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A FRAMEWORK FOR ADDRESSING HEALTH DISPARITIES: WATTS HEALTHY FARMERS’
MARKET
Elaine G. Williams, Ph.D., R.DProgram Director
Baptist Ministers’ Conference/Baptist Church of the New Covenant
Norwalk, California
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.
Watts Healthy Farmers’ Market Collaborative
Project
Formed in 2003Kaiser Permanente initiated farmers’ markets in two Kaiser facilities in Northern CaliforniaKaiser/Watts Counseling and Learning Center met with staff of Los Angeles County Department of Public Health to discuss feasibility
Participating AgenciesKing Drew Child Development ProgramLA Blacks in Nutrition and DieteticsLA County Dept. of Parks and RecreationLA Unified School DistrictNetwork for Healthy California – African American CampaignSuccess – A New BeginningWatts HealthCare CorporationW M Keck Diabetes InitiativeWomen, Infants and Children (WIC) ProgramYO- Watts Youth Outreach
Collaborative Officials
Maxine Liggins, MD, Co-Chair Medical Director, LA County
Department of Public HealthJoanne Robinson, M.Ed., Co-Chair
Executive Director, Watts Counseling and Learning CenterPompea Smith, CEO
Sustainable Economic Enterprises- Los Angeles
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.
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).
Watts Community Profile
Lowest per capita income per household in LA CountyHighest rate of diabetes, obesity and deaths due to cardiovascular diseaseHighest percentage of individuals with sedentary lifestyle combined with lack of safe exercise facilities
Percent of Households with incomes less than 200% of federal poverty level in Los Angeles County
Latina 74.9Whites 21.5African American 55.9Asian/Pacific Islander 41.0
Health Indicators for Women, LAC,2007
Zip Codes and Population of Watts compared to SPA
6
90001 57,00090002 46,00090003 62,00090059 40,00090061 26,000Total 231,000
Spa 6 - 1,036,466
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
NEED
Lack of full service supermarkets and other healthy food outletsWithin 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.
Supermarket Gap
Each supermarket in LA county serves 18, 649 people; low income communities serve 27,986Higher the concentration of poverty within a community, the fewer the supermarketsLow income zip codes have fewer supermarkets and lower supermarket square footage than higher income zip codes
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.
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 supermarketsLow income residents pay a higher percentage of their earnings for food
Lower Quality
More high calorie, high fat desserts, sweets, snacks, tobacco or alcohol at entranceSmaller selection of fresh fruits and vegetables, whole grains or nutritious foodsFruits and vegetables, or meats not fresh or low quality
Health Implications
Amount of fresh fruits and vegetables consumed by low income, inner city residents is frequently far less than recommendationsLimited access to fruits and vegetables caused increased risk of diabetes, hypertension, obesity and some cancers.
Fruit and Vegetable Intake
Percent of adults who consume five or more servings of fruits and vegetables a dayLatina 15.6White 24.4African American 14.3Asian/Pacific Islander 12.8
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%)
Health Benefits of Fruits and Vegetables
Current evidence demonstrates that fruit and vegetable intake is associated with Improved healthReduced risk of major diseasesPossible delay in preventing age related decline in cognition, behavior and neurodegenerative diseases
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
Benefit of Certified Farmers’ Market to
Communities
Bring together diverse groups of people and build communityUnite urban and rural segments of the populationProvide venues where customers learn about their food sources, have access to nutritional information and gain awareness of agricultural issues
Benefits of Farmer’s Market
Profit PotentialLess Overhead – cost of doing businessLess crime – theft, shoplifting, vendor dishonestyLocation – available land, zoning restrictions, etc.Availability of cultural foods
Consumer Benefits
African Americans who reported buying fruits and vegetables at a farmer’s market weekly ate significantly more servings of fruits and vegetables than those with less frequent purchases (3.5 vs 2.9 servings, p<.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, p<.01)
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
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.
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.
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.
Site Issues and Considerations for starting
a Certified Farmers’ Market
Proximity to a residential community for walk-in customersParking availabilityType of surface, size and shape of siteFire-lane allowanceCirculation (ingress and egress for trucks
Site Issues and Considerations
VisibilityWind, sun, shadeStorage facility for site equipment and location of dumpsterAccess to restrooms conforming to Health Department sanitation requirementsType of zoning and competing uses
Permits Required
Certificate from LA County CommissionerPublic Health Operating PermitEnvironmental Health/Event Sponsor Health LicenseCity Council MotionDepartment of Public Works (Revocable) PermitZoning VarianceStreet Closure FeesFire Department Permit
Budget Items
PermitsInsuranceEquipmentStaffPromotions and PrintingApproximate start up cost $45,000
FUNDING
California Community Foundation (WM Keck Diabetes Initiative at
Children’s Hospital)
Kaiser Permanente Community Benefit Charitable Contribution Program Community Grant
WILLINGNESS TO BUY FRUITS/VEGETABLES FROM A FARMER’S MARKET
N4%
Y91%
Missing5% N
3%
Y95%
Missing2%
March 2006 Events WIC May 2006 Classes
