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Creating Healthy Communities

State: OH Type: Model Practice Year: 2014

For Cincinnati, food access is an issue of health equity. The incidence of diet-related diseases is disproportionately high amongst populations in lower-income neighborhoods. In correlation, residents have a higher incidence of food insecurity compared to the average American household.A 2011 study of Cincinnati found that 69% of residents live at least 1.5 miles or more (a 30 min. walk) from a mainstream grocery outlet. Of these residents, 82% are African American compared to 41% White, further emphasizing the disproportionate inequities amongst minority populations and increasing risk of other chronic health conditions . Widening gaps in health disparities correlate with median incomes. For Cincinnati residents, median household income in 2009 was $21,971 for African Americans compared to $42,868 for White residents. This data illustrates the increasing strain on our current health system and the impending long-term costs. The Cincinnati Health Department’s Urban Farming Program, led by the CHD's Creating Healthy Communities program, addresses Cincinnati's food and health-related inequities through: Systemic assessment of food access issues Education and engagement Collaborating with local government, policymakers, and community stakeholders Effecting environmental, policy, and systems changes Goal: To increase access, consumption, and production of healthful fruits and vegetables amongst low-income populations. Our objectives are to: Establish and promote access to fresh produce and healthy living programs in targeted neighborhoods Support food production areas (community-gardens, urban farms, etc…) through education, engagement, and technical assistance Establish ‘shared-use’ of public space through developing community-based partnerships among community organizations Work with local policy makers to establish supportive urban agriculture policies Since it's inception in 2010, the Urban Farming Program has recognized urban agriculture as an innovative and comprehensive approach to improving the health of social, ecological, and economic systems. Through community engagement and small-scale intensive farming methods, our community-based farms are able to provide nutritious foods to neighborhood residents, community recreation centers, community food pantries, faith-based organizations and local senior centers. The Urban Farming program (servicing the neighborhoods of Winton Hills, Spring Grove Village, Bond Hill, North Avondale, and Madisonville) has strengthened community partnerships, leveraged local assets, and built sustainable local food sources that foster health, equity, and strong local economies. Based upon an innovative ‘open door’ model focusing on shared-use of public space, we have experienced annual increases in community participation and food production. In 2012, the UFP’s six community-based farms provided over 4,000lbs of fresh fruits and vegetables to residents and community organizations. Our work ‘on the ground’ within the communities helps educate and shape our policy initiatives. The UFP has worked with Cincinnati City Council to develop notable policies and programs that support the development of local food systems as key initiatives to the sustainable health of our region. Surveys administered annually indicate factors of: increases in daily consumption of fruits and vegetables, attributed to the proximity of the food source (garden) to home; increases in community participation, stewardship, and pride; increases in physical activity amongst youth and elderly populations (ages ranging from 8-68); increases in food literacy; increased awareness of a community’s food security and related ecosystem functions (such as storm-water management, enhanced biodiversity, and soil remediation). Finally, given the inter-dependent relationships of a ‘local food system’ our partnerships and collaborations continue to identify new opportunities for integrating food access and production into the places in which we live, work, and play to support healthy eating and community resilience.
This model practice addresses a multitude of public health issues. Foremost, the Cincinnati Health Department’s Urban Farming Program (UFP), serving the City of Cincinnati with a population of approximately 300,000, utilizes evidence-based change strategies to impact chronic disease and obesity rates amongst low-income populations within Cincinnati. Furthermore, the UFP comprehensively addresses issues of: assessment of local food systems; accessibility, consumption, and production of fruits and vegetables amongst low-income populations; disconnect between local health programs, community-based organizations, and the residents in need of services; sustainable community-building based on innovative engagement, education, and policy processes – premised on urban agriculture. According to a 2011 Food and Health study of Hamilton County (population 802,000), 69% of Cincinnati residents live in areas with low healthy food access, 1.5 miles or more from a mainstream grocery outlet . This data correlates with high incidence of chronic disease, limited access to healthful foods, and increased food insecurity. Poor health outcomes such as cancer, heart disease, diabetes, and obesity can, in part, be attributed to unhealthy diets, which are typically chronically low in fruits and vegetables. The UFP’s target neighborhoods include Winton Hills, Spring Grove Village, Bond Hill, North Avondale, and Madisonville, impacting an approximate population of 31,500. Of these residents, 82% are African American compared to 41% White, further emphasizing the disproportionate inequities amongst minority populations. Additionally, the widening gaps in health disparities correlate with median incomes. For our target neighborhoods the median household income in 2009 was $21,971 for African Americans compared to $42,868 for White residents. The consumers of this demographic group find they have greater distances to travel for healthy foods, with many lacking the appropriate means of transportation. As is common for most urban neighborhoods, the convenient stores that are within walking distance offer little in the ways of fruits and vegetables, while local food pantries have limited supplies and/or no cooling systems to keep produce fresh. The model practice of the UFP takes a systems perspective, seeking to utilize urban agriculture as an innovative and comprehensive approach to improving the health of social, ecological, and economic systems. Through innovative and strategic ‘shared-uses’ of public/private land, responsive community engagement, small-scale intensive farming methods, and comprehensive policy initiatives – our model practice has integrated food production and access into the fabric of neighborhoods. The systemic approach of the UFP is based on conceptual theories and scientific-evidences derived from the Guide to Community Preventive Services, Change Lab Solutions, and specific model practices from NAACHO’s Toolbox. The UFP’s model practice of urban food systems addresses the CDC’s Winnable Battles of Nutrition, Physcial Activity, and Obesity. Our innovative practice links the complex relationships of the food system. Our program goes beyond implementation of community-gardens. By identifying emergent properties and strengthening the integrative levels of the system, the UFP comprehensively addresses a multitude of issues related to the health of low-income populations.
