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TARRANT COUNTY PUBLIC HEALTH Accountability. Quality. Innovation.
September 13, 2019
A healthier community through leadership in health strategy.
Yvette M. Wingate, Ed.D.Health Equity and Community Engagement
8th Annual Dallas Hunger Summit
TARRANT COUNTY PUBLIC HEALTH
TARRANT COUNTY PUBLIC HEALTH
TARRANT COUNTY PUBLIC HEALTH
The assumption is that everyone benefits from the same supports. This is considered to be equal treatment.
Everyone gets the support they need, which produces equity.
All 3 can see the game without supports or accommodations because the cause(s) of the inequity was addressed. The systemic barrier has been removed.
One gets exceedingly more than is needed, while the other gets exceedingly less. Thus, a huge disparity is created.
EMPOWERMENTEQUITYEQUALITYREALITY
TARRANT COUNTY PUBLIC HEALTH
TARRANT COUNTY PUBLIC HEALTH
Health improves as advantage
increases.
TARRANT COUNTY PUBLIC HEALTH
Gaps in health equity remain W I D E and
persistent.
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TARRANT COUNTY PUBLIC HEALTH
Social Inequities:Root Causes of Health Inequities
Predatory Lenders
Air Quality and Environment
Access to Affordable
and Nutritious Foods
TransportationHousing
Discrimination
Physical Activity and Neighborhood
Conditions
Health Care AccessEducation
Segregation
Social Relationships and Community Capacity
Access to Income and Employment
TARRANT COUNTY PUBLIC HEALTH
▪ Health inequity limits people's ability to gain access to resources and experiences required for health and wellbeing.
▪ When people lack access to decision-making that affects their work life and living conditions, their health suffers.
WHY DOES IT MATTER?
TARRANT COUNTY PUBLIC HEALTH
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Cultural Awareness
▪ Acknowledges differences
▪ Does not seek broader context or understanding
▪ Very limited behavior change
Cultural Sensitivity
▪ Acknowledges different ways of seeing the world
▪ Integrates some changes in practices or behavior
Cultural Competency
▪ System elements are aligned with and respect others cultures
▪ Represents action on the part of an individual or organization
Cultural Humility
▪ A lifelong commitment to self-evaluation to redress power imbalances
▪ Develop and maintain respectful relationships based on mutual trust
TARRANT COUNTY PUBLIC HEALTH
TARRANT COUNTY PUBLIC HEALTH
The Minneapolis Staples Food
Ordinance (Minneapolis, MN)
The first city ordinance in the country to require that licensed grocery
stores carry a minimum level of certain staple
foods
2009 new WIC Standards and 2010 Healthy Corner
Store Program
Problem: Poor health outcomes and
insufficient access to healthy groceries in some
parts of the city
Urban Agriculture Ordinance (Fort
Worth, TX)
Problem: Limited healthy food access
and lack of fresh local produce
Designed to impact health equity, by providing fresh
food to underserved communities and by
enabling members of these communities to produce and market local food as a tool
for social and economic development
Collaboration and community input
NATIONAL LOCAL
Source: Healthy Food Policy Project, https://healthyfoodpolicyproject.org/wp-content/uploads/fort-worth-tx.pdf
Model
▪ Food is accessible when it is affordable, and community members can readily grow or raise it; find it; obtain it; transport it; prepare it; and eat it.
▪ 293 Policy Database: 9 TX cities included
▪ 6 Components: Grow, Process, Distribute, Get, Make, & Surplus/Waste Management
▪ 6 stories about healthy food policy initiatives
TARRANT COUNTY PUBLIC HEALTH
▪ 11 zip codes were surveyed.
▪ 4 zip codes had no grocery stores and
the least availability of healthy food.
▪ The lowest percentage convenience stores is
70%.
▪ Items available in convenience stores cost
about two times the amount of those in
grocery stores.
▪ 87% of grocery/convenience stores had at
least one milk item.
▪ 57% did not have any fresh fruit.
