Background:
Washington, D.C. has the highest rate of overweight among children ages 10 to 17 among states. Overweight and obesity often are concentrated in areas of high poverty - such as the neighborhoods separated from the rest of the District by the Anacostia River in Wards 7 and 8. In these low-income communities, residents face particularly daunting challenges to good health: inadequate access to full-service grocery stores that offer fresh fruits and vegetables; neighborhoods dominated by fast food, carry-outs, and corner stores that largely offer unhealthy foods; unsafe and unclean outdoor park space; and few other opportunities for physical activity.
Healthy Kids Healthy Communities is a national program of the Robert Wood Johnson Foundation (RWJF) that is working with low income communities across the country to help reshape their environments to support healthy living and prevent childhood obesity. DC was selected as one of nine leading sites to work over four years to address the city's alarming rate of childhood obesity. The Healthy Kids Healthy Communities DC partnership will work with residents and policymakers in Wards 7 and 8 to prioritize and implement two of the following healthy eating and active living policies:
Healthy Eating Policies
1) Instituting within the District the federal Afterschool Supper Program to provide low-income children with healthy suppers, as well as accompanying improvements to existing afterschool federal nutrition and nutrition education programs.
2) Creating a saturation index of unhealthy food and beverage vendors, with the opportunity for community residents to identify the types and quantities of healthy vendors that should exist instead.
Active Living Policies
3) Implementing and enforcing policies that will create a paid Park Keepers workforce, thereby increasing the safety and accessibility of D.C. parks and playgrounds.
4) Reimbursing community-based fitness and healthy living programs and non-traditional clinical providers by Medicaid and other insurers. (Reimbursable programs include but not limited to those offered at churches, park and rec sites, community centers, etc).
Healthy Kids Healthy Communities DC partners include: Summit Health Institute for Research and Education, Inc (SHIRE), DC Department of Health, DC Office of Planning, DC Hunger Solutions, and the National Black Child Development Institute. SHIRE serves as the lead agency.
Objectives:
Through a process of community consultation with Wards 7 and 8 residents, SHIRE aimed to engage the community directly in their own policy initiatives, as well as to gather valuable input on which of the four proposed policies were seen as the most effective ways of reducing obesity and improving health. In an effort to build on community momentum around childhood obesity prevention, SHIRE hopes to adopt and implement selected priority policy choices by 2012, as well as to train community residents to advocate for the adoption of priorities and policies.
Methods:
In order to identify priority policies out of the four proposed, SHIRE and its partner organizations conducted a series of surveys, focus groups, interviews with key stakeholders, and town hall meetings that reached over 400 residents. Participants were recruited through community connections built through other SHIRE programs, targeting community-serving organizations such as hospitals, high schools, parent associations, and youth programs. Special consideration was taken to include community members of varying age, gender, and lifestyles. In addition to fostering general conversation on topics of active living and healthy eating, these outreach efforts also included a final question asking participants to choose two policies out of the four.
Results:
Preliminary findings show that residents of the communities prefer the creation of a park keeper workforce (Policy #3) and the implementation of a saturation index to limit unhealthy foods (Policy #2).
Regarding qualitative data on active living, residents did raise some concerns, primarily the security of parks and open spaces, the quality of facilities and opportunities for physical activity, and the limited options for walking in the neighborhood.
Conclusions:
As this project is not yet completed, there are no final conclusions. However, HKHC outreach efforts in the community and the overwhelming response from residents demonstrate the necessity for these policy initiatives.
Further progress updates include the following:
• With encouragement and guidance from D.C. Hunger Solutions, the U.S. House of Representatives has a provision in its FY 2010 Agriculture Appropriations bill that would make D.C. a federal Afterschool Meal Program state.
• Results also show support for additional District government funding and infrastructure to improve community parks as safe places for recreation and physical activity.
• HKHC team members are working with other stakeholders as part of the State Obesity Work Group, which is tasked with developing the District’s State Obesity Plan by October 2009.
SHIRE will continue working its partner organizations to analyze focus group findings and to move further in implementing and adopting the priority policies.
