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Access to Nutritious Foods Planned Community Change

Access to Nutritious Foods Planned Community Change. NURS 340 Jerrene Bramble Angelique Kinyon Joella Show Sherry Brabon. Problem Statement.

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Access to Nutritious Foods Planned Community Change

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  1. Access to Nutritious FoodsPlanned Community Change NURS 340 Jerrene Bramble Angelique Kinyon Joella Show Sherry Brabon

  2. Problem Statement • Kent County residents are at risk of imbalanced nutrition related to lack of healthy food resources as evidenced by limited access to grocery stores, high rates of food insecurity and obesity.

  3. Objectives • Identify nutritional concerns in Kent County • Assess current access to nutrition resources • Identify strengths and weaknesses related to access to healthy food • Identify modifiable factors for good nutrition • Provide interventions to improve nutritional intake to Kent County residents • Evaluate effectiveness of interventions

  4. Kent County Statistics • Population in 2012 - 614,562 • Median household income, 2007-2011 - $50,801 • Persons below poverty level, 14.8%(United States Census Bureau, 2012). • Number of grocery stores -118 • Kent County 1.96/10,000 population • Michigan 2.34/10,000 population (City-Data.com, 2012).

  5. Modifiable Factors • Modifiable factors involved in obtaining a diet rich in healthy whole foods: • Knowledge • Understanding • Awareness • Availability • Farmers Markets • Grocery Stores • Food within the school systems and work places • Meals • Vending machines • Individual financial need • Resources

  6. Community Strengths Weaknesses Lack of knowledge about public transportation Lack of grocery stores/food sources/ limited farmer’s markets Crime rate Poverty Vending machines in schools with unhealthy choices Some school meal programs do not provide healthy choices Convenience/availability of fast food options Inconvenience/high cost of fresh whole foods • Community Gardens • Farmers Markets • Food Banks • SNAP benefits • WIC Double-Up Program • Healthy options available in some of the schools

  7. Community Gardens • "Community gardens provide residents of underserved communities the opportunity to grow their own fruits and vegetables, increasing access and affordability.“(Local Government Commission, n.d.). • There are over 20 community gardens in the Kent County area • For more information on a community garden in Kent County go to: • foodshed.net • School and Community Gardens on the Kent County Facebook Page • Extra produce harvested from community gardens can be canned, dried, or frozen for use during the winter months

  8. Food Banks & Food Insecurity Food Banks Deficits of West Michigan Food Banks 93% deficit of meat, poultry and fish 89% deficit of fresh fruits and vegetables 88% deficit of dairy products Available food fell short of USDA recommendations • Food provided by the food bank to people in need is nutritionally deficit in specific areas. • Supplies of food are too little to adequately assist in relieving the food insecurity.

  9. Government Assistance & Availability Issues Government Assistance Availability Issues There are very little or no low-cost grocery stores in the inner city of Grand Rapids. Choices are limited by stores such as WalMart, Meijers, and Kroger’s A program from Michigan State University called Project Fit is targeting neighborhood convenience stores to increase healthy and affordable food • In 2010 18% of people in Kent county relied on SNAP • Some individuals who qualify for SNAP do not understand how to apply for the benefits and/or are undocumented immigrants and are afraid of being deported if they make themselves known by applying for SNAP

  10. Transportation • Disability advocates of Kent County offer transportation to qualified individuals • The Rapid (Interurban Transit Partnership, ITP) • Go!Bus, PASS, RideLink, Car & Van Pooling • Faith in Motion (FIM) • The Hope Network provides transportation for individuals with disabilities or disadvantages • Other providers of transportation in Kent County, MI, many of which are non-profit • AIDS Care Network (G.R.A.C.E.), American Cancer Society, American Red Cross, Area Community Service Employment and Training Council (ACSET), FISH for my people (G.R.A.C.E.), Ready Ride Transportation, INC., Senior Neighbors, Sunshine Senior Assistance (RLS & Associates, Inc., 2011)

  11. Farmer's Markets • "Farmers markets allow consumers to have access to locally grown, farm fresh produce, enables farmers the opportunity to develop a personal relationship with their customers, and cultivate consumer loyalty with the farmers who grows the produce." (United States Department of Agriculture [USDA], 2013). • There are 13 Farmer's Markets in Kent County • All but 1 are only open seasonally • All have limited hours • Most only open 1 day • Only 6 take WIC or SNAP

  12. Community Concerns • 19,172  Kent County residents do not have access to a grocery store with fresh produce • 17,920 residents have limited access • Overall 15.2% of this population report food insecurities, children are reported to experience this at a rate of 23.2% (Michigan Public Health Institute[MPHI], 2011)