Nutrition, Physical Activity, and Obesity
The Cincinnati Health Department is the lead agency for the Creating Healthy Communities Urban Farming Program. The UFP demonstrates broad-based community participation and involvement from local government, residents, academic institutions, and community organizations.Since it's inception in 2010, the UFP has engaged residents and established thriving community partnerships with the fundamental goal of improving the health of Cincinnati residents. Ancillary goal(s) are to increase accessibility and consumption of healthy foods through increased production of local fruits and vegetables via ‘shared-use’ models of public space. Our objectives are to: (1.) establish and promote access points for fresh produce and healthy living programs in targeted neighborhoods; (2.) establish ‘shared-use’ of public space through developing community-based partnerships among community organizations; (3.) support food production areas (community-gardens, urban farms, etc…) through education, engagement, and technical assistance; (4.) and work with local policy makers to establish supportive urban agriculture policies. The innovative approach of the UFP embraces a systems perspective, seeking to utilize urban agriculture as a platform to improving the health of social, ecological, and economic systems. The comprehensive approach undertaken is sustained creating equitable, healthy partnerships. The UFP coordinator is responsible for the implementation and completion of program goals. Implementation processes include coordinating with local agencies, facilitating meaningful community engagement in planning and land-use decisions. Building community ownership is essential, meeting the needs of diverse neighborhoods and incorporating the collective vision is imperative in building broad support, effective public processes, and sustainability. Additional steps include conducting community assessments and identifying assets. Community stakeholders include neighborhood residents, community councils, governmental agencies, community redevelopment corporations, community recreation centers, local food pantries, faith-based organizations, local schools and senior centers. The role of community partnerships is specific to each neighborhood. Their roles in the planning and implementation processes vary based upon capacity and organizational mission. The UFP fosters collaboration with each community stakeholder, utilizing their assets to strengthen the collective network that comprises each neighborhood’s local food system. For instance, we support community-gardens at specific Community Recreation Centers, which serve as positive social hubs within our target neighborhoods. They provide the appropriate setting for shared-public space for food production, distribution, and educational classes. Collaborating partners include the Cincinnati Health Department, the City of Cincinnati’s Office of Environmental Quality, the Civic Garden Center, the Cincinnati Recreation Commission and the Bond Hill CRC, Winton Hills CRC, and North Avondale CRC, the Madisonville Community Redevelopment Corporation, Gaines United Methodist Church, New Mission Baptist Church, Cincinnati Bible Way Church, the Evergreen Holistic Learning Center, Funke’s Green House, SideStreams, the Light House Youth Center, the Cincinnati Nutrition Council, the Green Umbrella, and Cincinnati City Council. Through small-scale intensive farming methods and technical assistance, the UFP has been able to engage stakeholders and implement food production areas (community gardens, urban farms, etc…). Since 2010, we have implemented seven community-based gardens. Each site has its own group of ‘primary’ gardeners, engaged and vetted by the UFP coordinator. Additionally, each site is unique to itself personifying the vision of the neighborhood residents and community agencies. Initial start-up costs vary based on site remediation (soil quality and infrastructure). Approximate costs range from $500-$1,000. Beginning in January, monthly planning meetings are held to create a vision, share ideas, and plan for the upcoming year. Beginning in mid-March (weather pending) bi-weekly community workdays and technical trainings are held. Each ‘garden group’ shares information about sustainable gardening, volunteer management, food literacy, and healthy lifestyle practices. As the gardens grow, so does community participation. All sites adhere to an ‘open-door’ policy, in which the gardens are accessible to all. This is no fencing or any restrictive structures prohibiting access. Furthermore, food is available to all regardless of participation. The ‘grass roots’ initiatives taken by the UFP provide the framework for comprehensive policies that enhance local food systems and sustain healthful food access. Our collaboration with community partners, and work with community members on the ground and ‘in the gardens’, provides the experience and ability to understand the challenges to accessing healthful foods. We are provided first hand knowledge of the obstacles faced by residents and communities as a whole. This allows us to effectively work with policy makers and governmental agencies to implement effective and sustainable policy initiatives. Based upon the work of the UFP, the following notable programs and policies have been adopted by the City of Cincinnati:? 