Healthy Food Access in Urban Areas: Barriers and Solutions Full

Healthy Food Access in Urban Areas: Barriers and Solutions Full

Healthy Food Access in Urban Areas: Barriers and Solutions Full

By Bryan Wright 0 Comment August 22, 2019


MOLLY MITCHELL: Good afternoon,
everyone, and welcome. My name’s Molly
Mitchell, and I’m the manager of the Mid-Atlantic
Public Health Training Center. And on behalf of
the training center and the Maryland Department
of Health and Mental Hygiene, I’d like to welcome everyone
to today’s presentation, our May public health practice
grand rounds on healthy food access in urban areas,
barriers, and solutions. And before I introduce our
speakers today and get started, I’ve just got a few
announcements to make. For those of you who
are watching online, I’d like to invite you
to please check out some of our archived
grand rounds that are on our
website, as well as some of our other online
trainings as well. And I’d like to
draw your attention to some of our live face-to-face
trainings that are coming up, including grant writing
and logic modeling. And just alert that next
month’s grand rounds is going to be on reducing
asthma disparities in children. Also, for those watching online,
please know that any time during the presentation,
you can email a question to either of our presenters by
simply clicking on the link. And we also do ask that you
fill out the sign in form, so that we can give our federal
funders a better idea of who’s watching and how
many people want to watch in today’s webcast. And so with that, I’m going
to go ahead and introduce our speakers today, Anne
Palmer and Holly Freishtat. Since 2006, Anne has been Eating
for the Future program director at the Johns Hopkins Center
for a Livable Future. She’s responsible for directing
the food and nutrition work at the center. This includes
identifying opportunities to build awareness about
the current food system, and its impact on public
health, and the environment, collaborating at a regional
level with other institutions to determine the potential
of regional food systems reaching under-served areas,
working with Baltimore city’s food policy director on
improving food access in Baltimore, and facilitating
community food assessments with community organizations. Prior to this position,
Anne work for 13 years developing and managing
strategic communications and large-scale health
communication campaigns and programs in Asia. She holds a masters of
international affairs degree in communication and
development studies. And our second speaker
today is Holly Freishtat. Holly Freishtat is Baltimore
city’s first food policy director. In this role, she created
the Baltimore Food Policy Initiative and
intergovernmental collaboration that aims to increase access
to healthy, affordable food in food deserts
in Baltimore City. Ms. Freishtat has spent over a
decade working on food issues in a variety of
contexts, including work on food and health policy
as a food and society policy fellow and at the Washington
State University King County extension, where she founded
a farm-to-school program and developed the
program’s gardening and cooking
nutrition curriculum. Ms. Freishtat also
worked for Skagitonians to Preserve Farmland, where she
developed a farm to health care pilot project that provides
healthy seasonal foods to hospitals and
retirement communities while creating new
markets for farmers. Ms. Freishtat has a
masters of science from Tufts University in food
policy and applied nutrition and was a food and society
policy fellow in 2007. So with that, I’m going to turn
the floor over to Anne Palmer. Thank you. [APPLAUSE] ANNE PALMER: Good
afternoon, everybody. I’m thrilled to be here today. I just want to thank Molly for
inviting us both to come down. As she said, I work at the
Center for a Livable Future. We are an
interdisciplinary center in the School of Public
Health, and we really look at the intersections of
public health, the environment, agriculture, and food. And so a lot of our work
is looking at the systems, even though today we’re
going to be talking primarily about healthy food and
healthy food access. So why do we even
talk about food? And I think one of
the things that I’ve noticed since I’ve been
working on this topic area is that people– we have treated a lot
of different services in city governments such as
water, air, food, shelter, etc. Except for food, we
have treated those with– that they need
to be attended to and regulated in some way. And so I think one
of the things that we see with the increase
of diet-related disease is that food has primarily
been in the private sector. And we’ve sort of left it there
until certain trends started happening, and we realized
that maybe this needed to be considered more as
a service or as a good that the public has
to have access to. And so, I think
what you’re seeing– there has just been a boon in
literature, and art, research, and activities going on
around the country around food and what’s going on
with our food system, in large part driven by
the obesity epidemic. But by other reasons,
for other reasons as well, is that
there is an attempt now to try to structure food
and to attend to it in a way that we need to do
it from a policy perspective and an environmental
perspective as well. So I want to talk a
little bit about some of the current trends and what
has changed in our food system over the past, probably,
I’d say 30 to 40 years. And then I’m going
to talk specifically about how some of these
play out in urban areas. But I think overall, think about
going into a store, any store, and it is unlikely that
you’re going to find– you’re not going to
find food of some sort. I have noticed food in auto
parts stores, libraries. Any possible store you could
go into has a food display. So we have tons and
tons of opportunities to be eating all the
time, continuously. We have more food available now
than we’ve ever had available. So really, you don’t
ever have to be hungry. I think the other thing you’ll
notice in our food system is that we have an abundance
of the types of food products that we are developing. I don’t mean different
varieties of carrots. This is really more
processed food. So if you were in a
grocery store in the 1970s, you’d find about
8,000 food products. And now, you find about
48,000 food products. And so those are really
much more processed foods than we ever had
access to before. The other thing
that’s happened is you see a big increase
in serving sizes, and because people are eating
out more, that that actually has a bigger impact in terms
of the number of calories they’re taking in. Throughout the
presentation, I’m going to talk about what
some of the barriers are to people accessing
food in urban areas. And I’m going to look
at it from a perspective of physical barriers,
economic, social, and educational barriers. And where it’s
feasible to do that, I’m also going to
talk about some of the Baltimore-based
research that has been generated on these topics. Before we do that, I do want to
introduce you to some concepts and to some
definitions that we’re going to be using
throughout the presentation. Food security is
really just, do people have sufficient food to live? Do they have enough food? Are they experiencing
hunger on a regular basis? If you are a food
secure individual, there is some point in the
course of a month or a year where you don’t have
adequate access to food, and you do have–
you’re experiencing hunger of some sort. So food security
and insecurity are concepts that are generally
well-known in our field. The other definition
is something we call community food
security, and this is a much more
holistic definition about what’s happening at that
community level with regards to food. And so you look at– not only is there
just food there, but what’s the
quality of the food? Is it nutritionally
high in quality? Is it culturally acceptable? Where’s the food being grown? Where is it coming from? How is it being transported? How much participation
do the people who live in that area have
in getting their food? Or are they just
going to this one store that happens to be located
two miles from their house? So it really is
an attempt to look at what’s happening at
that community level, and recognizing the
household level’s important as well, but trying
to back up a little bit and saying, what’s happening
in a community with this And then when we use the
term food environment, we’re really just talking
about any source of food that exists in a given
area– a community, we could say, a geographic area. So it’s restaurants, gas
stations, food stores, supermarkets, corner stores. Anything like that is part
of that food environment. So what’s the food
situation in Baltimore. So I think we have a pretty
interesting situation. I’m sure a lot of you have heard
the term food deserts before, and I’m going to talk a
little bit about that. Holly we’ll talk about
that more in detail. But I think what you’ll
see happening in Baltimore is if you live in a lower
income community, the food that you have available
to you isn’t necessarily always the best quality. There’s a lot more processed
food, a lot more fast food. And in some cases, the food
is also not very affordable. Our food insecurity rate
in the state of Maryland has increased
pretty dramatically. I just updated these statistics. Used to be about 9%, and
we are now up to 12.5%. And that’s a steady
increase since 2008. And we have households
of 5.1% that experience hunger on a regular basis. And that was about 3%
just a few years ago, so we really are
seeing the effects of the recession
and the economics impacting people in their
ability to get food, to be food secure. And you’ll see that
we are still lower than the national average, but
we’re climbing, unfortunately. In addition, you will find that
even poverty isn’t necessarily a predictor. You find a lot of people
living in poverty that are not food insecure, but
that is that definitely is– there is a pretty
strong relationship. So I’m going to talk
about physical barriers now, and think a little bit
about the built environment and how that impacts people’s
ability to get healthy food. For each of these
bullet points, this is typically a study, one
study that’s been done. And you can, as you know for
being researchers yourself or people who have studied,
that you can– for every study you can find that
says one thing, you can find a study
that says something else. So you’re going to hear some
contradictions in what I’m saying, but just
kind of bear in mind that this is just to give you
some sense of the complexity of looking at these systems. So if you see a headline in
the New York Times that says, this is not a problem. This study shows that. It’s always important to
dig deeper and figure out what are they really
trying to measure there, because I think you’ll find
that there’s evidence depending on how you measure it. So this particular
study, it looked at if you added a
supermarket, did it have a change in the
consumption levels in fruits and vegetables, of produce. And in one study they
found that it is up to 30% more that consumption increased. And this is among a group
of African Americans in a low income neighborhood. You also find that if
