Health & Nutrition

The Coalition's mission is to promote a healthy, equitable, and sustainable food system - and being at the intersection of health and equity, it's no wonder Health & Nutrition is one of our powerhouse working groups.  Making fresh fruits and vegetables and other whole foods more available in our urban areas can counterbalance people's tendency to eat highly processed "fast foods" that contribute to heart disease, diabetes, and other diet-related illnesses (mainly because that's what's most available in "food deserts").  Increased availability may be through corner stores, farmers markets, the few-and-far-between urban grocery stores, restaurants, street vendors, schools, hospitals, and other institutions.  Health & Nutrition has addressed access in several of these areas and has made some major strides thus far, as you'll read below.

Follow this link to read a comprehensive policy brief prepared by Health & Nutrition about the state of healthy food access in Greater Cleveland and programs in place to improve it.

Current Goals for the Health & Nutrition Working Group

Recently the Health & Nutrition Working Group was focused on two main projects.  The first is to examine the public transportation system's impact on food access.  Primarily, this involves analyzing RTA routes that have been or are scheduled to be eliminated with respect to locations that healthy food can be purchased.  If it's found that access would be improved by retaining or reinstating those routes, an appeal to RTA will be made.

The other primary goal of the working group is to ensure that every farmers' market in Cuyahoga County accepts all forms of food assistance.  The background of this initiative is detailed in the section immediately following, as it pertains to some tremendous progress Health & Nutrition has helped catalyze in the last few years.

In addition to these two main projects, the group aims to review current and emerging policies related to food access in order to stay on top of trends, inform the two main projects, and set the stage for future projects.

If you're interested in joining the working group at an upcoming meeting, please email Morgan Taggart of Ohio State University Extension (OSUE) for more information.

The best way to stay up to date on what each of the working groups is doing is to frequently check the Blog.

Results Achieved through the Health & Nutrition Working Group

Increasing Use of Food Assistance at Local Farmers' Markets

One of the greatest successes of our Health & Nutrition Working Group has been a project to improve the ability of individuals receiving food assistance to redeem their benefits at area farmers' markets.  In 2008, Cuyahoga County had 260,000 recipients of federal food assistance (20% of the total population), administered through the Ohio Direction Card (which accounted for $258 million in total expenditures across the state).  Much of the food offered at farmers markets is "nutrient-dense" - such as fruits and vegetables, which are high in vitamins and minerals and low in calories.  These types of foods are incredibly important to a proper diet and thus overall fitness, but often times in areas where a high percentage of individuals require government-issued food assistance there is not sufficient access.  Recognizing this, a group at Case Western Reserve's Weatherhead School of Management conducted a study released in 2009 about how to create successful farmers markets in low-income, urban neighborhoods.  The study, which incorporated national and international perspectives but was focused on Cleveland, supports the notion of farmers markets increasing access for underserved urban populations and offers numerous strategies and best practices for doing so.  When the study was released the Health & Nutrition Working Group was already well underway in implementing these types of techniques.

In January 2009 Health & Nutrition offered a workshop for farmers' market managers to learn about opportunities and the process for including EBT (i.e. food stamps or Supplemental Nutrition Assistance Program (SNAP)) at their markets.  Over 20 market managers attended, coming from three counties.  Market managers learned of an Ohio Department of Agriculture program called the Farmers' Market Access Project that would provide free EBT machines to farmers' markets that want them.  The machines offered require access to a phone line and can only process EBT transactions, whereas more expensive models operate off a wi-fi network and can process credit card transactions.  However, the lowered barrier to a farmers' market at least starting to offer EBT access led to such access at 6 of the 9 markets in Cleveland and 8 of the 17 markets in Cuyahoga County by the summer of 2010.  It's become the goal of the Health & Nutrition Working Group to ensure that every farmers market in the county accepts food assistance benefits.  Currently, 16 farmers' market in Cleveland accept the EBT Ohio Direction Card.

As a tool to accomplish this, members of Health & Nutrition developed a comprehensive database that documents the markets that accept the different forms of benefits (EBT/Ohio Direction Card/SNAP, WIC, and Senior Vouchers).  Also, a member created a policy brief that examined the barriers and successes of food assistance at farmers' markets in Cuyahoga County through the end of 2009.

As healthy food advocates across the country have learned, increasing access to nutritious food does not necessarily result in it being purchased by members of the community.  In the case of farmers' markets this may be for a variety of reasons, including a widely held view that their prices are too high (largely due to small producers not being able to take advantage of economies of scale and the more extensive process of producing food organically, as many farmers' market suppliers do whether they're certified or not).  Therefore, Health & Nutrition partnered with the George Gund Foundation and the Downtown Cleveland Alliance to create a food assistance incentive pilot program at four area farmers' markets in the summer of 2010.  The program now offers $5 in extra tokens to EBT customer spending at least $5 from their card at 16 markets across Cleveland.Public Square Farmers Market, participant in EBT Incentive ProgramPublic Square Farmers Market, participant in EBT Incentive Program

The way it works is that if a customer decides to use $5 or more from the Ohio Direction Card, he or she receives an additional $5 to use that day at the market.  Doubling the benefit is a powerful way to attract first-time customers to a farmers' market and encourages them to come back in the future to spend their food assistance dollars on healthy food that supports the local economy.  The RTA and Cuyahoga County Employment and Family Services have each distributed marketing materials to increase the visibility of this program.  The pilot program is being evaluated based on the number of transactions per week, whether customers are returning or new, and how they found out about the program, so the feasibility and potential value of a more permanent program can be assessed.  This program was announced by Mayor Frank Jackson at Cleveland's Public Square Farmers' Market and generated a lot of interest among local media affiliates, including the Plain Dealer, WCPN 90.3 ideastream, and WKYC Channel 3.

