HealthyCal.org

Laurie Henry of Granville Farm tells customers about her multi-colored eggs. Henry has a small farm outside Bakersfield where she raises chickens on nine acres. She started selling at the Bakersfield Brimhall Market, pictured here, and will attend the Delano and Central Park markets when they open in the spring.

By Kellie Schmitt

To combat a growing obesity crisis in Kern County, farmers will be bringing their fresh vegetables and vibrant fruits to four burgeoning markets around the Central Valley.

For vendors like Laurie Henry, it means a chance to tell more residents about her white, green, blue and chocolate-colored hens’ eggs.

“A lot of people are unaware that the egg shell is like human hair – the color depends on the chicken,” Henry said. “And the more natural the egg, the higher it is in vitamin content.”

This May, Henry will showcase her free-range eggs at the Delano and Central Park at Mill Creek farmers’ markets, both of which opened on a pilot basis last year. They’re part of the four new markets the Kern County Public Health Department has helped create in low-income areas of the San Joaquin Valley.

The department’s effort to promote healthy eating is especially relevant in a county facing grim health figures. More than 60 percent of adults in Kern County are overweight or obese, and figure relating to heart disease and diabetes are among the worse in the state. Along with encouraging healthier food choices, the markets are also a way to bolster communities and keep locally-grown produce in the Central Valley.

“This is a way to promote a healthy lifestyle without being too in-your-face about it,” said Avtar Nijjer-Sidhu, a senior health educator with the county’s environmental health division. “We need to be in more areas where children are overweight and parents have limited income.”

Tackling Heath Disparities

Shortly after Nijjer-Sidhu joined the Public Health Department in 2006, she came up with a plan to tackle the county’s high health disparities. Despite the Central Valley’s rich agricultural base, most crops didn’t stay in the area.

“It’s hard for me to see the produce go to L.A,” she said. “We need that produce locally.”
Bakersfield already had farmers’ markets, but they were mostly clustered in wealthier, central areas.

Nijjer-Sidhu , who has a doctorate in nutrition, wanted to bring the local produce to outlying regions that didn’t have plentiful access to fresh fruits and vegetables. In 2007, she set-up the first pilot market at her home base, outside the Public Health building. There was just one vendor, not enough customers and interest waned.

The next year, she brought in more vendors and arranged for Women Infants and Children (WIC) food vouchers to be accepted. The department also took care of promotion, making sure residents learned of the new markets through radio, media, fliers and brightly-colored banners.

Soon after, Nijjer-Sidhu received a phone call from Kern County Supervisor Mike Maggard, requesting a market in Oildale. In 2009, the Oildale Market was born and the one outside Public Health grew. Last year, the department started new markets in the city of Delano and Bakersfield’s Central Park – efforts they’re hoping to expand this coming spring.

Overcoming Hurdles

Creating new markets in underprivileged areas hasn’t been without challenges. For one, the timing corresponded with the economic recession.

Nijjer-Sidhu worked with local agencies to ensure that WIC vouchers could be accepted in lieu of cash.

Brenda Luetger, of BJ’s Lavender Farm in Pumpkin Center, sells a variety of hand-crafted soaps, lotions, sprays, sachets and cooking lavender. “A lot of people say ‘that’s neat, but what do you do with it?’” she said. Luetger gives them recipes for simple healthy foods like roasted chicken or salmon seasoned with lavender. “I get them to try some, and then they come back for more.”

Vendors, too, say they’re willing to bend the rules for people who need extra help. Brenda Luetger of B.J.’s Lavender Farm, says she plays with prices if someone really wants a product but can’t afford the cost. “The prices are set, but if someone’s down on their luck, I try to help,” said Luetger, who will be joining the Central Park market this year. “I’m not in this to get rich.”
 
Keeping young markets like Oildale afloat is a challenge, said Charles Drew, the market manager there. Kern County’s spread-out geography makes it hard to create markets with sufficient farmers and customers. Many farmers can’t afford the expense of sending equipment, fuel and personal to smaller markets, especially on prime weekend days.