you have a low income, you’re designated low
income and particular zip codes, that you’re going to have
fewer supermarkets in your zip code. Again, by design. It’s This is more looking
at what’s the relationship. You know, what’s the density
of the food stores there? A newer study that has
come out, breaks this down a little in a
little more granular way that I think is really
important to look at. So if you don’t
have a supermarket, and then you do
have a supermarket– so you’re changing
that food environment, that that becomes a
source– that supermarket is a source for healthier food. However, if you’re
somebody who has access to a lot of different
supermarkets, having more access
doesn’t necessarily make it a healthier food choice. It makes it somewhat
unhealthier. And so you have–
then it ends up being kind of a dose
response almost. You’re getting so
much food around you that you’re not making
different choices. And what they found in
this particular study– that if you were now shopping
at a supermarket versus perhaps a smaller corner
store or grocery, that you were increasing
the number of purchases you made for produce. We also have a
situation in Baltimore. I think we have 44
supermarkets in Baltimore. Is That right, Holly? So 44 supermarkets. And what we know about
those supermarkets is they’re very different. If you go to a supermarket
in Roland Park, and you go to a supermarket
in southwest Baltimore or in east Baltimore, what’s
inside that supermarket and the quality of that
market varies dramatically. And so one of the issues– this research that I’m
referencing right now is actually funded by a Center
for a Livable Future Innovation grant. Dr. Franco had published
this, and so a lot of the data is going to be coming from that. But what he found
is when you looked at the food was
actually in the store– and he gave this a score
using a particular measurement tool called the Nutrition
Environment Measurement Survey– came up with an index
score, and those scores for supermarkets in low income
neighborhoods were about half if were in a– compared to a predominantly
middle to high income white neighborhood. So it really does
make a difference in terms of where
you’re living, in terms of what you have access to. And even within– this, I
found rather fascinating. Even if you were looking
at a chain market– so if you had a Safeway
store in Baltimore City, and a Safeway that
was out in the county, there would still be a
fairly dramatic difference in the Healthy Food
Availability score. So it is not consistent
across chains, and they actually do really
market to those neighborhoods what they think is
going to sell and what they think people want. If you look at diet, then
this is a relatively– this is, again, from
the same data set. I’ve now since
read data that has said this maybe isn’t as strong
a predictor, but certainly, in Baltimore– this was using
the MESA data set, which is a cardiovascular
disease data set of like 900 patients in Baltimore. And when Dr. Franco
looked at this, he found that those
patients had a lower quality diet than people– if you lived in a low
income neighborhood and had low healthy
food availability, then people who were living in middle
to upper income neighborhoods. So again, that does–
it’s not only affecting purchasing patterns, but it’s
affecting consumption patterns as well. Now I’m going to talk a little
bit about economic barriers and what happens. And as you can imagine,
if you’re supermarket, you aggregate a lot
of your purchases. And so, you have volume buying
and you can offer people much better prices. If you’re a small corner
store, you typically are buying from a wholesaler,
sometimes even going to maybe a big box store
and buying those items. And so, you’re going
to charge more, because you aren’t buying
the volume that you need to have lower prices. So that’s one way of explaining
sort of the difference in what happens with prices. They think even with that,
knowing that, there is still is probably some price inflation
going on that we can see. Brookings Institute had done a
study that looked at 132 food products, over 3,000, and
found that 2/3 of them were more expensive if you
were in a super store that was under 10,000 feet. A small supermarket would
be about 25,000 square feet. Some of the supermarkets
now, they’re closer to 50, 60 even
70,000 square feet. So just to give you
some sense of size, these are really like
more small grocers. And we had used some of the
data that Dr. Franco collected to look at what the cost
differences were in Baltimore. And this is– we found that
up to $1.30 more for a box of cereal, and then 1/2 gallon
milk was actually about 81 cents more. If you’re living
on a tight budget, that is a pretty dramatic
amount to be paying more for. The other study that
we are co-author on, that’s going to be published
in the next couple of months, is a supermarket study looking
at how people make decisions. And when people are factoring in
how to shop and where to shop, the other things they
are going to cost out aren’t just going to be
the cost of the food, but they’re also going to
look at how long does it take for them to get
to the store, what’s the cost of that transportation. And spoilage and
waste is a big factor. If they’re going to a store
that maybe the quality of the produce isn’t so
great, and it might only last a few days, that can
be a bit of a problem. Are you going to buy
your produce there? Or are you going to
just not buy produce? Because the chances
are, it might not go– it might go bad
before you need to eat it. So that becomes part of
those economic barriers that people calculate in when
they’re making food decisions. We did a community
food assessment in southwest Baltimore
back in 2008, just to give you an idea of
how the money gets divided. And on average– this is 100
and, about 147 people, I think, that we talked to in the
southwest neighborhood. There were two markets
there at the time. On average, in a month,
they spent about $280 at the supermarket, but
they also spent about $140 at the corner store, which
is pretty significant. So if you think about
walking into a corner store, and spending that type of money,
what food is available to you, it’s pretty poor quality
for the most part. And there are a
lot less options. What we tend to find in
terms of patterns of shopping is that people will go once
a month, maybe twice a month, to a larger supermarket and
do the bulk of their buying. And then they use those quarter
stores in smaller markets to fill in what they need. And so it ends up being not an
insignificant amount of cash when you’re on a budget. This is one of my favorite
topics, food marketing. And this kind of– I identify this as a social
barrier, because I think it does, really affects our
social norms and how we eat, and where we choose to eat. And I always like
to think that I’m too smart to be
pulled into marketing, and nobody is going
to pull it over on me. I’m not going to buy something
because they said that. And yet, I find myself
oftentimes going, oh, maybe they’ll just try this. So I think it is not– this has a huge influence on
the way we shop and how we shop. And they’re spending–
lots of money gets spent on this
to study humans and what their behaviors are. And what we have found,
one of the studies that shows that if you looked
at shows that were deemed African-American in
terms of the audiences they were reaching, that
they had more unhealthy foods were marketed during that time. And that there were just more
food commercials in general. And another study looking
at low income children and how much they watch
TV, and that they do have more exposure. And so again, this goes
back to the dose response. The types of foods that
you’re being regularly exposed to from a marketing perspective
can be dramatically different. And you don’t really
see commercials for fruits and vegetables. I mean, there was
raisin commercials, I think, years ago, but
that’s about the extent of it. We eat a lot of our
calories away from home. And because of that, we
have to look at restaurants and fast foods, fast
food restaurants, sit down restaurants, et cetera. I think some of the
more robust research we’re finding now,
because people are starting to realize
that we aren’t really– yes, there are a lot of
people going back to cooking, but in fact, a lot of
people still don’t cook, and they’re spending
a lot of money out– that the fast food issue
and the zoning issues around those and the
density of fast food has become a big
topic to be studied. So a couple of– these are
some of the newer studies that have come out on this. So if you have a
fast food restaurant within walking distance, and I
think in some of the cities– I’m not sure what
the measure was for this first one by Dr. Lee–
but in some of the studies, they were saying if it was
within a mile of your house, you were much more likely to
have a diet that was higher in fast foods. So it’s just that
convenience factor. It’s there. You’re going to– you
have more opportunities to shop there or buy food there. In general, the
other thing we find is that low income
areas have more access to all types of food. And so everything from
sit down restaurants to fast food restaurants
to convenience stores to grocery stores. I mean, this is a
relatively new finding. So it isn’t– again, I go back
to the quality of the grocery store, what does that mean? But that there’s just– they’re densely populated
with all kinds of food. And so if you look at it
from, again, a dose response, you’ve got lots of opportunities
to be eating all the time. And then they did a little bit
of modeling on this last study that looked at the availability
and what would happen. And it seems as though
if you had some kind of– and I don’t know how
you would do this, maybe Holly has some
ideas– but if you have some kind of
protective barrier in terms of how far away should those
fast food restaurants be from residential areas,
could you actually lower consumption in some cases? And they do think that if you
didn’t have as– it wasn’t as densely populated with
some of these stores, the opportunities to
lower consumption rates could be quite significant. Again, more on the
social barriers. What you’ll find is disparities
between populations. So if you’re an
African-American student living in an urban area, you’re going
to have much greater exposure than your white counterparts. The chain restaurants in
low income neighborhoods tend to be more
unhealthy, and this had been using what I would–
there’s like a nutrition environment measurement
service that’s done for restaurants as well. The restaurant issue gets
a little dicey sometimes you’re talking
about measurement, because I don’t think there’s
a lot of evidence that sit down restaurants
are healthier, but somehow they’ve
been deemed healthier. I think you can eat probably
just as much, and calorie wise, I don’t know that
there’s any evidence. But they seem there seems to
be some understanding out there that perhaps you
have more options, and so you would have healthier
options than you would at a fast food restaurant. And then the other
part of that is– the last bullet is talking
about is the sensitivity to cues and just the presence. They did find that if you
