APA - Texas Chapter
Plan4Health Tarrant County Plan4Health Tarrant County
EXECUTIVE SUMMARY Plan4Health Tarrant County is intended to highlight the policies, systems, and environmental changes (PSE) geared toward a healthy quality of life within three zip codes of southeast Fort Worth. These zip codes fall within the peripheries of a food desert; the US Department of Agriculture defines food desert areas as parts of the country lacking the resources of fresh fruits and vegetables critical to healthy, holistic diets, usually found in impoverished areas (U.S. Department of Agriculture, 2016). Improving access to healthy food vendors as well as the availability of produce in corner stores in close proximity to these neighborhoods is a critical goal for these initiatives. In addition, providing convenient, portable options such as mobile food markets and push carts (with proper City approval) within street environments and public areas such as schools, churches, etc. is also a goal. With the help of several health related coalition partners, the initiative seeks to enhance the City’s involvement in the health and livelihood of its residents, catalyzing the establishment of healthy best practices for current and future generations. The project team from the Institute of Urban Studies (IUS) in the College of Architecture, Planning, and Public Affairs at the University of Texas at Arlington analyzed the project scope area to find the most suitable stores to join the program, created designs and visualizations for the selected stores, and created a detailed report deliverable to the Plan4Health Tarrant County Coalition for final report compilation. The team from the Plan4Health Tarrant County Coalition provided support to the selected stores joining the program including new store layout design, locating high quality fresh food suppliers, promotions, necessary supplies, cooking demonstrations etc. The project end goal was to have pilot stores that would adopt models of healthy practice and establish a baseline target for surrounding stores to emulate. Reaching the populations within these zip codes with strategies aimed at generating a sustainable impact on not only the environment but also the health and well-being of residents was of paramount priority.
Team of Study Chapter 1
Institute of Urban Studies: • Shima Hamidi, Ph.D Director, Institute of Urban Studies • Amanda Kronk, LEED AP BD+C Project Manager, Institute of Urban Studies PROJECT LEAD: • Hamid Hajjafari PhD Student, Urban Planning and Public Policy DATA COLLECTION AND BACKGROUND: • Hamid Hajjafari PhD Student, Urban Planning and Public Policy • Yalcin Yildirim PhD Student, Urban Planning and Public Policy GIS SPECIALIST: • Yalcin Yildirim PhD Student, Urban Planning and Public Policy DESIGN: • Toluwalope Olayinka Master Student, Architecture • Hamid Hajjafari PhD Student, Urban Planning and Public Policy
Healthy Tarrant County Collaboration: • Linda Fulmer Executive Director, HTCC Project Director, Plan4Health Tarrant County • Shae Roundtree Project Coordinator Blue Zones Project: • Brandy O’Quinn Public Affairs Manager • Brenda Patton Public Affairs Coordinator • Carol Murray Marketing Communications Manager Tarrant County Public Health: • Ann Salyer-Caldwell Deputy Director APA-Texas Chapter • Mike McAnelly Executive Administrator Texas Public Health Association: • Melissa Oden President
Table of Contents
Table of Contents 1.
Executive Summary
2
2. Introduction
6
3.
Background Information
8
4.
Study Area
11
5.
Project Strategies a. Healthy Push Carts b. Mobile Food Market c. Healthy Corner Stores Other Alternatives a. Farm to School b. Community Garden
18
6. Analysis and Healthy Pilot Store Selection a. GIS Analysis b. Negotiation c. Analysis of Successful Stores i. Los Pastores ii. El Rancho iii. Other
26 28 30 33
7. Project Process a. Pilot Stores i. Ramey Market (a). Visual Assessment (b). Design ii. Miller Food Mart (a). Visual Assessment (b). Design b. Mobile Fresh Market c. Pushcarts d. Other Activities i. New Orleans Conference of Implementation and Dissemination for Chronic Disease ii. Fruitful Fridays iii. Media Coverage 8. Conclusion and Recommendations
45 47
9.
93
Bibliography
72 82 84
90
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Plan4Health Tarrant County | 5
CHAPTER
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Introduction
Introduction
6 | Plan4Health Tarrant County
Chapter 2
Introduction A serious issue that influences the lives of a considerable number of US residents is the lack of access to nutritious food. Just in 2009, approximately 23.5 million Americans lacked access to a supermarket or grocery store within one mile of their homes, and more than 8% of Americans did not have any access to fresh fruits and vegetables. These communities, referred to as “food deserts,� are highly concentrated in low-income areas where the only food options are fast food restaurants or convenience stores. Residents within these neighborhoods, especially children and the elderly, face far greater risks of disease, malnutrition, and hunger (Treuhaft & Karpyn, 2010). Planners and public health professionals are working to improve overall community health. They have the knowledge and expertise to support our communities to make changes that will lead to healthier lives. Thirty-five coalitions are working across the country to improve access to nutritious food and to increase opportunities for physical activity. Within each of the 35 coalitions are members of the American Planning Association and the American Public Health Association, uniting planning and public health experts under a common goal of creating healthier communities. The project will provide $2.25 million to boost efforts to reduce chronic diseases, including obesity, over the course of 3 years. Plan4Health Tarrant County is one of these coalitions that operates in the target area of Southeast Fort Worth. Meanwhile, Plan4Health Tarrant County approached the Institute of Urban Studies to collaborate on this project. This report narrates the approaches of the project and year-long process of defining the project, analyzing the project scope area, negotiating with store owners, designing for pilot shops, engaging local residents, and finally implementing the project.
Plan4Health Tarrant County | 7
Chapter 2
2
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3
Background Information
Background Information The U.S. Department of Agriculture defines a “food desert� as a community with a poverty rate greater than 20% where at least one third of residents live at least one mile from a grocery store (10 miles in rural communities). Research findings have emphasized the links between food access, the built environment, and health outcomes (Caspi, Sorensen, Subramanian, & Kawachi, 2012; Feng, Glass, Curreiro, Stewart, & Schwartz, 2010; Walker, Keane, & Burke, 2010).
Plan4Health Tarrant County | 9
Chapter 3
3 Background Information The U.S. Department of Agriculture defines a “food desert� as a community with a poverty rate greater than 20% where at least one third of residents live at least one mile from a grocery store (10 miles in rural communities). Research findings have emphasized the links between food access, the built environment, and health outcomes (Caspi, Sorensen, Subramanian, & Kawachi, 2012; Feng, Glass, Curreiro, Stewart, & Schwartz, 2010; Walker, Keane, & Burke, 2010). Considering 6.5 million children out of over 23 million U.S. residents are living within food desert areas (U.S. Department of Agriculture, 2016), actions to address this problem are vital.
Although there is a greater range of information regarding nutrition available to date more than any time in history (JE, 2004), more than half of U.S. adults are overweight (Flegal, Carroll, Ogden, & Curtin, 2010) which causes high expenses for the government and for residents. The U.S. medical expenses for obesity alone in 2008 were US $147 billion (Finkelstein, Trogdon, Cohen, & Dietz, 2009). Nutrition is a key factor in the prevention of diseases such as cardiovascular disease, hypertension, and type II diabetes that cause more than one-third of all deaths in the U.S. (Xu, Kenneth , Murphy, & TejadaVera, 2010). Chapter 7
Map 1: No Car and No Supermarket within a mile Source: Department of Agriculture, Center for Disease Control
10 | Plan4Health Tarrant County
Figure 1 Source: https://spoonuniversity.com/lifestyle/food-desert-obesity-rates
Tackling Food Deserts
Figure 2 Source: https://upload.wikimedia.org/wikipedia/commons/f/fc/Barack_Obama_ eats_a_peach_(3818237174).jpg
Figure 3 Source: https://theothercourtney.files.wordpress.com/2014/11/11lady_650.jpg
Plan4Health Tarrant County | 11
Background
Accordingly, the government is actively encouraging the culture of healthy food consumption. The previous First Lady Michelle Obama launched a comprehensive initiative called Let’s Move, dedicated to addressing the issue of obesity within a generation, in order to enable children to grow up healthier through the consumption of healthier foods.
Food Accessibility and Built Environment Studies are increasingly focusing on the availability of nutritious food within communities across the country, and suggest that factors within the built environment play a critical role in a person’s diet (Morland et al., 2002b; Rose and Richards, 2004). Accordingly, the collaboration of urban planning and public policy is the key component in the mitigation of food deserts.
Chapter 3
Plan4Health connects communities across the country, funding work at the intersection of planning and public health. Anchored by the American Planning Association (APA) and the American Public Health Association (APHA) affiliates, Plan4Health supports creative partnerships to build sustainable, cross-sector coalitions. Research-based experiments and policy interventions to mitigate food deserts have included working with supermarkets to determine new store locations in under-served neighborhoods, providing incentives to small store owners to improve offering, and encouraging the growth of farmer’s markets that can improve access to fresh and healthy food. Plan4Health Tarrant County aims to build on existing efforts to improve access to local, fresh food in southeast Fort Worth (including three zip codes of 76105, 76112 and 76119) through partnerships, new initiatives, and incorporating a public health perspective into planning efforts. Coalition partners for this project are: • American Planning Association-Texas Chapter • Texas Public Health Association • Healthy Tarrant County Collaboration • Blue Zones Project- Fort Worth • Planning and development, City of Fort Worth • DFW Hospital Foundation/ North Texas Community Health Collaboration • Tarrant County Public Health • Institute of Urban Studies, University of Texas at Arlington • Tarrant County Food Policy Council In order to improve accessibility to healthy foods, this project will promote healthy retail policies and practices by recruiting and launching new produce carts and mobile food markets that will be regulated for sale in neighborhoods and on public property. In addition, a healthy corner store strategy will permit some of the corner stores in the region to become models of healthy retail. Meanwhile the project will seek to improve the consideration of health as a top priority in the City of Fort Worth’s planning and zoning decision-making.
