Access to Nutritious Foods Planned Community Change

Access to Nutritious FoodsPlanned Community ChangeNURS 340Jerrene BrambleAngelique KinyonJoella ShowSherry Brabon

Access to nutritious foods, a planned community change, was developed by Jerrene Bramble, Angelique Kinyon, Joella Show, and Sherry Brabon in the Summer of 2013 as a group project for NURS 340 Community Nursing. 1Kent 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.Problem Statement

This presentation will focus on this problem statement: Kent County residents are at risk of imbalanced nutrition related to lack of food resources as evidenced by limited access to grocery stores, high rates of food insecurity and rate of obesity. Over 19,000 Kent County residents live in an area in which they do not have access to a grocery store. This limits food choices to what may be available at the convenience store. Furthermore, 23% of children in Kent County experience food insecurities. Finally, 29% of adults and 35% of the children are obese in this county.2Identify nutritional concerns in Kent CountyAssess current access to nutrition resourcesIdentify strengths and weaknesses related to access to healthy foodIdentify modifiable factors for good nutritionProvide interventions to improve nutritional intake to Kent County residentsEvaluate effectiveness of interventionsObjectives

Six objectives were established to develop this project. They are: Identify nutritional concerns in Kent CountyAssess current access to nutrition resourcesIdentify strengths and weaknesses related to access to healthy foodIdentify modifiable factors for good nutritionProvide interventions to improve nutritional intake to residentsEvaluate effectiveness of interventions

3Population in 2012 - 614,562Median household income, 2007-2011 - $50,801Persons below poverty level, 14.8%(United States Census Bureau, 2012).Number of grocery stores -118Kent County 1.96/10,000 populationMichigan 2.34/10,000 population (City-Data.com, 2012).Kent County Statistics

In 2012 there were 614,562 residents in Kent County, Michigan. The median household income between the years of 2007-2011 was just over $50,000. More than a 10th of the population in Kent County, MI is below poverty level. The number of grocery stores in Kent County is below the Michigan average of 2.34 per 10,000 people. Kent County has 1.96 grocery stores for every 10,000 people. There is a potential problem related to access to nutritional food in Kent County. This problem is related to several factors that will be discussed within this presentation.4Modifiable factors involved in obtaining a diet rich in healthy whole foods:KnowledgeUnderstandingAwarenessAvailabilityFarmers MarketsGrocery StoresFood within the school systems and work placesMeals Vending machinesIndividual financial needResources

Modifiable Factors

With the community change involved in this project, it is necessary to identify modifiable factors to focus on in order to enable the necessary change to happen. In focusing on obtaining a diet rich in healthy, fresh, whole foods, we identified some of the modifiable factors that could help accomplish this goal. First of all, knowledge is nearly always a modifiable factor and in this case we would focus on the understanding of what exactly healthy fresh foods are or aren't, and where to obtain these foods. Since we are increasing the awareness, we then need to ensure this is supported by an increase in the availability of fresh healthy foods. This can be done by facilitating an increase in Farmers Markets and grocery stores. In addition to modifying the knowledge and availability, the majority of children of Kent County are affected by the food within the school systems. This includes the foods provided for meals and any vending machines within the schools. Vending machines may pose an issue in any setting, not just schools. They may create issues in work places were people spend a large portion of their day and fill up on empty calories because of the ease of obtainability. Vending machines are convenient and should at the very least have healthy choices if not ONLY healthy foods available. Finally, individual financial need may not be modifiable in all situations. However, the resources and programs to help the residents of Kent County are modifiable. Programs and interventions will be discussed in further detail within this presentation. 5CommunityStrengthsCommunity GardensFarmers MarketsFood BanksSNAP benefitsWIC Double-Up ProgramHealthy options available in some of the schools

WeaknessesLack of knowledge about public transportationLack of grocery stores/food sources/ limited farmers marketsCrime ratePovertyVending machines in schools with unhealthy choicesSome school meal programs do not provide healthy choicesConvenience/availability of fast food optionsInconvenience/high cost of fresh whole foods

This slide explains our assessment of the community's strengths and weakness. As you can see, there are more apparent weaknesses than there are strengths. The amount of poverty causes a disruption in transportation that will allow residents access to a grocery store. If you recall, Kent county has a limited number of grocery stores per person.Most residents do have access to a convenience store however there is a limited food supply and very little nutritious foods. The healthy foods that are available typically cost more which makes these choices unavailable to some. Kent county does have several strengths including some food banks, SNAP benefits, and WIC for example. These strengths have the potential of being modified to fill needs that are not being met in the community. 6"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 areaFor more information on a community garden in Kent County go to: foodshed.netSchool and Community Gardens on the Kent County Facebook PageExtra produce harvested from community gardens can be canned, dried, or frozen for use during the winter months