looked at low income residents and having access to all these
fast food restaurants, that you had greater exposure,
greater opportunities to eat, but that finding
actually was really significantly true for
men, but not nearly as significant for women. So that’s kind of
an interesting– and I think this
is also, you know, across age ranges this was true. Women maybe are cooking more. They didn’t really
hypothesized that they tended– I think that’s probably
what you’re seeing more of. Then just looking a little
bit more at social barriers and what happens when we get
introduced to certain types of foods at a really young age. So if you’re growing
up in a neighborhood and you have a lot of
exposure to fast foods and unhealthy foods,
those tend to be– in fried foods, whatever– they
tend to be the foods that you know as your food. And that becomes part
of your food culture. And it is very hard to
change people’s food culture. I think you have to be
very deliberate about it. You have to have
a lot of agency, and wherewithal, and
resources in order to shift your eating habits. And I think one
thing that we don’t talk a lot about in the food
system studies is taste. You get accustomed
to certain tastes, and those taste good to you. And let’s face it, if you have
a bag of chips in front of you and you have an apple
in front of you, I immediately go, oh, I
should have the apple, but what I really
want are the chips. So if you don’t have those
apples in front of you, maybe you’re not eating those. Maybe it’s this kind of baked
chip versus a fried chip, that those are the tastes
that you begin to know. And they become the
ones that you want. And, again, that’s a really
tough thing to change. And I think they certainly
know, in terms of studies, introducing kids to healthier
food when they’re younger, their ability and
their taste buds, they actually become
more accustomed to those. This is good. This goes back to
a little bit more of the social barriers in
terms of what we look at, the disparities in general. We know that there
are disparities amongst low income populations
and middle and upper income. And that can go everything
from education and literacy to time available to just
daily stress in your life. The less you have
sort of a social fiber and a social network around
you to help support you in any of your life
activities, the less likely you are to probably
feel like you have the opportunities to
make changes or do things differently. Time, many low income people are
working, and sometimes working more than one job. Time, cooking becomes
a very big barrier. One of the things– the Thrifty Food
Plan, which I believe is used by USDA to help
determine food stamp benefits that we’re going
to call SNAP benefits. And they say that based
on what they allow people and what’s allocated to them. They should be cooking
14 hours a week. So in reality,
most women, if you look at a nationally
representative population, cook about seven hours a week. So that’s even a
greater disconnect when you add the other things
into a low income person’s lifestyle and what
they’re having to do in terms of child care. And if they don’t
have a car, they’re taking public transportation. The chances of them
cooking for 14 hours a week to be able to fill that
Thrifty Food Plan are probably pretty unlikely. So that becomes yet
another barrier. Then I’m going to talk
about educational barriers, and this is– there are some interesting
findings with this. And some of these have
come out relatively new. But we know that
education level does impact how people choose to shop
and what they choose to buy. What I think is probably less
clear is which comes first. Is it because those
unhealthy foods are there, and they’re cheap? And just how cheap is cheap? Are Do they have
the extra income to spend more on
healthier whole foods? So it’s not clear really,
I think, what direction that’s going in. So yes, they have unhealthier
food purchasing patterns, but what’s actually driving
those purchasing patterns? And I think there’s a lot
of things that drive it. We also know that
if you give people a little bit of education,
nutrition education, around food choices, that they
do make different choices. And they do a lot. They change shopping patterns. They’re more likely
to try new foods. You can increase– so you’re
increasing purchasing. And consumption. You see increases
in consumption. But that isn’t necessarily
going to always be enough, because there are a
lot of other things that factor into how they
make their decisions. And I think one of
the things we’re learning on the
supermarket study is just how
complicated it can get, and where are those levers that
you can push that are maybe a little bit easier to tip it
over that line versus something that’s going to be a
very dramatic shift. You know, can you get
people to purchase entirely new types of food? Or is that even necessary? Is it more about what’s a
healthy, affordable food? And then how can
they take that food and create a healthier
meal versus you need to buy a lot more of these
foods that you’ve never tried and maybe aren’t as familiar. So there’s probably
a sweet spot in there that I hope we’re going
to find with our latest– our supermarket study. But right now, I think, we know
it– obviously, information is not enough. It really needs to be more. And then this I think I
kind of covered already. It’s just that, you know, how– I believe environments
really do have a lot to do with how people
choose to shop. Even if you walk
into a store and see what’s immediately
available to you, what’s available at
eye level, what’s available at the cap aisles. All of those are
very strategically located within a
store to make you want to purchase those items. Most of the time, those items
are not healthier food choices. And if you’re in a
neighborhood that already has a supermarket
that isn’t selling particularly a lot
of healthy food, you’re going to be prone to it. You’re going to see
a lot more food items in there that are not healthy. And so your
opportunities, again, are going to be much
greater than if you’re in a supermarket that
doesn’t have as many of these processed
food products. And then, last,
this other, I think, it’s just I’ve covered this. It’s just the, what actually– the strategies that people
use to kind of overcome these obstacles. And our paper hasn’t
been published yet, but it’ll be coming out soon. So hopefully I’ll
be happy to share with anybody who’s interested. But this does really look at,
from a qualitative perspective, how these decisions
are being made. And so I hope– I think that’s the end of mine. I’m going to turn
it over to Holly. And just, I hope given
you guys some appreciation for just the system that’s
in place that makes our food choices difficult– there we go– makes it difficult
for people in low income areas. So thanks. [APPLAUSE] HOLLY FREISHTAT: Thanks, Anne. You set me up very well
for this next presentation. So I’m going to talk about
the Baltimore Food Policy Initiative, food deserts,
and food access solutions. So I want to first give you a
quick overview of the Baltimore Food Policy Initiative. So to start, Baltimore City has
an Office of Sustainability, but we also have a
sustainability plan. In our sustainability
plan, we have a goal. Greening goal number
two, I refer to it. Establish Baltimore as a leader
in sustainable local food systems. To me, that alone
is quite innovative. On here, in a city,
an urban environment, we have a goal to have a
sustainable local food system. My favorite slide I like to use. Everyone– food system is
a word that many people are starting to use. It has some jargon
to it, but I really want to define it
for the context of today’s presentation. This is from the mock group
from Michigan State University. It’s still my favorite diagram. And I would like to use Great
Kids Farm as an example. Great Kids Farm is a farm owned
by the Baltimore City School District. And it’s around a 30 acre farm
with around five or six acres in production right now. And I’m going to explain the
food system through this farm. So the kids grow
organic produce. So you’re looking at the
inner circle right now. And then it creates jobs. Kids are learning
how to grow food. They’re learning how to then
sell at the Waverly Farmers Market where they accept
SNAP benefits or food stamps, which is creating
healthier individuals. So in this model, we’re
looking at one example of how a farm and kids are
creating a local, sustainable food system. OK, so within this plan, our
goal related to food access is to improve health
outcomes by increasing access to healthy, affordable
food in food deserts. I want to spend a moment
to define food deserts. And the work that we’re using in
Baltimore City on food deserts is really because of Johns
Hopkins School of Public Health and Center for a Livable
Future, and Anne, and all the folks at her shop. Around three years ago
was the first definition of a food desert, and
the first level of maps. Since then, we’ve
been working together to come up with a food desert
map and definition that really resonates and takes into
consideration the food environment. Now, as Anne was
mentioning earlier, there’s different
stories, or studies, saying that this is
good or this is bad. You may have seen in the New
York Times, several times now, about food deserts,
and some thoughts and questions on those issues. What we have found with
our work is initially, the initial definition
that Johns Hopkins had was really a binary
approach, which is how far away is
a grocery store, and is it in a low income area. And that is currently the
USDA food desert definition, is that they’re saying,
one mile from a grocery store and a low income. Now, what we’ve decided
in Baltimore City, that that indicator will
not work well for us, and that we have four key
components to our definition. For Baltimore, a quarter
mile from a grocery store, because that is the most
people are likely to walk. And if it was New
York City, you might have a different definition
as far as distance. Our public
transportation, I think there’s more to be
desired, and that we needed to take into consideration
walking and how long buses take and so forth. So we included the low
vehicle availability. Low income, at or below
185, federal poverty level. But this is the most
interesting piece, and Anne already alluded
to this, low healthy food availability score. So with Center for
a Livable Future, they went through and scored
the healthy food availability score for every food retail
establishment in Baltimore City and gave it to score. So just so you understand,
it is a index score, but a corner store,
convenience store will have a low score somewhere
between one and seven. A full service grocery store,
somewhere in the high 20s is your range. And So the reason why this
measurement was very important in our new definition
is that we want to understand that the food
environment impacts health. So what Anne was
already talking about– there’s 164 corner
stores and convenience stores in Baltimore
City’s food deserts. By definition of a
food desert, there’s not a grocery store
within a quarter mile. So where are people
going to eat? What’s convenient
and close to them. With not having a lot
of time on their hands, making that assumption, they’re
