gfh plan 10-15

A Comprehensive Plan to increase Healthy

Nutrition and Regular Physical Activity among

Children and Youth in Santa Cruz County

Go For Health! 2010-20152

Go for Health! is a community-wide collaborative that exists to improve nutrition and physical fitness for the children of Santa Cruz County. The overarching goal of the collaborative is: All children will be physically fit through healthy eating and regular physical activity. Go For Health! hopes to achieve this goal by utilizing environmental prevention strategies which change or improve community standards, systems, structures and attitudes that influence individuals’ behaviors To that end, the collaborative has updated its strategic plan to serve as the vision

and direction of the group and to reflect the realities of the current obesity epidemic evident throughout the U.S.

Obesity affects more than an individual’s health. It also impacts our society’s economic health. In 2009, the California Center for Public Health Advocacy released a study on the economic consequences of the obesity epidemic. It stated that California currently spends $41 billion annually on the consequences of overweight/obesity and physical inactivity. These costs are associated with health care

Executive Summary

8/ STRATEGIC PLAN » 8/ Schools » 9/ Built Environment » 10/ Physical Activity » 12/ HealthY food » 13/ Health Care » 14/ Public Policy

11/ PRACTICE 52-10 EVERY DAY FOR A HEALTHIER LIFE

14/ REFERENCES

15/ INVITATION TO PARTICIPATE

15/ THANK YOU

16/ GFH! ACTIVE MEMBERS » Community Support

Table of

Contents

2/ EXECUTIVE SUMMARY » The Local Epidemic » Health Inequities

4/ PREVALENCE OF CHILDHOOD OBESITY

5/ HISTORY AND ACCOMPLISHMENTS

6/ LOGIC MODEL » Strategies » Outcomes

Go For Health! 2010-2015 3

costs and lost productivity in the workforce. In Santa Cruz County, the annual estimated cost of this epidemic was $317,081,285 during 2006.1

These costs can be reduced through policy decisions that can improve neighborhoods and individual’s lives. One example of a policy that can affect obesity and health outcomes is a workplace policy that encourages women to continue to breastfeed by requiring employers to provide a quiet, private space to pump while at work. Breastfeeding has been shown in a number of studies to reduce an infant’s risk of childhood obesity.2 Another example is a school district policy to share their recreational facilities with outside agencies and/or the public so that local residents can use these facilities when school is not in session. These types of policy interventions are long lasting and can greatly reduce the cost to society created by the obesity epidemic.

Santa Cruz County faces significant health inequities across the community that result in differences in health outcomes and chronic illnesses among our residents. These inequities usually unfold along ethnicity and income levels and are apparent by observing the differences in neighborhoods in which people live. In poorer

neighborhoods, there tends to be less access to healthy food, safe parks and outside recreation areas. All of these factors play a role in the nutrition and physical activity of our residents and all must be addressed in order to reduce health inequities.3

Creating and supporting a healthy environment in Santa Cruz County is

an essential strategy for the reduction of obesity and other diseases related to sedentary lifestyles and unhealthy eating. Go For Health! is working to make a healthier Santa Cruz County by promoting specific environmental changes and engaging in partnerships with community agencies such as schools, health care and government agencies.


The prevalence of obesity and overweight in the United States has reached epidemic proportions and is increasing at an alarming rate. According to the CDC, in

2008, 20% of 6-11 year olds were obese and 18% of 12-19 year olds were obese.4 The resulting health problems of overweight children are a major public health challenge facing the country. Children who are overweight are at risk of developing cardiovascular disease, asthma, and type 2 diabetes. Overweight children are more likely to be overweight adults; therefore, they are susceptible to these same diseases plus at increased risk of stroke and arthritis.

The Local Epidemic

Even though Santa Cruz County offers many outdoor venues and opportunities for physical activity, the obesity epidemic parallels that of the state and nation. In 2008, Santa Cruz County ranked as one of the worst

(40 out of 66) of California’s counties and health jurisdictions for overweight children under the age of five.5

Health Inequities

When broken down by geographic area within our county, alarming disparities can be seen. For example, in the city of Watsonville, where 18% of the 50,000 residents are living below the poverty level and 48% of adults do not have a high school diploma, the obesity and overweight problem becomes more apparent.6 The charts on this page clearly show the disparities between Pajaro Valley and the rest of the county. In response to the inequities seen between northern and southern Santa Cruz County, Go For Health! sought and received additional funding in 2009 to increase prevention efforts in Watsonville and the Pajaro Valley.