Drew said he’s hopeful that smart scheduling such as having two nearby markets on the same day can alleviate farmers’ financial concerns and encourage them to attend newer, smaller markets.

When it comes to customers, building new markets also can be a hard sell in a region where people aren’t always accustomed to eating healthy and buying local. “Remember the old saying ‘You can lead a horse to water, but you can’t make it drink?’” Drew said.

But, Mariel Mehdipour, the county’s director of health promotion, stressed the importance of creating a more conducive atmosphere.

“If the environment doesn’t support healthy behaviors, how can individuals do what their doctor is telling them?” she said.

Experimenting with Ingredients

For Oildale resident Chris Hollinger, 46, last year’s farmers’ market presented a rare opportunity to have fresh local produce near her home. Hollinger attended the market with her parents, who are both disabled.

“A lot of people like my parents who aren’t able to travel long distances came to the market,” she said. “It brings a lot of people who would like to eat healthier and fresher, but who aren’t able to get stuff like that.”

Hollinger and her parents would come home and improvise meals with their fresh produce, such as adding a bounty of vegetables to their fresh egg omelets.

Fresh beets at the market.

While fruits are best-sellers, customers are often baffled by ingredients like kale, thai basil, or even zucchini, Nijjer-Sidhu said. Cooking skills are increasingly being lost in a world where parents both work, and pre-packaged microwave or fast food meals are the norm.
 
Having a bread vendor is always a good draw, even if it means enticing people with freshly-baked brownies. Providing recipes also helps encourage people unfamiliar with new products. Nijjer-Sidhu created an email list where she sends out information on one vegetable or fruit, such as a pluot.

Along with healthy eating, the markets also add a sense of optimism and foster community in areas that may need it most, Nijjer-Sidhu said. In Oildale, an area known for its love of country music, they brought in The Trout Band. She’s exploring adding a mariachi band for Latino-heavy Delano.

Looking Long-term

While Nijjer-Sidhu and the Public Health Department promote the new markets, the day-to-day responsibilities fall to the market managers. Finding a strong manager is key to their ongoing success, she said.

Jaclyn Allen, who will manage the Delano market this spring, stresses the importance of building markets with “all the staples” to make the effort fruitful for customers. Allen tries to create a fun environment, where residents want to socialize and get excited about trying new products such as hummus. “Now my customers are hooked on it,” she said. “They come for the hummus.”

Allen says she thinks strategically about market hours, such as changing markets from weekday mornings to evenings when more customers are free. She also encourages her vendors to arrange their booths in a visually-appealing way and offer free samples.

When people tell her they don’t like grapefruits, she’ll insist they try the sweet Oro Blanco variety. When they say they have no idea what to do with bok choy, she’ll tell them to marinate it and throw it on the grill.

Despite the hurdles, Allen and other market organizers say Kern County is ready for healthier options.

“People are so new to the concept that they’re like kids in a candy shop,” Allen said. “People here are ready to make that choice to eat healthy.”

Tennille Spruell, a parent who volunteers as a crossing guard, helps students at Pioneer Elementary School cross diagonally to avoid the sidewalk deficits near the school.

By Minerva Perez

Pioneer Elementary School in Merced has two pedestrian pathways for kids who walk to school: one’s a paved sidewalk and the other is a strip of gravel on the side of the road. A local organization is trying to bring more sidewalks to pedestrian-heavy areas like the elementary school with GIS mapping, but ongoing efforts to improve Merced’s walkability might be cut short by budget shortfalls.

Using aerial photography and Geographical Information Systems (GIS) software, the Merced County Association of Governments has mapped out the locations where there are incomplete or non-existent sidewalks, what they call sidewalk deficits. The sidewalk inventory began when valley counties started upgrades to their traffic models in 2010 that included alternative modes of transportation such as transit and pedestrian access.

So far, the process has shown what many residents already know. Merced could stand to be more pedestrian friendly.