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4
Study Area
Study Area
CHAPTER
The study area is located in southeast Fort Worth, including three zip codes of 76105, 76112 and 76119. It is a low-income area with low accessibility to healthy food, and has a combined population of 103,948. Residents are predominantly African American and Latino/Hispanic, with these two demographics comprising 78% and 18% of the population, respectively; additionally, 2% are White and 2% other races. Residents tend to have lower income levels and lower education levels compared to the county as a whole and the prevalence of single parent households is considerably higher (41% vs. 19.4%).
14 | Plan4Health Tarrant County
Chapter 4
Study Area
4 Study Area The study area is located in southeast Fort Worth, including three zip codes of 76105, 76112 and 76119. It is a low-income area with low accessibility to healthy food, and has a combined population of 103,948. Residents are predominantly African American and Latino/ Hispanic, with these two demographics comprising 78% and 18% of the population, respectively; additionally, 2% are White and 2% other races. Residents tend to have lower income levels and lower education levels compared to the county as a whole and the prevalence of single parent households is considerably higher (41% vs. 19.4%). Another significant indicator in this area is the risk factor and chronic diseases. This factor is significantly higher in this area compared to the whole county. Recent data revealed higher rates of diabetes (12.6%), heart disease (6.4%), high blood pressure (29.9%), and overweight or obesity (7%). Community leaders have recognized chronic disease as a major concern and recent feedback found that the top five priorities to address chronic disease disparities included food access. A considerable amount of this study area is considered within a food desert that by definition is a “low-income census tract where a significant number of residents live more than 1 mile (urban) or 10 miles (rural) from the nearest supermarket� (U.S. Department of Agriculture).
Map 2: Study Area in Southeast Fort Worth
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Chapter 4
Chapter 4
The low-income map shown in Map 3 shows that this area is a lowincome area which is by definition a “tract with a poverty rate of 20% or higher, or a tract with a median family income less than 80% of median family income for the state or metropolitan area� (U.S. Department of Agriculture).
As showed in the Map 5, a majority of the study area exists within the identified food desert. Almost all restaurants in the area are fast food chains, meaning that the area is a food swamp as it has an overabundance of high-energy, low nutrient foods.
Map 4: Food Desert in the Study Area
0
0.75 1.5
3 mi
Low income Map 3: Low-Income in Study Area Date: 2/9/2017For Source: USDA information: Economic Research Service, ESRI. For more information: Source: USDA Economic Research Service, ESRI. more Low Income tract 2015 https://www.ers.usda.gov/data-products/food-access-research-atlas/documentation https://www.ers.usda.gov/data-products/food-access-research-atlas/documentation
16 | Plan4Health Tarrant County
0
1.25 2.5
5 mi
food Map 5: Food Deserts in the Dallas-Fort Worth Area Date: 9/3/2015 Source: USDA Economic Research Service, ESRI. For more information: Source: USDA Economic Research Service, ESRI. For more information: https://www. LILA at 1 and 10 http://www.ers.usda.gov/data-products/food-access-research-atlas/documentation.aspx ers.usda.gov/data-products/food-access-research-atlas/documentation
0.64
mile, share
Chapter 4
Housing units, total Group quarters, tract population residing in, share Population, tract total Low access, people at 1/2 mile, number Low access, people at 1/2 mile, share Low access, low‐income people at 1/2 mile, number Low access, children age 0‐17 at 1/2 mile, number Low access, children age 0‐17 at 1/2 mile, share Low access, seniors age 65+ at 1/2 mile, number Low access, seniors age 65+ at 1/2 mile, share Vehicle access, housing units without and low access at 1/2 mile, number
1,508 0.05 5,851 3575.05 1 2740.51 1,123 0.57 213 0.64 104
Vehicle access, housing units without and low access at 1/2 mile, share
0.07
Low access, people at 1 mile, number
1,086
Low access, people at 1 mile, share
0.19
Low access, low‐income people at 1 mile, number Low access, low‐income people at 1
875 0.15
104
Vehicle access, housing units without and low access at 1/2 mile, share
0.07
Low access, people at 1 mile, number
1,086
Low access, people at 1 mile, share
0.19
Low access, low‐income people at 1 mile, number Low access, low‐income people at 1 mile, share Low access, low‐income people at 1 mile, share Low access, low‐income people at 1 mile, share Low access, children age 0‐17 at 1 mile, number Low access, children age 0‐17 at 1 mile, share Low access, seniors age 65+ at 1 mile, number Low access, seniors age 65+ at 1 mile, share
875 0.15 0 0.15 318 0.16 93 0.28
Vehicle access, housing units without and low access at 1 mile, number
39
Vehicle access, housing units without and low access at 1 mile, share
0.03
Table 1: Statistical facts about Southeast Fort Worth Source: United States Census Bureau
Plan4Health Tarrant County | 17
Study Area
Statistical facts Following are some other statistical facts about the area.
Vehicle access, housing units without and low access at 1/2 mile, number
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5
Project Strategies
CHAPTER
Project Strategies
Plan4Health Tarrant County will increase the availability of healthy foods by promoting retail policies and practices, including piloting food carts and a mobile food market as well as recruiting stores to participate in a Healthy Corner Stores program. These efforts will serve as a model for other municipalities within Tarrant County and beyond. Additionally, the coalition will work to incorporate health considerations into the city’s planning and zoning efforts and use media campaigns to increase engagement in order to improve the dialogue between the community, partners, and stakeholders.
Plan4Health Tarrant County | 19
Chapter 5
5
Project Strategies Plan4Health Tarrant County will increase the availability of healthy foods by promoting retail policies and practices, including piloting food carts and a mobile food market as well as recruiting stores to participate in a Healthy Corner Stores program. These efforts will serve as a model for other municipalities within Tarrant County and beyond. Additionally, the coalition will work to incorporate health considerations into the city’s planning and zoning efforts and use media campaigns to increase engagement in order to improve the dialogue between the community, partners, and stakeholders.
a. Healthy Push Carts
Green Carts are one of the several strategies implemented by cities to encourage healthy food consumption and have proven to be successful. In New York, the success of their Green Cart program is evident in the decrease in the percentage of adults surveyed who said they did not eat any fruit or vegetables the previous day from 19% in 2004 to 15% in 2010. The Green Cart program in New York is quickly becoming a pioneer for other cities in America. In 2011, Philadelphia launched its own Healthy Cart program. Since then, similar programs have been established in other cities including: Chicago, IL, Los Angeles, CA, Madison, WI, and California’s Santa Clara County. The Fort Worth City Council has approved several amendments to the pushcart ordinance to allow for the sale of fresh, uncut, whole produce in residential areas and for the ability to park carts on private property in non-residential areas with permission from property owners. The Plan4Health Tarrant County Coalition is actively seeking an entrepreneur to be the first to offer fresh produce to be sold in key neighborhoods located in the 76105, 76112, and 76119 zip codes of southeast Fort Worth.
Figure 4 Source: https://blog.rsed. org/2015/03/25/fresh-fruits-veggiesare-rolling-your-way/
20 | Plan4Health Tarrant County
Figure 5 Source: http://assets. inhabitat.com/files/ juice_cart.jpg
6 Foot Long EZ‐Cart
48x36x72 inches
1.2x0.9x1.8 meters
Link
1.60 x 1.80 x 2.000 x 90 x 1.70m
http://www.alibaba.com/product‐ detail/Super‐Quality‐Corrosion‐Protection‐ Accept‐ Oem_60210905173.html?spm=a2700.772 4857.29.380.odUj90
165 x 101 x 116
http://www.alibaba.com/product‐ detail/2014‐Hot‐and‐Popular‐Practical‐ Hand_1692771680.html?spm=a2700.772 4857.29.353.odUj90
US $1,000 ‐ 3,000 / Piece
http://cart‐king.com/ez‐carts‐kiosks/
3999
23 x 30 x 81
Price
http://cart‐king.com/wp‐ content/uploads/2014/11/EZ_cart.pdf
You can customize the size
http://cart‐king.com/wp‐ content/uploads/2014/11/EZ‐Cart‐ wrap_instructions.pdf `
http://static.katomcdn.com/pdf/121‐ 668.pdf
30 x 60 x 72
a. Healthy Push Carts
33 x 34 x 23
1.20 x 1.00 x 1.37
4816.35
http://www.alibaba.com/product‐ detail/mobile‐bufet‐car‐ice‐cream‐ cart_60254080474.html?spm=a2700.7724 857.29.216.5nE4jS
This Canadian company http://icetrikes.com/food‐bike‐ (Icicle) offers Salad Bikes (Produce) that look to be business/food‐bikes‐for‐sale/produce‐on‐ wheels/ very similar to what we are looking for
2100
Table 2: Food carts available in the area
Plan4Health Tarrant County | 21
Strategies
Required size : 4x3x6 feet
Chapter 5
b. Mobile Food Market Regardless of the contested investigation findings, there is a strong assumption, especially among policy makers, that enhancing food access in food deserts will lead to better health results (Cummins & Macintyre, 2002). Consequently, numerous nonprofit organizations in America tend to mitigate the challenge of food access through improving mobile food markets in low-income, low-food access communities (Sifferlin, 2012). Research regarding mobile markets is limited with mixed results. Widener, Metcalf, and Bar-Yam (2012, 2013) indicate that while both permanent stores and mobile markets improve fruit and vegetable consumption, mobile markets have the advantage of covering a larger area. While this addresses accessibility, affordability still remains a problem. This might explain the contradictory findings about mobile markets and fruit and vegetable consumption. Tester, Yen, and Laraia (2012) show that the existence of a mobile fruit vendor improved children’s consumption of produce and decreased their intake of unhealthy snacks during a 14-day study.