Prevalence of Childhood obesity


In 2003, the Santa Cruz County Go For Health! Collaborative (GFH!) was convened by the United Way, the Children’s Network of Santa Cruz County, Children’s Food and Fitness Coalition, and the Pajaro Valley Community Healthy Trust to address the rising rates of childhood overweight in Santa Cruz County. In 2004, GFH! launched its first Strategic Plan with comprehensive, collaborative strategies aimed to prevent childhood obesity via all sectors of the Santa Cruz County community. Through their research, GFH! found that environmental prevention strategies have been the best method to address this epidemic. Environmental prevention strategies strive to create long-lasting change within systems so that individuals are able to make healthy choices.

Over the past 6 years, GFH! has made great strides in addressing this health epidemic in Santa Cruz County. Here are a few examples of the major successes::

• Co-hosted with Congressman Sam Farr and Assemblymember John Laird a local nutrition and physical activity policy summit in Spring 2004

• Created school wellness policies with comprehensive language around nutrition and physical activity for each school district in Santa Cruz County

• Worked with the City of Watsonville to incorporate recommendations for healthy lifestyle components into the Watsonville General Plan. The work that GFH! did with the City of Watsonville has been used as an example with many state-wide public health organizations such as Public Health Law Program

• Co-hosted tri-county summit on the built environment

• Hosted workshops for healthcare providers featuring pediatricians who are experts in the field of childhood obesity prevention

• Launched the 52-10 social marketing campaign

• Created and launched recognition programs to provide incentives to schools and restaurants to adopt and implement healthy policies (School Wellness Recognition Awards; Golden Carrot Awards)

• Coordinate Jovenes SANOS, a Watsonville based youth advocacy project striving to create a healthier environment by working with schools, markets, and city infrastructure

History and

accomplishments

Go For Health! Staff/United Way of Santa Cruz

County

Go For Health! Collaborative

Go For Health! Member Agencies

Jovenes SANOS Working Group

Funding

52-10 Social Marketing

Strategies

Environmental Prevention Strategy

Existing Fitness & Nutrition Programs

Schools y Support schools in actively implementing school wellness policies y Act as liaison for food services departments to facilitate incorporation of healthy foods into schools

y Increase nutrition education in schools among children and parents y Promote, maintain and sustain physical activity through extended learning, SRTS activities and other opportunities during and after school

Physical Fitness y Promote and expand physical activity opportunities within schools and the community

y Increase community and media knowledge of childhood obesity prevention as it relates to built environment/physical activity

y Promote increased use of active transportation through the promotion and expansion of related programs and community events

Built Environment y Advocate for inclusion of health language in General Plans y Improve perception and actual park and open space safety y Educate on the link between the built environment and health y Advocate for and help facilitate joint use agreements y Work with city and county to improve the community’s infrastructure to include increased bikeways and walkways

Healthy Foods y Work with food outlets to increase the promotion of and access to fruits and vegetables

y Work with child and family development programs and services to teach and model healthy eating

y Connect local farms with obesity prevention efforts y Work toward increased number of school, home and community gardens y Promote healthy food choices in local restuarants

Health Care y Maintain partnership with related collaboratives to increase advocacy for access to healthy foods and breastfeeding support

y Increase community and media knowledge of childhood obesity prevention as it relates to healthcare

Public Policy y Track public policy that promotes healthy living y Mobilize the community to advocate for public policy and funding avenues for healthy living

y Increase community and media knowledge and awareness about healthy living and childhood obesity, include promotion of 52-10

y Engage media and the public to move funders and public policy makers in key areas

StrategiesGo

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el

Inputs

y Increased fruit and vegetable consumption

y Decreased sugary drink consumption y Increased time spent exercising for children/adults

y Increased number of children/adults who use active transportation

y Increased number of bikeways y Improved sidewalks/walkways y Increased number of residents who feel safe in their neighborhoods and their children have safe place to play

Improved life long health by supporting schools to provide

access to healthy food, nutrition education and by promoting physical activity during and after the school

day

Increase the level of physical activity among Santa Cruz County children and adults by decreasing barriers and improving opportunities for

physical activity

y Increased access to an improved variety of fresh local produce

y Increased number of community and school gardens

Increased access to and demand for fresh fruits and vegetables among residents

of Santa Cruz County

y Increased number of health care providers that utilize 52-10 tools

y Increased number of hospitals utilizing “Ten steps to successful Breastfeeding for Hospitals” from 0 to 3.

Increased number of children will practice life-long healthy

habits.

