by SHANICE BIBBS
Roosevelt is a 1.8 square mile hamlet on the South Shore of Nassau County with 16,258 residents – rich in diversity, cultural and social assets – a “small town” feel based on physical proximity between homes, schools, businesses; an appreciation of its multicultural nature; new school buildings and a new library; and a youth run farmer’s market (Photovoice Project, 2015; Hofstra University, Roosevelt Community Revitalization Group).
Yet, Roosevelt is also a community with a significant number of children and families facing health disparities. According to the New York State Department of Health (Nassau County Department of Health “Community Health Assessment 2014-2017) over 40% of Roosevelt elementary children are “overweight or obese.”
This statistic is also true for many underserved communities in Nassau County that neighbor Roosevelt. In addition, a research study conducted by Hofstra University and Nassau University Medical Center that close to 60% of Roosevelt Middle School children were either “overweight or obese” (2011) – citing lack of physical spaces, physical inactivity and access to healthy food options, particularly in the corner stores, as some of the root causes. With these rates being significantly higher than overall obesity rates in Nassau County, this represents an urgent call for change in improving health outcomes lead by residents.
The health-related needs of the Roosevelt community were identified and were presented at two community meetings in 2017 (one held in English and one in Spanish) by Choice For All and the Long Island Community Academic Research Partnership (LICARP). The topics that was considered the most significant were voted on using a mobile based polling application and facilitated table feedback. A need that was selected for action was “lack of healthy food choices” within Roosevelt, especially as Roosevelt is designated as a “food desert” area.
WHAT IS A FOOD DESERT?
The United States Department of Agriculture (USDA) has declared Roosevelt as a food desert – an underserved community vapid of fresh fruits, vegetables and other healthful foods due to lack of grocery stores, farmers’ markets and healthy food providers. Our one square mile community is home to 33 corner stores selling household items, supplies and food and a large fast food restaurant chain, McDonald’s to contribute to a lack of commercial tax base. Residents identified that the corner stores are a significant source for food purchases among community members of all ages, and particularly for youth and those who do not have access to a car.
Although the community has one supermarket, residents have grown concern about the access of options readily available.
BUILDING A CALL TO ACTION
At a follow-up community meeting in 2017 led by Choice for All and LICARP, a vision statement and call to action was developed and approved by community members: “All community members have access to healthy nutritious food which they can afford to buy and have the information and skills needed to eat a healthy diet.” The vision statement led Choice and its partners to develop more collaborative spaces of residents, non-profits, health systems, businesses and government to come together to address the consequences of a food desert impacting our community. Inspired by The Food Trust, Choice for All formed a partnership table known as the Roosevelt Healthy Corner Store Network.
The Roosevelt Health Corner Store Network (RHCSN)’s is a coalition and membership network that includes Western Suffolk BOCES, Cohen Children’s Medical Center at Northwell Health, Cornell University – Cooperative Extension Nassau County, Roosevelt Union Free School District with Ulysses Byas Elementary School and Hofstra University. The intent is bold – to reduce obesity and hunger by increasing healthy food access in our corner stores.
The network has four charges that will serve as our compass for all of the network activities: 1) increase access to fruits and vegetables at affordable prices; 2) increase visibility of healthy food and snacks through education and health promotion; 3) improve internal and external appearance of corner stores in Roosevelt and 4) bridge relationships with corner store owners through capacity building and technical assistance.
The network is funded by the Long Island Community Foundation, Kohl’s and New York State Department of Health’s Creating Healthy Schools and Healthy Communities Initiative with Western Suffolk BOCES. The network is led by a team of community health workers at Choice for All, including myself, Dana Faison, Patrice Peterson and Olga Gomez. We were all trained by Northwell Health through “From the Community, For the Community” community health worker program .
The purpose of the program is to build capacity as a community health worker in providing holistic care coordinator in underserved communities and have a background in public health, psychology, mental health, and business management. Our team at Choice For All is unique where three of the four team members reside and live in Roosevelt, therefore being familiar with the community assets and needs.
