Alderson W, Brosius Lutz A, Craig D, Foo P, Howe M, Huynh G, Lonyai A, Macleod L, Sundberg M

1. Collective Roots at Stanford: A community-based approach to integrating food system change and health services provision in urban communities Alderson W, Brosius Lutz A, Craig D, Foo P, Howe M, Huynh G, Lonyai A, Macleod L, Sundberg M Population Health Project, Practice of Medicine Course Office of Community Health Stanford University School of Medicine Background Individual and community health are directly connected to the quality and accessibility of the food system. East Palo Alto (EPA) has a rich agricultural history, but economic and environmental challenges have negatively impacted the food system and the health of the community. East Palo Alto has not had a supermarket for over 20 years and the community has little opportunity to connect with the environment and their sources of food.  By engaging the community in food system change, this project aims to improve individual and community health and increase public knowledge and participation in food production and policy development. Multiple recent reports [1, 2, 3, 4] show that residents of EPA have a higher prevalence of childhood obesity and asthma compared to averages at the national or local level. Obesity and its associated chronic health outcomes have been observed to correlate with poverty. Community Partner Collective Roots is the organization sponsoring the development of a farmers’ market in the city of East Palo Alto. Collective Roots first began as a community garden club involving students, teachers and other members of the Menlo Park community [5]. The organization has since relocated to East Palo Alto and became a 501(c)(3) non-profit organization. Its projects have been expanded to include advocacy for food systems change within the city of East Palo Alto, which involves addressing the need for access to fresh fruits and vegetables. In May 2008 a farmers' market is expected to begin operation in the city of East Palo Alto. Located near St. Francis of Assisi Church on Bay Road, it is hoped that a farmers' market will help ameliorate the burden of finding fresh healthy foods in East Palo Alto. Collective Roots will maintain community sponsorship of the program, and funding will be provided through various grants, sponsorships, and endorsements [6]. • Recommendations • We recommend the following to CR and involved organizations. • Continue to add to online resource document. • Extract relevant (food-system related) health indicators for the interactive map. • Integrate food systems change education into school systems. • Formalize undergraduate student group. • Formalize community partners and schedule for Farmers' Market days. • Lessons Learned • Working with Wolfram Alderson and CR as community partners has been an instructive experience for us as medical students.  Over the past several months, we have: • Gained a deeper appreciation for the delicate balance between "helping" a community and taking advantage of that community for the purposes of study. • Had the opportunity to learn a great deal about the history of East Palo Alto and how to navigate through its complex array of stakeholders. • Observed firsthand that the health of individuals within any community is dependent on the effects of numerous elements.  • Thus, our experience working with CR has left us with a lasting appreciating for the needs of a community -- as the community frames these needs -- and the role of a physician and major university in offering support to community endeavors. • Acknowledgments We would like to thank the members of the CR organization, especially Wolfram Alderson, for their effort and attention in working with us and helping us complete our project goals. We would also like to thank our project advisor, LaVera Crawley, and the other population health faculty for their continuing guidance and feedback throughout the year. Finally, we would like to thank the members of the East Palo Alto community for their help in planning and participation in CR initiatives. • References • 1. Ruben Abrica and Health Profile Team, EPA Community Health Roundtable Discussion report - EPA Health Profile: A summary of the current understanding of Health in EPA. Accessed June 2007, • 2. National Center for Health Statistics, Prevalence of Overweight Among Children and Adolescnets: United States, 2003-2004. Accessed 12.6.07, http://www.cdc.gov/nchs/products/pubs/pubd/hestats/overweight/overwght_child_03.htm • 3. As described by Ruben Abrica Youth United for Community Action (YUCA) Health Survey Team, EPA Health Profile: A Summary of the Current Understanding of Health in EPA. • 4. Kwate, 2008. Fried chicken and fresh apples: Racial segregation as a fundamental cause of fast food density in black neighborhoods. Health and Place. 14, 32-44. • 5. Collective Roots History. Collective Roots Web Site. Available at: http://www.collectiveroots.org/about/history. • 6. Collective Roots. East Palo Alto community farmers' market is opening in spring 2008. Available at: http://www.collectiveroots.org/epafarmersmarket • Project Description • The overall goal of our project was to develop resources to support Collective Roots’ Food Systems Change Initiative in East Palo Alto. Our project was accomplished in four major activities: • Food resources map • Interactive farmers’ market literature review • Farmers’ market health programming schedule • Undergraduate involvement • Outcomes • Created a comprehensive review of the literature pertaining to farmers’ markets, health outcomes, and the implications for the East Palo Alto community. Collective Roots will use this to apply for funding and to plan future initiatives. • Created an interactive food system map of East Palo Alto and neighboring Belle Haven. This map shows the distribution and nature of food sources in EPA, contains informative health indicators, and can be used by Collective Roots and local residents to analyze the food systems of EPA. • Created a suggested plan for a year’s worth of health activity programming for the farmer’s market. This prioritized list of potential partners will be useful in scheduling events at upcoming farmers’ markets. • Began the creation of an undergraduate Collective Roots group at Stanford. Collective Roots works with many graduate groups every year, and an undergraduate group will provide, among other things, longevity and management to these connections. Leadership for this group has been recruited, and official filings for the group are underway.