Increased Breastfeeding rates

y Increased time spent exercising for children/adults

y Increased number of children/adults who use active transportation

y Increased public policies promoting access to healthy food/regular physical activity

Public policies promoting access to healthy food/

healthy eating/regular physical activity in school boards, city councils, the County Board of Supervisors, County and

city agencies, non-profits and for-profit businesses will be

adopted

All children will be

physically fit through

healthy eating and

regular physical activity

There will be a decrease in adult

and children obesity rates in

Santa Cruz County

Outcomes

Long-Term MeasureImpact

Short-Term Measure


Objective: Promote life long health by supporting school to provide access to

healthy food, nutrition education, and by promoting physical activity during and

after the school day.

Key Strategies

» Support schools in actively implementing school wellness policies » Act as a liaision for food services departments to facilitate incorporation

of healthy foods into schools » Increase nutrition education in schools among children and parents » Promote, maintain, and sustain physical activity through extended

learning

Measurable outcomes

» By 2015, there will be a 5% increase in the number of 7th, 9th and 11th grade children eating five or more fruits and vegetables within the last 24 hours7

» By 2015, there will be a 5% increase of 7th, 9th and 11th grade children who have exercised for at least 20 minutes, causing sweating, 3 out of 7 days within the last week8

» By 2015, there will be a 10% increase in the number of children who walked/biked/skated to or from school during the last week9

» By 2015, there will be a 10% decrease in the number of 7th, 9th and 11th grade children who drank soda pop within the last 24 hours10

Schools


Objective: Improve the man-made physical structures and infrastructure in order to support a healthy lifestyle for all residents of santa cruz county.

Key Strategies

» Advocate for inclusion of health language, as jurisdictions’ General Plans are ready for updating; follow and support the impact of adopted health language in General Plans

» Improve perception and actual park and open space safety » Educate key opinion leaders/community on the link between the built

environment and health » Advocate for and help facilitate joint use agreements in order to

increased access to physical activity opportunities

Measurable outcomes

» By 2015, there will be a 5% increase in the number of residents who feel safe in their neighborhoods11

» By 2015, there will be a 5% increase in the number of parents who feel their children have a safe place to play in their neighborhood

» By 2015, there will be a 5% increase in the number of bikeways to promote active and safe transportation and recreation

» By 2015, there will be a 10% increase in the number of people biking for transportation, recreation and fun

» By 2015, there will be a 10% increase in the number of people walking for transportation, recreation and fun12

Built

Environment


Key Strategies

» Promote and expand physical activity opportunities within schools and the community

» Increase community and media knowledge of childhood obesity prevention as it relates to physical activity

» Promote increased use of active transportation through the promotion and expansion of related programs and community events

Measurable outcomes

» By 2015, there will be a 10% increase in the number of people biking for transportation, recreation and fun

» By 2015, there will be a 10% increase in the number of people walking for transportation, recreation and fun13

» By 2015, there will be a 5% increase in the number of adults participating in regular physical exercise, at least 30 minutes for 3 or more days per week14

» By 2015, there will be a 5% increase of 7th, 9th and 11th grade children who have exercised for at least 20 minutes, causing sweating, 3 out of 7 days within the last week15

» By 2015, there will be a 10% increase in the number of children who walked/biked/skated to or from school during the last week16

Physical Activity Objective: Increase the level of physical activity among

Santa Cruz County children and adults by decreasing barriers and improving

opportunities for physical activity.


In 2008, GFH! adopted the 52-10 social marketing campaign. 52-10 is a simple, evidence-based, effective and easily remembered method of promoting a healthy lifestyle. GFH! is working with schools, businesses, agencies, medical providers and the media to bring the 52-10 message to the community.

Drink 0 beverages with sugar y Drinking sugar-sweetened beverages is linked

with obesity & dental cavities. y A can of soda contains an average of 150

calories. Adding one soda a day to a person’s diet without doing anything to offset the calories could cause an average weight gain of 10 pounds in a year.

5 servings of fruits & vegetables daily

y Eating fruits and vegetables is important in weight control, healthy growth, and development in children, preventing diseases such as high blood pressure, diabetes and heart disease.

Limit “screen time” to 2 hours/day y Children who spend more than 2 hours per

day watching television are more likely to be overweight.

1 hour of physical activity every day

y Exercise helps to control your weight, improve your mood, and strengthen bones & muscles.

Practice 52-10 every day for a healthier life


Objective: Increase access to and demand for fresh fruits and vegetables among residents of

Santa Cruz County.