  13. Health Concerns • Only 26% of adults and 34% of youth in Kent County report eating healthy balanced meals • Lower income adult residents (<$35,000 per annum) have higher obesity rates than higher income residents • 29% of adults in Kent County are obese. (KCHC, 2013a) • 34% of the youth eat 5 or more servings of fruits and vegetables daily • 52.4% of the youth report 60 minutes of physical activity in at least 5 days per week • 10.5% of youth are obese (MPHI, 2011)

  14. Importance of Diet • Dietary factors are the cause of 4 out of the 10 leading causes of death.  Heart disease, cancer, stroke and type 2 diabetes are all controlled with diet(Harkness and DeMarco, 2012) • USDA Recommendations: • Make 1/2 your plate fruits and vegetables • Make at least 1/2 your grains whole grains • Make your protein choices low fat • Switch to fat free or low fat (1%) milk

  15. Edible Food Forest:Seven Level Beneficial Guild • Goals • Mimics nature while providing free healthy food to the community • Providing fruits and nuts to those who cannot afford to purchase them • Works on the honor system:  Take some but leave some for others (Edible Forest, 2012). • Forest Levels • Canopy- Large fruit and nut trees • Low tree layer-Dwarf fruit trees • Shrub layers- Berries • Herbaceous- Herbs • Rhizosphere- Root vegetables • Soil surface- Ground cover (such as  strawberries) • Vertical layer- Climbers and vines (Beacon Food Forest,2012).

  16. Community Education: Recognizing the Need and Getting Involved • Help the members of the community to recognize the lack of access some people have to nutritious food • Encourage a banding together of community members to provide for neighbors by donating to the food pantry • Encourage local schools to serve nutritious food • Advertise for food drives • Involve churches and other non-profit organizations

  17. Health Model • The collaborative model • Requires all community members • Best to involve affected residents • Requires funding from stakeholders • Allows for resident suggestions for improvement which may promote program sustainability

  18. Stakeholders/PartnersIt requires a community to feed a community. • There are two sides • Those who lack access to nutritious foods • Those who have enough nutritious food • The entire community in Kent County should be involved regardless of which side they are on. • Healthcare facilities/ healthcare professionals • Community leaders/ public officials • Local business owners, farmers • Individuals, families, churches, volunteer groups • Schools: Students, parents, and staff: From Pre-K to college • Senior citizens, ethnic or specific cultural groups • Local health department • Michigan State University Extension • USDA-Farmers markets and farm to school programs

  19. Target Population:Senior Citizens • Senior Meals Program, Inc. • All seniors deserve access to healthy, nutritious food • Home delivered meals • Meals cooked from scratch, chilled, and delivered all over Kent County, MI • Dining centers • Senior pantry • Nutritional supplements • Emergency meals • Project fresh • Nutrition information

  20. Target Population:School Children Improve quality of food served and/or available in schools • More fruits and vegetables • Less sodium • Reduce amount of nutritionally deficient foods and drinks • Provide free cold drinking water • Provide nutrition education for students and families • Work with the schools to institute a “Farm to School” program

  21. Target Population:Native Americans & Men • 0.7% American Indian and Alaska Native persons(United States Census Bureau, 2012) • Identify tribal leaders • Establish report • Provide education on health and nutritious foods • Offer assistance in the form of WIC or SNAP • 49% of the entire population consists of male persons (United States Census Bureau, 2012) • Identify predominant male workplaces • Encourage employers as stakeholders • Offer healthy foods in vending machines • Offer information specific for healthy foods • Handouts with income guidelines for WIC and SNAP • Food pantry locations and times • Farmers market information

  22. Goals Short Term - 1 Year • Greater access to nutrition foods • Fresh produce available to all residents of Kent County Long term - 5 Years • Reduced rates of obesity • Reduced rates of stroke, diabetes, and heart disease

  23. Outcome / Evaluation • Successful implementation of a USDA approved "Farm to School" Program in all public schools in Kent County within two years. • This should be evaluated frequently. Survey all schools in three month intervals to evaluate progress until full implementation is reached.

  24. Outcome / Evaluation • The percentage of residents with limited access to healthy foods will decrease until the National Benchmark is reached • 5% of the population in Kent county currently has limited access to healthy foods • The National Benchmark is 1% • This can be evaluated via tracking made possible by “County Health Rankings & Roadmaps” (Robert Wood Johnson Foundation, 2013) • A decrease of at least 0.5% per year is necessary or revaluation of interventions will be required

  25. Outcome / Evaluation • The percentage of adult residents of Kent county with obesity (a BMI ≥ 30) will decrease to at least the level of the National Benchmark or further. • Reports for 2013 show 30% of Kent County adults are obese. • The National Benchmark is 25% • This can be evaluated via tracking made possible by “County Health Rankings & Roadmaps” (Robert Wood Johnson Foundation, 2013). • A decrease of 0.5% or more per year is necessary or revaluation of interventions will be required.

