What We WantAn informed community where all people are respected,

valued, engaged and treated fairly

INCLUSIVE DUBUQUE HEALTH EQUITY SECTOR GROUP ISWorking to bring an equity and inclusion lens to the health space in

Dubuque. Focusing on community-wide health conditions and resources that support getting, being, and staying well

REDUCING HEALTH DISPARITIESWHAT WORKS

Introducing Double Up Food Bucks as a tactic to reduce Health Inequity in Dubuque

Presented August 10, 2016 by Carolyn Scherf Inclusive Dubuque Health Equity Working Group

Local Food Coordinator – ISU Extension & Outreach, Dubuque County

How it works

Bring your SNAP EBT Card to the Market Money Booth On the corner of 12th & Iowa Street Saturday morning Farmers’ Market

Open 7am-12pm FREE BUS RIDES FOR SNAP CARD HOLDERS TO MARKET AVAILABLE

Buy any SNAP-eligible foods at the market with your SNAP EBT dollars.

Double Up Food Bucks will match what you spend with FREE Double Up tokens – up to $10, every

market day.

Use them right away or later on to buy locally grown fruits and vegetables

Background: Equity & Health conditions in Dubuque• Diet-related chronic diseases disproportionately effect low income individuals• 57% of Inclusive Dubuque survey participants do not think healthy food is affordable

Double Up Food Bucks: How it works & How it’s working • Impacts so far in Dubuque (Pilot began in July 2016)

Will this really move the needle? • Results in other communities

Call to action How can network partners contribute to program success?

What We KnowCommunity Equity Profile

Diet Related Illnesses

Disproportionately effect Iowans with low household income

WHAT WE KNOW About being and staying well

A diet rich in vegetables and fruits can lower blood pressure, reduce risk of heart disease and stroke, prevent some types of cancer, lower risk of eye and digestive problems, and have a positive effect upon blood sugar which can help keep appetite in check.

-Harvard T.H. Chan School of Public Health Dietary Guidelines For Americans 2015-2019

WHAT WE KNOWOver 70% of Americans do not consume the recommended amount of fruits & vegetables

Dietary Intakes Compared to Recommendations. Percent of the U.S. Population Ages 1 Year and Older Who Are Below, At, or Above Each Dietary Goal or Limit

Local surveys have produced similar results – that the majority of people in Dubuque are not eating a healthy amount of fruits and vegetables

In 2010 77% of Dubuque County Survey respondents reported eating fruit less than 3x per day in the previous week. In 2012, 70% reported the same.

With vegetables in 2010 and 2012 79% of respondents indicated eating vegetables less than 3x per day.

What We Know

Iowa is now ranked dead last – 50th out of 50 states in fresh fruit and

vegetable consumption. Gallop-Healthways Well-Being Index, 2016

Iowa is ranked 38th and 42nd in fruit and vegetable production,

respectively. USDA National Agricultural Statistics Service, 2009

Childhood Obesity RateStrongly correlated with poverty Has climbed from 12 to 27%

In schools with a majority of students eligible for free & reduced priced lunch (and which are located in

USDA Food Desert Neighborhoods):

33-44% of students are overweight(median 37%)

In schools with less than 65% of students eligible for free and reduced price lunch:

11-33% of students are overweight (median 28%)

INCLUSIVE DUBUQUE HEALTH EQUITY SECTOR GROUP ISWorking to bring an equity and inclusion lens to the health space in Dubuque

Community Equity ProfileFROM THE SURVEY• While 76.21% of respondents believe that fresh and healthy food is accessible in Dubuque, 57% do not believe it is affordable

FROM THE DIALOGUES• Since it began accepting SNAP benefits as a payment, the farmers market has become more inclusive and has made healthy, local food more accessible by all populations. • While there is an abundance of fresh, healthy food available, it may not be easy to access or affordable for those with limited income or access to transportation.

INCLUSIVE DUBUQUE HEALTH EQUITY SECTOR GROUP IS Focusing on community-wide health conditions and resources that support getting, being, and staying well

STRATEGY Increase availability and affordability of fresh healthy foods 

How it works

Bring your SNAP EBT Card to the Market Money Booth On the corner of 12th & Iowa Street Saturday morning Farmers’ Market

Open 7am-12pm FREE BUS RIDES FOR SNAP CARD HOLDERS TO MARKET AVAILABLE

Buy any SNAP-eligible foods at the market with your SNAP EBT dollars.

Double Up Food Bucks will match what you spend with FREE Double Up tokens – up to $10, every

market day.