Figure 6 Source: http://www.profitguide.com/wp-content/uploads/2014/12/Mobile_Good_ Food_Market-Pickup-450_x_300.png
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Although mobile markets are realized mostly as convenient, adding stops on weekends would allow a greater number of residents to shop there. Furthermore, offering staple food items along with fruits and vegetables would bring in additional customers, especially for seniors who have limited access to transportation. Funding programs to work on weekends and to grow products sold at mobile markets, particularly local value-added goods (e.g. baked goods and dairy products), can improve both convenience and the view that the market is attuned to customer preferences. Lastly, trust is a vital factor in these vulnerable neighborhoods. Research shows that some have negative connotations of mobile food vendors and consequently do not feel comfortable shopping at mobile markets. Produce carts comprise another concept that residents generally support in a city where some areas only have one supermarket per 60,000 residents (Zepeda, 2013).
Figure 7 Source: http://blog.nycfoodscape.com/wp-content/uploads/2014/11/MGFM bus-LB1310_5634-w.jpg
Chapter 5
In the 1960s and 1970s, a considerable population of white, middle class families moved from urban centers to the suburbs, which then brought with it the notion of supermarkets. This phenomenon required grocers to adapt their operations to the changing conditions. They constructed larger shops and developed chain-wide contracts with large suppliers and distributors to stock stores with foods demanded by a relatively homogeneous suburban population. Over the past several decades, the organization of the grocery industry has altered radically, with major mergers and the development of discount stores and supercenters, in addition to specialty/natural food retailers. Simultaneously, other sources of fresh foods such as farmers markets, produce stands, and community-supported agriculture programs have been developed, mainly in middle class and wealthy neighborhoods.
choices to reach full-service grocery stores. Ninety-seven of these researches found unequal access to healthy food, 14 had some mixed findings, and two researches did not find inequities (Kaiser, 2009). Low-income neighborhoods have half as many supermarkets as highincome neighborhoods and four times as many smaller grocery stores, according to an assessment of 685 urban and rural census tracts in three states. The same study found four times as many supermarkets in predominantly White neighborhoods as compared to predominantly African American neighborhoods. Another multi-state study found that 8% of African Americans live in a tract with a supermarket as compared to 31% of Whites (USDA Economic Research Service, 2009)
Studies show that residents with greater access to supermarkets or a greater abundance of healthy foods in neighborhood food stores consume more fresh produce and other nutritious items. Without nearby access to healthy ingredients, families have a harder time meeting recommended dietary guidelines (Treuhaft & Karpyn, 2010). The U.S. Department of Agriculture’s 2009 “Food Desert� study examined access to supermarkets and determined that 23.5 million people cannot access a supermarket within one mile of their home. For every additional supermarket in a census tract, produce consumption increases 32% for African Americans and 11% for Whites , according to a multi-state study (Treuhaft & Karpyn, 2010). Around 113 researches have studied whether supermarkets and healthy food items are fairly distributed across communities according to socioeconomic status, racial composition, or level of urbanization (population density) (Treuhaft & Karpyn, 2010). Their results are noticeably consistent; residents living in low-income areas, minority neighborhoods, and rural communities face far higher problems accessing healthy food, particularly those who lack transportation
Figure 8 Source: http://councill.net/healthy-corner-store-mural-a-national-initative-in-nc/
Plan4Health Tarrant County | 23
Strategies
c. Healthy Corner Stores
Chapter 5
Other Alternatives There are some other approaches to the issue of food desert. Although these approaches are not applied in this project, we considered them as alternatives that can be implemented in future food accessibility projects in this area.
a. Farm to School Farm to School programs are an option that can be considered in the study area for the future. Students will achieve better access to healthy, local foods and educational opportunities such as school gardens, cooking lessons, and farm field trips. Farm to School programs strengthen children and their families to make informed food choices while supporting the local economy and contributing to the livelihood of communities. Farm to school application varies by location but always comprises one or more of the following results: • Procurement: Local foods are bought, promoted and served in the cafeteria or as a snack or taste-test; • Education: Students participate in educational activities related to agriculture, food, health or nutrition; and • School gardens: Students engage in hands-on learning through gardening.
Figure 9 Source: http://theabundanttable.org/farm-education/farm-to-school/
24 | Plan4Health Tarrant County
b. Community Garden
Community gardens are generally defined as an effective grassroots solution to urban disinvestment and decay. The community garden provides quality produce cultivated by various residents and offers unique economic opportunities. It is a place for citizens to connect with nature, utilize physical exercise, and offers a learning environment for the city’s youth while providing seniors a chance to pass on their valued wisdom. Advantages: 1. Establishes dining enjoyment; 2. Promotes community engagement 3. Produces healthy, fresh foods and omits the cost of food transit 4. Generates a vibrant farmers market 5. Provides nutritious food for local charities. Core Beliefs: 1. “In order for a garden to be sustainable as a true community resource, it must grow from local conditions and reflect the strengths, needs and desires of the local community.” 2. “Diverse participation and leadership, at all phases of garden operation, enrich and strengthen a community garden.” Gardens can be stronger when they are developed and led by people from different backgrounds. 3. “Each community member has something to contribute.” Useful skills and good suggestions are often overlooked because of how people communicate. 4. “Gardens are communities in themselves, as well as part of a larger community.” This is a reminder to involve and be aware of the larger community when making decisions. (McKelvey, 2015)
Strategies: 1. Talk with friends, neighbors and local organizations about your idea. 2. Hold a meeting with community members interested in the garden. 3. Find and evaluate potential garden sites. 4. Identify local resources necessary for starting a garden. 5. Draft a lease agreement. 6. Develop a site plan. 7. Establish gardener guidelines and draft the gardener application. 8. Prepare the site.
Strategies
Vital Infrastructure of a Garden: Garden infrastructure includes rainwater harvesting and storage, area for plant propagation, durable paths and garden edges, means of documentation and social networking, storage for tools, log book, soil improvement and management, and area for compost production.
Figure 10 Source: http://r1.cltampa.com/files/base/scomm/cltampa/image/2011/05/960w/ 2b852_1305206017_community_garden_550.jpg
Figure 11 Source: https://traceylind.files.wordpress.com/2011/07/trinity-community-gar den-planting.jpg?w=460
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6
6
Analysis and Healthy Pilot Store Selection
6
CHAPTER
Analysis and Healthy Pilot Store Selection
A critical element of the project was to select pilot stores within the study area to implement strategies for healthy food distribution in order to analyze the success of such strategies for future operations targeting the issues of food deserts. The first approach of pilot store selection focused on corner stores. More than 100 corner stores were observed in the area.
Plan4Health Tarrant County | 27
Chapter 6
6
Analysis and Healthy Pilot Store Selection
A critical element of the project was to select pilot stores within the study area to implement strategies for healthy food distribution in order to analyze the success of such strategies for future operations targeting the issues of food deserts. The first approach of pilot store selection focused on corner stores. More than 100 corner stores were observed in the area. The IUS team first utilized GIS data to create a shortlist of corner stores. The team then negotiated with selected stores to identify two pilot stores for project implementation and then analyzed other stores in the area that were successfully providing healthy foods and vegetables to utilize their strengths and strategies.
a. GIS Analysis
During the store selection process, the team considered many factors before selecting potential corner stores. The first criterion was to examine store proximity to highways as accessibility was of paramount concern. All major arterials and highway access points within the vicinity were analyzed. In addition to highway proximity, open space proximity was another critical factor that was considered. It was important to ensure that the distance between potential corner stores and parks was under 1 mile in order to facilitate pedestrian access and connectivity. The team also analyzed the proximity of local churches to potential corner stores to increase access and activity on weekends. Finally, the proximity of corner stores to education facilities was considered with a major goal of providing access to healthy food for children of all ages. Store_Name CVS PHARMACY INC 6817
Longitude
Latitude
Address
City
State
Zip5
Zip4
County
‐97.21772
32.746033
6548 Meadowbrook Dr
Fort Worth
TX
76112
5125
TARRANT
‐97.214722
32.766224
6770 Bridge St
Fort Worth
TX
76112
816
TARRANT
‐97.215706
32.746105
6617 Meadowbrook Dr
Fort Worth
TX
76112
5240
TARRANT
‐97.218193
32.766998
901 Bridgewood Dr
Fort Worth
TX
76112
‐97.239594
32.759956
5312 Brentwood Stair Rd
Fort Worth
TX
76112
2915
TARRANT
‐97.223961
32.720776
6156 Ramey Ave
Fort Worth
TX
76112
8054
TARRANT
Ocean Mini Mart 4
‐97.244682
32.741039
5101 E Lancaster Ave
Fort Worth
TX
76112
6350
TARRANT
QUIKTRIP 861
‐97.215164
32.754356
6601 Brentwood Stair Rd
Fort Worth
TX
76112
3302
TARRANT
Quickway Food Store # 10
‐97.216339
32.732098
6753 E Lancaster Ave
Fort Worth
TX
76112
7047
TARRANT stores for possible
BRAUM'S 84 Family Dollar Store 2416 Family Dollar Store 6556 Family Dollar Store 7232 Family Dollar Store 5915
28 | Plan4Health Tarrant County
TARRANT
Table 3: Shortlisted selection
Analysis
Figure 12a: Map showing corner stores observed in analysis
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Chapter 6
3
4
2 5 7
6
1 8 9
Figure 12b: Map showing the narrowed down list of corner stores
30 | Plan4Health Tarrant County
No 1
Store Name Ocean Mini Mart 4
Longitude Latitude Address -97.244682 32.741039 5101 E Lancaster Ave -97.239594 32.759956 5312 Brentwood Stair Rd
City Fort Worth
2
Family Dollar Store 7232
3
Family Dollar Store 6556
-97.218193
32.766998 901 Bridgewood Dr
Fort Worth
4
BRAUM'S 84
-97.214722
32.766224 6770 Bridge St
Fort Worth
5
QUIKTRIP 861
-97.215164
32.754356 6601 Brentwood Stair Rd
Fort Worth
6
Family Dollar Store 2416
-97.215706
Fort Worth
7
CVS PHARMACY INC 6817
-97.21772
32.746105 6617 Meadowbrook Dr 32.746033 6548 Meadowbrook Dr
8
Quickway Food Store # 10
-97.216339
32.732098 6753 E Lancaster Ave
Fort Worth
9
Family Dollar Store 5915
-97.223961
32.720776 6156 Ramey Ave
Fort Worth
Fort Worth
Fort Worth
b. Negotiation Analysis
Once the analysis led to a shortlist of potential corner stores to be involved in the project, negotiation with these stores began in order to establish relationships and brief them of the project guidelines if selected. Ms. Shae Roundtree handled the responsibility of negotiating with store owners with the help of the IUS team. Shae introduced the project to the store owners and explained the incentives that were to be provided to them upon participation in the project. The IUS team analyzed the each shortlisted store in terms of architectural and contextual features, spatial configuration, and proximity to critical neighborhood infrastructure. The steps for the shortlist selection process are as follows: • Step One: Shortlisted stores were visited and introduced to the project with store owner or manager. Information packets were distributed and follow-up calls were administered within a week of distribution. (Refer to Figure 12 and Table 4 for distributed information and statistics.) • Step Two: Requests for store participation were solicited. The application form was to be completed by the store owner (with community organizer’s aid if necessary) and then submitted to Linda Fulmer. • Step Three: Applications were evaluated and participating stores were selected. An Advisory Committee would then evaluate stores based on their proximity to critical neighborhood components, capacity to participate, as well as their level of interest. Level of interest was gauged through conversations with the merchant and personal observations of the store. Representatives from other Healthy Corner Store projects across the country have stressed that the store owner interest is key to the success of the project (Tauzin & Stewart, 2011) • Step Four: Selected stores were notified. A letter of acceptance and memorandum of understanding (MOU) were distributed to selected stores. On this visit, project requirements were reviewed with store owners and next steps were outlined (i.e. store inventory and interview). Store owners were not required to sign memorandums at that time.
