Upstream Public Health Dr. Tia Henderson Research Coordinator

1. Upstream Public HealthDr. Tia Henderson Research Coordinator Health Impact AssessmentHB 2800: Farm to School and School Gardens Funding Health Impact Project, a collaboration between PEW Charitable Trusts and the Robert Wood Johnson Foundation & Northwest Health Foundation *Opinions expressed here do not reflect those of the funders

2. Overview • HB 2800 HIA • Participation • Policy and HIA separation • Communication • HIA finding examples

3. HB 2800 Components Reimbursement @ $19.58 million Schools buy Oregon foods with 15 cents for lunch and 7 cents for breakfast Part of National Lunch and Breakfast Programs Federal matching funds 2% ODE administration funds Food, Garden, Agriculture Education Grants @ $3 million Support food, garden and agriculture-based activities Support gardens in schools

4. HB 2800 Components & HIA Scope:Health Determinant Pathways

5. Participation Screening Scoping Assessment Recommendations Two Advisory Committees: 30+ Expert Advisors Community Forums: 100+ Citizens Umatilla (Rural) Eugene (Urban) Reporting Monitoring & Evaluation

6. Lesson Learned: Separate Research from Direct Policy Advocacy & Involve Experts Policy Advocacy Team HIA Research Team Upstream Public Health – Health Advocacy Organization • Co-Director & Campaign Manager Roles: • Connect to coalition • Explain HIA findings to legislators • Explain policy recommendations to legislators • Research Coordinator & Co-Director, Committee members Roles: • Collect data & community information • Convene community members and advisors • Connect to coalition • Inform Policy Advocacy Team • Develop DRAFT policy recommendations

7. Connect and Separate Upstream Public Health Human Impact Partners

8. HIA Practice and HIA Communication F2SSG HIA Goals Communication Goals • Inform Oregon legislature decision making process. • Outline linkages & magnitude of interactions between the policy and health outcomes • Inform agency work plans. • Inform regional institutional procurement efforts. • Create model F2SSG policy HIA. • Share findings with legislators • Share findings with relevant Oregon F2SSG stakeholders • Share findings with relevant HIA stakeholders • Increase desire for people to READ about the health and policy linkages

9. Lesson Learned: Legislative Testimony is Part of Communications Strategy • Why HIA? • Basics of HB 2800 • Relevance to their constituents • Current employment conditions • Current poverty and health conditions • Impact of HB 2800 from HIA predictions… • General Advocate Message: You can make people’s lives better with this bill • HIA Message: Here are specific health outcomes you will affect Upstream Public Health Human Impact Partners

10. Testimony ExcerptEmployment - Findings • HB 2800 IMPACT: •  Life span •  Mental/physical health issues Mental health, life span, chronic disease Jobs

12. Testimony ExcerptDiet and Nutrition Food Insecurity School Meal Programs Student Learning, Achievement and Educational Attainment HB 2800 IMPACT: •  Promotion and use of Oregon products •  Meal participation •  Positive behavior, learning, cognitive development and educational attainment •  food insecurity for families with children

14. Testimony ExcerptFarm to School and School Garden K-12 Education Farm to School and School Garden Programs: 3 Core Elements Procurement – Buying Oregon food Promotion – Promoting Oregon food Education – Gardening, Food and Agriculture-based Activities Farm to School & School Garden Programs: 2010: ~ 50% of SD’s bought local (ODE) 2007: 75 school districts had active gardens (ODE) HB 2800 IMPACT: •  SD purchase of Oregon products • 150 new gardens

15. Testimony ExcerptFarm to School and School Garden K-12 Education HB 2800 IMPACT: •  Offerings of fruits and vegetables •  Child preferences for fruits and veggies •  Child consumption of fruits and veggies •  Physical activity, positive class behaviors •  Overweight and obesity •  Knowledge, learning, academic achievement Child Learning Outcomes, Physical Activity Child Self-Efficacy – Belief they can accomplish their goals Child Diet and Nutrition Overweight and Obesity (1 in 4 kids overweight, 2009 OHTS) Image from Samuel Mann

17. Upstream Public Health Human Impact Partners

18. Testimony ExcerptHIA Policy Recommendations To increase positive job growth and food security: #1 Modify the eligible items for reimbursement program to “produced” or “processed” To increase child nutrition, food security, and student learning: # 2 Education Grants – prioritize schools serving: • Low income populations or • Ethnically and culturally diverse student populations or • Food insecure areas #3 Education Grants – prioritize schools developing multi-component programs Procurement Promotion Education Community Support ** All of #1, ½ of #2 and all of #3 were included in the amended version of HB 2800

19. Policy Recommendations – Committee and Community Input Beginning: Policy – 3 Operations – 5 Committees: Refine and expand Community Forums: Refine/add and prioritize Final (Prioritized): Policy – 3 (expanded details) Operations – 10 Upstream Public Health

20. Communication Workshop: Training Stakeholders • Communication Exercise Example (From Metropolitan Group) • Breakout into groups by target audience

21. Example Message Results HIA Messages F2SSG Messages Value: If we want to live healthful lives, we need to be able to make healthy choices. Barrier: Too often health isn’t factored into all of the decisions policy-makers are making or it might not always seem relevant. Outcome: HIA provides policy-makers with objective data they need to consider health in decisions, and increase our access to healthy options Value: Healthy kids; strong communities. Barrier: In tough economic times, our state legislature has to make choices. Outcome: This HIA shows Farm to School programs and school gardens lead to: more jobs, kids eating more fruits and vegetables, and a stronger local economy. Upstream Public Health

22. Summary Lessons Learned • HIA Communications includes • Community participants • Existing advocacy efforts (e.g. coalitions) • Legislative testimony • Separating policy advocacy from HIA research maintains integrity • Build relationships with advocates AND legislators • Inform community members, advocates and legislators Upstream Public Health Human Impact Partners

23. Sources and Abbreviations WHO = World Health Organization ODE = Oregon Department of Education OHTS = Oregon Healthy Teens Survey ACS = American Community Survey (Part of the Census Bureau) USDA ERS = United States Department of Agriculture, Economic Research Service OLMIS = Oregon Labor Market Information System (From Oregon Employment Department) Grussing, J. and Edwards, M. 2006, Non-Metropolitan Hunger and Food Insecurity In the Northwest, Rural Studies Program Working Paper Series, RSP 06-02 Jin et al., 1995. The impact of unemployment on health: A review of the evidence. Canadian Medical Association Journal, 153(5), 529-540.