Health Evaluation &Implementation

Improving Community Health: One Food Desert at a Time

MD4Assgn2 Reynolds K.

Improving Community Health: One Food Desert at a Time

K. Reynolds (student name)

Example of Health Promotion Proposal

*This proposal is being used as an example by Dr. Allison Litton with permission from the student.

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Improving Community Health: One Food Desert at a Time

Introduction

Food Insecurity and Food Deserts

According to the United States Department of Agriculture (USDA) food insecurity is the

inability to access to adequate food for an active and healthy life (Camp, 2015). Camp (2015)

goes on to suggest that food insecurity has been increasing since 1995 and that in 2011

approximately 15% of all households in America experience food insecurity. The USDA also

proposes that food deserts are areas, often located in low income communities, that do not have

access to healthy food options due to a lack of full service supermarkets (American Nutrition

Association, 2015). Food insecurity and food deserts are increasingly problematic for children

and minorities. A research study conducted in 2012 found that between 12% to 15% of Black Health Evaluation &Implementation

and Hispanic children elementary aged children experienced food insecurity (Xu, Zhu, &

Bresnahan, 2016). Camp (2015) cites that 25.1 % of Black households and 26.2% of Hispanic

households’ experience food insecurity. The US Department of Health and Human Services

(2014) states that approximately 30 million Americans live food deserts with a large percentage

being people of color.

Alabamians also face the complications of food insecurity and food deserts. The

Alabama Food Bank Association (2016) reports that 19.2% of Alabama’s population or almost 1

million people live with food insecurity. Furthermore, 1.8 million Alabamians live in areas

without full service supermarkets (Lang, Koprak, & Treering, 2015). In fact, almost every

county in Alabama has difficulty providing access to healthy food options (Lang, Koprak, &

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Improving Community Health: One Food Desert at a Time

Treering, 2015). In Birmingham 40% of the population lives in a food desert and currently there

are only 24 full service supermarkets for a population of 212,000 (Change Lab Solutions, 2012).

Health Problems Related to Food Insecurity and Food Deserts

The impact that food insecurity and food deserts have on public health is unequivocal.

Several studies have noted a possible relationship between obesity and food insecurity (Camp,

2015) Camp (2015) also noted that poorly controlled diabetes, hypertension, and heart disease

are were significantly higher among individuals living with food insecurity. Brown & Brewster

(2015) support this idea by hypothesizing that there is a link between food insecurity and

sedentary lifestyles, cancer, arthritis, and metabolic syndrome. Ortega et al (2014) posits that the

exponential growth of obesity and chronic illnesses can be traced to the insufficient intake of

healthy foods that occurs within food deserts.

Alabamians face even higher rates of obesity and chronic disease. Nationwide the rate

for obesity is 68% and the rate for diabetes is 6% however, 75% of the residents in Birmingham

have been diagnosed as overweight or obese and approximately 11% have been diagnosed with

diabetes (Lang, Koprak, & Treering, 2015). The Alabama Department of Health (2015) states

the following statistics:

 In 2012 Alabama ranked fifth among the nation’s top eight obese states

 From 2010-2012 more than 35,919 Alabamians died from heart disease

 Preventable strokes caused approximately 7,759 Alabama deaths in 2010-2012

 In 2008-2010 Alabama had the highest rate of stroke incidents in the nation

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Improving Community Health: One Food Desert at a Time

Much current research supports the idea that making healthy food available in food deserts is a

strategy that will help citizens to make better food choices thus improving health outcomes

(Centers for Disease Control and Prevention, 2014). They go on to state that having access to

full service supermarkets increases fruit and vegetable consumption and can possibly lower the

prevalence of obesity for adults. The Alabama Department of Public Health (ADPH) (2015)

cites that 24.3% of adults in Alabama eat vegetables less than once daily and 43.8 % eat fruit less

than once daily. Increasing access to healthy food options within food deserts will improve the

health outcomes of Alabamians and help to alleviate obesity and chronic diseases (The Food

Trust, 2015).

