DNPAO August Teleconference/Webinar

August 11, 2011

DNPAO Online Training Calendar

DNPAO Online Training Calendar

DNPAO Online Training Calendar

Interactive Calendar includes:•DNPAO-coordinated calls and webinars•CPPW Communities Webinar Series•Other Organizations’ Obesity-Related Webinars

Search the Calendar•Find events using key words you enter

Archived Webinars•Selected organizations’ links to their archived training webinars

Where’s the Link?•Posted on the ARRA Listserve (on 8/8/2011)•Your DNPAO Project Officer can email it to you

DNPAO Online Training Calendar

Healthier Food Retail: Guidance Products from the Centers for Disease

Control and Prevention

Leah Maynard, PhDAmy Lowry, MPASonia Kim, PhD

Demia Wright, MPH

Division of Nutrition, Physical Activity, and ObesityCenters for Disease Control and Prevention

August 11, 2011

Rationale for Healthier Food Retail Strategies

People living near grocery stores tend to have healthier diets and lower levels of obesity.

Low income, rural, and minority communities have poor access to supermarkets and healthier foods.

Smaller stores often do not carry healthier foods because of limited space and equipment, or cost of obtaining healthier food.

(Larson, et al. 2009; Morland, et al. 2002; Rose and Richards, 2004; Morland and Evenson, 2009; Powell, et al. 2007; USDA 2009; Kaufman, et al. 1997; Neckerman, et al. 2010; Sharkey and Horel, 2008)

Healthier Food Retail Products

Assessment Brief

Legislative Document

Action Guide

HEALTHIER FOOD RETAIL: BEGINNING

THE ASSESSMENT PROCESS IN YOUR STATE OR

COMMUNITY

Purpose and Audience

Provides an overview of steps that public health practitioners can take to assess retail food environment.

Can use to understand the current landscape and differences in accessibility to healthier foods.

Level of Data

County Level

ZIP Code Level

Block, Block Group, and Tract Level

Address (Geocoded) Level

Considerations for Level of Data

Size of Geographic Unit

Boundaries of Geographic Unit

Use for State or Community Assessments

Public Data Sets

USDA Food Atlas County level

County Health Rankings County level

The Reinvestment Fund Policy Map Block group level

US Census Bureau’s County and ZIP Code Business Patterns ZIP Code, County, Metropolitan, Micropolitan level

USDA Agriculture Marketing Service Geocoded level

Commercial Data Sets

Dun & Bradstreet, Inc

InfoUSA, Inc

National Establishment Time Series

TD Linx

Considerations For Using Data Sets

Commercial datasets may be prohibitively expensive.

Commercial datasets are proprietary.

Public and commercial datasets can have a lag time.

Public and commercial datasets can have data validity concerns.

Other Sources for Data

State or local departments of health or agriculture

WIC and SNAP

USDA Food Desert Web Site

NCCOR Catalog of Surveillance Systems

Geographic Information System (GIS) Mapping

Work with partners City or county planning offices Universities (particularly urban planning or agriculture

departments) State departments of health or agriculture

Consider Software Consider Map Features

Geographic boundaries Geographic features

In-store Assessments of Availability, Cost, and Quality

Market basket audits NEMS USDA/ERS Food Store

Survey

Linear shelf space

Store owner survey or interview

State and Community Examples

Illinois

Louisiana

Washington

NYC, New York

Baltimore, Maryland

STATE LEGISLATION SUPPORTING HEALTHIER FOOD RETAIL: AN OVERVIEW OF THE NATIONAL LANDSCAPE

Purpose and Audience

Provides public health practitioners with information about the characteristics of healthier food retail legislation.

Provides action steps and resources that public health practitioners can use to support healthier food retail initiatives.

LEGISLATIVE ANALYSIS: BILL CODING PROCEDURES

Bill Search

Primary Data Sources: DNPAO’s newly updated database of State Legislative

and Regulatory Action to Prevent Obesity and Improve Nutrition and Physical Activity (SLRA)

• Database search criteria for HFR legislation :o Enacted between January 2001-January 2011o SLRA’s pre-defined search strings:

• “Grocery store/Food Markets”• “Access to Healthy Foods”

*CDC’s State Legislative and Regulatory Action to Prevent Obesity and Improve Nutrition and Physical Activity: http://apps.nccd.cdc.gov/DNPALeg/index.asp

Bill Search

*CDC’s State Legislative and Regulatory Action to Prevent Obesity: http://apps.nccd.cdc.gov/DNPALeg/index.asp

Bill Search

Primary Data Sources: National Conference of State Legislatures, Healthy

Community Design and Access to Healthy Food Legislative Database

• Database search criteria for HFR legislation:o Enacted between January 2004- December 31, 2009o Used pre-defined search strings

• “Supermarket/Food Access ”

*NCSL Healthy Community Design Legislative Database: http://www.ncsl.org/?tabid=13227

Legislative Analysis

Phase I: Bill Relevancy Review

The project team read all bill abstracts included in the legislative databases.

The full text of bills were retrieved from the states legislative webpage.

The project team read each bill to ensure it met pre-defined Healthier food retail criteria.

Legislative Analysis

A bill was included in the analysis if it addressed any of the following Healthier Food Retail criteria:

• building or placement of new or expansion of existing food retail outlets;

• renovation or equipment upgrades of existing food retail outlets;

• increases in the stocking or promotion of foods encouraged by the 2005 Dietary Guidelines for Americans; or

• the examination of healthier food access.