Measurable outcomes

» By 2015, there will be an increase in access to an improved variety of fresh local produce, as measured by:

y A 10% increase in the Food Stamp/EBT (Electronic Benefit Transfer) participation rate in Santa Cruz County

y A 5% increase in the number of WIC participants y A 40% increase in the number of pounds of produce distributed by Second Harvest Food Bank

y 10-15 food outlets in low income areas will provide and promote fruits and vegetables

y 10-12 child and family development programs will teach and model healthy eating

» By 2015, there will be 20 new places where Santa Cruz County residents can access fresh, locally grown foods

» By 2015, there will be 20 new community and school gardens producing fresh foods for Santa Cruz County residents

» By 2015, there will be a 10% increase in the number of childen/adults who eat at least 5 servings of fruits and vegetables per day17

Key Strategies

» Work with food outlets to increase the promotion of and access to fruits and vegetables

» Work with child and family development programs and services to teach and model healthy eating

» Connect with local farms » Work towards increased number of

school, home and community gardens » Promote healthy food choices in local

restaurants » Increase media activity around healthy

food issues

HealthY

food


Objective: Work with medical providers and healthcare systems to promote life-long healthy habits.

Key Strategies

» Promote the 52-10 campaign in the healthcare arena by providing education and training to medical providers

» Maintain partnerships with related collaborative to increase advocacy for access to healthy foods and breastfeeding support

» Increase community and media knowledge of childhood obesity prevention as it relates to healthcare

» Identify and pilot methods of collecting data on individual behavior change related to goal setting and bmi

Measurable outcomes

» By 2015, 25 Pediatric and family practice healthcare providers will utilize motivational interviewing and 52-10 tools to promote healthy eating and regular physical activity

» By 2015, there will be a 10% increase in breastfeeding rates among Community Bridges WIC clients who are breastfeeding infants up to 6 months of age

» By 2015, all 3 hospitals in Santa Cruz County will implement “The Ten Steps to Successful Breastfeeding for Hospitals,” as outlined by UNICEF/WHO

Health Care


Key Strategies

» Track public policy that promotes healthy living » Mobilize the community to advocate for public policy and funding

avenues for healthy living » Increase community and media knowledge and awareness about

healthy living and childhood obesity including promotion of 52-10 » Engage media and the public to move funders and public policy makers

in key areas

Measurable outcomes

» By 2015, 3-5 public policies promoting access to healthy food/healthy eating/regular physical activity in school boards, city councils, the County Board of Supervisors, County and city agencies, non-profits and for-profit businesses will be adopted

» By 2015, Go for Health! will maintain and increase funding to agencies and groups that work towards Go For Health!’s goals

Objective: Public Policies promoting access to healthy food/healthy

eating/regular physical activity in school boards, city councils, the

County Board of Supervisors, County and city agencies, non-profits and for-profit businesses will be adopted.

2 A Policy Brief on Preventing Obesity in Early Childhood; California Women, Infants, and Children (WIC) Association and the University of California, Davis Human Lactation Center; 2009.12,13,14,16 California Health Interview Survey (CHIS); http://www.chis.ucla.edu/; 2007. 7,8,9,10,15 California Healthy Kids Survey (CHKS); http://www.wested.org/cs/chks/print/docs/chks_

home.html; 2007, 2009. 4 Center for Disease Control (CDC); http://www.cdc.gov/HealthyYouth/obesity/; 2008. 1 Economic Costs Associated with Overweight, Obesity, and Physical Inactivity Among California Adults--2006; Center for Public Health Advocacy; 2009. 5,9,14,17 Santa Cruz County Community Assessment Project (CAP); http://www.

santacruzcountycap.org; 2007, 2009. 3 Strategies for Enhancing the Built Environment to Support Healthy Eating and Active Living; Prevention Institute; 2008. 6 United States Census Bureau; http://www.census.gov/; 2008.

Public Policy

References


The Go For Health! Collaborative continuously seeks to increase its membership. Organizations and individuals can become involved in a number of ways. GFH! convenes quarterly collaborative meetings at various locations throughout Santa Cruz County. Additionally, the Steering Committee and all subcommittees meet on a monthly basis. We welcome new members at all meetings. For more information about GFH! or for upcoming meeting dates, please contact the GFH! Coordinator at 831-479-5466 or visit our website at http://www.unitedwaysc.org/Go_for_Health.php.

A special thanks to the Go For Health! Steering Committee members and those who worked to create the 2010-2015 Strategic Plan. Your time, energy and dedication to the community are greatly appreciated!

