Friday, November 22, 2024
11/22/2024
Stockton is the San Joaquin County, California, county seat and its most populous city. The city is home to approximately 33,000 African Americans: 11% of the population yet 37% of those living in poverty. Here as elsewhere, African Americans create fellowship after church with Sunday dinners of sweet tea, fried chicken, and peach cobbler. Passed down through generations, these habits compound poor health outcomes that come from limited access to nutritious foods, beverages, and physical activity, contributing to disproportionate rates of chronic illnesses. Diabetes and obesity are the top health concerns in the county’s 2016 Community Health Needs Assessment. In Stockton, 45% of African American adults are obese compared with 40% of white Stockton adults and 26% of white adults statewide. More than half (54%) of Stockton adults have either diabetes (9%) or prediabetes (45%); diabetes rates for African Americans are estimated to be 50% higher. Key to rectifying these disparities is removing barriers to healthy eating and physical activity in low-income African American neighborhoods and addressing their underlying causes, including adverse childhood experiences (ACEs) and trauma. With a 2014 four-year CDC-REACH grant, Public Health Advocates’ Within Our Reach (WOR) project began to work with African American faith- and community-based organizations (F/CBOs) to cultivate environments that promote healthy food and activity choices. WOR’s overarching goal is to reverse health disparities by reducing the incidence of obesity, diabetes, and related chronic illnesses in Stockton’s African American community. Implementing guidelines promoting nutritious food, water as the default beverage, and the integration of physical activity into daily life—augmented by pulpit messaging and educational campaigns—the project began to shift the culture to make healthy behaviors the norm where people work, play, and worship. Using a policy, systems, and environmental strategy, WOR assessed the health climate of F/CBOs, then worked with leadership and members to adopt and implement the healthy guidelines. Through incremental changes, WOR supported a transformation of churches and CBOs into environments that are “healthy by default.” WOR proved remarkably successful, with organizational policy change and education together prompting measurable behavior change: the proportion of congregants touched by WOR who reporting drinking water daily increased from 86% to 96%; and daily fruit consumption increased from 41% to 58% over three years. To reinforce these changes, WOR worked with African American residents and city officials and staff to include substantive health policies in the City of Stockton’s 2040 General Plan Update. As a result, community health was named a priority and the city included a health element with policies consistent with community priorities. Building on PHAdvocates’ success and the deep community relationships we have cultivated, we are poised to increase WOR’s impact in four important ways: (1) support additional congregations to implement previously adopted physical activity, nutrition, and breastfeeding guidelines; (2) work with new F/CBOs to adopt and implement guidelines addressing trauma and ACEs; (3) train residents to advocate for implementation of health policies in Stockton’s General Plan Update and for using CA Prop 68 Park Bond funding in park poor neighborhoods; (4) train resource liaisons to link residents to evidence-based tools and resources and create resource hubs to build resilience. The proposed project will expand and spread our successful model by continuing our work with F/CBOs serving Stockton’s low-income African American residents to create environments that are healthy by default.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).
