TARRANT COUNTY PUBLIC HEALTH …dallashungersolutions.org/wp-content/uploads/YVETTE...TARRANT COUNTY PUBLIC HEALTH 11 zip codes were surveyed. 4 zip codes had no grocery stores and

TARRANT COUNTY PUBLIC HEALTH Accountability. Quality. Innovation.

September 13, 2019

A healthier community through leadership in health strategy.

Yvette M. Wingate, Ed.D.Health Equity and Community Engagement

8th Annual Dallas Hunger Summit

TARRANT COUNTY PUBLIC HEALTH


http://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwi2quP6yqzTAhUK5YMKHb5RDQMQjRwIBw&url=http://www.hconc.org.au/contact-us/&psig=AFQjCNHfJY_eBuklAomEJtMeyVDfpRppNQ&ust=1492556068286508


The assumption is that everyone benefits from the same supports. This is considered to be equal treatment.

Everyone gets the support they need, which produces equity.

All 3 can see the game without supports or accommodations because the cause(s) of the inequity was addressed. The systemic barrier has been removed.

One gets exceedingly more than is needed, while the other gets exceedingly less. Thus, a huge disparity is created.

EMPOWERMENTEQUITYEQUALITYREALITY

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=&url=/url?sa%3Di%26rct%3Dj%26q%3D%26esrc%3Ds%26source%3Dimages%26cd%3D%26ved%3D%26url%3Dhttps://communitiesintransition.com/blog/liberation-logic%26psig%3DAOvVaw3mfYYEDmCuL0uVPWRvD9Ua%26ust%3D1566680060023073&psig=AOvVaw3mfYYEDmCuL0uVPWRvD9Ua&ust=1566680060023073



Health improves as advantage

increases.


Gaps in health equity remain W I D E and

persistent.

8


Social Inequities:Root Causes of Health Inequities

Predatory Lenders

Air Quality and Environment

Access to Affordable

and Nutritious Foods

TransportationHousing

Discrimination

Physical Activity and Neighborhood

Conditions

Health Care AccessEducation

Segregation

Social Relationships and Community Capacity

Access to Income and Employment


▪ Health inequity limits people's ability to gain access to resources and experiences required for health and wellbeing.

▪ When people lack access to decision-making that affects their work life and living conditions, their health suffers.

WHY DOES IT MATTER?


11

Cultural Awareness

▪ Acknowledges differences

▪ Does not seek broader context or understanding

▪ Very limited behavior change

Cultural Sensitivity

▪ Acknowledges different ways of seeing the world

▪ Integrates some changes in practices or behavior

Cultural Competency

▪ System elements are aligned with and respect others cultures

▪ Represents action on the part of an individual or organization

Cultural Humility

▪ A lifelong commitment to self-evaluation to redress power imbalances

▪ Develop and maintain respectful relationships based on mutual trust



The Minneapolis Staples Food

Ordinance (Minneapolis, MN)

The first city ordinance in the country to require that licensed grocery

stores carry a minimum level of certain staple

foods

2009 new WIC Standards and 2010 Healthy Corner

Store Program

Problem: Poor health outcomes and

insufficient access to healthy groceries in some

parts of the city

Urban Agriculture Ordinance (Fort

Worth, TX)

Problem: Limited healthy food access

and lack of fresh local produce

Designed to impact health equity, by providing fresh

food to underserved communities and by

enabling members of these communities to produce and market local food as a tool

for social and economic development

Collaboration and community input

NATIONAL LOCAL

Source: Healthy Food Policy Project, https://healthyfoodpolicyproject.org/wp-content/uploads/fort-worth-tx.pdf

Model

▪ Food is accessible when it is affordable, and community members can readily grow or raise it; find it; obtain it; transport it; prepare it; and eat it.

▪ 293 Policy Database: 9 TX cities included

▪ 6 Components: Grow, Process, Distribute, Get, Make, & Surplus/Waste Management

▪ 6 stories about healthy food policy initiatives

https://healthyfoodpolicyproject.org/wp-content/uploads/fort-worth-tx.pdf


▪ 11 zip codes were surveyed.