going eat where the food is. And so that was another
piece that we really wanted to think about. And so we’re working with USDA
in their revisions and drafts for the next definition
of food deserts, because big cities and Baltimore
has a population of 625, 625,000 people. But, I mean, Boston,
LA, New York, Chicago, all some of these
bigger cities as well, are having the
same findings as we are when we look at the
USDA Food Desert Locator. We don’t really have any food
deserts according to that map, because density isn’t
always taken into account. And so we’re working
with USDA to really look at how can these cities that
have a lot of food deserts and food access issues be
represented on their USDA map. And they’ve been a
great partner as we’ve been developing and working
through those issues. So as far as what does
food deserts really mean to Baltimore– 20% of the city. Residents live in food
deserts, 120,000 people. That’s one and three– no, sorry, excuse me. One in four kids
live in food deserts. What I thought was interesting
in the most recent analysis of this map, approximately 83%
of the residents are employed. I thought that was interesting. Being in a food desert, and by
definition of a food desert, we’re talking low income
and poverty areas, meaning that we really need to
be taking into consideration under-employment. And the fact that we need to
create more job opportunities in this area as well. And it may be that
people are already working two or three jobs
or higher paying jobs. And this last
number is something I need to continue researching
with Johns Hopkins on this one. Our numbers for SNAP benefits
in food deserts was 24.5%. I really expected
to see those numbers in food deserts much higher. So that’s a new
figure we just started to unravel a few weeks ago,
and we’re going to dig deeper into that one, of why. So the Baltimore Food
Policy Initiative, as far as the organizational
structure goes. As we know, food intersects
many government agencies. It’s not it’s just one agency
in city government, state government, or federally
for that matter that all food is related to. It in transportation. It’s in health. It’s in planning. It’s in economic development. It intersects so many agencies. So that’s why we have
the Baltimore Food Policy Initiative, which is
really for agencies. It’s a Baltimore City
Planning, Health Department, Office of Sustainability, and
also the Baltimore Development Corporation. They’re the four
key lead agencies. But we understand that
government alone cannot solve the issue of food access,
and so we have Food PAC, Food Policy Advisory Committee. It’s Baltimore’s equivalent
of a food policy council. And it is growing. It has 60 members currently. It’s 35 organizations
represented. My goal is that
every organization in Baltimore City
that has anything to do with food access,
nutrition, gardening, cooking, health, will be a
part of food pack. They are not a
decision-making body. The goal of this is to be able
to help implement the 10 Food Policy Task Force
recommendations, which I’ll talk about just one second. And one thing I realized– I was born and raised
here in Baltimore, but I was out in Washington
state for 15 years and just moved back around
2 and 1/2 years ago. I realized coming
back to Baltimore that there was a
lot of silo work. There was a lot of great
work happening here, and a lot of great
work happening here, but they didn’t know about
what each other was doing. And everyone’s trying to work
on barebone budgets here. And so, one of the
goals with Food PAC is really increasing
collaboration among Food PAC members. OK, here are the 10 food policy
task force recommendations. Prior to my hiring
of my position, so it three years ago, the
mayor at the time, Sheila Dixon, said we need to establish
a Food Policy Task Force. So the Planning Department and
the Health Department became the co-chairs– Anne Palmer was actually one
of the key leads on this task force as well– and developed out, with
18 key stakeholders, the 10 key priorities for
Baltimore City as it relates to food access and food issues. And so when I came
into this role, this was sort of my world view. I came in, not needing
to figure out what to do, but here are the 10,
and sort of the timing and the details related
to these 10 issues. OK, so now when I
move into more details related to the Food Policy
Task Force recommendations. So I have three
key areas I’m going to talk about related to this. The first one is around healthy
food retail and food deserts. OK, so the virtual supermarket. One of the goals with the
First Lady and then Let’s Move! is to eliminate food deserts
in five years from now. And we know that
building grocery stores is very important, the brick
and mortar grocery stores, but we also understand
that it takes– if you’re lucky–
five to 10 years to get a grocery store
into a neighborhood. There’s a lot of
costs, a lot of loans, a lot of logistics
and expenses to do so, and we need to do those. But there needs to be
things we can do now. We need to be able to bring food
access into communities now, not 10 years from now. So the virtual supermarket is
a really innovative solution to that. The Health Department
runs this program. Its history started in
the libraries, libraries located in food deserts. It’s a private-public
partnership between Santoni’s, an
independent grocery store, and the Health Department. And so Santoni’s already had
an online ordering system, a web-based system
for ordering food. And so, what the goal here was
that you could go to a library first, and then there’d
be a health department coordinator there who would
help you order your food online. On the provider computer,
they would put the food in, order the food. Or over time, they
realized that there was a lot of people who
had their own computers, and they wanted to order the
food whenever they wanted to and not have to come to the
library to order the food. So they got a promotional
code, and then now, today, if you’re
anywhere– public computer, private computer– you could
go online and order your food, and then, once a
week, pick it up. And so that was really
the beginning origins was starting with libraries. As of probably around
five or six months ago, they’ve expanded that model. And I really believe that
this is the model that has national ramifications. Is in– right now,
they have expanded in the senior and
disabled public housing. And by the end of
the summer, they will also be in family public
housing, which is great, because our housing,
public housing, could have from 100 units
to several thousand units. And the convenience
of just being able to go into your
lobby, order your food, and then pick it up down in your
lobby is way more convenient. It’s really hard,
as Anne already mentioned, to change food
purchasing habits and food behavior. People have a hard time
thinking of going to a library to order food. It was innovative, because
the libraries are all throughout food deserts. They’re very easy to
access at walking. It’s a really
innovative solution, and we’re continuing
with the libraries. But I think public housing
and really understanding convenience is key here. And that we know
with this strategy, it needs to be pulled ordering. So it’s not a matter of
like a pea pod or a model just going from door
to door to door. We’ll be able to bring in
the right amount of money. But when you
ordering at one site and there’s 10, 20,
30 orders per week, it can be a very viable
option for grocery stores. With this being said Baltimore
is the only city in the country right now that has this model,
and there is a reason for it. Santoni’s, our grocery store,
independent grocery store, is willing to take payment
at the time of pickup, because there’s 26 policy
federal policy barriers prohibiting online
use of SNAP benefits. So a large grocery
chain is not going to be able to take order, go
get all the food together, and then bring it to a
site, and then take payment. What if people don’t show up? Now we like to use
an hour to here in Baltimore how many of
you go to a grocery store fill your cart full of
groceries and walk out you’ve already invested so
much time you don’t do that and that’s what we
have found in Baltimore with the virtual supermarkets. It’s not really an
issue for Santoni’s, but if we’re really going
to address food deserts nationally, that the
virtual supermarket has a national implication for it. But we need to, and we
are working with USDA. Actually, I think it’s in
the language for the Senate, for the farm belt. They
mentioned online SNAP pilot projects to F&S, Food
and Nutrition Services, which we’re hoping
that Baltimore could be one of those. So we really do want to see on
this become a national model. OK, public markets. We’re one of the only
cities in the country that still has many public markets,
a whole public market chain. And when I mean
public markets, I’m talking about covered
historic markets. We have six of them
in Baltimore City. I’m not referring
to farmers markets. I’ll get to that
in a few minutes. So these were historic
markets, you know, before the times
of grocery stores. They were where everyone came
to sell their foods and goods, and where everyone shopped. Over time, the public markets
reflect their neighborhoods that they are housed in. And so we have six public
markets in Baltimore. Lexington Market is the largest
and most well known market. And what we have found– we
did a healthy food assessment of these public markets
around a year ago. And it was two key
findings we found. One, four out of the six public
markets are in food deserts. Two, 70% of the food in the
public markets are carry-outs. Baltimore, we use
the word carry-out. We don’t need the
word fast food. Carry-outs are
more independently owned restaurants,
whereas fast food, we refer to it as more
a chain restaurant. But they could be
interchangeable if you think about nationally. So anyway, it’s prepared foods. So 70% of the food in the public
markets are prepared food. And so what does
that really mean? It means that our
public markets, where we’re in food deserts,
is contributing to the density of prepared
foods and unhealthy food choices in our food
deserts where there’s an absence of grocery stores. So we took this really
seriously, and wanted to see how could we figure
out a solution for our public markets. And so working very closely
with Joel Gittelsohn and Seung Hee Lee with Johns
Hopkins School of Public Health, they’ve been
doing prolific research on healthy carry-outs and
healthy corner stores. And we took their research,
their research tools, and their researchers,
for that matter, and have been working
very closely with them to take their model and apply
it to the public markets. And so we developed out a
healthy carry-out model, where we currently have piloted
10 carry-outs in Lexington Market. With our more recent funding
from Kaiser and Abell, we are now expanding into 22
carry-out vendors at Lexington Market, eight carry-out
vendors at Northeast, and it looks like we’ll be going
into Hollins Market as well. And the goal here is to work
with the current retailers. That’s very important
to start with is that there’s two strategies. The first strategy is we
already have carry-out vendors in the public markets. We want to work with
