A FRAMEWORK FOR ADDRESSING HEALTH DISPARITIES: WATTS HEALTHY FARMERS

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A FRAMEWORK FOR ADDRESSING HEALTH DISPARITIES
WATTS HEALTHY FARMERS MARKET

• Elaine G. Williams, Ph.D., R.D
• Program Director
• Baptist Ministers Conference/
• Baptist Church of the New Covenant
• Norwalk, California

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PRESENTATION OBJECTIVE

• Describe the steps in planning and implementing a
  community centered farmers market in partnership
  with community leaders, healthcare providers,
  faith based organizations, and governmental
  agencies.

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Watts Healthy Farmers Market Collaborative
Project

• Formed in 2003
• Kaiser Permanente initiated farmers markets in
  two Kaiser facilities in Northern California
• Kaiser/Watts Counseling and Learning Center met
  with staff of Los Angeles County Department of
  Public Health to discuss feasibility

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Participating Agencies

• King Drew Child Development Program
• LA Blacks in Nutrition and Dietetics
• LA County Dept. of Parks and Recreation
• LA Unified School District
• Network for Healthy California African American
  Campaign
• Success A New Beginning
• Watts HealthCare Corporation
• W M Keck Diabetes Initiative
• Women, Infants and Children (WIC) Program
• YO- Watts Youth Outreach

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Collaborative Officials

• Maxine Liggins, MD, Co-Chair
• Medical Director, LA County Department of
  Public Health
• Joanne Robinson, M.Ed., Co-Chair
• Executive Director, Watts Counseling and
  Learning Center
• Pompea Smith, CEO
• Sustainable Economic Enterprises- Los Angeles

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MISSION

• The mission of the Watts Healthy Farmers Market
  Collaborative Project (Watts-Healthy) is to
  improve the quality of health in the Watts
  community by providing direct access to fresh
  produce and healthy lifestyle education
  opportunities in a farmers market.

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LOCATION

• The Watts Healthy Farmers Market Collaborative
  Project is located on the south side parking lot
  of the Ted Watkins Park, a LA County Park
  bordered by Central Avenue (west), Success Avenue
  (east), 103rd Street (south) and Century
  Boulevard (north).

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Watts Community Profile

• Lowest per capita income per household in LA
  County
• Highest rate of diabetes, obesity and deaths due
  to cardiovascular disease
• Highest percentage of individuals with sedentary
  lifestyle combined with lack of safe exercise
  facilities

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Percent of Households with incomes less than 200
of federal poverty level in Los Angeles County

• Latina 74.9
• Whites 21.5
• African American 55.9
• Asian/Pacific Islander 41.0
• Health Indicators for Women, LAC,2007

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Zip Codes and Population of Watts compared to SPA
6

• 90001 57,000
• 90002 46,000
• 90003 62,000
• 90059 40,000
• 90061 26,000
• Total 231,000
• Spa 6 - 1,036,466

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THE PROBLEM

• LIMITED ACCESS TO HEALTHY FOODS
• Most Californians have access to
• healthy foods through supermarkets.
• Studies have confirmed unequal access based on
  where we live, income level, race and ethnicity

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NEED

• Lack of full service supermarkets and other
  healthy food outlets
• Within a one mile radius of the market, there is
  only one full service supermarket, eight fast
  food franchises and no sit-down restaurant with
  service staff.

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Supermarket Gap

• Each supermarket in LA county serves 18, 649
  people low income communities serve 27,986
• Higher the concentration of poverty within a
  community, the fewer the supermarkets
• Low income zip codes have fewer supermarkets and
  lower supermarket square footage than higher
  income zip codes

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Supermarket Gap

• Higher the concentration of whites in community,
  the greater the number of supermarkets.
• Higher concentrations of African Americans and
  Latinos in community are associated with fewer
  supermarkets.
• African American communities had fewer
  supermarkets per capita than any other
  racial/ethnic group.

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Higher Prices

• Fewer large stores mean less competition which
  leads to higher prices
• Prices at smaller stores were at least 10 higher
  than at larger supermarkets
• Low income residents pay a higher percentage of
  their earnings for food

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Lower Quality

• More high calorie, high fat desserts, sweets,
  snacks, tobacco or alcohol at entrance
• Smaller selection of fresh fruits and vegetables,
  whole grains or nutritious foods
• Fruits and vegetables, or meats not fresh or low
  quality

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Health Implications

• Amount of fresh fruits and vegetables consumed by
  low income, inner city residents is frequently
  far less than recommendations
• Limited access to fruits and vegetables caused
  increased risk of diabetes, hypertension, obesity
  and some cancers.