▪ 4 zip codes had no grocery stores and

the least availability of healthy food.

▪ The lowest percentage convenience stores is

70%.

▪ Items available in convenience stores cost

about two times the amount of those in

grocery stores.

▪ 87% of grocery/convenience stores had at

least one milk item.

▪ 57% did not have any fresh fruit.

▪ 80% did not have any fresh vegetables.

▪ 32% of the stores had no cereal.

▪ 35% of stores had no bread or baked goods.



CHIP Priority Area 1: EDUCATION

GOAL 1: Progressively influence living and

working conditions that will have a positive

impact on the health and behavior of

individuals and communities.

FOCUS:

▪ Participate in the political process

▪ Increase access to affordable, nutritious foods and decrease food insecurities

▪ Engage the community residing in food deserts to participate in community gardens

http://www.google.com/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=OB-ch_OaATlXOM&tbnid=AKAc_wjcQzRWtM:&ved=0CAUQjRw&url=http://www.ecoliteracy.org/essays/civic-engagement&ei=0JXNUtCiPISs2wWOqoHIBA&bvm=bv.58187178,d.b2I&psig=AFQjCNEuX1VJFesGdccL5QWMn4JMe7JWOA&ust=1389290260596717


Johns Hopkins Bloomberg School of

Public Health (Baltimore, MD)

Used HFAI to assess 8 food groups; A higher score

indicates greater availability of healthy foods

Adapting the NEMS instrument to Baltimore

food stores

Crafting new programs that will be effective, efficient,

just, and sustainable.

Austin/Travis County Health and Human

Services

Used grants to develop an expansive mapping

platform that can be accessed

online

Healthy Tarrant County Collaboration

739 surveyed grocery stores, approx. 600

remaining

SNAP vendors list provided by TCPH was

sorted by zip code

Special focus on 3 high need zip codes

NATIONAL STATEWIDE LOCAL

Sources: Johns Hopkins Bloomberg School of Public Health, Center for a Liveable Future, The Baltimore City Food Environment, https://www.jhsph.edu/research/centers-and-institutes/johns-hopkins-center-for-a-livable-future/research/clf_publications/pub_rep_desc/bal_city_food_env.html; Fulmer, L., & Harrison, S. (2019). Healthy food access: Tarrant county priority areas.

https://www.jhsph.edu/research/centers-and-institutes/johns-hopkins-center-for-a-livable-future/research/clf_publications/pub_rep_desc/bal_city_food_env.html


Fulmer, L., & Harrison, S. (2019). Healthy food access: Tarrant county priority areas.


Ethnic Grocery Stores


The Food Trust (Philadelphia, PA)

Increase the availability and awareness of healthy foods

in corner stores in Philadelphia through a multifaceted approach

In partnership with the Philadelphia Department of Health's Get Healthy Philly

initiative

Expanded the Healthy Corner Store Initiative throughout

Pennsylvania and New Jersey

Philadelphia Healthy Corner Store Network in more than

600 corner stores

Food Policy Council of San

Antonio

Pilot program in City Council District 3 to increase access to

healthy, affordable food, with $50,000 City

funding

Enrolled five stores and stocked them with fresh

fruits and vegetables

Unique collaborative partnership

Plan4Health Tarrant County

Promote healthy retail policies and practices to increase the availability

of healthy foods

Improve access to local, fresh food in southeast

Fort Worth

1 corner store worked with community and nearby high school

Work led to United Way Grant focusing on 3 new

corner stores


Urban Farming Institute, http://ufi.us.org/; Small Places, LLC., https://www.smallplaces.org/

http://ufi.us.org/


Photos courtesy of Healthy Tarrant County Collaboration and Blue Zones


Photos courtesy of Healthy Tarrant County Collaboration


Urban Farming Institute (Oakland

Park, FL)

60 Community garden beds

Largest agricultural facility in Broward County

500+K Honey-making bees per year

50 Members & Supporters

60+ Gardens in local Broward County schools

Small Places, LLC (Houston, TX)