our current vendors and help them sell
healthier foods and make money selling
healthier foods. If they can make money
selling healthier foods, they will sell healthier foods. And what our assessment
showed is that over 50% of them on their menu
or in their contract said they were going to
sell healthier food choices, but it was not– they were
not currently selling them. And so we asked them,
on your contract it says that you’re going
to sell these foods, and why aren’t you? They said, well, I
tried telling them, but no one would buy them. And so, it’s not a matter of
just one carry-out at a time, trying to figure out the demand
issues and trying new foods, but if we can have
many carry-outs at the same time
working on the issues, we could really start to
move the needle on the issue. So we have these 10 carry-outs. We’ve done an analysis
of their menus. We actually gave
them menus where we’re highlighting
the healthiest foods relative to their menu. We’re making an assumption here. The assumption is
you’re standing in front of the carry-out,
and you are buying food. You’re eating lunch here. And if you’re eating
lunch here, how can you choose the healthiest
food on that menu? And so that we launched with
the mayor and Dr. Thurman in a press conference
this past spring. And that we’ve been getting
some really good feedback on those issues. But we understand that a
carry-out strategy alone is not going to be enough. We really need to increase
demand for healthy food purchasing. We’re looking at doing that. I mean, one is through
cooking demos and nutrition education, of course. But it’s also looking
at financial incentives, meal deals. And Reading Terminal,
in Philadelphia, has a great model for
meal deals, $7 meal deals. And the goal here, remember,
is to drive more people to buy the healthier
food choices at the carry-out vendors
that we’re working with, so they can start to see they
can make money off of this. And so the meal deals would
help increase incentives towards that. And the third part
is really to increase more local farms
and local vendors in the public markets
who are preparing, whether they’re making their own
food, growing their own food, or making their own crafts and
arts, to have that represented into our public markets. Right now, they’re not
really well represented, and we want to see
a change on that. In the third area,
which is really the one you hear the most
about nationally, around addressing
food desert issues is bringing in grocery stores. So Howard Park Grocery
Store is a grocery store that we’ve been wanting
to see a grocery store in Howard Park for a long
time, for over 10 years now. We received healthy
food financing funds, federal funds for
around $760,000 to help make this
grocery store happen. And it’s going to be a ShopRite. It’s actually Jeff
Brown’s ShopRite with Klein Family Markets. He’s in quite a few of the
grocery stores in Philadelphia in food deserts. It’s a really successful model. We’re looking forward to
seeing it here in Baltimore. And what makes it
successful is one key thing, is that they invest a lot
of money in job training. And they really try to employ
people from their neighborhood, train them well,
and have them be working in their neighborhood
through the grocery store. This specific proposal is we’ll
have a commercial kitchen. There’s an elementary school
across the street and Chef Connie. And she has been doing
catering with her kids, this elementary school. And the kids just
actually catered an event for the mayor and the governor
a few weeks ago on the launch of the HBO salad bar program. And it was amazing,
but they really do need a kitchen,
a larger kitchen. And so, there’s going to
be a commercial kitchen in this grocery store for
them and for other food entrepreneurs. OK, so moving on. I just talked about the
healthy food retail piece. Now, I’m moving on to
Homegrown Baltimore. Grow local, buy
local, eat local. The mayor actually
titled this herself. And the goal really is
how to grow farmers, and how can farmers
sell their food and create a local food
system here in Baltimore. So to start, the
first part is around supporting urban agriculture. This is one of the Food Policy
Task Force recommendations. We’re a city that will
be growing very soon, but for the last decade or
so we have been more of one of those shrinking cities. So as a result of that, we
have a lot of vacant land. And so we did a vacant land
assessment, and looked at can any of this land be used? You know, conducive
for urban agriculture. I need to take a moment to
define urban agriculture, because everyone
defines it differently. And I think we in Baltimore
City are defining it very specifically, so I
should define it for you. So when I’m talking
about urban agriculture, specifically in
Baltimore City, we’re talking about farmers who are
trying to sell for production purposes for sales. I’m not referring
to community gardens right now for the sake
of this conversation. It’s really those who are
trying to be full time farmers, or are trying to make a
livelihood off of farming. And so, we looked at this
vacant land assessment, saw around, probably
around 20 acres or so that would be
conducive for urban farming, or that we thought would be
conducive for urban farming. We did a national lit
review around the country. If I remember correctly,
Center for a Livable Future was very instrumental in
helping us do that lit review to figure out all of the
other cities and entities that have done a request for
qualifications for urban farms on publicly owned land. So then we put
together a request. We had 10 farmers apply. Five farmers prequalified,
which was important for me for two things. One, it made me realize that we
have to have a farmer training program in the city. So we partnered
with Future Harvest. And they’re doing an
urban farmer training program, so that we– pretty much, we would
like every farmer who wants land to have land. And they need to
qualify, so we want to make sure they’re trained
and are able to qualify. That was number one. Number two, so now we
have these five farmers, and we’re working with them on
finding the most appropriate land for them to farm. And through this process,
in this 20 acres or so, what we realized is
that the farmers who are trying to make a full
time livelihood on this needs the very
best land possible. As we know, nationally it’s
hard to make a livelihood off of farming. And then add it into a
city, and they really need to have the very
best start possible. So we’re working with them
to find the best land. And in the meantime,
we realized that we needed to develop out sort
of a new kind of farming in the city, the
market gardener. So it’s the person who had
their own community garden, or they had their
own plot of land. They really like growing food. They’re growing more,
and more, and more, and suddenly their
family and friends can no longer eat all
the food they’re growing, and they want to
sell some of it. And so, we’re really looking
at creating that opportunity in the city through some
of these smaller plots that we have, less than an
acre, for our market gardeners. And then obviously, we have
well over 100 community gardens in the city, and we want
to support their efforts. And one of the ways that
we’re supporting their efforts is, up until around a year
ago, they were pretty much– I think it was a one
year lease, and they had to keep renewing every year. And now we’re moving many of
those into five year leases to give them a little
more stability. So that’s one area around
sort of urban farming. Another piece is that
we have our proposed land use zoning code that
we’ve been working on. And in that, in
our current code, it made it to that farming was
not permissible in the city. And that’s why we
didn’t see any farms. We saw an example of Great
Kids Farm and Real Food Farm, because they were on school
land, and that was OK. So in our proposed– sorry, proposed zoning code,
that we made it permissible, one, to farm. And two was if you have
a community garden, and you want to put a farm stand
out to sell your extra produce, you can now. So we’re trying
to make it easier for farmers to grow and
sell their food in the city. And then there is sort of
the whole high tunnels. You see here, this is
an example, I’m sorry, from the hoop houses– or we call hoop houses,
or high tunnels– is that we started to see
more and more and more hoop houses popping up nearly
overnight in Baltimore City and realized, uh-oh, we better
change our building code. Because the building
code hasn’t been revised, and it has no language to
high tunnels or hoop houses. So we changed the
building code so that it’s permissible to
have hoop houses in the city as well. The last point I
want to talk about is animal husbandry regulations. In all honesty, this was just– we were really
fortunate on this one. We’ve seen and watched cities
all over the country struggle with sort of the
changing of animal regs. How many chicken can you have? Can you have
chickens in the city? Can you have more
than four chickens? And it could go on forever. In Baltimore, it was
a week, because what happened was that the
Health Department was– it’s a regulation. It’s not a health code. Because they had
animal regulation that they’re reviewing
every so often, every so many years,
that we realized that they were going to
be reviewing it, and said, hey, you know what? Can we look at this regulation
and see what’s in here? And can we put some
recommendations of what we would like to see? And so we looked at it, and
it had four chickens to start. And we were able to change that
regulation from four chickens to 10, space dependent. Same with bees. We went from– I can’t remember the
details of how many beehives you could have, but it went
from maybe two up to more depending on the
amount of space. And then we also were able to
include rabbits and miniature goats into the animal regs. And it was really just
a very nice, quick one. It’s always nice to have
some nice low-hanging fruit. So that’s really the
support urban agriculture piece of Homegrown Baltimore. Moving on to sort of the
market share piece of buying and eating local food. Baltimore City has
20 farmers markets. As with the national trends,
we have actually eight machines that have EBT machines
at farmers markets. It’s seven, but I’m counting– July 1 is coming up so soon. I’m counting it in my number. Our largest farmers market,
Baltimore Farmers Market and Bazaar has received
funding from Kaiser Permanente to have SNAP benefits
offered this summer. And we have received
Baltimore Bonus Bucks, or double incentive
dollars, to incentivize those who are on SNAP benefits
to come to the market. And for every $10 they
spend– up to $10– they can get $10 more
in produce, or in food eligible for SNAP benefits. What we realized– we did a
farmer’s market assessment, and pretty much my conclusion
of this lengthy assessment was if you wanted to set up a
farmers market in Baltimore, good luck, because the
regulations that we were putting forth in the city– it wasn’t that
they were any more than anywhere else
in the country, but there was no guide. No one was saying anything
consistent of, OK, you want of a farmers market? Here’s your guide. This is who you talk