Figure 13: Invitation Letter and Fact Sheet
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Chapter 6
No
1
2
Name
Address
Quickway Food Store #9 6665 Randoll Mill Rd (CIS#1571212)
Lucky No. 7 Food Mart 1201 Country Club Ln
Post Code
Condition
Comments
76112
Shae to follow up. Also very good prospect. Not in The surrounding area looks really safe and quiet. close proximity/walking distance to residential area The store was clean, organized. Just the but can suggest adopting the new practices in their surrounding area doesn’t look very dense store on 6101 E Rosedale St, 76112
76012
A very good prospect. Already adopting some good healthy options. Good visibility with low height The condition of the store was good. Area was shelving, perimeter shopping, food stamps, EBT etc. safe. Density of the residential looks high Bananas at the counter
3
Nablus #1 Inc.
1525 E Berry St
76012
The safety of the area and the condition of the store was ok
4
Hitching Post Grocery
5101 Wilbarger St
76019
The safety of the area and the condition of the Owner not in. Not suitable for project. Next to a bail store was ok bonds and bait shop.
5
Stop and Shop Grocery
5037 Wilbarger St
76019
Next to Hitching Post Grocery with a gas station
Parking Issues that can be resolved. In‐store spatial capacity limited. Not safe
Owner not interested.
6
Smokey’s Paradise
5310 E Rosedale St
76015
The area was super unsafe, we did not stopped there jus took some picture driving by. Still a guy was asking may rude questions and making comments
7
Dallas Food Store
3400 E Rosedale St
76015
It looks fine especially with the gas station
Owner not interested. Spatial constraints
8
Rainbow Food Mart
1936 Mitchell Blvd
76105
Exterior look clean and safe. Next to a hamburger shop
Limited parking possibilities. Spatial concerns: space issues could be resolved with better spatial management and organization. Owner not in
9
Quick Check Food Store
2301 E Berry St
76119
Surrounding area nice and clean. Close proximity to residential apartments. Also parking possibility is good.
Owner not interested
10
On the Go Food Mart
5300 Brentwood Stair Rd
76112
Exterior area looks safe and clean also with the Shamrock gas station attached
Too close to the highway. Surrounding residential area is not a comfortable walking distance. Owner not in. Could comeback.
Table 4: Example of stores observed in the area
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c. Analysis of Successful Stores
i. Los Pastores This grocery store is a local favorite for a number of reasons. Figure 14 exhibits successful traits of Los Pastores, and the following information details these traits.
Figure 14: Successful Traits
• Produce Room One of the main strengths of this store in providing produce was its separate produce room. The low temperature of the room helped to keep produce fresh. A wide variety of fresh fruits and vegetables were offered here and were displayed within an organized layout. Meanwhile, thoughtful stacking of items allowed for proper air circulation and each produce type was allotted its own basket or box to eliminate cross contamination. And finally, reasonable product prices allowed for the store to compete with supermarkets such as Walmart.
Figure 15: Produce Room
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Analysis
Other local stores that were successfully implementing strategies of healthy food distribution with proper proximities to neighborhood infrastructure and components were analyzed to garner helpful information and best practices. Two successful case studies included Los Pastores and El Rancho.
Chapter 6 Figure 15b: Produce Room
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Figure 16: Appropriate temperature for different foods
Analysis
Figure 17a: Informative webpage and Facebook page Web page: http://www.lospastoresfoods.com/Carniceria.html Facebook: https://www.facebook.com/Los-Pastores-Restaurant-187800504660754
Figure 18: Displaying Healthy snacks and drinks at the register counter
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Chapter 6
Circulation with a Uniform Distribution of Products
Outdoor Dining
Displaying a wide variety of products within the framework of a successful circulation pattern within the store allowed for customers to shop more easily and efficiently.
The outdoor dining has created a friendly and welcoming community space with tables and chairs. It can be improved by potted plants, and a trash can in front of the store.
Figure 19: Circulation with a uniform distribution of products
Figure 20: Outdoor dining
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Chapter Successful Takeaways from Los Pastores Analysis
• Display fresh fruit—remove bruised and moldy fruit. • Display quick fruits such as bananas and apples in convenient locations that are easy on-the-go snacks and do not need to be refrigerated. • Use inexpensive displays such as a wicker or wire basket. • Price fruit by individual piece rather than by weight • Advertise through local media • Place “WIC and EBT Accepted Here” sign outside and near Register • Increase food affordability through Food Stamps and WIC • Engage neighborhood youth to paint a mural on exterior walls with images that are contextually appropriate and consistent with the Healthy Corner Store mission.
ii. El Rancho El Rancho had a welcoming atmosphere upon initial entry and was also well organized from entry to exit. The wide variety of affordable fruits and vegetables was just one of the practices that made the store successful. Having a smoothie bar in the store served as an instant healthy option and also as an additional revenue generator.
Figure 21a: Smoothie bar in El Rancho
Figure 21b: Appropriate price and fresh products
Figure 21b: Appropriate price and fresh products
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Chapter 6
Takeaways from EL Rancho • Place signs throughout the store directing customers to the healthy food area • Consolidate posters covering windows so customers have full visibility into the store. Create a community board for flayers and other postings. • Sell Imperfect Produce with reduced prices • Create a “Healthy Reward Card” program and other giveaways such as recipe cards, magnets, and coupons for a price reduction on healthy foods. • Have a Healthy Corner Store project sign displayed
Guide to start smoothie bar by $500: https://www.youtube.com/watch?v=1AkWQc8SIZs Costs to Start: https://www.youtube.com/watch?v=LOq_55KtNA4 Business Models: https://www.youtube.com/watch?v=0Ein5Phgsf0 Top 5 Juice Bar Business Expert Tips: https://www.youtube.com/watch?v=HTjOosn-tb0 Design a smoothie bar: https://www.youtube.com/watch?v=RFIjlgzJfT8&list=PLo_qDCx2IB5nTFuetnvzdzQXL9r2DOCCv
Figure 22a: Smoothie bar Source: http://nomss.com/radicle-juice-vancouver-main-street-smoothie-bar/
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Figure 22b: Smoothie bar Source: https://www.pinterest.com/pin/19421842115608170/
iii. Other
• Posters with the notion that “Healthy foods are not expensive” • Recipes for quick healthy options • Taste test and food demo
Healthy Recipes
Figure 23: Recipes for making healthier foods Source: http://eatdrinkbetter.com/2015/04/14/quick-easy-healthy-meals-weeknight-cooking/
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Analysis
Studies and resources have proposed additional successful strategies such as posters advocating for healthy food, noting that it is not necessarily as expensive or as time-consuming to prepare. These strategies also include recipes for quick healthy options, taste tests and food demonstrations, imperfect produce price reductions, healthy checkout lanes, and store organization and zoning.
Chapter 6
Healthy Foods are not Expensive
Figure 24: Posters with the notion that “Healthy foods are not expensive”
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Analysis
Figure 25a: Taste test and food demo Source: https://www.pinterest.com/pin/413697915740226321/
Figure 25b: Taste test and food demo Source: Delridge_HCS_Toolkit.pdf http://photos.uc.wisc.edu/photos/11757/original/Health_food_demo10_462. jpg?1286781002
Figure 25c: Taste test and food demo
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Chapter 6
Imperfect Produce Imperfect produce can be leveraged to incentivize customers toward healthy food purchases by reducing prices due to a lack of cosmetic appeal. In the United States, 1 in 5 fruits and vegetables grown do not meet strict cosmetic standards as they are either too small, of a wrong color, or of an incorrect shape. These fruits and vegetables are of the same nutritious value as cosmetically standard items, however their appearance often leads to their disposal. They are usually found in larger family farms, due to their lack of standard appearance regulation, however they can be utilized well in low-income areas through price reductions.