Use them right away or later on to buy locally grown fruits and vegetables

How it works – Behind the scenes 2015 – Dubuque created capacity for SNAP at Market with centralized EBT Station – Over 50 vendors began accepting tokens (avg. 9 transactions $160/week)

2016 – Local DUFB pilot programs coordinated by Healthiest State Initiative in 6 Iowa Communities with technical support from Fair Food Network and funding from the World Food Prize; Coordinated by Healthiest State Initiative This Fall: FINI application will be submitted

2017- 2020 – Iowa communities eligible for up to $500K in matched federal dollars – limited by what is promised as a local/state match. Can be used to build capacity in existing pilot communities or expand to new markets.

2015 – Dubuque created capacity for SNAP at Market with centralized EBT Station – Over 50 vendors began accepting tokens (avg. 9 transactions $160/week)

2016 – Local DUFB pilot programs coordinated by Healthiest State Initiative in 6 Iowa Communities with technical support from Fair Food Network and funding ($25k) from the World Food Prize; Coordinated by Healthiest State Initiative

2016 – Local DUFB pilot program July Impacts so far – (Spencer IA not included*)

Impacts: Month 1 (July 2016) Dubuque Avg. 2015

Dubuque Avg July 2016

Iowa July 2016

Total # SNAP Transactions/week 9/week 24.4/week ~51.25/week

Total Value SNAP Transactions $167.12/week $206.40/week ~$721.8/week

Total Double Up Food Bucks distributed

$0 $1,032 ~$2,163+

Total: July 2015: $882

July 2016: $2,064.00

July 2016 ~$5,106.00+

2017- 2019 – Iowa communities eligible for up to $500,000 in matched federal dollars – limited by what is commited as a local/state match for 2017-2019.

* Note to sponsors: Letters of Commitment needed by November 2016 *

Food Insecurity Nutrition Incentives Program (FINI) Supports projects to increase the purchase of fruits and vegetables among low-income consumers participating in the Supplemental Nutrition Assistance Program (SNAP) by providing incentives at the point of purchase. There are three categories of projects: (1) FINI Pilot Projects (awards not to exceed a total of $100,000 over one year); (2) Multi-year, community-based FINI Projects (awards not to exceed a total of $500,000 over no more than four years);

and (3) Multi-year, FINI Large-Scale Projects (awards of $500,000 or more over no more than four years).

Includes $31.5 million for FINI

Pilots of DUFB in 140+ communities across the U.S. were so successful USDA is investing over $30 million in expanding similar programs

?

Dubuque Farmers’ Market

Goal:

$36,000 Statewide

fundraising goal for Iowa:

$500,000

Will this really make a difference?

Diet Related Illnesses

Disproportionately effect Iowans with low household income

A diet rich in vegetables and fruits can lower blood pressure, reduce risk of heart disease and stroke, prevent some types of cancer, lower risk of eye and digestive problems, and have a positive effect upon blood sugar which can help keep appetite in check.

-Harvard T.H. Chan School of Public Health

National Success Stories: Michigan

National Success Story: New Mexico State funds help ensure program sustainability, capture federal match

• 2015 $400K state funds allocated towards food incentives + $100 K federal funds • 2016 – 2020: With the $400K recurring

state funds as committed federal match, it is projected NM DUFB will receive $500K of federal funding per year, or $2 million total• More than 75% shared that DUFB was a

strong incentive to shop at farmers’ markets and that they increased their purchase of fruits and vegetables as a result.

Iowa is now ranked dead last – 50th out of 50 states in fresh

fruit and vegetable consumption.

Gallop-Healthways Well-Being Index, 2016

Become a Program Sponsor • Local and Statewide recognition opportunities

available

Join the DUFB Outreach & Promotion working group• Monthly meetings held to plan creative community

engagement

Sponsorship Needs • This year: $5,500 • Promised by November - $30,000 • Opportunity to have this matched by USDA to = $60,000

Outreach & Promotion Needs• How can we reach SNAP participants to make them aware of the

program?• How can we make the Farmers’ Market welcoming to first time

market-goers?• How can we ensure people are supported in learning to cook with

new foods?

If you’re interested in creative solutions to these questions – Join us!

Performance Measures

“Developing a shared measurement system is essential to collective impact. Collecting data and measuring results consistently on a short list of indicators at the community level and across all participating organizations not only ensures that all efforts remain aligned, it also enables the participants to hold each other accountable and learn from each other’s successes and failures.”

The Iowa Double Up Food Bucks program (DUFB) uses existing infrastructure - farmers’ markets and the Iowa EBT card - to: 1. Improve access to and affordability of fresh fruits and vegetables for low-

income families; 2. Grow the local economy by supporting purchases from local farmers;3. Shift public policy so that future federal (and state) nutrition assistance

programs can simultaneously address health, hunger, and nutrition and support a more sustainable food system.

Things to consider:

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Other upcoming events - Inclusive Dubuque Health Equity Working Group