▪ 80% did not have any fresh vegetables.
▪ 32% of the stores had no cereal.
▪ 35% of stores had no bread or baked goods.
TARRANT COUNTY PUBLIC HEALTH
TARRANT COUNTY PUBLIC HEALTH
CHIP Priority Area 1: EDUCATION
GOAL 1: Progressively influence living and
working conditions that will have a positive
impact on the health and behavior of
individuals and communities.
FOCUS:
▪ Participate in the political process
▪ Increase access to affordable, nutritious foods and decrease food insecurities
▪ Engage the community residing in food deserts to participate in community gardens
TARRANT COUNTY PUBLIC HEALTH
Johns Hopkins Bloomberg School of
Public Health (Baltimore, MD)
Used HFAI to assess 8 food groups; A higher score
indicates greater availability of healthy foods
Adapting the NEMS instrument to Baltimore
food stores
Crafting new programs that will be effective, efficient,
just, and sustainable.
Austin/Travis County Health and Human
Services
Used grants to develop an expansive mapping
platform that can be accessed
online
Healthy Tarrant County Collaboration
739 surveyed grocery stores, approx. 600
remaining
SNAP vendors list provided by TCPH was
sorted by zip code
Special focus on 3 high need zip codes
NATIONAL STATEWIDE LOCAL
Sources: Johns Hopkins Bloomberg School of Public Health, Center for a Liveable Future, The Baltimore City Food Environment, https://www.jhsph.edu/research/centers-and-institutes/johns-hopkins-center-for-a-livable-future/research/clf_publications/pub_rep_desc/bal_city_food_env.html; Fulmer, L., & Harrison, S. (2019). Healthy food access: Tarrant county priority areas.
TARRANT COUNTY PUBLIC HEALTH
Fulmer, L., & Harrison, S. (2019). Healthy food access: Tarrant county priority areas.
TARRANT COUNTY PUBLIC HEALTH
Ethnic Grocery Stores
TARRANT COUNTY PUBLIC HEALTH
The Food Trust (Philadelphia, PA)
Increase the availability and awareness of healthy foods
in corner stores in Philadelphia through a multifaceted approach
In partnership with the Philadelphia Department of Health's Get Healthy Philly
initiative
Expanded the Healthy Corner Store Initiative throughout
Pennsylvania and New Jersey
Philadelphia Healthy Corner Store Network in more than
600 corner stores
Food Policy Council of San
Antonio
Pilot program in City Council District 3 to increase access to
healthy, affordable food, with $50,000 City
funding
Enrolled five stores and stocked them with fresh
fruits and vegetables
Unique collaborative partnership
Plan4Health Tarrant County
Promote healthy retail policies and practices to increase the availability
of healthy foods
Improve access to local, fresh food in southeast
Fort Worth
1 corner store worked with community and nearby high school
Work led to United Way Grant focusing on 3 new
corner stores
NATIONAL STATEWIDE LOCAL
Urban Farming Institute, http://ufi.us.org/; Small Places, LLC., https://www.smallplaces.org/
TARRANT COUNTY PUBLIC HEALTH
Photos courtesy of Healthy Tarrant County Collaboration and Blue Zones
TARRANT COUNTY PUBLIC HEALTH
Photos courtesy of Healthy Tarrant County Collaboration
TARRANT COUNTY PUBLIC HEALTH
Urban Farming Institute (Oakland
Park, FL)
60 Community garden beds
Largest agricultural facility in Broward County
500+K Honey-making bees per year
50 Members & Supporters
60+ Gardens in local Broward County schools
Small Places, LLC (Houston, TX)
Quality, local food should be made available to all people regardless of location and income
Develop a CULTURE OF HEALTH in our
communities by renewing the bond between PEOPLE, PLACE, and FOOD
Limited Resource Farming
Plan4Health Tarrant County
Grow Southeast –4 Urban Farms
Improve community health and health equity
outcomes of the built environment
City of Fort Worth’s Urban Agriculture Ordinance
Equipment for farmers to borrow (tractor, tiller and
plow)
NATIONAL STATEWIDE LOCAL
Urban Farming Institute, http://ufi.us.org/; Small Places, LLC., https://www.smallplaces.org/
TARRANT COUNTY PUBLIC HEALTH
Photos courtesy of Healthy Tarrant County Collaboration
TARRANT COUNTY PUBLIC HEALTH
Photos courtesy of Healthy Tarrant County Collaboration
TARRANT COUNTY PUBLIC HEALTH
Unity Unlimited, Inc., https://www.unityunlimited.org/opals-farm.html; Photos courtesy of Unity Unlimited, Inc., February 15, 2019
“Everyone deserves to be fed and to eat healthy food. Unfortunately,
that’s rarely the case in many of our neighborhoods. A lot of people
don’t know what it is to have fresh vegetables….We will provide
healthy options and the education to use them.”