The lack of sidewalks makes it difficult for people without cars to navigate daily life. Gloria Minero, 57, waited for the school bell to ring at Pioneer Elementary School on a recent afternoon. She regularly walks her grandkids, a first and fourth grader, home from school. When the bell rings, a flood of children come out of the gates, some jump into cars. Others walk, some taking a paved sidewalk west to a newer development of homes, some to the gravel on the side of the road that doubles as a sidewalk.

Minero said she’s lucky, because she lives in the new development and has a straight sidewalk path to and from the school. Without a car, however, she can’t get to many other places in Merced as easily. “Some houses have sidewalks,” Minero said. “Others don’t.”

MCAG is still validating their GIS findings by checking them against other sources of information, and don’t have an exact count of how many sidewalk deficits exist in the city or county yet. Rich Green, MCAG’s GIS program manager, said that he is not surprised by the findings so far. Small county pockets have many deficits, as do the outermost edges of the city of Merced, such as the Weaver area.

Pioneer, a K-5 school in the Weaver Unified School District, is one area of particular concern because many of the pedestrians are children, said district superintendent John Curry.

Most of the 2,500 students in his district have adapted to the lack of sidewalks and have developed safe walking skills, Curry said.

A bus stops at the corner of East Gerard Avenue and South Coffee Street by Pioneer Elementary School. The K-5 school is in the outermost edges of the city of Merced and has many sidewalk deficits.

Parents have adapted too, organizing carpools and creating a ‘walking school bus’ for children to safely get to and from school, all with the support of the school board and the Safe Routes to School program.

“We are using a multiple approach, educating our students, newsletters, simple things,” he said. “We are also having good conversations with other schools and the city to find solutions.”

The city of Merced has been doing its part to upgrade sidewalks, councilman John Carlisle said. “We spend a lot of time and money in (improving) the sidewalk system,” Carlisle said.

He cites the construction projects that are underway, such as the G Street Undercrossing and the Parsons Avenue Shopping Center and Street Improvements projects that all pay special attention to bicycle and pedestrian access.

Still, the GIS maps may not be capturing the full extent of the sidewalk problem. While MCAG is mapping where sidewalks exist, they are not collecting information on the condition of the sidewalks. In older parts of Merced, sidewalks show up as street grids marked mostly in a bright blue, indicating deficit-free sidewalks, but they may be hard to use. Walking through an old part of town like south Merced means navigating obstacles like raised tree roots and other wear and tear.

The combination of grants, redevelopment funding and Measure C monies that has financed sidewalk renovations so far will likely dry up as Merced tries to find a way to fill a deficit nearing $5 million.

“The issue has been and will continue to be a lack of money,” Carlisle said.

But there will come a time when the city will once again be able to invest in improving pedestrian access and when they do, Green said, MCAG hopes to have a comprehensive plan with feedback from all the stakeholders.

In April, MCAG will take their findings on the road. Aside from getting input from city agencies, they also want to get reaction from the very people that walk on those streets on their way to school, the grocery store or work.

“We would like to have sidewalks,” Curry said. “We know they are coming. We just don’t know when.”

Students celebrating their harvested fruit from their first house, over 220 lbs! Clockwise from top left: Manuel Gomez, Lidia Villasenor, Jose Villasenor, Janai Robinson, James Daniels, Pete Green, Dominique Villanueva, Janelle Robinson and Jessica Muldrew.

By Ramona Mosley

Nearly 900 pounds of citrus fruit is making its way to the tables of many hungry Stockton families, thanks to Healthy Choices, a program of the Health Education Council. The YMCA’s Healthy Choices afterschool group at Franklin High School has been spending their afternoons harvesting fruit from citrus trees in the Eastside neighborhood surrounding Franklin High School.

The Healthy Choices students decided to do something about all of the unused citrus they saw around their neighborhood after doing a community mapping project to assess the healthy and unhealthy food sources available.