Invitation to Participate

SUSAN AHLSTROMCLARK BEATTIE

PAUL BELLERJEAUILDI CARLISLE-CUMMINS

CATHY CAVANAUGHMARY LOU GOEKE

LESLIE GOODFRIEND SHEBREH KALANTARI

BOB KENNEDY

DENA LOIJOSSASKIA LUCAS

KATHLEEN MCCARTHYCHRIS MOSS

RICHARD PUENTERAQUEL RAMÍREZ RUIZ

ANGELA ROCCHIOSHELLY WINGERT

LAURA YOUNG

Go For Health! would like to extend its gratitude to our funders:

» Catholic Healthcare West » Pajaro Valley Community Health Trust » Robert Wood Johnson Foundation » The California Endowment » The many individuals who donate through the United Way’s

Annual Giving Campaign

Layout and Design: MICHELLE LUEDTKE

Thank You

BOYS AND GIRLS CLUB

CALIFORNIA CONGRESSIONAL DISTRICT 17 REPRESENTATIVE

CASA OF SANTA CRUZ COUNTY

CENTRAL CALIFORNIA ALLIANCE FOR HEALTH

CITY OF SANTA CRUZ PARKS AND RECREATION DEPARTMENT

CITY OF WATSONVILLE »Parks and Community Services

»Public Works and Utilities »City Council

»Community Development

COMMUNITY ALLIANCE WITH FAMILY FARMERS

COMMUNITY BRIDGES »Women, Infants and Children

»La Manzana Community Resources »Live Oak Family Resource Center »Beach Flats Community Center

COUNTY OF SANTA CRUZ »Health Services Agency

»Parks, Open Space and Cultural Services »Sheriff’s Office

DOMINICAN HOSPITAL

DRISCOLL STRAWBERRY ASSOCIATES, INC.

ECOLOGY ACTION

FAMILIA CENTER

FIRST 5 SANTA CRUZ COUNTY

HEALTH IMPROVEMENT PARTNERSHIP

LIFE LAB SCIENCE PROGRAM

LIVE OAK SCHOOL DISTRICT

MESA VERDE GARDENS

MID-PENINSULA HOUSING

MONTEREY COUNTY HEALTH DEPARTMENT

PAJARO VALLEY COMMUNITY HEALTH TRUST »Diabetes Health Center

PAJARO VALLEY PREVENTION AND STUDENT ASSISTANCE

PAJARO VALLEY UNIFIED SCHOOL DISTRICT »Healthy Start Program

»Migrant Education »Extended Learning Program

PALO ALTO MEDICAL FOUNDATION

PHYSICIANS MEDICAL GROUP

SALUD PARA LA GENTE

SAN LORENZO VALLEY UNIFIED SCHOOL DISTRICT

SANTA CRUZ CITY SCHOOLS

SANTA CRUZ COMMUNITY COUNSELING CENTER

»Head Start »Early Head Start

SANTA CRUZ COUNTY OFFICE OF EDUCATION

SANTA CRUZ COUNTY REGIONAL TRANSPORTATION COMMISSION

SANTA CRUZ EDUCATION FOUNDATION

SECOND HARVEST FOOD BANK SANTA CRUZ COUNTY

STATE ASSEMBLY REPRESENTATIVE 27TH DISTRICT

STATE ASSEMBLY REPRESENTATIVE 28TH DISTRICT

UNITED WAY OF SANTA CRUZ COUNTY

WATSONVILLE COMMUNITY HOSPITAL

WATSONVILLE FAMILY YMCA

AMERICAN CANCER SOCIETYAPPLIED SURVEY RESEARCH

CALIFORNIA STRAWBERRY COMMISSIONCALIFORNIA FOOD POLICY ADVOCATES

CALIFORNIA STATE UNIVERSITY MONTEREY BAYCOMMUNITY FOUNDATION OF SANTA CRUZ

COUNTYCOMMUNITY TV CTSCC

KSBW-TV8

NUTRITION AND FITNESS COLLABORATIVE OF THE CENTRAL COAST

REGIONAL DIABETES COLLABORATIVEREGISTER-PAJARONIANSAFETY NET COALITION

SANTA CRUZ COUNTY FARM BUREAUSANTA CRUZ SENTINEL

THE GOOD TIMESUNIVERSITY OF CALIFORNIA, SANTA CRUZ

In addition to those listed above, many other individuals and agencies participate in Go For Health! in a variety of ways; including meetings, participating at events, recieving newsletters and disseminating information.

Go for Health! Active Members

Community Support

gfh plan 10-15

Documents

individuals health

health outcomes

public health advocacy

significant health inequities

societys economic health

regular physical activity

healthy nutrition

children of santa cruz