Quality, local food should be made available to all people regardless of location and income

Develop a CULTURE OF HEALTH in our

communities by renewing the bond between PEOPLE, PLACE, and FOOD

Limited Resource Farming

Plan4Health Tarrant County

Grow Southeast –4 Urban Farms

Improve community health and health equity

outcomes of the built environment

City of Fort Worth’s Urban Agriculture Ordinance

Equipment for farmers to borrow (tractor, tiller and

plow)


Urban Farming Institute, http://ufi.us.org/; Small Places, LLC., https://www.smallplaces.org/

http://ufi.us.org/






Unity Unlimited, Inc., https://www.unityunlimited.org/opals-farm.html; Photos courtesy of Unity Unlimited, Inc., February 15, 2019

“Everyone deserves to be fed and to eat healthy food. Unfortunately,

that’s rarely the case in many of our neighborhoods. A lot of people

don’t know what it is to have fresh vegetables….We will provide

healthy options and the education to use them.”

~Greg Joel, Farm Manager of Opal’s Farm

2500 LaSalle St., Fort Worth, TX 76111

(5-acres)

https://www.unityunlimited.org/opals-farm.html


Mobile Fresh Markets:Meet People Where They Are

▪ Started by Texas Health Resources in Azle

▪ Higher Praise Family Church and Sayer’s Family Farmers Market in Haltom City

▪ Church volunteers are then able to pack out the bags on Friday evenings, and began sales on Saturday, July 6th from 8am to 10 am.

▪ They plan to start with 100 bags of produce at $5/bag and hope to expand to 200 or 300 bags within a year.


SHARE TABLE, recycling and composting at North Hi Mount

Elementary School (Fort Worth, TX)

A project of the Tarrant County Food Policy Council’s Food

Recovery Work Group



Promotes health equity in all policies, programs, and services by prioritizing resources to reduce health inequities.

Assesses and reduces systemic barriers to equitable access to high quality services for all.

Addresses specific health needs of people all along the social gradient, including the most health disadvantaged.

Ensures that the methods used to provide health services contributes to the reduction of health disparities.

Helps to evaluate, communicate and recognize health equity strategies.


Select Issue

Collect and Analyze Data

Identify a Policy/Program/Service that Addresses the Issue

Implement and Monitor with Internal or External Stakeholder Input

Evaluate with Internal or External Input

Report Back

1

2

3

4

5

6


Women, Infants and Children (WIC)

Dual HandsetsLimited English

Proficiency Language Line


#1

• Provide effective, equitable,

understandable, and respectful quality care and services

that are responsive to diverse cultural

beliefs and practices, preferred languages, health literacy, and

other communication needs.

#5

• Offer language assistance to

individuals who have limited English

proficiency and/or other communication at no cost to them, to

facilitate timely access to all health care and services.

#7

• Ensure the competence of

individuals providing language assistance, recognizing that the

use of untrained individuals and/or minors should be

avoided.

Working together on a common agenda with mutually reinforcing actions, shared measures and constant

communication =

Hunger

Eliminated

TARRANT COUNTY PUBLIC HEALTHTARRANT COUNTY PUBLIC HEALTH

Yvette M. Wingate, Ed.D.Health Equity CoordinatorP: 817-321-5318E: [email protected]



http://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0ahUKEwjg-Krym4vTAhWV0YMKHUp8C-MQjRwIBw&url=http://onlinecrowd.com.au/perfect-client-thank-you-use-social-media/&psig=AFQjCNE7IYHGPuBG36H2Ns3tV1KgjDBEgw&ust=1491409526695417

Main Address:1101 S. Main Street

Fort Worth, TX 76104

Phone:817-321-4700

Website:health.tarrantcounty.com

Social Media:



Documents

TARRANT COUNTY PUBLIC HEALTH …dallashungersolutions.org/wp-content/uploads/YVETTE...TARRANT COUNTY PUBLIC HEALTH 11 zip codes were surveyed. 4 zip codes had no grocery stores and