Figure 26a: Imperfect produce Source: http://www.imperfectproduce.com/#ugly-produce-delivered
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Figure 26b: Imperfect produce
Figure 26c: Imperfect produce
Healthy Checkout Lanes Analysis
Adding healthy grab-and-go items in checkout lanes is also a successful strategy. Replacing unhealthy, processed food items in checkout lanes with fruit, nuts, and 100% fruit juice is an easy and marketable tactic to employ. A report by Wisconsin Department of Health Services explains 4 main steps for making a healthy check out (Wisconsin Department of Health Services, 2013). Step 1: Knowing Your Community Step 2: Knowing Your Food Store Step 3: Establishing Partnerships Step 4: Developing Your Program
Check Out Healthy Retail: Policies that put health on the shelf Limit the amount of all storefront advertising
Maintain clean, attractive premises
Stock staple foods, such as whole grains, fresh produce, lean meat, and low-fat dairy BEANS
BEANS
Whole Grain
WIC AND
ACCEPTED HERE
Encourage WIC and SNAP (food stamps)
BEANS
BEANS
Brown Brown Brown Rice Rice Rice
Require tobacco to be kept behind the counter and away from candy and toys
Prohibit tobacco product discounts and coupons
Encourage a reduction in the number of unhealthy snacks and sugary beverages
Quit Smoking Now! Require tobacco retailers to get a local license and pay a fee LICENSE
Fabulous Fiber Make Salsa
Display fresh produce at the front of the store
Health on the Go Nuts Nuts
Popcorn
Nuts
Eat the Rainbow Prohibit tobacco from being sold near schools or other child-oriented places
Figure 27a: Healthy Checkout Sorce: http://www.albertleatribune.com/ 2011/03/hy-vee-introduces-a-blue-zones-lane/
Post signs or shelf labels promoting healthy products in the store
Restrict sales of tobacco products targeted to teens
Figure 27b: Healthy Checkout www.changelabsolutions.org/childhood-obesity/healthy-food-retail Source: http://www.changelabsolutions.org/healthy_retail
Seltzer Seltzer
1%
1%
ICED ICED TEA TEA
Granola Bar
100% 100% JUICE JUICE
Encourage healthy products at the checkout counter
ChangeLab Solutions is a nonprofit organization that provides legal information on matters relating to public health. The legal information in this document does not constitute legal advice or legal representation. For legal advice, readers should consult a lawyer in their state. Support for this document was provided by a grant from The California Endowment. Š 2014 ChangeLab Solutions
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Chapter 6
Organization and Zoning By studying successful local store models and additional models found elsewhere, the following zones are proposed for having a healthy corner store.
Figure 27: Proposed Zones
Produce Zone: With a different Color (Green)
Butcher
Healthy Snacks & other products
Express Zone: Drink+ Healthy Check out
Healthy smoothie Bar
Food demo
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APA - TEXAS CHAPTER
CHAPTER
Plan4Health Tarrant County | 45
CHAPTER
7
Project Process
Project Process Based on analysis and efforts explained in the previous chapter, two corner stores were selected as pilot locations for this project, Ramey Market and Miller Market. Plan4Health received an American Planning Association grant to help fund the store transformations in order to reorient them toward improved operations in the name of promoting healthy food distribution.
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Process
7 Project Process a. Pilot Stores Based on analysis and efforts explained in the previous chapter, two corner stores were selected as pilot locations for this project, Ramey Market and Miller Market. Plan4Health received an American Planning Association grant to help fund the store transformations in order to reorient them toward improved operations in the name of promoting healthy food distribution.
i. Ramey Market Following GIS analysis and negotiation with store owner Ramey market got selected. This is store is located in food desert area and it’s near distance to a high school and several churches. Plan4Health Tarrant County worked with the new owners of Ramey Market to transform their store into a healthy corner store. The previous owner had stocked a limited supply of fresh fruits and vegetables, but they were hidden in the back of the store behind many rows of shelves, limiting visibility and access. With the help of the grant, the store has been being re-arranged to make it easier for customers to find fresh produce and other healthy food items and beverages. On the exterior, the store received fresh paint, including a mural painted on one full wall. Students from Dunbar High School helped to design and paint the mural.
Figure 28: Location of Ramey market
Figure 29: Ramey market exterior
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Chapter 7
Food Desert in Surrounding Area By looking at the food desert map and low-income map, it can be see that Ramey market is located in both areas. It means that there are more than 100 households living in this area with no access to Vehicle and the average distance of residents to the nearest supermarket is more than 1/2 mile. Meanwhile, the poverty rate 20% or higher, or tracts and the median family income is less than 80% of a median family income in the metropolitan area (United States Department of Agriculture, 2010).
Figure 30: Location of Ramey market in the map of food desert areas Source: http://www.ers.usda.gov/data-products/food-access-research-atlas/go-to- the-atlas.aspx
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Figure 31: Location of Ramey market in the map of low income areas
(a). Visual Assessment
SWOT Analysis
Process
SWOT Analysis
• Weaknesses
Poor Organization of the Products
Strengths
Weaknesses
Opportunities
Threats
Unattractive and Old Building Negative Impression of Empty Shelves on Costumers
The Communication Issue of The Salespersons
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Chapter 7
• Poor Organization of Shelves There is an aisle of vegetable and fruits in the shop that is located in the back of empty aisles and it is difficult for a new customer to guess there is an aisle of produce behind empty shelves. Moreover milk bottles are located at the bottom of beer fridge.
Figure 32a: Location of healthy produce in Ramey Market
Figure 32b: Location of milk bottles in Ramey Market
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Figure 33: Unorganized and empty shelves in Ramey Market
Process
Existing Circulation Plan of the Store
Empty Full Healthy Circulation
Figure 34: Circulation in Ramey market
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Withered and Pricy Produce
Figure 35: Unattractive entrance
Figure 37: Pricy produce
Figure 36: Poor window advertising
Figure 38: Withered produce
Chapter 7
Unattractive and Older Building Structure
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• Strengths Process
Many Customers Know Each Other
Helpful and Welcoming Storeowner
Variety of Products and Services
Appropriate Food Signs Plan4Health Tarrant County | 53
Chapter 7
• Threats
Figure 39a: The surronding urban space do not have good condition
Figure 39b: Deserted buildings and shops show the area is shrinking
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Figure 40a: High rate of crime in the surronding area
Figure 40b: It was seen and emphasized by the owner that shoplifting is so high in this shop. We tried to address this issue in the new design Source: https://www.linkedin.com/pulse/retail-loss-prevention-shoplifting-101-ex pert-article-larry-wolf.
• Opportunities
Chapter 7
Process
Large and spacious store
Proximity to schools and churches
Church Corner Store Educational
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Chapter 7
(b). Design Interior Design • Wider Aisles: To improve access and visual continuity, wider aisles were introduced. This allowed for an improved circulation pattern throughout the store, therefore creating greater access to store products. • Improved Signs & Displays: Improved product signage and displays were introduced to ease consumer access and convenience. • Lower Shelving Height: One of the main problems initially identified in the store was empty, unorganized shelves. For better visibility throughout the store, lower shelving height was introduced, lessening the impact of excessive shelf space. Reducing the scale of the shelves helped to reduce inventory costs and created a more intimate and convenient atmosphere by placing items at eye level. The lower shelves also helped to reduce concerns of shoplifting throughout the store as they resulted in increased visibility from checkout counters. • Promotion: In-Store marketing was improved by introducing healthy alternatives in the store with the integration of the smoothie bar as well as various advertising throughout the store reinforcing the benefits of healthy diets.
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Process
Figure 41: Re-designed floor plan for Ramey Market
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Chapter 7
Figure 42: Interior Design for Ramey Market
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Process
Figure 43: Interior Design for Ramey Market
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Chapter 7
Exterior Design
Figure 44a: Site Plan of Ramey Market- Option1
Figure 44b: A view of the design for the surronding area of Ramey Market- Option1
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Process
Figure 45a: Site Plan of Ramey Market- Option2
Figure 45b: Dining are for Ramey Market-Option2
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Chapter 7
Community Engagement During Implementation For a healthy corner store to succeed, it is critical for the surrounding community to embrace that store as their own. As part of the community engagement efforts, the senior art students at Dunbar High School designed a mural for the east facade of the store, celebrating their neighborhood, school, and store. The store owners approved the design and the students proceeded to paint the mural. The finished product was unveiled on Saturday, December 10th during a ceremony that included local officials, project partners, and the proud artists and their families. Ramey Market is now the neighborhood store and the owner Sam and his family are proud to be a part of the community. Through this project, the owners have become very excited about becoming more than a “beer and lotto ticket� shop. The IUS team produced a new interior layout design for the store that allows the store to function as two separate spaces –a healthy corner store and a laundromat. The owners purchased all new shelving for the store and are in the process of implementing the plan, including the installation of a smoothie bar. Their excitement, coupled with the improved, healthier business model from the community and the added laundromat profit center, will provide the community with a sustainable, healthy corner store.
Figure 46a: Contribution of citizens in renovation of Ramey Market
Figure 46b: Contribution of citizens in renovation of Ramey Market
Figure 46c: Contribution of citizens in renovation of Ramey Market
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Process
Figure 47a: Contribution of citizens in renovation of Ramey Market
Figure 48a: Contribution of citizens in renovation of Ramey Market
Figure 47b: Contribution of citizens in renovation of Ramey Market
Figure 48b: Contribution of citizens in renovation of Ramey Market
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Chapter 7
ii. Miller Food Mart Miller Food Mart is another selected store, it’s located in food desert area and chosen by the GIS analysis. Meanwhile, the owner is interested to participate in the program.