to, this is what you do. It should take you
x amount of months. You just need to get
this in by this time. Pretty much it
took me a long time to figure it out, because
I talked to so many people and got some different answers,
and realized that all we really need in the city was a
guide, and to simplify some of the permits and how
the permits were organized. So we’re really– we’re trying
to make it easier to set up a farmers market in Baltimore. And I think those are really
the key pieces related to farmers markets. And the last area I
want to talk about is about healthy eating
marketing campaign. As Anne was talking to
you about marketing, and how marketing foods really
influence our food behavior habits, we had a one year
grant in collaboration with Associated Black
Charities, and Fox 45, and Kaiser was a key funder,
for Get Fresh Baltimore. And the initial goal
for Get Fresh Baltimore was really around public
service announcements. And we had these great five
public service announcements. And by the way, this whole
PowerPoint is hyperlinked. So if you click on
the top of every slide you will then go
into more detail. And you can see the five
public service announcements. So these great five public
service announcements on where to eat, and get
fresh fruits and vegetables, whether it’s a
virtual supermarket, farmers market, Great Kids Farm. But we realized that we could
do so much more than just public service announcements. So we collaborated
with the University of Maryland Extension
and the school district, and we had 2,000 elementary kids
create fruit and vegetable ads. We then took those ads,
and with the support of the mayor’s office and
free ad space on the buses, we had 250 of the kids ads–
individual, original artwork– in the buses. It would have been way cheaper
if I just took one of the best piece, and make
it in our contest, and take that and multiply by
250, but that wasn’t the goal. This goal was not
about an art contest. It wasn’t about one kid having
the best piece of artwork. This is about having 250
kids influence and be proud of creating an ad that
can influence people’s behavior choices. And that’s really
the goal, and that’s how we had 250 individual
ads on the buses. So they were in the
inside of the bus, they were on the
outside of the bus, they were on the Light Rail,
the Metro Rail, and so forth. And we have seven key messages. You can see three colors. Each color is a message. Get fruits and vegetables
at your virtual supermarket. Get fruits and vegetables
at your farmers market. Goes onto grocery
stores, schools, public markets, and so forth. And this was such a
great, successful campaign that, as a city, we’re now using
their artwork and the Get Fresh Baltimore message for all
our healthy eating campaigns in the city. And then moving on to
Baltimore City Schools, we’re working with
the school district around healthy foods
in the schools. We established a
Green Schools Network. It was called Sustainable
Food System Action Team. And the goal there was to
have everyone– once again, it was around a
collaboration issue. We realized that there were
so many different partners in the school district. One school had this
organization doing gardening. Another school on the
other side of the city had this great nutritional
education class, they have extension coming in. But there really was not much
coordination or collaboration of what strategies are being
used in the school districts, and everyone knowing what
everyone else was doing. So that this team is really
about increasing collaboration of nutrition, gardening,
cooking, education in the schools. In addition, we have the
Healthy Food Challenge Grant, where we had 11 schools
write mini grants for $1,000 for a Healthy Food
initiative in their school district. We’re going to be having a
celebration of their work in the next month. Let’s Move Salad
Bars, as you guys saw. Hopefully, all of you guys
saw it last night on HBO. Weight of the Nation– as a part of the Weight
the Nation, HBO– I think it was on May 1– gave salad bars to, I think
it was 20 school districts. I can’t remember the
exact number of 20, but I know we’re one of them. And so Baltimore
City School District received 10 salad bars. And that’s really helping
to launch our Salad Bar Initiative. That brings us up to 20 salad
bars in the Baltimore City School District. Our goal is to have a
salad bar in every school. In addition to that, we have
the Fruit and Vegetable Program. Last year we had 20,
approximately 20 to 25 schools participating. Now we have 86 schools. And we really wanted to create
a farm to school movement within that. So Great Kids Farm actually grew
the micro greens and carrots for individual program. I want to sort of
set very quickly, before I conclude here, sort
of the national perspective on food policy. So when I came in, I was by
one of several, definitely less than a handful,
of food policy. The positions may
have different titles. Director, adviser,
or coordinator. But anyway, the key
person in the city related to food access. And so with the assistance
of Wholesome Wave, we developed out the Food
Policy Director Network. To date, there’s 10 cities with
the equivalent– me included, so there’s nine other cities. So that’s grown quite a bit
in the last couple of years. And the goal, really,
is that– what we found is that even though we’re
all in different cities, and our cities look
very different, we’re dealing with
the same issues. So there’s a lot of
collaboration happening. But what– personally, what
I think is most exciting is the United States Conference
of the Mayors established a Food Policy Task Force. Mayor Menino in
Boston is the chair. Mayor Rawlings-Blake in
Baltimore is the vice chair. This was just established
this past January in DC. And since then, we’ve
had a meeting in Boston a few weeks ago for
our food policy. And we have already
tackled quite a few issues. There’s been several
letters that they’ve written for the farm bill. And we’ve been working on the
food desert locator definition, online SNAP benefits. And that this has
been a really– this is really one
of the first times the mayors have taken a voice
in this stance on the farm bill. And this task force
had a lot to do with the mayors coming
with a collective voice to talk about the farm bill. With that being
said, when we started to think about
cities and farm bill, I was wanting to make sure
that this city was really thinking about the farm bill. And so, someone
in the policy shop said, well, how much
money does Baltimore receive from the farm bill? I said, why, that’s a
really good question. Let me figure that out. So Baltimore City, a
population 620,000 people– so just imagine New York, OK? But Baltimore City,
620,000 people, we receive over a billion
dollars on the farm bill. And that is for SNAP benefits. That’s also, though,
has been very important for our ag issues
for our community food projects in the city. And when you hear it and
think about SNAP benefits and the farm bill,
you immediately go and think about those
people on SNAP benefits who need to go to a grocery
store to use the SNAP benefits. But what we forget to
realize are how much money. Our grocery stores are getting
income from SNAP benefits. So if we’re seeing huge
reductions in SNAP benefits, it’s not only impacting
the individual using their SNAP benefits. It’s impacting the
retailers as well. And we did interviews
with grocery stores. In one of our grocery stores
located near a food desert, 80% of our sales come
from SNAP benefits. So it’s just a very
interesting perspective to think about on both
sides of the coin related to SNAP benefits. And that wraps up
my presentation. Thanks so much. [APPLAUSE] MOLLY MITCHELL: Great. Thank you, Holly. Thank you, Anne. At this point in
the presentation, we will now be able
to take questions for both of our presenters. Yeah, if you guys could join us
on stage, that would be great. And just a reminder for those
who are watching online, just click on your
link on the screen, and you can send in
emailed questions to either of our presenters. In the meantime, why don’t we
start with our live audience here if anybody has
questions for Anne or Holly? Yeah. AUDIENCE: Hi. Thank you Anne and Holly
for the presentation. I have a few questions. MOLLY MITCHELL: And
if you could just wait for someone
to come with a mic, so everyone online can
benefit from your question. AUDIENCE: Hi, thanks
for your presentation. It’s very promising. I have a few questions
lingering in my mind about farmers markets and
also community garden. So as I observed, or I did
some field trip with it, most of the farm
owners are white. And I was wondering if there
isn’t any African Americans who owns a farm? And this might be
better in– they might be better in
developing relationship with the African
American community, thus increasing fruit and
vegetable consumptions among them. And also, is there any
best practice guideline for plants growing for
a community garden, so that they don’t need
to start from scratch? You want to promote
community garden, right? So it’s going to be frustrating
if they don’t have any best practice guideline to refer to. And also, I’m also
thinking is there any regulations of the safety
concerns of the farm stand? Because food and [INAUDIBLE]
has really taught us a lot about the
contaminations of E. coli, pesticides, and others. Thanks. HOLLY FREISHTAT: OK,
sounds like, I think, those all three were mine. Maybe I’ll share one with you. I’m going to start
with number two, because that’s a
really quick, easy one. Second one you were mentioning
was around community gardens. Is there a guide? Parks and People, which is a
nonprofit in Baltimore City, has really been the lead
on community gardens. And you should go
to their web site. It’s a great resource. And also, the University
of Maryland Extension just hired a sustainable
ag specialist to really support community
gardens and other growing experiences in the city. Going to your first question
now on farmers markets. Going back to the farmer
training program, what we have realized is we want to see– we have all this vacant land. And for the most part, the
vacant land is in food deserts. A lot of it’s in food deserts. And as our food desert map
showed us, most of it– the residents are
African American. And so, our ideal
is that we would be having African
American residents, or any residents
living in food deserts would be the ones who’d
be applying for this land to be able to grow
food for themselves and then also to be
able to sell as well. In this request for
co-applications of 10 farmers, I think we had three African
American farmers who applied. But I really would like to see
our farmer training program being part of housing authority
and a part of really reaching out to the communities that
are living in food deserts, so that they are
having– maybe this is one of their extra
jobs, to help grow food. So our goal is to
make sure, I hope, that we can provide the
resources so those people living in food deserts
would be the ones who would have access growing
the food on the vacant land. Since this initiative
is relatively new, and we just did our first
year for the request for qualifications, we knew
