Exploring Food Access and Food Environments as an Adjunct Assessment Feature. Cyrus Ghaemi, DO Laura McCain, RD Les Hagamen

Transcription

1 Exploring Food Access and Food Environments as an Adjunct Assessment Feature Cyrus Ghaemi, DO Laura McCain, RD Les Hagamen

2 What is (healthy) food insecurity? 1 - A family with grocery stores nearby, but a lack of experience preparing meals from raw ingredients 2 - Only store in town is a convenience store whose produce selection is apples and bananas 3 - Transportation options consist of borrowing one family member s car, which they use to commute daily to work 4 - Having a tight budget that forces decisions between paying rent, utilities, gas. 5 - All the above

3 Healthy Food Access Access refers to the ability to connect a person with a specific resource Challenges may arise at multiple points: transportation, resource availability, finances Simply having access is insufficient Necessary knowledge, skills and capacity to leverage access is crucial

4 At Risk Individuals Combination of factors increase risk of healthy food insecurity Lower socio-economic status Minority ethnic groups Transportation challenges Physical relation to markets Quality of available markets Knowledge of healthy food choices Food & culinary skills

5 Privilege and Social Determinants of Health

6 Why is this important? Rural adults are less likely to consume >5 daily servings of fruits and vegetables compared to urban adults Obesity and chronic disease rates higher in rural vs urban areas 8.6% and 38.8% higher prevalence rates for DM and CHD in one study, likely associated with higher rates of poverty, obesity, and tobacco use Other studies show increased prevalence of metabolic syndrome in rural vs urban popula9ons in the US Children with food insecurity become adults with chronic disease

7 Community Health Needs Assessment MMC conducts assessments every three years, recently 2016 Conducted 5 community conversations to collect primary data Secondary data collected by Xerox Community Health Solutions MMC Community Health Committee laid out Priority Areas Develops Community Health Implementation Strategy to address prioritized areas

8 Data on our communities GT County: 28.5% of adults eat 5+ fruits/ vegetables daily 5 County (Antrim, Leelanau, Benzie, GT, Charlevoix): Obesity incidence: >20yo 26-32%, HS students 11-26% Food Insecurity: 11-15% adults, 17-23% kids / year Diabetes: 9-13% adults / % Medicare pop HTN: 50% Medicare pop Heart Disease: deaths/100k pop.

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11 What does this mean in our community? Most adults don t eat enough fruit & veg Obesity is a problem for adults AND children At least 1 in 10 adults and 1 in 5 kids experience food insecurity at some point every year Chronic disease burden is high, and prevention is key in management

12 Existing Programs & Resources Different programs address different barriers Financial barriers: SNAP & Double Up Food Bucks + Skill Development: Cooking Matters + Connection to Healthcare: Rx for Health

13 Our Approach Fruit & Vegetable Prescription Program Modeled after Washtenaw County s Prescription for Health program Connects healthcare providers, patients, farmers, and educators

14 The Munson Fruit & Vegetable Prescription Program

15 Creation of Shape Up North (SUN) to address Obesity (2013, 2016 CHNA) Vision: We envision a region where all citizens will achieve and maintain a healthy weight. Mission: To achieve our vision a multifaceted approach must be used which includes schools, businesses, health care providers, and the community at large. This collaboration will work to influence sustainable change in: behavior, policy, social norms and systems

16 Partnering with Providers Survey of providers: Providers were seeking support and more information on community nutrition resources for patients 2014 Food, Farms and Health Conference

17 Fruit and Vegetable Rx Program Shape Up North ~$50,000 in grant funds from MDHHS for FY2016 Michigan Health & Wellness 4x4 Plan MiHealthier Tomorrow Piloted at Munson Family Practice Center Expanded to other clinics in 2017 Modeled after Washtenaw County Public Health Department s Prescription for Health

18 The Village at Grand Traverse Commons Farmers Market Coupons offered and accepted at Outdoor Market 12-4p, May-Sept 2016 Participating vendors must sell fresh fruits and vegetables, accept program coupons Includes herbs and seedlings Farmers were reimbursed monthly through grant funds

19 Barriers to Ea9ng Well No experience cooking No cooking equipment No 9me Dislike / unfamiliar with many types of produce Overwhelmed with recipe details

20 Cooking at the Market

21 Education Sessions Content focused on cooking skill development, basic nutrition, and shopping techniques

22 Fruit & Vegetable Rx Program Video hrps://

23 Enrollment Traverse City Clinics: Adults: 121 Pediatrics: 73 Benzie Co: 63

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29 Assessing Food Insecurity Hunger Vital Signs "Within the past 12 months we worried whether our food would run out before we got money to buy more." "Within the past 12 months the food we bought just didn't last and we didn't have money to get more." Documenta9on Code: Z594 - Lack of adequate food and safe drinking water

30 Pa9ent Resources Financial Assistance Programs Old Ways: hrps://oldwayspt.org/ Educa9onal / Training Programs

31 References Munson Community Health Department Kristina Olsen, KMS Poor nutritional habits: a modifiable predecessor of chronic illness? A North Carolina Family Medicine Research Network (NC-FM-RN) study. Gaskins ND; Sloane PD; Mitchell CM; Ammerman A; Ickes SB; Williams CS. Journal of the American Board of Family Medicine: JABFM. 20(2): , 2007 Mar-Apr. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or Metformin. N Engl J Med 2002;346: A cross-sectional study of US rural adults consumption of fruits and vegetables: do they consume at least five servings daily? Lutfiyya et al. BMC Public Health 2012, 12:280 Prevalence of Obesity Among Adults From Rural and Urban Areas of the United States: Findings From NHANES ( ). Befort et al. NIH Public Access, J. Rural Health (4):