Community Gardens

"Local government leaders are in a unique position to promote healthy eating and active living in their communities by supporting community gardens. Community gardens are places where neighbors can gather to cultivate plants, vegetables and fruits. Such gardens can improve nutrition, physical activity, community engagement, safety and economic vitality for a neighborhood and its residents. Barriers, such as liability expenses, code restrictions and a lack of resources, which often make it difficult for communities to establish or maintain gardens in their neighborhoods, can be overcome with local government engagement" (Local Government Commission, n.d.). For more information on community gardens visit www.urbantilth.org7Food Banks & Food InsecurityFood BanksFood 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.Deficits of West Michigan Food Banks93% deficit of meat, poultry and fish89% deficit of fresh fruits and vegetables88% deficit of dairy productsAvailable food fell short of USDA recommendations

There are food banks available in Kent county, for this reason, they were noted to be a strength in the community for the people they do serve. However, despite their efforts, they lack nutrient rich food sources. Also, the supply of food at the food banks is a concern as there is too little food available for the demand. If residents were aware of the food bank's deficit, perhaps donations would improve. Most of the major food groups are lacking at food banks, especially so when it comes to nutrient rich foods.8Government Assistance & Availability IssuesGovernment AssistanceIn 2010 18% of people in Kent county relied on SNAPSome 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 SNAPAvailability IssuesThere 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 KrogersA program from Michigan State University called Project Fit is targeting neighborhood convenience stores to increase healthy and affordable food

SNAP benefits and WIC Double-Up program are recognized as strengths for Kent County residents in relation to having access to nutritional foods. However, not all people may be utilizing these benefits possibly due to inadequate understanding of the programs or in some cases, the residents are not legal US citizens and are afraid of deportation. Despite the previously mentioned programs, issues remain due to availability issues and food insecurities. Part of the reason for food insecurity in Kent County is the high cost at both large chain grocery stores and small convenience stores. A program from Michigan State University called Project Fit is targeting neighborhood convenience stores to increase healthy and affordable food.

9Disability advocates of Kent County offer transportation to qualified individualsThe Rapid (Interurban Transit Partnership, ITP)Go!Bus, PASS, RideLink, Car & Van PoolingFaith in Motion (FIM)The Hope Network provides transportation for individuals with disabilities or disadvantagesOther providers of transportation in Kent County, MI, many of which are non-profitAIDS 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)Transportation

"According to the 2000 U.S. Census Data, there were a total of 14,981 or 7.0 percent, of occupied housing units in Kent County with no vehicles available" (RLS & Associates, Inc., 2011). Lack of knowledge about transportation options was noted to be one of the barriers for access to nutritional food sources. Kent County offers a variety of public transportation services including transportation for senior citizens, the disabled, and the disadvantaged members of the community. 10"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 CountyAll but 1 are only open seasonallyAll have limited hoursMost only open 1 dayOnly 6 take WIC or SNAPFarmer's Markets

Farmers markets are listed as strength of Kent county, but it may also be a potential barrier related to having access to nutrition foods in Kent County. ***there are more than 13 farm markets listed but only 13 were updated with days, hours, products available, and if they took WIC or SNAP***Although farmer's markets are an excellent opportunity to obtain fresh, whole foods, in this case not all farmers markets within Kent County are readily available.Only one is open year round, they all have limited hours, many are only open one day a week and less than half accept WIC or SNAP. Farmer's markets are an excellent source of nutritious foods and it was determined that this area would be an important area to focus on for improvement to increase the availability to the residents of Kent County. This would also assist with the local economy as the money earned goes back into the farms to produce more quality produce for the county thus beginning a positive cycle.

1119,172 Kent County residents do not have access to a grocery store with fresh produce17,920 residents have limited accessOverall 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)Community Concerns

Lack of available grocery stores/food stores were identified as a barrier to access to nutrition foods.Upon further investigation, we found that food deserts are common in Kent County, 3% of the population do not have access to food and another 3% have limited access to grocery stores. Food insecurities mean people do not have enough food to lead a healthy, active lifestyle. In Kent county, this represents 15.2 percent of the overall population, but 23.2% of the child population. According to the United States Department of Agriculture, the US rate of food insecurities is 14.9%.

12Only 26% of adults and 34% of youth in Kent County report eating healthy balanced mealsLower income adult residents (