that our first year coming out– how we wrote the
qualifications, you had to have a year
experience farming, and you needed to
have a business. And so, we knew by that
those qualifications– because this a business
agreement with the city, this is not community garden– that we were going to
most like to have farmers from the outside coming in. Outside meaning it
could be Baltimore City, or some other part of
the city, or the county, or even another area. We did have one resident
move from DC to Baltimore, now has bought a house, and is
now growing food in the city. So our goal is to diversify the
farming community in Baltimore. And I think there
was a third question on safety and regulations. And what I’m saying
around zoning code is making it permissible
to open a farm stand. And they still need to go
with the Health Department for all related health codes. So that was a very zoning
specific component. MOLLY MITCHELL: OK, we
have right in the back. AUDIENCE: I’m just wondering
if you have any information, or are you working at all on
the idea of food co-ops and food buying clubs? It seems to be something
that’s gone past and maybe hopefully
will come back around. If a lot of profit is being
made from the SNAP benefits that are being given to
private grocery stores, perhaps those profits could be
turned back into the community with food that’s for
people, not profit. HOLLY FREISHTAT: Do
you have much on that? ANNE PALMER: I have only read– I don’t know much
about what’s going on. I think there is a food
co-op that people– there’s a food
co-op in Baltimore, still fairly expensive,
not necessarily affordable, that I think– a lot of the literature
I’ve looked at has shown there hasn’t
been a lot of success in low income neighborhoods
and food co-ops. That’s like three studies, so
that’s only ones I’ve read. HOLLY FREISHTAT: Yeah, I’ve been
watching it nationally right now. There’s been more and more
chatter and talk on that issue. I’m still waiting to see
some successful models. I know that New York
City was trying one, and there’s been
some other ones. I want to see a good
model come across. And if– we see something
that’s really valuable. And then maybe if anyone
online has any great models of food co-ops and food deserts,
I would love to hear about it. MOLLY MITCHELL: OK, we do
have a couple of questions from our online audience. I’d like to get those in. One is asking
whether there’s been any consideration for the role
for rooftop urban gardening as a commercial
enterprise opportunity. HOLLY FREISHTAT: That’s me. [LAUGHTER] So rooftop gardening is
really valuable in cities where there’s no land. We’re not one of those. We have land here for farming. In New York City,
it’s– you know, that is where you’re seeing
the farms, is on the rooftops. We are seeing some
rooftop gardens, but I think that it
all depends on expense. Is it more expensive or less
expensive to be on a rooftop? So in Baltimore,
we do seem to have plenty of land for farming. We see more on land
than on the roofs. But it’s not saying that there
won’t be some rooftop gardens. In our growth land,
in the zoning code, we did make rooftop gardening
permissible, though, to encourage it. MOLLY MITCHELL: OK. And another one is noting that
both the University of Maryland in Baltimore and Johns Hopkins
on the east Baltimore campus are in or near food deserts,
and wondering if either of you know whether there’s been
any attempt by either of those institutions to
locate a large grocery store within walking
distance of the campus. HOLLY FREISHTAT: I could
speak about the University of Maryland piece. So Dr. Perman with the
University of Maryland is a part of the
West Side Initiative. Or I think that initiative’s
actually changed. Sorry, City University is
called the initiative now. And it’s a partnership between
the city and University of Maryland around the whole
west side, where University of Maryland is housed, which
is bordering in food deserts as well. And so, within that initiative,
one of the key strategies is to improve food
access and food retail. It may or may not be
bringing in a grocery store, but it’s improving the
food retail establishment, along with the vitality and
viability of the west side. ANNE PALMER: And I
think EBDI, which is connected to Hopkins
and in Hopkins area, has been looking at food
retail and bringing more food retail to the area. I think there’s still
issues around what’s considered affordable and would
that help or not necessarily impact the community at all. I think I’ve heard people
toss around getting a Whole Foods or something else. And that probably wouldn’t
make a big difference if you’re in a food desert
and cost is an issue. HOLLY FREISHTAT: So I
want to take one more stance on that question. That question was specifically
about University of Maryland and Johns Hopkins School of
Public– or Johns Hopkins, excuse me. But I do want to talk very
quickly about Baltimore’s our approach to food deserts,
as far as a retail approach. So we have just approved a
food desert retail strategy in Baltimore City. We looked at the mall in New
York City called New York City Fresh and are doing
a similar model. Those details in New York City
doesn’t apply to Baltimore, but the concept was a
really good concept. And so the main
concept with it, how do you have grocery stores in
food deserts, which is really what I hear that question’s
really getting at is what we’re looking at
is financial incentives, obviously. But there’s not that much money
on the table, so it’s just working with our existing
financial incentives and tax credits we have,
how to package them. But what we’re doing
that’s innovative is we have eleven
government agencies that has something to do with the
development of grocery stores in Baltimore. And we have asked each
agency to contribute one to three services
that they can do in kind to help reduce
the financial grocery gap for grocery stores. And when we take those 11
agencies’ contributions plus the tax credits
and tax incentives, we’re hoping that we will then
have a financial package that would be substantial
enough to attract grocery stores into food deserts. So this kind of ties
into the public health– oh wait, sorry. PHA, Public Health for America. I think I’m getting
my acronym wrong. But it’s the nonprofit that’s
working with grocery stores around the country, who
are committing to locating food retailers in food deserts. And so, we’re really wanting
to see those stores that are already committing into food
deserts to commit to Baltimore. And also for other
stores that may be in Baltimore who need some
financial incentives or support to [INAUDIBLE] for deserts. MOLLY MITCHELL: I believe
we had some more questions right in the front here. AUDIENCE: I have a question,
one for each of you. So for Anne, you’ve mentioned
that small stores had higher prices, because they don’t
buy in as much bulk as larger stores. But have you seen any difference
in prices in chain stores that are in different
neighborhoods? ANNE PALMER: That’s a
really good question. I don’t know. I have not seen an instance
where that has happened, but that would be
something that would be very interesting to look at. And the reason I’d say
that there probably isn’t a great difference is
because typically the circular, which is the promotional,
the sales every week that go out to the
newspaper, they’re not going to change that for
different neighborhoods, because it just– they
print one circular and that goes out to everybody. But not in chains. That’s I don’t think so, but
I could be wrong about that. AUDIENCE: And for
Holly, you said that 24.5% of people
in food deserts were using SNAP benefits. You said you weren’t sure
why, but do you have any idea? Do you think it’s the
qualifying income or just knowledge of the program? HOLLY FREISHTAT: You know,
just recently the mayor signed a memorandum we meant for
the Baltimore Partnership to End Childhood Hunger,
and one of the goals is to increase our
participation rate, and SNAP benefits, and also WIC. And so when we looked at those
numbers for Baltimore City and also in the state,
our SNAP numbers were looking relatively
strong, for at least those with families. And so what– my analysis,
which I need to be doing, is looking at– I think our SNAP
numbers may be higher in other areas of
the city, but not necessarily in food deserts. And once we start
to delve into that, we’ll figure out– so the
question that you’re really asking is why is
that number low. And also, I want to look
at is that number low? I want to compare it
to other food deserts and see is that consistent
to other food deserts. It’s a really new
finding for us. We just figured it out
around two weeks ago. AUDIENCE: Thanks. MOLLY MITCHELL: Yeah? AUDIENCE: Hi, Holly and Anne. Thank you very much. A lot of talks I go
to, I leave deflated, but this one I think I’ll
leave feeling motivated that there’s policy change
being enacted, so thank you. I have a question, though,
about energy balance. And energy balance
is certainly the most approximal to
overweight and obesity, when we’re talking about
a public health problem. And so, I hear a lot of
promotion towards how healthful foods, and food access, food
availability, but does– I guess my question is maybe
larger, or maybe next steps, or looking and thinking
about the private sector, and the vast availability and
access of the unhelpful foods and unhealthy foods,
and how we, or how you think we can combat that,
or whether we should, or? Because I didn’t hear that
at all in the presentation, and I’m just wondering
if you have any ideas. ANNE PALMER: Giving
that one to me? That, I think, is
obviously there are– we live in a capitalist
country, and it’s all about making profits. And it is not– we don’t take kindly to
regulating in the way I think we would
need to regulate if we were considering– we just have way too
many calories out there. We have way too
much food out there. We have way too
much unhealthy food. If you just looked at dose
response from that perspective and said, how many times you
encountered food in a given day, and how many times is it
a healthy food choice, it’s– that’s a huge part of it. And in some ways I tend
to not talk about obesity, because I feel like we’re
obsessed with obesity, and that becomes the
indicator that everybody’s looking towards. I feel like we
have to step back, because there are so
many steps before that, that we have got to reacquaint
ourselves with food. We have to, got to just– there’s really
big system changes that need to happen
for people to want to make different choices
when they’re eating, and those system changes
have to be in place. So I like to look at it like
this is a systems approach. Obesity is a symptom
of what I call a dysfunctional food system
and that– a symptom, sorry, of a dysfunctional food system. And it’s the one we see most
often probably in our work. And that– back that
up and keep thinking about what is
creating that, then it becomes a much more complicated
problem than just energy in, energy out. I mean, ultimately that’s
what you want to measure, but I think we
really have to look at how are we going to change
our relationship to food, and how do we start to
do that from a policy perspective with
some of the policies Holly’s talking about at a