The Program Initiative

The South Park Invests in Fresh Foods (SPIFF) intervention will work collaboratively

with the Urban Food Project to provide access to healthy food choices to the residents in the

West End Area of Birmingham, Alabama. The Urban Food Project, an economic development

organization located in Birmingham, Alabama, believes in developing creative ways to make

fresh fruits and vegetables available to residents of food deserts. Their research has shown that

residents shop in stores that are most convenient to them and providing food in easily accessible

and unconventional venues gives citizens access to healthier foods (Change Lab Solutions,

2012). SPIFF will utilize the South Park Health Food Store as a venue to provide fresh fruits and

vegetables for residents in West End.

Target Audience and Location

Birmingham covers 43 square miles has 23 communities and 99 neighborhoods (Marie

Gallagher Research & Consulting Group, 2010). Per Marie Gallagher Research & Consulting

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Improving Community Health: One Food Desert at a Time

Group (2010) 88,409 Birmingham residents live in areas that experience food insecurity or are

food deserts. The West End Community has been identified as a food desert with the closest

healthy food store being twice the distance of the nearest unhealthy food store (Marie Gallagher

Research & Consulting Group, 2010). The West End area is covers 4.7 miles and has a

population of 15, 588 (Urban Mapping, 2016). The target audience for this intervention will be

the residents of West End neighborhood. The South Park Seventh Day Adventist Church located

at 414 South Park Road Birmingham, Alabama will be the selected venue for SPIFF

intervention. Locating SPIFF in the church’s health food store will allow physical space for the

fresh fruit and vegetables as well as affording the opportunity to promote food literacy to

customers.

Needs Assessment

The purpose of the needs assessment was to examine the number of people that

experience food insecurity on a monthly basis and the various ways in which people are food

insecure. The needs assessment identified the target audience by conducting a review of the

available literature on food insecurity and food deserts nationwide and in Alabama, by

examining statistics from the US Department of Agriculture’s Food Environment Atlas (2016),

and by conducting a community assessment. The community assessment consisted of face to

face surveys in the West End area. The surveys sought to understand how the following factors

influenced food insecurity:

 Proximity to a nearest grocery store

 Transportation to and from store

 Type of store available near residents

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Improving Community Health: One Food Desert at a Time

 Number of residents receiving food assistance

 Number of days during the month food insecurity is experienced

 Chronic health issues

 Socio-economic factors (race, income, education)

The needs assessment also examined urban maps for the West End Community and noted that

the community had been identified as a food desert. Since the entire community was located

within a food desert all residents of the West End Community would be eligible for participation

in the SPIFF intervention. Surveys were returned and results tabulated and it was discovered that

40% of those surveyed were experiencing food insecurity at some point during the month.

Surveys also showed that residents were interested in having access to healthy foods and

understanding how to properly use healthy foods. Residents were invited to four planning

meetings to discuss health needs related to living in a food desert, healthy food preparation, and

additional community needs that could be addressed by the SPIFF program.

Socio-ecological Factors

The following socio-ecological factors are related to food insecurity and food deserts:

 Median household income

 Availability of food stores

 Neighborhood

 Quality of food accessible

 Dependence on food assistance programs

 Knowledge about managing healthy foods

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Improving Community Health: One Food Desert at a Time

 Employment Level

Stakeholders

Stakeholder #1 South Park Health Ministries Committee- The South Park Church Health

Ministries Committee is committed to reducing food insecurity and food deserts in the West End

community by providing financial assistance for the purchase of fresh produce weekly, offering

fresh produce at a reasonable price, providing food bank services, and providing food literacy to

community members

Stakeholder#2 Residents of the West End Community- West End residents have expressed

concern about how residing in food deserts has a direct relationship to years of life (Marie

Gallagher Research & Consulting Group, 2010). They believe that having access to healthy

food options and having food literacy on how to manage healthy foods will improve community

health and add quality years to life. As stakeholders, they will work toward community buy in

by all residents in West End. Health Evaluation &Implementation