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Fruit and Vegetable Intake

• Percent of adults who consume five or more
  servings of fruits and vegetables a day
• Latina 15.6
• White 24.4
• African American 14.3
• Asian/Pacific Islander 12.8

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Effect of Age

• Women ages 18 to 49 years (17) reported eating
  fewer servings of fruits and vegetables compared
  to women ages 50 to 64 years (20) and 65 years
  and older (22)

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Health Benefits of Fruits and Vegetables

• Current evidence demonstrates that fruit and
  vegetable intake is associated with
• Improved health
• Reduced risk of major diseases
• Possible delay in preventing age related decline
  in cognition, behavior and neurodegenerative
  diseases

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Benefits of Certified Farmers Market to Consumers

• High quality, fresh picked produce
• Customers pay less for produce because the cost
  of middleman marketing and shipping is eliminated

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Benefit of Certified Farmers Market to
Communities

• Bring together diverse groups of people and build
  community
• Unite urban and rural segments of the population
• Provide venues where customers learn about their
  food sources, have access to nutritional
  information and gain awareness of agricultural
  issues

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Benefits of Farmers Market

• Profit Potential
• Less Overhead cost of doing business
• Less crime theft, shoplifting, vendor
  dishonesty
• Location available land, zoning restrictions,
  etc.
• Availability of cultural foods

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Consumer Benefits

• African Americans who reported buying fruits and
  vegetables at a farmers market weekly ate
  significantly more servings of fruits and
  vegetables than those with less frequent
  purchases (3.5 vs 2.9 servings, plt.001).
• African Americans who reported buying fruits and
  vegetables at a farmers market weekly were more
  likely to meet the 5 a Day recommendation (24 vs.
  14 percent, plt.01)

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PROJECT STRATEGIES AND ACTIVITIES

• Establish a low-cost certified farmers market
  where each month a minimum of 200 purchasers and
  visitors purchase fresh foods and horticultural
  products directly from farmers and producers.
• Increase the accessibility of nutritious foods
  for EBT, WIC recipients and other residents

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STRATEGIES/ACTIVITIES

• Increase Women, Infant and Children (WIC)
  recipients consumption of fruits and vegetables
  as evidenced by the redemption of fruit and
  vegetable vouchers at the marketplace.
• Organize and participate in educational and other
  activities that promote the use of fresh produce
  and horticultural products.

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STRATEGIES/ ACTIVITIES

• Work with Kaiser Permanente Watts Counseling and
  Learning Center, the Los Angeles County
  Department of Public Health and other
  organizations in the collaborative to promote
  healthy eating habits.

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STRATEGIES/ACTIVITIES

• Provide direct access to health screenings and
  referrals.
• Conduct research necessary to further the
  development of the farmers market by
  disseminating, collecting and tabulating
  participant and vendor surveys.

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Site Issues and Considerations for starting a
Certified Farmers Market

• Proximity to a residential community for walk-in
  customers
• Parking availability
• Type of surface, size and shape of site
• Fire-lane allowance
• Circulation (ingress and egress for trucks

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Site Issues and Considerations

• Visibility
• Wind, sun, shade
• Storage facility for site equipment and location
  of dumpster
• Access to restrooms conforming to Health
  Department sanitation requirements
• Type of zoning and competing uses

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Permits Required

• Certificate from LA County Commissioner
• Public Health Operating Permit
• Environmental Health/Event Sponsor Health License
• City Council Motion
• Department of Public Works (Revocable) Permit
• Zoning Variance
• Street Closure Fees
• Fire Department Permit

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Budget Items

• Permits
• Insurance
• Equipment
• Staff
• Promotions and Printing
• Approximate start up cost 45,000

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FUNDING

• California Community Foundation
• (WM Keck Diabetes Initiative at Childrens
  Hospital)
• Kaiser Permanente Community Benefit Charitable
  Contribution Program Community Grant

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WILLINGNESS TO BUY FRUITS/VEGETABLES FROM A
FARMERS MARKET
March 2006 Events WIC May 2006 Classes
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CONTACT INFORMATION

• Elaine G. Williams, Ph.D., R.D.
• ewilliams_at_theclinicinc.org
• egwms35_at_aol.com