STORE OWNERS & COMMUNITY RESIDENTS LEADING THE CHANGE
Although the corner stores bring convenience and affordability to residents, there is a lack of healthy food options from a majority of the corner stores from a preliminary assessment conducted by Choice for All. In addition, some corner stores have oversaturated their stores with exterior and interior advertisements related to smoking, alcohol beverages and gambling.
In response, parents of students from our Student Success Center and other community leaders identified three new strategies that will increase healthy food options while increasing business to the corner store. The strategies include: 1) adding fruits and vegetables to the corner store, 2) placing water at eye level for the customers and 3) displaying advertisements, integrally and externally, that promotes healthy eating habits and nutritional education. For each strategy that is fully implemented, an incentive in cash form, gift card or needed equipment will be provided.
PILOT PROJECT - STOP 'N GO AND MIDWAY DELI
During the recruitment process of the corner stores, the community health workers visited all thirty- three corner stores in Roosevelt to encourage their participation.
With a bold goal of ten corner stores, we visited each corner store for a minimum three times. With a low response in the beginning, we strategized to involve more community members as our Health Advocates. As a result, we were able to obtain at least one large corner store on each of the highly-traffic roadways in Roosevelt – Stop & Go on Babylon Turnpike and Midway Deli on Nassau Road in November 2018. As our first members, a community health worker worked with each one to develop a specific plan to improve healthy options, health promotion and revenue.
STOP 'N GO
With a new owner, Stop & Go has changed the layout of the store to provide more shelving to promote healthy produce with a refrigerated equipment with healthy fresh fruit and vegetables.
Since joining the corner store network, Stop & Go has introduced fruit salad to their menu of options, agreed to place water at eye level across their refrigerators and install new shelving and bottle dispensers for refrigerators.
Additionally, Stop & Go has signed on to be the first store in Roosevelt to introduce the “Lunch ‘n Learn’ coupon incentive program sponsored by Kohl’s and Cohen Children’s Medical Center at Northwell Health. The coupons, each valued at $7.00, will feature healthy items that are sold at Stop & Go in efforts to promote healthy food potions to the community. The event was launched in January 2019.
As one of the most frequented corner stores in the community, Midway Deli’s hot food buffet selection brings in an immense crowd as they are known for serving delicious, authentic Hispanic- cultured food to customers.
Since signing on to the network, Midway Deli has incorporated woven fruit baskets to store fruits and vegetables thanks to our partners at Cornell Cooperative, as well as, introduce grapes into the store’s menu. Midway Deli also is interested in adding healthy signage on refrigerators doors, above the fruit stand and on store shelves.
With a year-long planning and assessment process, along with two months of action with the corner stores, we have met some great strides thus far. Yet, we need additional support to ensure this project can reach its fullest potential as a strategy in building a health equity model in Roosevelt.
We are positioning our work with the University of Pennsylvania School of Medicine and Hofstra University to continue assessing the available options and continued impact of potential changed behaviors by the consumer in getting access to healthy food options.
Additionally, we believe this initiative is an economic driver in the Roosevelt community. For example, in North Carolina, “Healthy Food Small Retailer Act” was designed to increase fresh, healthy food access in corner stores and convenience stores with a designated fund to support this work with the goal of increasing healthy food sales, improving store offerings and promoting good nutrition.
The act calls for the state’s Department of Commerce, Department of Agriculture and Department of Health and Human Services to work in partnership to increase food options while reducing public medical care costs, particularly in areas designated as food desert zones. A similar effort should be applied in New York where communities across all zip codes can benefit from such a program.
By increasing access to healthy food options and increasing health education the initiative can reduce obesity, hypertension, high blood pressure, and other chronic illness that are related to unhealthy diets. As a result of the decrease of these chronic diseases, health care cost to manage these chronic illnesses will decrease. Individuals within the community will also reap the benefits of living in a healthy community, including, but not limited to, improved physical health, lower susceptibility to disease obtained by living unhealthy lifestyles, and increase of student engagement in school.