(a). Visual Assessment
Miller Food Mart had previously implemented a few successful practices for a successful corner store but was lacking the presence of healthy food options. Some of its current successes included low shelves, a variety of goods, wide aisles, and a fast food restaurant and beverage bar. The greatest improvement to be made to the store would be the inclusion of healthy food options; a fruits and produce section in the store and also on the restaurant menu would aid tremendously. Another suggestion was to convert the beverage bar into a smoothie bar as a healthy grab-and-go option. Although the interior design of this store is in good condition, the exterior of the store is extremly unattractive. Therefore we tried to make more change in the exterior and also make a connection between the interior and exterior of the store.
Figure 49: Interior of Miller Food Mart
Figure 50: Exterior of Miller Food Mart
Figure 50a: Interior of Miller Market
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Interior Design
• Convert Beverage Bar to Smoothie Bar: this conversion would allow for healthier grab-and-go beverage options • Provide Fruits and Produce Section: this will allow for greater visibility of and access to healthy food options • Provide Healthy Restaurant Menu Options: this will allow for healthier meal options
Figure 51a: Exterior of Miller Food Mart
Figure 51b: Panorama of Miller Food Mart
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Process
This store has a good organization of the products that causes a good circulation in the store. However, there is no produce part in the store. With following minor changes the store will be converted to a successful healthy store.
Chapter 7
ii. Design
Figure 52: Re-designed floor plan for Miller Food Mart
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Process
Figure 53a: Interior Design of Miller Food Mart - Smoothie bar
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Chapter 7 Figure 53b: Interior Design of Miller Food Mart - Healthy Checkout
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Process
Figure 53c: Interior Design of Miller Food Mart - Produce section
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Chapter 7 Figure 54a: Exterior Design of Miller Food Mart - Outdoor Dining
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Process
Figure 54b: Exterior Design of Miller Food Mart - Outdoor Dining
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Chapter 7
b. Mobile Fresh Market A mobile food truck initiative is being proposed with Poly Wes Gardens owner and social entrepreneur, Kimberly McLean, to create the first pilot produce truck: Trolley Pride Mobile Fresh Market. Within the identified food desert areas, the goal is to provide a sustainable and more convenient alternative that will visit these neighborhoods regularly. The proposal seeks to make these mobile markets available to the neighborhoods on a weekly basis and to educate residents on the benefits of healthy living and the importance of nutrition. Based on the surveys taken in these areas, cash was the most favored method of purchase followed by debit cards. For neighboring zip codes currently utilizing a mobile fresh market that provides bulk produce including fresh fruits and vegetables, 56.5% of the surveyed population expressed a strong desire for a more frequent offering. The Blue Zones Project in conjunction with the Tarrant County Food Policy Council are working on several initiatives aimed at loosening regulations over the sale of produce and encouraging entrepreneurship in parts of the city with low access to fresh foods. These initiatives could help to offer a higher frequency of mobile market offerings, enabling greater access to healthy food within this community. Benefits • To provide healthy food options to residents currently living in food deserts in Fort Worth. • Alter eating behaviors by incorporating healthy options. • Aid in the reduction of obesity and adolescent diabetes within these zip codes. • Opportunity to expand Poly Wes Gardens recognition and reach undeserved markets.
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• Opportunity for market research and penetration into new locations. • Generate awareness and feasibility of a project with the hope of encouraging similar entrepreneurial endeavors. With over 360,000 residents across Fort Worth lacking steady access to healthy food options, the best opportunities for vendor investment include marketing fresh fruits, vegetables, and grab-and-go produce. The ultimate goal is to corner the untapped market by providing produce at affordable prices while also providing educational prospects to the community. The following are 16 identified locations as potential stops for the Mobile Fresh Market based on feedback from community residents and stakeholders.
Education Pairing the provision of healthy produce with educational resources will increase the success of the mobile fresh market as one of the main factors to the purchase of produce is having the ability to prepare and cook it. Education will help to keep produce in high demand. When families learn that leading healthier lives can be creative and more affordable, they are more likely to make healthier choices.
Address
Point of Contact
A. M. Pate Elementary School
3800 Anglin Dr., 76119
Rochelle Horton, Principal, Rochelle.horton@fwisd.org, 817‐815‐3850
Tarrant County College Opportunity Center
5901 Fitzhugh Ave., 76119
Frederick Schmidt, Manager of Community & Industry Education Program Development, Frederick.schmidt@tccd.edu, Gwen Morrison, TCCD Board Trustee, gwen11morrison@yahoo.com
Paul Laurence Dunbar High School
5700 Ramey Ave., 76112
SaJade Miller, Principal, Sajade.miller@fwisd.org, 814‐815‐3000
Martin Luther King Community Center
5565 Truman Dr., 76112
Whitney Rodriguez, Marketing Coordinator, Park and Recreation Department, Whitney.Rodriguez@FortWorthTexas.gov, 817‐392‐ 5778 Paula Jackson, Supervisor, Paula.jackson2@fortworthtexas.gov, 817‐871‐5960
Christene C. Moss Elementary School
4108 Eastland St., 76119
Seretha Lofton, Principal, Seretha.lofton@fwisd.org, 914‐815‐3600
Boys & Girls Club of America
4651 Ramey Ave., 76105
Larry Braziel, Manager, lbraziel@fortworthtx.org
McDonald Southeast YMCA
2801 Miller Ave., 76105
Reeshemah Davis, VP of Operations/Community Development, rdavis@ymcafw.org, 817‐543‐1591
Young Men’s Leadership Academy (not able to participate during 20162017 academic year due to construction)
5100 Willie St., 76105
Rodney White, Principal, Rodney.white@fwisd.org, 817‐815‐ 3400
Grace Temple (#1)
4200 E. Berry St., 76105
Grace Temple (#2)
Near Village Creek R. and Freshfield Rd., 76119
Sycamore Recreation Center
2525 E. Rosedale St., 76105
Handley Meadowbrook Recreation Center
6201 Beaty St., 76112
Eugene McCray Recreation Center
4932 Wilbarger St., 76119
WIC Office #1 WIC Office #2 WIC Office #3
Tarrant Woman, Infants and Children Program, 1500 Circle Dr., Fort Worth, 76119 WIC Office, 3212 Miller Ave., Fort Worth, 76119 WIC, 1100 Bridgewood Dr., Fort Worth, 76112
Process
Location
Benita Parker, Administrative Assistant, Grace Temple Seventh Day Adventist Church, prkrbnt@yahoo.com
Whitney Rodriguez, Marketing Coordinator, Park and Recreation Department, Whitney.Rodriguez@FortWorthTexas.gov, 817‐392‐ 5778
Ann Salyer‐Caldwell, Associate Director, Community Health Promotion, Tarrant County Public Health, asalyer‐ caldwell@tarrantcounty.com Table 5: Mobile Food Market Stops
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Chapter 7
Organization
Point of Contact
Resources Available
Bravo Catering
Chef Dena Peterson 817‐310‐1000 dena@bravodfw.com
Recipes and Cooking Demonstration
Cafe Modern
Chef Denise Shavandy 817‐840‐2176 dshavandy@themodern.org
Recipes and Cooking Demonstration
Expanded Food and Nutrition Education Program (EFNEP) via AgriLife Extension
As a special, federally‐funded program of Texas A&M AgriLife Extension Service, EFNEP offers limited‐resourceadults with small children a 7‐part series of hands‐onlessons in basic nutrition, meal planning, food selection/buying, safe food handling practices (with recipe demonstrations & taste‐testing) and the need for increased physical activity. Classes are facilitated at convenient locations Darlene Myatt, Extension Agent at EFNEP Myatt@ag.tamu.edu throughout inner‐city Fort Worth by community nutrition educators (817) 212‐7501 who are bi‐lingual (English/Spanish) with educational materials, copies of the recipes prepared and incentive items for participants. This free, self‐help program also offers age‐appropriate nutrition activities organized as a lesson series for classroom presentations, after‐school projects and summer outreach activities to help schoolage youth develop healthy, well‐thy lifestyles as well.