  26. Outcome / Evaluation • The percentage of residents within Kent County with diabetes, heart disease, and/or stroke will decrease steadily as the overall health of the community increases • Prevalence of diabetes in 2005: 49.6 people per every 100,000 people • Prevalence of heart disease in 2005: 17.7 people per every 100,000 people • Prevalence of stroke in 2005: 206.8 people per every 100,000 people (Kent County Health Department, 2005) • This can be tracked through hospital records and reporting • A decrease of 0.2% after 1 year followed by 0.5% each year after until the National Benchmarks have been met or exceeded is necessary or revaluation of interventions and plan are required

  27. Long-Term Monitoring •  Healthcare facilities and professionals will be utilized to monitor the overall health of individuals. • Monitoring of health data and trends through the health department and organizations such as the Robert Woods Johnson Foundation will continue indefinitely in an effort to prevent recurrence of the issue. • Residents will be surveyed one year after implementation of interventions then annually until all benchmarks have been met or exceeded. • The survey will be utilized to monitor the public perception and understanding in addition to overall health status.

  28. Conclusion • Our group wanted to focus our efforts on enhancing the strengths of the community and capturing those groups most affected by poor nutrition.  It was decided that educating the public and offering some solutions that involve community members would help sustain our interventions.  This is a long term commitment that will require ongoing program evaluation and intervention modification to remain successful.

  29. References Baders, S., & Rydahl, N. (2010). Reducing food insecurity in Kent county: Assessing the progress. Retrieved from http://faculty.gvsu.edu/borderss/Food%20Insecurity%20in%20Kent%20County.pdf City-Data.com. (2012). Kent County, Michigan. Retrieved from http://www.city-data.com/county/Kent_County-MI.html Cramer, J. (n.d.). Beacon Food Forest-About. Retrieved June 26, 2013, from http://beaconfoodforest.weebly.com/ Harkness, G. and DeMarco, R. (2012). Community and public health nursing. Philadelphia: Lippincott Williams and Wilkins. Kent County Health Connect (KCHC). (2013a). The facts. Retrieved from http://www.kchcct.com/THEFACTS.aspx Kent County Health Connect (KCHC). (2013b). Healthy eating and active living strategies. Retrieved from http://www.kchcct.com/en-us/healthyeatingactiveliving.aspx Kent County Health Department.  (2005).  The health of Kent County, 2005.  Retrieved from http://www.accesskent.com/Health/Publications/ Local Government Commission. (n.d.). Cultivating community gardens. Retrieved from http://www.urbantilth.org/wp-content/uploads/2008/09/local-government-commission-flyer-on-policies-to-encourage-community-gardens.pdf Michigan Public Health Institute [MPHI]. (2011). 2011 Community health needs assessment and health profile. Retrieved from http://www.kentcountychna.org/default.html

  30. References Michigan State University [MSU]. (2012). Michigan farm to school. Retrieved from http://www.mifarmtoschool.msu.edu/ RLS & Associates, Inc. (2011). Kent County transit needs assessment. Retrieved from http://www.gvmc.org/transportation/documents/KCTNA/Kent%20County%20Final%20Report-1.pdf Robert Woods Johnson Foundation. (2013). Kent County, MI: County rankings and roadmaps. Retrieved from http://www.countyhealthrankings.org/app/michigan/2013/kent/county/outcomes/overall/snapshot/by-rank Senior Meals Program, Inc. (2011). About us. Retrieved from http://seniormealsonwheels.org/about-us United States Census Bureau. (2012). Kent County QuickFacts. Retrieved from http://quickfacts.census.gov/qfd/states/26/26081.html United States Department of Agriculture [USDA]. (2012). Choose a food group. Retrieved from http://www.choosemyplate.gov/food-groups/ United States Department of Agriculture [USDA]. (2013). Agricultural Marketing Service: Farmers markets and local food marketing. Retrieved from http://www.ams.usda.gov/AMSv1.0/farmersmarkets Wall, T. (2012). Edible Forest Free for All in Seattle. Retrieved June 26, 2013, from http://news.discovery.com/earth/plants/edible-forest-free-for-all-in-Seattle-120321.htm

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