~Greg Joel, Farm Manager of Opal’s Farm
2500 LaSalle St., Fort Worth, TX 76111
(5-acres)
TARRANT COUNTY PUBLIC HEALTH
Mobile Fresh Markets:Meet People Where They Are
▪ Started by Texas Health Resources in Azle
▪ Higher Praise Family Church and Sayer’s Family Farmers Market in Haltom City
▪ Church volunteers are then able to pack out the bags on Friday evenings, and began sales on Saturday, July 6th from 8am to 10 am.
▪ They plan to start with 100 bags of produce at $5/bag and hope to expand to 200 or 300 bags within a year.
TARRANT COUNTY PUBLIC HEALTH
SHARE TABLE, recycling and composting at North Hi Mount
Elementary School (Fort Worth, TX)
A project of the Tarrant County Food Policy Council’s Food
Recovery Work Group
TARRANT COUNTY PUBLIC HEALTH
TARRANT COUNTY PUBLIC HEALTH
Promotes health equity in all policies, programs, and services by prioritizing resources to reduce health inequities.
Assesses and reduces systemic barriers to equitable access to high quality services for all.
Addresses specific health needs of people all along the social gradient, including the most health disadvantaged.
Ensures that the methods used to provide health services contributes to the reduction of health disparities.
Helps to evaluate, communicate and recognize health equity strategies.
TARRANT COUNTY PUBLIC HEALTH
Select Issue
Collect and Analyze Data
Identify a Policy/Program/Service that Addresses the Issue
Implement and Monitor with Internal or External Stakeholder Input
Evaluate with Internal or External Input
Report Back
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TARRANT COUNTY PUBLIC HEALTH
Women, Infants and Children (WIC)
Dual HandsetsLimited English
Proficiency Language Line
TARRANT COUNTY PUBLIC HEALTH
#1
• Provide effective, equitable,
understandable, and respectful quality care and services
that are responsive to diverse cultural
beliefs and practices, preferred languages, health literacy, and
other communication needs.
#5
• Offer language assistance to
individuals who have limited English
proficiency and/or other communication at no cost to them, to
facilitate timely access to all health care and services.
#7
• Ensure the competence of
individuals providing language assistance, recognizing that the
use of untrained individuals and/or minors should be
avoided.
Working together on a common agenda with mutually reinforcing actions, shared measures and constant
communication =
Hunger
Eliminated
TARRANT COUNTY PUBLIC HEALTHTARRANT COUNTY PUBLIC HEALTH
Yvette M. Wingate, Ed.D.Health Equity CoordinatorP: 817-321-5318E: [email protected]
TARRANT COUNTY PUBLIC HEALTH Accountability. Quality. Innovation.
A healthier community through leadership in health strategy.
Main Address:1101 S. Main Street
Fort Worth, TX 76104
Phone:817-321-4700
Website:health.tarrantcounty.com
Social Media:
TARRANT COUNTY PUBLIC HEALTH Accountability. Quality. Innovation.
A healthier community through leadership in health strategy.