DNPAO August Teleconference/Webinar August 11, 2011

1. DNPAO August Teleconference/WebinarAugust 11, 2011

2. DNPAO Online Training Calendar

3. DNPAO Online Training Calendar

4. DNPAO Online Training Calendar

5. 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

6. Healthier Food Retail: Guidance Products from the Centers for Disease Control and Prevention Leah Maynard, PhD Amy Lowry, MPA Sonia Kim, PhD Demia Wright, MPH Division of Nutrition, Physical Activity, and Obesity Centers for Disease Control and Prevention August 11, 2011

7. 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)

8. Healthier Food Retail Products • Assessment Brief • Legislative Document • Action Guide

9. Healthier Food Retail: Beginning the Assessment Process in Your State or Community

10. 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.

11. Level of Data • County Level • ZIP Code Level • Block, Block Group, and Tract Level • Address (Geocoded) Level

12. Considerations for Level of Data • Size of Geographic Unit • Boundaries of Geographic Unit • Use for State or Community Assessments

13. 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

14. Commercial Data Sets • Dun & Bradstreet, Inc • InfoUSA, Inc • National Establishment Time Series • TD Linx

15. 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.

16. 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

17. 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

18. 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

19. State and Community Examples • Illinois • Louisiana • Washington • NYC, New York • Baltimore, Maryland

20. State Legislation Supporting Healthier Food Retail: An Overview of the National Landscape

21. 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.

22. legislative Analysis: Bill Coding Procedures

23. 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 : • Enacted between January 2001-January 2011 • 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

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

25. 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: • Enacted between January 2004- December 31, 2009 • Used pre-defined search strings • “Supermarket/Food Access ” *NCSL Healthy Community Design Legislative Database: http://www.ncsl.org/?tabid=13227

26. 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.

27. 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.

28. 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

29. 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

30. Legislative Analysis • Phase III: Bill Coding • Coded key elements of enacted HFR Legislation • Low-income or Underserved component • Report or Evaluation Required • Implementing organization

32. 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.

33. Healthier Food Retail Legislation in States Dist. Columbia Enacted legislation Did not pass or pending legislation Did not introduce legislation

34. 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.

35. 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.

36. 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.

37. 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.

38. Action Steps: Evaluate HFR Initiatives • Evaluate public health impacts of healthier food retail legislation and initiatives.

39. 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.

40. 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

41. Healthier Food Retail Action Guide

42. 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.

43. 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

44. Outline of Action Guide • Introduction • Planning the Approach • Assessment • Partnership • Planning and Prioritization • Strategies • Grocery Store Development • Small Store Initiatives • Farmers Markets • Mobile Vending

45. Outline of Action Guide (continued) • Rounding the Approach • Transportation • Distribution • Evaluation

46. 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

47. For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE, Atlanta, GA 30333 Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348 E-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