TCC Culinary Program
Katrina Warner, Culinary Arts Coordinator, 817‐515‐3609 katrina.warner@tccd.edu
Writer
Lauran Samuel Meyn 817‐925‐7138 laura@samuelmeyn.net laurameyn@charter.net
Texas Health Resources
Recipes and Cooking Demonstration
*Texas Health Harris Methodist Hospital Southwest Fort Worth Jennifer Thomas MSN, RN, Clinical Education Specialist 817‐433‐ 6264 jenniferthomas@texashealth.org *Texas Health Harris Methodist Hospital Alliance Mandy Forbus | Community Integration Director T 682.212.5310 | M 817.723.4942 MandyForbus@TexasHealth.org Recipes, classes, etc. at the four locations noted, counseling services *Texas Health Harris Methodist Hospital Fort Worth Margaret Galvez, MPH, RN | Community Health Manager T 817‐250‐5584 | F 817‐250‐5019 MargaretGalvez@TexasHealth.org *Texas Health Harris Methodist Hospital Azle Marsha Ingle, BS, MA, CHES Director of Community Health 817‐444‐8668 marshaingle@texashealth.org
Sherry Marishak‐Simon, R.D.N./L.D., Vice President of Nutrition and Health Programs, 817‐258‐6427, ssimon@mealsonwheels.org
Recipes and diet plans
Blue Zones, Healthways
Victoria Puente, victoria.puente@healthways.com
Recipes, meal plans, nutritional information
Tarrant Area Food Bank
Barbara Ewen, Senior Director, Food Programs, 817‐857‐7105, Barbara.ewen@tafb.org
Recipes, meal plans
Meals on Wheels Inc. of Tarrant County
FWISD Culinary Program
Gloria Starling, President of Tarrant County Restaurant Association, gstarling@tcgdine.com, 972‐953‐7713 Chef Tim Kelly, Career and Technical Education with FWISD, timothy.kelly@fwisd.org, 817‐8141810
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Recipes, cooking demonstrations
Table 6: Mobile Food Market Stops: List of Resources available to provide recipes, cooking demonstrations, and other materials for the Mobile Food Truck
Results of the Survey
Process
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Process
Source: This survey was conducted by Fort Worth Leadership Team
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Chapter 7
c. Pushcarts On March 1, 2016, Plan4Health sent a request to the City of Fort Worth to initiate amendments to both the City Code and the Zoning Ordinance for mobile vendors and pushcarts. The primary purpose of the amendments was to allow mobile vendors and pushcarts to sell fresh produce in residential zoning districts. These amendments support the Blue Zones initiative to bring fresh produce to residents in undeserved areas where very few stores provide healthy food choices. The amendments also support the Plan4Health Tarrant County Coalition, which received an American Planning Association grant to improve access to healthy food. Mobile vendors operate out of a self-contained motorized vehicle, are regulated through the Zoning Ordinance, and receive a Vendor Certificate of Occupancy (VCO) from Planning and Development. Pushcarts are smaller, non-motorized, and are propelled manually by the operator and are regulated through the City Code by Code Compliance. Produce is currently allowed to be sold on both units, but only within nonresidential zoning districts. The proposed amendments to the Zoning Ordinance create a Fresh Market Mobile Vendor category with limits on the products that may be sold. To be considered a Fresh Market Mobile Vendor, no less than 75% of the inventory shall be fresh produce and the remainder may be prepackaged foods. The changes will allow produce sales from a mobile vendor on vacant lots in nonresidential districts with the permission of the property owner. They will also allow sales in residential zoning districts on property used for non-residential purposes such as schools and churches, but not on vacant lots. Fresh Market Mobile Vendors will also be permitted to function as a transient vendor (in one place for less than 60 minutes) and as an on-street vendor, similar to the requirements of an ice cream truck. The proposed amendments to the City Code include allowing pushcarts on vacant lots in nonresidential districts and in residential zoning
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districts on property used for non-residential purposes such as schools and churches, similar to Fresh Market Mobile Vendors. Only one pushcart will be allowed on a property, except for school property where multiple pushcarts may be permitted. The maximum size of the pushcart will be increased to carry more produce into neighborhoods. As an incentive, staff has proposed a reduced fee for pushcarts selling at least 75% produce with the remainder being prepackaged goods. Other regulations for mobile vendors and the Downtown Pushcart Slot Auction process are not being amended with these proposals. There are several advantages of a produce pushcart over an ice cream pushcart: Requirements Size Limit
Produce Pushcart 4 feet high 3 feet wide 6 feet long
Ice Cream Pushcart 2 feet high 2 feet wide 2 feet long
What you can sell
whole uncut fruits and vegetables
Prepackaged ice cream and other frozen treats
Plan Review Fee
None
$65
Annual Health Permit Fee
None ‐ if more than 75% is whole, uncut fruits and vegetables and no more than 25% is packaged foods that do not require heating or refrigeration
$85
Table 7: Advantages of produce pushcarts over ice cream pushcarts
Through the Healthy Tarrant County Collaboration and Blue Zones Project Fort Worth, Plan4Health can provide the following to support the first produce pushcart: 1. Information regarding areas in southeast Fort Worth that have an existing market for fruit and vegetable sales 2. Promotion of the pushcart through social media, flyers, door hangers, and bus benches/shelters 3. Necessary supplies such as signs, umbrellas, sales equipment, etc. 4. Cooking demonstrations at larger sales locations
Site
Street Address
City State Zip
Phone
Answer
1
PALETERIA LA FLOR DE MICHOACAN
2201 W BERRY ST
FORT WORTH TX 76110‐2804
817‐207‐0333
They do not have any interest and they are interested in selling ice‐cream (paletta).
2
LA LUZ
1324 NW 24TH ST
FORT WORTH TX 76164‐7848
817‐986‐9364
No answer. I left a phone message
3
PALETERIA LA PRINCESA
1101 GRAHAM AVE
DALLAS TX 75223‐ 1846
214‐828‐4926
Spanish Speaker, No answer
817‐927‐0313
They are interested in the idea. However, instead of pushcarts, they want to do a standing building. They have occasional public events.
4
ALMAS PALETERIA
1215 E SEMINARY DR
FORT WORTH TX 76115‐2910
5
MELT ICE CREAMS
954 W ROSEDALE ST
FORT WORTH TX 76104‐4578
817‐866‐8365
The phone number is not in service
6
PALETERIA LA MEXICANA
3307 AZLE AVE
FORT WORTH TX 76106‐3322
817‐624‐4131
Spanish Speaker, No answer
7
DIPPIN DOTS
145 LAKEVIEW DR
ALEDO TX 76008‐ 3926
817‐308‐9399
He mentioned he is sure that he is not interested in the program and he prefers to just have ice cream
8
PALETERIA LA SUPER #2
3031 S 1ST ST
GARLAND TX 75041‐ 3459
214‐533‐6056
No answer. I left a phone message
9
O FLAHERTYS ICE CREAM
121 E EXCHANGE AVE
FORT WORTH TX 76164‐8211
817‐279‐6088
No answer. I left a phone message
10
SKYLARS ICE CREAM SWEETS
7321 VALENCIA GROVE CT
FORT WORTH TX 76132
972‐567‐4308
No answer. I left a phone message
11
STEEL CITY POPS
908 CURRIE ST
FORT WORTH TX 76107‐2912
817‐744‐8544
He hung up the phone!
12
LA REYNA
4030 E BELKNAP ST
FORT WORTH TX 76111
214‐402‐7766
No answer. I left a phone message
13
PALETERIA DELICIAS
2008 W CLARENDON DR
DALLAS TX 75208
214‐395‐5875
Spanish Speaker, No answer
Table 8: Selection of pushcar owners contacted
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Process
No
Chapter 7
d. Other Activities i. New Orleans Conference of Implementation and Dissemination for Chronic Disease
The 2016 Technical Assistance Workshop of the National Implementation and Dissemination for Chronic Disease Prevention initiative was held April 25- 27, 2016 at the Marriot Hotel in New Orleans. The workshop was funded by the Center for Disease Control and Prevention, an entity striving to educate and improve the health of individuals and communities across the nation. Chronic diseases are responsible for 7 out of 10 deaths each year, and treating people with chronic diseases accounts for 86% of our nation’s health care costs. Although chronic diseases are among the most common and costly health problems, the good news is that many can be effectively controlled and managed. The workshop team represents 97 sites across the country that will be funded over the course of two years to improve nutrition, enhance community linkages for clinical care, increase physical activity, and reduce tobacco use and exposure. To address these chronic disease risk factors, members will be implementing policy, systems, and environmental improvements to make healthy living easier where people live, learn, work, and play. The workshop was designed to empower members with new information, skills, networks, and resources to achieve success and enhance community action plans, network with other teams, ask questions, and to creatively strategize the execution of healthy communities and a healthy nation. The American Heart Association, American Planning Association, Directors of Health Promotion and Education, National WIC (Women, Infants, and Children) Association, and Society for Public Health Education are the organizations that participated this workshop.
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The cooperative agreement provided two categories of funding to national organizations: 1. Category A - Community Capacity Building and Implementation includes the American Heart Association, American Planning Association, and National WIC (Women, Infants, and Children) Association 2. Category B - Dissemination and Training includes Directors of Health Promotion & Education Society for Public Health Education Main Conference Discussion Topics • Using community-based resources related to better control chronic disease • Increasing daily consumption of fruit, vegetables, and healthy beverages • Increasing physical activity • Leading local movement • Federal anti-lobbying guideline • Coalition maintenance and community engagement • Diversifying partnership to achieve health equity • Formatting inclusive and equitable communities Conference Benefits A. Each team identified the ways in which its coalition can initiate, implement, and sustain policy, systems, and environmental changes that lead to healthier and more equitable communities. B. Teams showed approaches to address one or more of the following disease risk factors: tobacco use and exposure, poor nutrition, physical inactivity, and lack of community-clinical linkages. C. Identifying peers working in similar disease risk factor areas and exchange ideas, resources, and technical assistance.
Process
Project Takeaways 1. Building a Cathedral: the important point that was emphasized in the conference several times was that our job is much like building a cathedral. Designing cities for improving public health is a longterm process that needs long-term commitment. 2. Education as the next step: educating youth and adults in surrounding areas of the health and economic benefits of producing locally grown food. Through hands-on training, residents should be taught alternatives available to them in securing fresh, healthy food.
5. Networking with other coalitions all over the nation: the most important takeaway from this conference was networking with members of coalitions that are doing similar project in other states. Learning from one another’s failures and successes will be the greatest advantage of being in touch with attendees. Table 9 lists members involved in similar or related projects within the network.
3. Food accessibility should go hand-in-hand with active transportation: improving access to opportunities for physical activity by creating a sustainable cycling hub that provides education on bicycle safety for recreation and transportation. This operation would train local community members on bicycle repair, provide resources for bicycle repair and maintenance, and certify community members. Through building this capacity in the local community, the community will be able to leverage this capacity to create economic growth through cycling. 4. Making a coalition that doesn’t just work for the community but with it: several sections of this conference focused on the creation and management of coalitions as they are necessary to ensure a sustainable connection between health and urban planning. We should first understand why community members participate in coalitions and then design strategies for it the implementation of them, define proper roles for perspective members, and make incentives for members. Six R’s are essential to make a successful coalition that meets the need of members, including: Recognition, Respect, Role, Relationship, Rewards, Results
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Chapter 7
Contact Person
Project
Approach
Plan4Health Lake County It aims to develop personalized Community Health Action Plans for communities in Lake County lacking access to healthy foods and opportunities for physical activity. By working with a diverse group of Nutrition and physical activities. professional partners and residents, Plan4Health Lake County will create a framework for developing comprehensive Community Health Action Plans Focusing on Community gardens and farmer markets in addition to the Plan itself. David Radachy Monica Jordan
Idavid.radachy@lakecountvohio.gov
440‐350‐2740
MonicaJordan@lakecountvohio.gov Pathways to Health Tulsa, OK Through cross‐sector partnerships with public health professionals, schools, and local organizations. Tulsa County cities will create greater access to locally grown foods; reduce barriers to physical activity; and promote systemic and policy changes supporting a health in all policies approach.