“We harvest the fruit because we went to the community and seen that the stores did not have fruit at all,” said Healthy Choices senior Janelle Robinson.

The project began with the students canvassing the neighborhood, passing out flyers and talking to neighbors, asking them if they would be willing to donate their fruit to shelters and local food distribution sites. Most of the neighbors have been responsive and are happy to get the excess fruit off their hands and donated to those who need fresh fruit. Janelle remembers “one community member said there was fruit that needed to be picked because they were being thrown at cars and they were going to waste.”

Even when living in a designated “food desert,” an area with low accessibility to healthy foods, such as Eastside Stockton, there are small ways to challenge that label, like harvesting the fruit of the neighborhood trees. Many of the Healthy Choices students talk about the struggles their families face with diabetes and obesity. They are beginning to see that with a little work, they can access healthier foods without trekking to a supermarket.

“These little actions are the first steps to preventing the cycle of diabetes and obesity in their families and their communities,” states Aly Kronic, Coordinator of Healthy Choices project.

Boxes of tangerines, navel oranges, meyer lemons, blood oranges, and grapefruits were filled and donated to St. Mary’s Interfaith Dining Room, St. Mary’s Family Shelter, the Emergency Food Bank and Garden Acres Community Center.

The students are determined to surpass 1000 pounds of fruit. They are waiting out the rainy weather and planning to harvest the last of the fruit in early March.

If you have excess fruit on your citrus tree that you would like harvested or would like to help volunteer with Healthy Choices, please contact the Healthy Choices coordinator, Aly Kronick at (916) 556-3344 or akronick@healthedcouncil.org.

Ramona Mosley is a project director for the Health Education Council, which is funded by the USDA Supplemental Nutrition Assistance Program, an equal opportunity provider and employer.

A Stockton non-profit group that originally formed to fight a neighborhood’s drug trade has morphed out of necessity into an organization that is buying up abandoned homes, fixing them and getting them back on the market for low-income buyers. Without the group, life in the blighted neighborhood would be even grimmer. See our profile of the group, Stocktonians Taking Action to Neutralize Drugs, below.

Sub-Prime Times Pt. 1 from Tony Wilson on Vimeo.

Williams Brotherhood Park in South Stockton was plagued with gangs and crime. Families stopped going there and parents told their children to stay away. But a group of area youth decided they wanted their park back. They started a campaign to reclaim the park and won the support of local community organizations and, ultimately, the city. Now the park is cleaner, the bathrooms are open and families and kids are returning.

LeCresia Hawkins, special projects coordinator for Community Partnership for Families of San Joaquin, which has offices in the park, shared the story at a recent meeting of the Healthy Eating Active Living Collaborative:

LeCresia Hawkins

The problem was that for many years the park had kind of been neglected and a lot of gang activities, and other undesirable types of elements, were more commonplace in the park than children playing and parents recreating. The younger children, the youngest was five years old, started talking about how she lived near the park, she wasn’t able to play in the park, how her mom wouldn’t let her go to the park.

So, we had a group of teenagers who had gone through a training about advocating for their communities. These youth, the older youth took on the project of cleaning up the park and making the appropriate changes so the park was more accessible to the children and the families in the area.

In January they started meeting together, put together a Power Point, did a photo voice project first, of what they saw as the problems. They put a Power Point together and presented it to a city council member, who then committed to work with them to make the changes that were needed.

So over the course of several weeks they were able to make some of the changes.

The youth adopted the park and will be going through and picking up trash, cleaning up graffiti, as will other community members as well, the adults, their parents and so forth.

At one of the meetings, with the council members, the council members had brought the community service officers, and code enforcement. The youth told them about the bathrooms being locked. The reasons the bathrooms had been locked was because of the crime element. The youth did such a good job advocating — “We need to be able to play in the park” — we in our office said we would step up and make sure the bathrooms were closed in the evening when our office closed. The bathrooms would be open when the kids get out of school. So there would be a three hour window when the kids could use the bathroom, during daylight hours, so the kids while playing after school could use the bathroom appropriately rather than next to a tree or in a tunnel or other places like that.