city level, at a state level, and at a federal level. And what I think you find is the
most interesting work going on around the country is
really at the city level, because we have a
lot more leverage. And you see people
like Holly and people in those similar positions
that are trying to figure out what’s going to make– how do you shift these things
around and change the equation, so somehow we don’t have this
be just one more disparity that we’re seeing. And we’re seeing obesity
in all income groups. It’s growing significantly
in middle and upper income as well. I think what you see is
just the lack of access and the disparity
between what you can do about it, affordability
and things like that. So I don’t think that
answered your question, but I think it’s– I don’t know if I have the
answer to that question. MOLLY MITCHELL: We do
have an online question that’s a little bit of
a follow up to that. It’s a congratulations
to Holly’s office for all the great work
that you’ve been doing. But a question about
how much staff you have, or whether most of your work
is done via partnerships. HOLLY FREISHTAT: So
the answer is both. So it started off
with my position and was really grant-funded
in the beginning, seed funding from four foundations. I had a consulting
firm prior to this, and I was actually on maternity
leave I took the position. I said 10 hours
a week was great. And so then at 10 hours a week,
I was like, wait, is too much work for 10 hours a week. We need to secure
some more grant funds. And so, eventually I
came up to full time, and the community
foundations were fantastic in supporting
these efforts. Then the city actually decided
to make my city a full time permanent position
into city government. And so when we went
into city council to ask for the position
to be a full time city permanent position, the
community foundations once again stepped up
to the plate and said, OK, we’re going to match
you double plus your salary, so that when you go into really
asking for this position, you’re going to have some
money to help you hire staff and to really be able
to make an impact. So that was a great windfall. So I became a city employee
and had one full time staff plus an operating
budget, which was night and day compared to what
I was doing prior to that. Since then we’ve raised
more grant funds. I now have two full time staff
plus myself, but as you know, that it’s not enough. We do a lot of work, and we do
the work because of Food PAC. And with the 35
organizations, it’s an army. We have an army
in the city who’s working on food access issues. And then within,
really, the leadership of the mayor, so many, most of
the agencies in Baltimore City are supporting these efforts
in so many different capacities as well. MOLLY MITCHELL: Great. I thought I saw some hands
way in the back over there. AUDIENCE: This is about
the unanswerable question, so maybe you should just
call it a comment instead. And I’d like your
reaction to the comment. You were talking about earlier,
Holly, about how SNAP benefits, they actually help
retailers, because the money is in their pockets, too. But I was reading this
morning, actually, that 75% of the people who get
SNAP are employed, actually. So not only is it a benefit
to our subsidy, to retailers, but also to a lot
of employers, who aren’t paying a living wage. So I guess if you turn
this into a question, I’m just curious that’s part
of the conversation, the idea of a living wage, and how– you know, when you talk
about affordability, there’s two sides to it. One is what is the price, and
the second, the other side, is what is the person’s
purchasing power? And, of course, that is
driven mostly by what what their income is. So I’m just wondering if that
comes up in the conversation, say, with your Food
PAC or any of that. HOLLY FREISHTAT:
I’m actually really glad you raised
that comment just now, because your figure
you just mentioned is actually consistent
to our figure, because we see 82% of
the residents living in food deserts are employed. So that’s consistent. Now, I know my SNAP number’s
a little lower in the food deserts, but the fact that
there’s such a high employment rate, which is why we really
need to have a food desert retail strategy, because
it’s about job growth along with food access. It can’t just be
one or the other. And so when I’m talking
about job growth, yes, with the grocery stores
and developing grocery stores you see are construction
jobs, which has certain wage associated to it. And then in the grocery
stores, there’s also another wage associated to
that as well, whether it’s full time, part time, whether
a manager, or a clerk, and so forth. But I think that there’s a
lot of opportunity for job growth in the food sector. I want to use Boston
as a quick example. Boston has had this
transformation of food trucks. But what was interesting
with the food truck culture in Boston was that it created
over 200 jobs, new jobs through food trucks. You know, whether it was
a food entrepreneur who developed their own
business concept, they are highly educated,
and had the skills and the business plans. But then they hired a
whole bunch of staff to help them with
their food trucks. And I think that
there’s many ways that we can be looking
at food sector jobs, and hopefully start to
change that price point, because they notoriously seem
to be a little lower than we would like to see them be. But since food seems to
be– we all eat a lot of it, as we know. It sure would be nice
that people could actually make money off of food as well. AUDIENCE: Hello,
my name’s Chris. I’m with the Street
Wize Foundation. We’re based in
Washington DC, and I’d like to share a quick anecdote. OK, we do a youth
outreach programming, and one of our programs
that we do is nutrition. And did a great program with
a bunch of 13, 14-year-olds. And two days later, a
parent comes into, you know, are she’s very upset, OK? And we’re like, whoa,
what’s going on? So she’s like, well,
I don’t appreciate what you told my child and
all this type of stuff. And of course, I’m the
executive director, so I’m thinking that
there was an issue, but turns to find out is
that parent had an issue, because, of course, we
did our programming, and when she went grocery
shopping or shopping, and she brought home the
groceries for the child, the child said, I’m
not going to eat this because it’s unhealthy, OK. So I was like,
why are you upset? This is great. I understand the fact
that you wasted x amount of money on food that the
child’s not going to engage in, but you should feel proud. But what the
conversation turned into was that the parent,
obviously overweight, was using the child as an excuse
to engage in that type of food and that type of behavior. And that was like the staring
into the abyss, so to speak, because not only is it
the fact that we provide not only great programming,
great food, great all these different
opportunities, but at the end of the day,
it’s a lifestyle situation, and that a lot of people
aren’t ready necessarily to engage in that
or come to grips with their own inner dark
secrets, so to speak. And I think that’s
one of the things that it’s kind of like
a top up type approach, because we can provide
all these great things, but at the end of the day,
if they don’t want them, or if they’re not ready to
expand their horizons, so to speak– and the reason why I say
this is because I know in DC there’s a growing
Muslim population, and they’re located in a
lot of these food deserts that we have in Washington. And what has happened is that
because the lifestyle has changed in a lot of these
neighborhoods, a lot of the food desert
convenience stores, you know, Chinese food
restaurants, fast food restaurants, have
changed, because that is what the community wants. So what’s happening
is that now they’re starting to do Halal, which
is like like, I guess, the Muslim, what is it,
kosher type situation. So I’ve seen that
the neighborhood can change what is being
offered as far as food. And definitely with
food truck situation, we had that in Greater DC. But from our perspective as far
as service providers and things like that– from your perspective,
how do we start to engage in the
actual, the lifestyle change that has to happen? And what’s your
thoughts on that? ANNE PALMER: I’ve heard
a very similar story from a woman we work
with, Antonia Demas, who does a food for life,
I think that’s Food is Elementary Program with kids. And a parent called up
and said a similar thing. And her issue was she couldn’t
afford the healthy foods. And they were creating
demand for this food, and she didn’t want it. And it was like,
it just pained her to know that she
couldn’t provide for a child what she wanted. And I think that the
behavior change part of that is, it is a slow moving
train, and that the more– just as we have been exposed
to so many unhealthy foods, the more exposures,
the more opportunities, the more chances you have
of incorporating parents into the programming, having
community dinners for them– that’s part of the Food
is Elementary Program– and really recognizing
that we may never get people to make a lot of
the changes that they know are the best changes for them. That’s a tough nut to crack. And I think about
Geoffrey Canada’s work in the Harlem Children’s Zone. And he works with the
parents of the kids, but he has basically said I
cannot afford to go and try and start with their– he didn’t say, I’m not
going to do anything about their parents,
but basically, I can’t afford to put my
resources into the parents. I have got to work
with the kids. And so, as much as
parents, kids can gateway– their behaviors can be
gateways to the family. Vice versa, the parent’s
behaviors are also gateways, but I think– I don’t think there’s an easy
answer, but I think it is just, you know, this
continuous idea of you’ve got to have multiple ways of
interacting, and influencing, and getting them
to participate in, maybe it’s gardening
at home, maybe it’s something else, where
they start to recognize that there are some things
that they may be able to do. And make it really simple. We start with very simple
things in a lot of our programs, recognizing that
people aren’t going to make big changes
overnight, and that part of it is just this slow process. No funder wants to hear that. Everybody wants
to hear that, oh, you’re going to stop obesity? Oh sure, I’m going to stop
obesity in three years. We’re going to be able to– like, hello, hello? How long did it
take us to get here? And there’s got
to be recognition that there’s a whole
system in place that works against us making good
food choices every single day. Every time you walk out. You don’t even have to
walk out your front door. Look at my cupboards. My god, you know? There’s all– look in
your own that there’s just all these opportunities
and that that is not going to change overnight. MOLLY MITCHELL: OK,
well, on that note, I think that wraps up our
presentation for today. Again, I just want to
give a really big hand to Anne Palmer and
Holly Freishtat for a wonderful presentation. And thank you all, and I
hope to see you next month for our next
presentation on reducing asthma disparities in children. Thank you.

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