Valley Up: Creating Healthier Communities in California’s Central Valley

Presented by: Genoveva Islas-Hooker, MPHRegional Program Coordinator, CCROPPGreat Valley Center Annual Conference

California’s Central Valley

Central California stretches almost 300 miles.

It’s home to more than 3.8 million residents. The population is expected to more than double 2050.

Our families represent over 70 ethnicities and speak over 105 languages making it one of the most culturally diverse areas in California and the nation.

Poverty in Central California

Annual unemployment rate is almost 2x greater than the unemployment rate for California.

21.7% of our population live below 100% of the FPL, the average rate in California is 15.5%

More than 1 in 4 of our children live in a household whose income is below 100% of the FPL.

The Paradox

Within our valley lies one of the largest and richest agricultural regions in the world.

Families still struggle to put food on their tables.

"It's ironic that those who till the soil, cultivate and harvest the fruits, vegetables, and other foods that fill your tables with abundance have nothing left for themselves."

-Cesar Chavez

Overweight & Obesity

1 out of 3 children, <12 years of age, are overweight and obese

17.2% of adolescents, ages 12-17, are overweight and obese

64.3% of adults, ages 18-64, are overweight and obese

62.9% of adults age 65 and over are overweight and obese

Source UCLA Center for Health Policy Research, 2003; 2007; 2009

Overweight & Obesity by Age Group,San Joaquin Valley and California, 2001, 2005 and 2007

CountyAges 12-17 Ages 18-64 Age 65+

2001 2005 2007 2001 2005 2007 2001 2005 2007

Fresno 14.1% 19.8%*

24.7% 65.0% 56.7% 63.3% 55.3% 64.7% 66.2%

Kern 7.7%* 9.6%* 6.5%* 61.4% 66.9% 60.1% 50.8% 62.1% 62%

Kings 16.3% 7.5%* 17.7%*

63.5% 62.9% 64.9% 58.0% 70.3% 68.7%

Madera 11.5%*

4.8%* 27.1%*

66.1% 64.5% 67.6% 58.6% 60.8% 68.5%

Merced 18.2%*

12.5% 17.1%*

67.4% 66.8% 67.6% 67.2% 65.5% 65.6%

San Joaquin 17.9% 12.2%*

15.0%*

66.9% 71.6% 65.7% 62.3% 59.7% 61%

Stanislaus 12.9%*

17.0%*

17.0%*

62.8% 67.2% 64.7% 53.4% 63.0% 51.7%

Tulare 7.6%* 21.10%

20.7%*

71.0% 66.5% 68.3% 56.1% 63.8% 69.5%

San Joaquin Valley

12.8% 15.5% 17.2% 65.1% 65.0% 64.3% 56.5% 63.0% 62.9%

California 12.2% 14.2% 13.3% 55.% 56.2% 57.2 54.3% 55.7% 58.3%

Healthy People 2010 Objective

5.0% 5.0% 5.0% 15.0% 15.0% 15.0% 15.0% 15.0% 15.0%Source UCLA Center for Health Policy Research, 2003; 2007; 2009

* Statistically unstable

Working Together

Grassroots Community Members, including youth Community Based Organizations including Fresno Metro

Ministries, Kern County Network for Children, Livingston Medical Group, Community Partnership for Families of San Joaquin, Ceres Partnership for Healthy Children and Tulare County Nutrition Collaborative

Public Health Departments in Fresno, Kern, Kings, Madera, Merced, San Joaquin, Stanislaus and Tulare counties

California State University, Fresno

Central California Regional Obesity Prevention

Program

Kern

Kings

Tulare

Fresno

Madera

Merced

Stanislaus

San Joaquin

Regional

Our Approach

We believe that in order for community members to eat healthier and be active they need the environmental context and policy support to practice these behaviors.

Assessment

How easy is it to eat healthy? How easy is it to be physically active?

Challenges

Limited access to healthy foods.• Cost, availability and convenience of fast food,

distance/transportation Limited opportunities for physical activity.

• Safety, air quality, heat, closed green space, no park or limited use parks, loose dogs

Community Driven Logic Models & Work Plans

State

Region

County

LocalCom

munit

y-D

rive

n

Access to Healthy Food

Maximizing EBT & WIC at Alternative Food Outlets

Merced and Atwater Flea Markets

Ceres Farmers Market

Madera Farmers Market

Kern County Department of Public Health farmers market

Access to Healthy Food

School Farm Markets/Stands

Farmers Market at Burroughs Elementary School

Pixley Elementary School Fruit and Vegetable Stand

Access to Healthy Food

Small Store Conversion

Youth in Kettleman City transformed their only small store , the Hla Hla Market. Good quality affordable produce is now available.

Opportunities for Physical Activity

Making Parks Safer

Stiern Park, Bakersfield, CA

• Greenfield Walking Group

• Cesar Chavez Youth Leadership Program

Opportunities for Physical Activity

Improving Park Amenities

Pixley Park Pixley, CA

• Soccer Goal Posts• Youth rebuilt park

arbor

Opportunities for Physical Activity

Built Environment Inclusion of health

elements in general plans• Include

accommodations for complete streets; walking, biking, etc…

Institutional Change

Worksite Wellness Policies center around

the • Healthier food

choices (removal of unhealthy items from vending machines)

• Promotion of increased physical activity

• Promotion of breast-feeding

Unexpected Successes

San Joaquin Valley voice & identity influencing/informing statewide & national work in the field.

Grassroots Community Leadership (Assets not liabilities)

Increase Community Cohesion

Immigrant Integration

Increased Civic Participation

Some Lessons Learned

Obesity Prevention through policy and environmental change:

is intensive and takes time – don’t rush it. necessitates relationship building across stakeholders –

find your allies, transform your opposition. requires a deep level of community engagement – kitchen

table work by candlelight grassroots leadership development is fundamental to

sustainability. requires educating decision makers and persuading them

to act - grassroots advocacy & mobilization. should be community driven- they are the experts!

Social Determinants of Health

The social determinants of health are the conditions in which people are born, grow, live, work and age, including the health system. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels, which are themselves influenced by policy choices.

– Commission on Social Determinates of Health

For more information…

Genoveva Islas-Hooker, MPHRegional Program Coordinator1625 E. Shaw Avenue, Suite 106Fresno, CA 93710gislas@csufresno.edup: 559.228.2142f: 559.228.2149visit us at www.ccropp.org

Thank you!

This project is funded by