Legislative Analysis

Phase II: Bill Coding Tool Development

The project team coded key elements of enacted HFR Legislation:

• Most common components included in HFR bills• Most likely to impact access to healthy foods and economic

development• Most useful to stakeholders working on HFR initiatives

Legislative Analysis

Phase III: Bill Coding Coded key elements of enacted HFR Legislation:

• General info: state; bill & law citation; year of introduction

• Focus of bill: pilot program; program or initiative; task force or advisory committee; appropriations

• Type of retail: small or corner store; grocery store/supermarket

• Financial or other incentive: tax incentive; grants; low interest loans

• Type of projects or costs: Store building / construction; store renovation; Equipment and furnishings; Land acquisition / assembly

Legislative Analysis

Phase III: Bill Coding

Coded key elements of enacted HFR Legislation• Low-income or Underserved component

• Report or Evaluation Required

• Implementing organization

Category Explanation of Bill Coding

Focus The overarching focus or action of the bill as related to healthier food retail.

Task Force / Advisory Committee * – The bill establishes a task force, advisory committee, or other official committee; or directs the activities of such bodies.Appropriations** – The bill authorizes the expenditure of money and denotes the dollar amount appropriated. Program or Initiative – The bill establishes a program or initiative, including tax incentives.Pilot Program – The bill establishes an activity planned as a test or trial.* For Task force/Advisory Committee bills, only the categories “Low-income or Underserved Component” and “Report or Evaluation Required” were coded.

** Appropriations included in this table represent only monies stipulated in the actual bill language. This does not represent an exhaustive search of budget bills and General Appropriations Acts.

Type of Retail Type of retail establishment specifically listed in the bill.

Grocery/supermarket – “Grocery”, “supermarket”, “market” or “retail” is specified in bill text.Small or Corner store – “Small grocery”, “small”, “corner”, or “convenience” store is specified in bill text.Farmers Markets – “Farmers Markets” is specified in bill text.Other – Other types of retail establishments is specified in bill text.

Findings from Healthier Food Retail Legislation in States

Based on our analysis, healthier food retail legislation in the last decade has generally:

Established a legislative task force or advisory panel

Provided financial assistance or other type(s) of incentives to attract healthier food retail outlets to underserved areas or to improve healthier food offerings in existing stores.

Healthier Food Retail Legislation in States

Dist. Columbia

Enacted legislationDid not pass or pending legislationDid not introduce legislation

Action Steps

Action steps are based on core competencies identified by HPEC. Collect, analyze and present data Work with partners Develop or suggest strategies Evaluate HFR initiatives

Consult legal counsel before engaging in healthier food retail initiatives.

Action Steps: Collect, Analyze, and Present Data

Identify communities that lack access to healthier food retail.

Prepare reports, fact sheets, and other materials that demonstrate the need to improve the food environment.

Collect data that demonstrates co-benefits of HFR initiatives to multiple partners.

When invited, present health data or information at Committee Hearings or other venues.

Consult subject matter experts.

Action Steps: Work with Partners

Convene stakeholders and partners, or become a member of an existing coalition.

Collaborate with non-traditional partners.

Once healthier food retail legislation has been passed, work with the implementing agency to ensure public health goals are addressed.

Action Steps: Develop or Suggest Strategies

Consider strategies that are feasible.

Determine if existing state policies or programs have similar or overlapping goals with HFR initiatives.

Develop education and communication strategies to frame key messages.

Action Steps: Evaluate HFR Initiatives

Evaluate public health impacts of healthier food retail legislation and initiatives.

Resources

State Legislative Search Guide (Washington University in St. Louis)

CDC’s State Indicator Reports Children’s Food Environment Fruit and Vegetable

USDA Food Desert Locator Food Desert Web Page

Directors of Health Promotion and Education Public Health Solutions through Changes in Policies, Systems,

and the Built Environment: Specialized Competencies for the Public Health Workforce.

Resources (continued)

The Food Trust Pennsylvania Fresh Food Financing Initiative

Policy Link Improving Access to Healthy Food Equitable Development Toolkit: Healthy Food Retailing

Robert Wood Johnson Foundation Reversing the Trend in Childhood Obesity: Policies to

Promote Healthy Kids and Communities

HEALTHIER FOOD RETAIL ACTION GUIDE

Purpose

Will provide guidance for state health department staff on how to develop and implement policies, initiatives, or other activities around food retail

Will address increased consumption of healthier foods through access and availability strategies.

Will address health equity/health disparities through focus on work in underserved areas.

Audience

State health department employees working in nutrition and obesity prevention

State health department employees working in chronic disease prevention, partnership development, and other relevant areas

• State-level partners and local public health practitioners

Outline of Action Guide

Introduction

Planning the Approach Assessment Partnership Planning and Prioritization

Strategies Grocery Store Development Small Store Initiatives Farmers Markets Mobile Vending

Outline of Action Guide (continued)

Rounding the Approach Transportation Distribution Evaluation

Acknowledgements

Assessment Brief Latetia Moore, PhD (CDC) Amy Auchincloss, PhD (Drexel University)

Legislative Analysis Kathy Golson (Texas Department of Agriculture) Kathryn Parker-Karst (Tulane Prevention Research Center) George Manalo-LeClair (California Food Policy Advocates)

Action Guide Personnel from various state health departments Subject matter experts from various universities and organizations

For more information please contact Centers for Disease Control and Prevention

1600 Clifton Road NE, Atlanta, GA 30333Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348E-mail: cdcinfo@cdc.gov Web: http://www.cdc.gov

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

National Center for Chronic Disease Prevention and Health Promotion