources, and links to related topics and non-governmental organizations. The HHS site includes state by state information as well as reports; the WA page can be found here.

The Healthiest State Campaign together with the state Department of Health is working to promote a statewide private-public partnership that may identify positive after school trends as part of the Healthiest Communities Partnership. The partnership aims to make healthy choices the easy choices across Washington.

For more information on the Healthiest Communities Partnership, click here.

Community Gardens as Antidotes to Isolation

By Greg Cook, WHF Associate

Across the nation, more and more people are re-discovering gardening. Some do it to become self-sufficient, while others are concerned about food coming from far-away places. Neophyte gardeners are learning about planting, maintenance, harvesting, nutrition, and preservation. A related trend is the rise in community gardening. Networks of neighbors are pitching in to make vacant spaces in the urban landscape sources of bounty for families and individuals. Sometimes these community gardeners get assistance in the form of small grants, in-kind services or technical advice/expertise from municipalities and/or non-profits.

An example of that in our state is Tacoma’s 2010 initiative to help community gardens throughout the city. Tacoma partnered with The Tacoma-Pierce County Health Department, Pierce Conservation District, and Cascade Land Conservancy to hire a full-time community garden coordinator. A column from The News Tribune tells some of the story behind that position what it entails. Coordinator Kristen McIvor reports that there is widespread enthusiasm for the gardens, but not just for the obvious reasons. While growing nutritious local food would be an obvious result of the gardens, for many community gardeners “getting to know their neighbors” was important, McIvor said. That anecdotal evidence reinforces research that isolation has an impact on individuals in our society. Community gardens are a way for people to voluntarily get together to accomplish a common task and build local bonds of trust and cooperation while engaging in healthy activity.

An example of the possible links between isolation and chronic diseases comes in the field of immigrant health. Public health workers have found that many immigrants are in good health when they arrive in the U.S., but that their health can often decline as they live here and become acculturated in their communities if residence. Researchers believe one reason for health declines is the stress on family life and social networks. Immigrants typically come from vibrant families, but long hours of work fray those connections. In the film “Unnatural Causes,” one girl tells that when her family lived in Mexico, her mother was at home when the children returned from their school day. But in the U.S., her parents work long hours to support the family and arrive home hours after their children. Fortunately for that family, their community offers a welcoming place for children to come for recreation and tutoring after school. Many school-age children do not have healthy alternatives.

The Washington Health Foundation and the state Department of Health are reaching out to the private and public sectors to look at these issues and join together to fight chronic disease across Washington. It is all about exploring together the best ways to make healthy choices about diet, exercise and tobacco the easy choices.

To learn more about the Healthiest Communities Partnership, click here.

Good News for Employee Wellness Programs

By Robin Brown and Greg Cook, WHF Associates

Cost-conscious employers looking to help their employees and be more productive may find that investing in workplace wellness is one piece of the puzzle. Earlier this year Bloomberg Businessweek reported on a new study unveiled at a meeting of the American Heart Association's Nutrition, Physical Activity and Metabolism Conference. That study showed promising results for “a voluntary 12-week, team-based wellness program that focused on diet and exercise.” A growing number of studies show that workplace wellness—when correctly targeted, planned, and managed—can help employees attain better health and employers see lower rates of absenteeism.

Another piece of good news on this front is the inclusion of workplace wellness funding and incentives in the federal Patient Protection and Affordable Care Act. The largest benefits for small businesses in terms of wellness programs come from the authorization of grants to be issued for up to five years for small businesses (defined as businesses employing under 100 workers that are working over 25 hours each week) to create new, comprehensive workplace programs. Eligible businesses are those that, as of March 23, 2010, did not already have workplace wellness programs in place. Such programs must include health awareness initiatives, efforts to expand employee participation to the highest degree possible, programs such as counseling and self help programs that promote healthy lifestyle choices and discourage unhealthy choices. Programs must also take place in a work environment that is considered supportive due to policies that promote healthy choices.

An additional change that comes under this bill requires the CDC to provide businesses of all sizes with resources in the form of technical help, tools, and consultations that will help the employers assess their wellness programs. A nationwide assessment of wellness programs will also be undertaken by the CDC and will result in recommendations to congress for guidelines for the most effective means of implementing employee wellness programs. Finally, the bill allows for an increase in incentives employers can offer for participating in wellness programs and for meeting health goals. It increases the amount from twenty to thirty percent of the cost of coverage and provides that these incentives can be offered as rebates or discounts. This amount may eventually be raised to fifty percent after a study is conducted by the Secretaries of Labor, Health and Human Service, and the Treasury. In the case that employees are at a particular disadvantage for meeting the health goals an alternative standard must be offered.

Encouraging workplace wellness is one more way that healthy choices can be the easy choices. The Healthiest State Campaign in collaboration with the Washington State Department of Health is bringing together a public-private partnership to promote ways to fight chronic diseases across the state. For more information on the Healthiest Communities Partnership, click here.

Chronic Diseases and Minority and Low-Income Communities

By Greg Cook, WHF Associate

Chronic diseases are found in all groups of people of all different races and income levels. However, minority and low-income groups represent a disproportionate number of those suffering from chronic diseases linked to poor nutrition, lack of physical activity, and tobacco use. The federal Centers for Disease Control (CDC) and Washington State are both addressing the health disparities found in minority communities.