Now there are more families playing in the park. Men are playing soccer. Mothers with strollers are walking in the park. Graffiti is cleaned up a lot faster.

The park has taken on more of a vibrant role, like it had before, and there is less of a criminal element.

By Dr. Katherine Flores

In Fresno County, located in the heart of California’s Central Valley, about 50 percent of the residents — but only five percent of the doctors — are Latino. That glaring cultural divide results in potential misunderstandings between doctor and patient that can translate into poorer health outcomes.

As the child of migrant farm workers, I witnessed firsthand the often tragic consequences of this divide. My own grandfather lost his leg to gangrene, complicated by diabetes, because he couldn’t afford the prescribed medications and couldn’t adhere to the treatment plan. I believe that had the doctors inquired more about his specific living conditions and environmental circumstances, they might have approached his care differently, which may have led to a better health outcome.

Today, there is clear evidence that increasing the diversity of the healthcare workforce will improve access to health care and reduce health care disparities. That evidence and my own experiences, as well as those of others, guide our work at the Latino Center for Medical Education and Research (LaCMER). Through our LaCMER programs, we are inspired to see local students preparing for medical careers with the desire to return to the Central Valley, where we desperately need them.

The program is known as the Doctors Academy. It began in 1999, in partnership with the University of California, San Francisco’s Fresno campus and multiple community partners, including Fresno Unified School District, Fresno County Office of Education, California State University, Fresno, State Center Community College, Community Medical Centers and the California Area Health Education Center.

The goal is to recruit students from low-income families beginning in seventh grade and support them through high school and college. We provide academic and career guidance, academic support with tutorial services and tiered mentoring, mentoring with a health professional, service-learning opportunities, summer programs with leadership development and exposure to the health professions.

The Academy focuses on building self-confidence and teaching time-management skills, analytical thinking and how to study in order to prepare students for the rigors of college and health professional schools. It also focuses on parent empowerment (most of whom never attended college), offering help in securing financial aid and advice about how to support their child’s academic journey.

In a school district where a quarter of students drop out by senior year, the Doctors Academy is achieving some much-needed results. Every student in the program has graduated from high school, and every student who has finished the program has been accepted to college. The program’s alumni have gone on to medical school at Brown University and the University of California, San Francisco, among others.

We all recognize how long and difficult the road to higher education can be. Having been raised by immigrant grandparents, and being a farm worker myself, I found myself struggling as an undergraduate at Stanford University. Social and emotional support from two classmates, also from “low-performing” high schools and from immigrant families, helped pull me through. My dream was to return to the Central Valley as a physician to help smooth the way for others in similar circumstances to be successful in college and achieve their professional dreams.

Today, the Doctors Academy is preparing students to succeed even at Ivy League schools, providing them with mentors and other resources to make the adjustment. At the same time, the Academy instills a sense of community service so that its students will, hopefully, return to the region one day as doctors, nurses, dentists and other health workers and provide culturally appropriate services.

By supporting high school health professions pathways — pathways that are academically challenging and focused on the health professions — we can improve student achievement, expand career choices for young people, as well as develop a more culturally sensitive healthcare workforce for each of our communities.

Dr. Katherine Flores is the director of the UCSF Fresno Latino Center for Medical Education and Research and a 2010 recipient of the James Irvine Foundation Leadership Awards.

Dr. Katherine Flores of the UCSF Fresno Latino Center for Medical Education and Research has been awarded a $125,000 James Irvine Foundation Leadership Award for her work helping low-income Latino students graduate from high school and attend college. The Doctors Academy recruits students beginning in 7th grade and supports and tutors them through the end of high school. So far, every participant has graduated and been accepted to college.

Here is a video profile about Flores and the program, provided by the Irvine Foundation:

Dr. Katherine Flores, UCSF Fresno Latino Center for Medical Education and Research, Fresno from The James Irvine Foundation on Vimeo.