Joani Dotson
lidotson@tulsa‐health.org Thomas County Healthy Coalition, KS "It seeks to improve the health of Thomas County residents by adopting policies that promote safe streets designed with pedestrians in mind; improve healthy food and beverage offerings for schools, workplaces and public facilities; and educates community members about the County's goal to be the "healthiest county in Kansas."
Sue Evans
Nutrition and physical activity
Nutrition and physical activity
(sue@nwksprevention.com)
Table 9: Coalitions that participated in the conference, Continued on next page
Shawano and Menominee Counties Health in Planning Coalition It is working with Native America Tribes and jurisdictions in Wisconsin to 86 | Plan4Health Tarrant County improve access to local, fresh food by convening a team of planning and public health professionals to identify barriers to healthy diets. The
Nutrition
improve healthy food and beverage offerings for schools, workplaces and public facilities; and educates community members about the County's goal to be the "healthiest county in Kansas." Sue Evans
(sue@nwksprevention.com)
(Casey.Mitchell@co.shawano.wi.us) Metropolitan Area Planning Council This project has a similar approach to us. Improving healthy food accessibility by corner stores. Their project is as progressive as ours and we can be very good peer for each other to exchange experiences and data.
Lola Omolodun
Nutrition
lomolodun@mapc.org
Nutrition by corner stores
617‐933‐0728
Design 4 Active Sacramento (D4AS) brings together professional engineers, planners and public health professionals to create streets that are conducive to safely walking, biking and living through active design. D4AS seeks to change the way design and health professionals work together with the goal of creating communities built for health. Kirin Kumar
KKumar@mail.walksacramento.org
Miriam link‐Mullison
miriam@jchdonline.org
Chris Wallace
cwallace@ci.carbondale.il.us
Nutrition and physical activity
American Planning Association(APA) David Rouse
drouse@planning.org
Elizabeth J. Hating
eharting@planning.org
Becky Steckler
becky@oregonapa.org
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Process
Shawano and Menominee Counties Health in Planning Coalition It is working with Native America Tribes and jurisdictions in Wisconsin to improve access to local, fresh food by convening a team of planning and public health professionals to identify barriers to healthy diets. The Coalition will establish a local food council to address identified barriers. Casey Mitchell
Nutrition and physical activity
Chapter 7
ii. Fruitful Fridays Fruitful Fridays is part of collaborative grant effort between Plan4Health and the following partners: Blue Zones Project, Healthy Tarrant County Collaboration, and Live a More Colorful Life – a nutrition education campaign by the Tarrant County Public Health. The goal is to provide 1-2 pieces of fruit to people to introduce fruit as a healthy snack and to also distribute information on the Live a More Colorful Life Campaign. The giveaways will be in plastic totes, and include a reusable bag, a cookbook, and recipes. For more information you can look at the following link: http://access.tarrantcounty.com/content/main/en/public-health/ chronic-disease-prevention/nutrition/live-a-more-colorful-life.html
Figure 55b: Fruit distribution at Fruitful Fridays
Figure 55a: Fruit distribution at Fruitful Fridays
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Figure 55c: Fruit distribution at Fruitful Fridays
iii. Media Coverage
Date
Media
Link
News
11/25/2015
City News (City website
http://fortworthtexas.gov/news/20 15/11/APA‐fresh‐food‐grant/
Anouncement of the grant. 356 page views; 319 unique
1/25/2016
CBS 11 (TV news)
http://dfw.cbslocal.com/2016/01/2 5/fort‐worth‐rolls‐out‐veggie‐to‐ curbside‐delivery‐service/
Positive news story on ordinance amendments
1/27/2016
Star‐Telegram (newspaper)
Positive newspaper coverage. 2066 page http://www.star‐ telegram.com/news/local/communi views for the online edition. Circulation ty/fort‐worth/article56745298.html is 100,000 and Readership is 300,000.
1/27/2016
City News (City website
http://fortworthtexas.gov/news/20 16/01/Fresh‐Market‐Mobile‐ Vendors/
1/28/2016
Star‐Telegram (newspaper)
http://www.star‐ Positive editorial. Circulation: 100,000. telegram.com/opinion/editorials/art Readership: 300,000. icle56916778.html
11/ 30/2016
CBS 11 (TV news)
http://dfw.cbslocal.com/2016/11/3 0/art‐students‐creating‐mural‐in‐ fort‐worth‐neighborhood/
Positive report to the public about proposed ordinance amendments. 211 page views; 185 unique
Positive news story on renovation of Ramey Market
Table 10: List of Newspaper and television reports
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Process
This project was the center of attention with several local media outlets. Table 10 lists newspaper and television reports that reported on this project. The media campaign also went beyond local media outlets to include billboards, bus benches, mobile geo fencing, direct mail, posters, flyers, bookmarks, sidewalk decals, and more. The aim of the campaign has been to increase awareness of the importance of fresh produce in the diet, and also to increase awareness of the new healthy foods vendors.
APA - TEXAS CHAPTER
CHAPTER
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CHAPTER
8
Conclusion and Recommendations
Conclusion and Recommendations The development of a sustainable and long term action plan to tackle the issue of food accessibility is of paramount concern. To achieve this goal, the cooperation of urban planners and public health officials is critical.
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Chapter 8
8 Conclusion and Recommendations The development of a sustainable and long term action plan to tackle the issue of food accessibility is of paramount concern. To achieve this goal, the cooperation of urban planners and public health officials is critical. Creating local coalitions is a key factor in food accessibility projects as local implementation helps to determine best practices. In the Fort Worth Plan4Health project, the community engagement process was the most difficult and time consuming portion of the project since the idea of consuming healthy foods is not well-known, especially in working-class neighborhoods. Our experience showed that local negotiators are crucial in the process and being a member of the dominate race in the neighborhood resulted in more successful communication. Analyzing existing selected corner stores and comparing them with successful store models in adjacent communities, yielded a lot of insight in the design process for the selected pilot stores. For the design process, affordability is key. Store owners are often most concerned with their ability to overcome initial upfront costs. Therefore a good relationship between designers and store owners is critical. For instance, the team conducted frequent visits to stores, involved the owners in the design process, and received their feedback before starting the next step. In implementing push carts, it was observed that persuading ice-cream pushcart owners to be involved in the program was really difficult. Instead, making incentives for new entrepreneurs to be involved in the project was more beneficial.
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The online survey enhanced the data regarding resident needs which allowed for more informed decisions regarding mobile markets due to the influence of decisions made by the city council. Attending the New Orleans Conference also broadened the team’s horizon to different aspects of food accessibility and allowed for the opportunity to exchange our knowledge and experience with the coalition with similar project teams across the country. These workshops are important and crucial for food accessibility projects that are newly beginning. Finally, coverage from local media was a significant success factor. Aside from being an incentive for store owners to gain publicity, it informed residents of the program. Future coverage will also help aspiring entrepreneurs to become interested and engaged in the program to better communities across the nation.
Bibliography
Bibliography
9 Bibliography Caspi CE, Sorensen G, Subramanian SV, Kawachi I. The local food environment and diet: A systematic review. Health Place. 2012b;18(5):1172– 1187. available from: PM:22717379. Cummins, S., & Macintyre, S. (2002). “Food deserts”—evidence and assumption in health policy making. BMJ 325(7361). Finkelstein, E., Trogdon, J., Cohen, J., & Dietz, W. (2009). Annual Medical Spending Attributable To Obesity: Payer-And Service-Specific Estimates. Health Affairs. Flegal, Carroll, Ogden, & Curtin. (2010). Prevalence and trends in obesity among US adults, 1999-2008. National Center for Health Statistics, Cen ters for Disease Control and Prevention, 3311 Toledo Rd, Room 4315, Hyattsville, MD 20782, USA. kmf2@cdc.gov. Gustafson A, Hankins S, Jilcott S. Measures of the consumer food store environment: a systematic review of the evidence 2000-2011. Journal of Community Health. 2012;37(4):897–911. available from: PM:22160660. JE, T. (2004). America’s obesity: conflicting public policies, industrial economic development, and unintended human consequences. Annual Review of Nutrition 24(1):617-43. Kaiser, C. (2009). Healthy Food Access in Minneapolis: MN: Institute for Agriculture and Trade Policy,. Larson NI, Story MT, Nelson MC. Neighborhood environments: disparities in access to healthy foods in the U.S. Am J Prev Med. 2009;36(1):74–81. available from: PM:18977112. Morland K, Wing S, Roux A. The contextual effect of the local food environment on residents’ diets: the atherosclerosis risk in communities study. American Journal of Public Health. 2002;92(11):1761–1767. Rose D, Richards R. Food store access and household fruit and vegetable use among participants in the US Food Stamp Program. Public Health Nutrition. 2004;7(08) Treuhaft, S., & Karpyn, A. (2010). The Grocery Gap: Who Has Access to Healthy Food and Why It Matters. PolicyLink. U.S. Department of Agriculture. (2016). Creating Access to Healthy, Affordable Food. Retrieved from http://apps.ams.usda.gov/fooddeserts/
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Wisconsin Department of Health Services. (2013). Checkout Healthy: A Wisconsin resource for healthier foods & beverages in food stores. Re trieved from https://www.dhs.wisconsin.gov/publications/p0/p00566.pdf Xu, J., Kenneth , D., Murphy, S., & Tejada-Vera, B. (2010). Deaths: Final Data for 2007. National Vital Statistics Reports. Zepeda, L. (2013). Measuring Effects Of Mobile Markets On Healthy Food Choices.
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