2012 Mobile Food Vending Program; ? a pilot program to increase the vitality of city streets, establish new markets, expand small business opportunities, and improve affordable food choices. Pilot program runs July 1, 2012 – June 30, 2014. 2012 Mobile Produce Vending Program; a pilot program to increase access to fresh produce by issuing permits to community gardeners, urban farmers, and entrepreneurs to sell fresh fruits and vegetables near community gardens and in neighborhoods with 'food deserts'. Pilot program runs May 1, 2012 – April 30, 2013. 2012 approval for commercial composting facility; 2010 Urban Agriculture Program; a program for community members to utilize vacant, city-owned parcels of land for agricultural use. 2009 defined 'community garden' and permitted use in all zones, excluding Downtown and Riverfront zones.
The purpose of the UFP is engage residents and established thriving community partnerships with the fundamental goal of improving the health of Cincinnati residents. Furthermore, we seek to increase accessibility and consumption of healthy foods through increased production of local fruits and vegetables through ‘shared-use’ models of public space. Through strategic community engagement and effective partnership building, we have determined that there is a strong community desire to incorporate localized food systems within our neighborhoods.Based upon annual surveys conducted by the UFP and in-depth gardener interviews, our processes have successfully engaged community participation and awareness. Our gardener evaluations have determined an increased desire for a more intimate relationship with food, the land that produces it, and affiliated healthy lifestyle choices. Outcomes have indicated that the ‘hands-on’ participation resonates with an inherent relationship with our natural environment. The food becomes then a product of this relationship. Based upon our successful model of unrestricted accessibility, it is difficult to quantify the amount of food produced. According to local extension offices approximation of plant production, the UFP’s seven community-gardens yielded approximately 4,000lbs of fresh fruits and vegetables in 2012. During the months of March-November, community participants indicated a decrease in dollars spent at the grocery, amounts ranging from $10-$25 weekly. The UFP’s policy outcomes are clearly identified. The UFP coordinator has worked with local policy makers to implement five separate policy initiatives and/or programs. Beginning in 2009, the City of Cincinnati defined ‘community gardens’ as a permitted use in all zones, established a City-wide Urban Agriculture Program making available vacant city-owned parcels for agricultural use; the approval of a commercial composting facility; and the implementation of a Mobile Produce and Food Vending Program, allowing access points to be strategically identified within neighborhoods classified as ‘food deserts’. Participant data is collected by the UFP. The data collected includes only participating community members. Much of the recipients from our food production are through extended partnerships, including local food pantries, senior centers, and community recreation centers.
The UFP has established strong collaborations with committed stakeholders within each of its targeted communities. Our initial engagement processes successfully identified committed community partners. Site locations, partnering organizations, and dedicated community members were all part of the initial visioning and planning sessions. These practices create a sense of ownership, providing a strong foundation for commitment over the years.Our community-garden model is designed around sustainable practices. Our gardening techniques ensure sustainability. Adhering to organic gardening practices such as composting, water harvesting, seed collection, and strong community engagement, our food production sites (gardens) increase prosperity and production annually. These practices contribute to the overall health of the site’s eco-system, reducing the need for long-term financial support for supplemental resources. Additionally, each year our gardeners gain experience and knowledge, which contributes to site sustainability. Beyond the community garden component, bridging the complex relationships of the local food system comprehensively strengthens the overall network of partners and their roles. As a whole, the network is stronger. This unique attribute contributes to the sustainability of our program and fundamental goal of improving the health of Cincinnati residents through increased access to healthful foods. Sustainability is rooted in the overall strength of the system. Utilizing our experiences within the neighborhoods to affect appropriate policies and identify the necessary community agencies, strengthens the local food system. Our model practice of identifying emergent properties and strengthening integrative levels, allows us to enhance and sustain the complexities of our local food system.
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