Cleveland Corner Store Project

Another success of the Health & Nutrition Working Group was the Cleveland Corner Store Project, which helped increase the availability of fresh fruits and vegetables in convenience stores in underserved Cleveland neighborhoods as a way of addressing food insecurity.  The research was conducted through the Center for Health Promotion Research and was led by co-founder and former co-convener of the Coalition, Matt Russell.  Members of Health & Nutrition contributed through OSU-E's Extended Family and Nutrition Education Program (EFNEP).  While funding for the project concluded in 2009, the findings and protocol of the project are being applied in the core project of the new Prevention Research Center for Healthy Neighborhoods, called "Increasing Access to Healthy Foods in Urban Neighborhoods" - and some of the convenience stores in the original program have continued on with the practice of carrying fresh produce for their customers' benefit.  The program was featured in a New York Times story in 2009 and also resulted in an academic paper on the topic.  You may be interested to peruse the final report, FAQ, and a large poster describing the results of the study.  You may also want to learn more about the role of the Local Purchasing Working Group in this project.

Sustainable Street Food Pilot Program

In 2009 and 2010 the Coalition collaborated with the City of Cleveland and other partners to establish the Sustainable Street Food Pilot Program, which offers grants and favorable loans to new food cart operators who will provide healthy, locally-sourced menu items in a wide array of culinary styles.

Dim and Dem Some food truckDim and Dem Some food truck

Cleveland has a strong and diverse culinary tradition. The program was created in order to expand on this tradition, as well as encourage small business growth and sustainable business practices, activate public spaces, promote local artists, and facilitate the availability of healthy local food options. Partners include the City of Cleveland, Case Western Reserve University, Cleveland Public Art, Charter One Bank, Playhouse Square, and the Coalition.

Members of the Health & Nutrition Working Group have been closely involved in the creation and streamlining of the RFP/Application, as well as the evaluation of food cart proposals specifically in terms of the healthfulness of the food offerings.  Health & Nutrition members have provided guidance to applicants on how to improve their menus accordingly and were involved in the creation of legislation that allowed the program to come into existence.

In its first year in 2010 the program filled approximately 10 slots, most of which involve a favorable loan to get the carts up and running, along with a grant to work with Cleveland Public Art to design appealing exteriors to carts in order to ensure the program contributes to a more vibrant culinary scene.  Read more here about the launch event for the program.

Food Access Analysis & Education

In addition to providing the valuable program assistance detailed above, the Health & Nutrition Working Group has done a number of things to help assess the state of food access in communities and to offer information that can be helpful in taking maximum advantage of the healthy, local food that is presently available.

In the summer of 2010 Health & Nutrition completed work on its Local Foods Guide, which provides a cornucopia of information aimed at helping consumers find ways to engage in the local food movement.  Highlights include a guide to buying food in season (and thus maximally nutritious), shopping at the historic West Side Market, listings of area farmers' markets and community gardens, and tips on how to select and prepare healthy food.  The Health & Nutrition Working Group recently released the second edition of the Food Guide in the summer of 2011.

The working group received regular updates and provided advice to two projects investigating barriers to food access in area neighborhoods, Community Conversations 2010 and Ohio Neighborhood Harvest.  Community Conversations 2010 was based on focus groups held with individuals of all ages in about a half dozen area neighborhoods to see how they make their food choices and learn more about their thoughts and feelings about the community's food environment.  It builds on the work of the Community Conversations project completed in 2009.

As participants in the Ohio Food Policy Council's Healthy Food Access Task Force, members of Health & Nutrition provided recommendations for the development of a community food assessment toolkit for urban communities in Ohio to identify food access gaps.  These members work with the Ohio Department of Health to use GIS data to map food deserts in major metropolitan areas of Ohio as part of Governor Strickland's Ohio Neighborhood Harvest initiative.

When this grocery store in East Cleveland closed it left behind a sizeable "food desert"When this grocery store in East Cleveland closed it left behind a sizeable "food desert"

Members of the Health & Nutrition Working Group also made an important presentation to the members of the Cleveland City Council's Health and Human Services Committee in March 2010.  The committee was briefed on the extent of food access issues faced by city residents (particularly based on the 2008 Cuyahoga County Food Insecurity Analysis) and informed of programs and strategies that have been and may be effective in combating such problems.  Several members of the committee expressed deep concern over these issues and indicated they would like to help bring about policy that may alleviate the problems.