Now local efforts to improve health within minority communities seem to be bearing fruit. The REACH coalition of Public Health—Seattle and King County has been working to reduce levels of diabetes in high-risk communities. The Seattle Times reports on one Mexican restaurant owner who—concerned for both his personal and community health—worked with REACH to provide a healthier menu for his patrons. Growing awareness of the costs of chronic disease among minority communities and business owners coupled with technical assistance from local public health experts is proving to be a winning combination in reducing health disparities and improving health for all of our state’s residents. Restaurant owner Ramiro Rubio recognized the possible took advantage of public health’s nutritional expertise to use more healthful ingredients to replace some of the less-healthy starches and fats. He and a nutritionist worked together to balance concerns about elements like flavor, amounts of carbohydrates, and traditions such as chips and salsa on every table. Rubio is trying to make a small contribution to the health of his community while acknowledging the deep rootedness of food habits within a culture.

Foods once considered “ethnic” are moving into the mainstream. One example of this trend is the fast-growing national chain Chipotle Mexican Grill, which operates on a “food with integrity” philosophy to serve its customers locally-sourced and nutritionally sound products. Chipotle has gone outside the standard mass-procurement model to locate and work with producers of meat, poultry, and other foods who eschew the industrial style models that prevailed for decades. Leaders in the effort to get a broader range of healthy nutritious foods to the public and especially populations in public institutions are considering alternative methods of food procurement.

Minority and low-income communities may be especially prone to chronic disease due to lack of access to a full range of nutritional food and healthy activities. The CDC’s approach to pushing down chronic disease takes into consideration those factors and uses a range of “MAPPS” strategies: Media, Access, Point of decision information, Price, and Social support/services. The Washington Health Foundation (in collaboration with the Washington State Department of Health) is guided by MAPPS in its Healthiest Communities Partnership, a public/private partnership to reduce chronic disease across Washington state and throughout all its communities.

To find out more about the Healthiest Communities Partnership click here.

Smoking Cessation Efforts for American Indians in Washington

By Coral Sisk, WHF Associate

More than 160,000 people in Washington State identify themselves as American Indian or Alaska Native. While some are members of the 29 federally-recognized tribes and live on reservations across Washington, approximately two-thirds live in or near cities such as Seattle, Tacoma, and Spokane. In Washington roughly one third of American Indians smoke commercial tobacco [1]. They also suffer from chronic diseases, such as cancer, diabetes and heart disease, at a much higher rate than the general population [2].

Tobacco cessation and prevention programs are effective and important ways to reduce the rates of chronic disease. Currently, American Indian communities across Washington are receiving funds from various sources to help them develop effective and sustainable tobacco prevention programs. These include:

• The Washington State Tobacco Prevention and Control Program, administered by the Department of Health, is currently providing $635,000 to 19 tribes, the Seattle Indian Health Board, and the American Indian Health Commission to reduce commercial tobacco in American Indian communities.
• Tribes operating gaming casinos in Washington State are required by gaming compacts to provide a percentage of their revenues on smoking cessation and prevention. For 2009 and 2010 combined, tribal casinos used over $3 million to groups around the state to discourage tobacco use. Approximately 70 percent of these funds were distributed to support Tribal smoking cessation and prevention efforts [5].
• The state Department of Health received federal stimulus funds to help addictions and mental health treatment centers to integrate tobacco cessation into their treatment plans and create tobacco free facilities. Many of the treatment centers receiving this training and technical assistance serve tribal and urban Indians [4].

The Healthiest State Campaign with help from the Washington State Department of Health is reaching out to American Indian and other communities across the state to build a broad-based public/private partnership to prevent chronic diseases. It is all about exploring together the best ways to make healthy choices about diet, exercise and tobacco the easy choices.

To learn more about the Healthiest Communities Partnership, click here.

Sources:

1. Washington State Department of Health Tobacco Use Statistics: http://www.doh.wa.gov/tobacco

2. Northwest Area Indian Health Board Statistics: http://www.npaihb.org/programs/project/nttpn_data_statistics/

3. Indian Country Today News: http://www.indiancountrytoday.com/living/health/80266097.html

4. U.S. Dept. of Health & Human Services: http://www.hhs.gov/news/press/2010pres/02/20100205a.html

5. Washington State Gambling Commission: http://www.wsgc.wa.gov/agendas/archives/2010/jul_tribal_contributions_presentation.pdf

Quality School Physical Education Leads to More Active Kids

By Adam Nelson, WHF Associate

According to Washington State standards, students in grades 1-8 must participate in 100 minutes per week of Physical Education (PE). But a 2009 study by the University ofWashington Center for Public Health Nutrition says that the average 7^th grader takes part in 50 minutes per week of PE, and only 7 minutes of aerobic activity per PE class. Improving the quality of physical education by maximizing the quantity, enjoyment, knowledge and physical abilities for youth, is an important step toward increasing the overall physical activity children level of children in Washington.

There has been innovation in PE coming from the private sector. One company, HOPSports, developed a system to improve the quality of physical education that is now used at three sites in Washington including Camas High School. To improve traditional PE, HOPSports system is a pre-package set of video PE lessons, tailored to meeting national physical education standards. The PE teacher can choose videos based on their goals for specific lesson plans. In addition to lessons which lead students through a 10-30 minute exercise routine, the warm-up videos provide health education on topics of anti-smoking, nutrition, and the environment.

A 2008 case study of 16 North Carolina schools that implemented the program found that compared to traditional PE courses, physical activity class time increased by 45 percent, student enjoyment of PE increased significantly, and students' intent to be physically active outside of class also increased. By implementing fun innovative ways to engage a broader base of students, it makes sense that children will be more physically active.

Programs like HOPSports and SPARK are just one way to increase the quality of physical education in Washington. Moving forward on PE is only one reason the Healthiest State Campaign is teaming up with the state Department of Health to promote a new public/private Healthiest Communities Partnership. We want to make healthy choices, like regular physical activity, the easy choices in our state.

To learn more about the Healthiest Communities Partnership, click here.