Healthcare and Food Partnerships for Food Access and Security in Chicago and Cook County

1. Food Access/Security and Healthcare Partnerships Chicago and Suburban Cook County Genny Turner Illinois Public Health Institute Alliance for Health Equity September 2019

2. The Illinois Public Health Institute (IPHI) mobilizes stakeholders, catalyzes partnerships, and leads action to promote prevention and improve public health systems in order to maximize health, health equity and quality of life for the people of Illinois CENTER FOR POLICY AND PARTNERSHIP INITIATIVES CENTER FOR HEALTH INFORMATION TECHNOLOGY CENTER FOR COMMUNITY CAPACITY DEVELOPMENT

3. Alliance for Health Equity 37 hospitals in Chicago and Suburban Cook County Partnering with health departments and community partners Illinois Public Health Institute is the backbone organization Food workgroup co-chairs: Christopher Nolan, Rush; Lindsey Arenberg, Lurie Children’s; Emily Daniels, GCFD

5. Healthcare and Food Landscape ScanCollaborative Initiatives

6. Healthcare and Food Landscape Scan Objectives

7. Draft Food Access and Food Security Workgroup Program Planning Model Landscape Scan and Case Studies April-June 2018: Develop landscape scan methods for health & food partnerships March-May 2019: Develop at least 3 case studies April 2019: Present and discuss landscape scan data and case study findings July-Dec 2018: Alliance for Health Equity Food workgroup partners with Dr. Angela Odoms-Young & Sabira Taher on Landscape Scan Pillars for Healthcare and Food Partnerships February-May 2019: Discussions with health and food key informants in Chicago and Suburban Cook County (including this meeting!) 2019: Revised pillars, draft collective goals, track implementation strategies for individual institutions and for collective system of partners July 2018: Draft Pillars Tracking Outcomes and Impact Economic Development, including procurement May-June 2019: Agreement on initial shared metrics Ongoing: implementing and tracking shared metrics Policy Coordination with other collaboratives and partnerships

8. Don’t Blink This Photo by Unknown Author is licensed under CC BY-SA-NC

9. Healthcare and Food Landscape Scan 30 Respondents • Feed1st at the University of Chicago • Greater Chicago Food Depository • Grow Greater Englewood • Heartland Alliance Health • Hines VA Hospital Food Pantry • Lawndale Christian Health Center • MacNeal Hospital • Mercy Hospital and Medical Center • Norwegian American Hospital • PCC Community Wellness Center • Proviso Partners for Health • Rush University Medical Center • The Loretto Hospital • United Way of Metro Chicago • University of Chicago Medicine - Urban Health Initiative • Access Community Health Network • Advocate Trinity Hospital/Advocate Health Care • American Heart Association • AMITA Saints Mary and Elizabeth Medical Center • Ann & Robert H. Lurie Children's Hospital of Chicago and CLOCC • Chicago Botanic Garden-Windy City Harvest • Chicago Department of Public Health • Chicago Food Policy Action Council • Cook County Department of Public Health • Cook County Health • Enlace Chicago • Erie Family Health Centers • Evanston Health and Human Services • Experimental Station A LOT

10. Healthcare and Food Landscape Scan Information Collected • Organizational Information: Contact, location, organizational strategies • Program Information: • Name of program, location(s) of program, program start date, partners, organizational role in program, program funding, stage of program implementation • Motivation for starting program, program goals, • Components of program • Number served, eligibility requirements • Program marketing, program target audience • Who enrolls/refers participants, how documented • Evaluation metrics of program • Challenges and barriers A LOT • Additional information based on type of program: • Screening: • Vouchers • Nutrition Education • Food Distribution, • Food Waste/Surplus, • Food Procurement

11. Healthcare and Food Landscape Scan Partnerships A LOT (Additional Organizations listed as partners: Bickerdike Redevelopment Corporation; Casa Central; Erikson Center for Children and Families; Greater West Town Project; ICIRR; Lincoln Park Zoo; LUCHA; Openlands, Puerto Rican Cultural Center; RAGE; ReUse Depot; West Town Bikes; USDA/FINI; Wholesome Wave)

12. Healthcare and Food Landscape Scan Program Goals of “High” Importance Program Components Used Alongside Screening

13. Healthcare and Food Landscape Scan Program Components

14. Healthcare and Food Landscape Scan Evaluation and Metrics Among 25 programs that report “collecting information to evaluate the program”:

15. Healthcare and Food Landscape Scan Funding

16. Healthcare and Food Landscape Scan Challenges and Barriers Draft Framework/Categories for Challenges and Barriers, based on preliminary analysis of open-ended responses:

17. Challenges and Barriers – Some High-Level Themes

18. What Now This Photo by Unknown Author is licensed under CC BY

19. DRAFTDriver Diagram: Food Access/Food Security AIM & MEASURABLE GOALS STRATEGY AREAS PRIMARY DRIVERS KEY ISSUES to SOLVE Economic Economic Inequities • Long-term divestment in segregated communities • Inequities in income, wealth, and debt across communities and structural barriers to accessing capital for minority-owned businesses • Healthy food is unaffordable and/or unavailable in low-income communities of color, and relates to a concentration of fast-food businesses and corporate reluctance to establish grocery stores and retail businesses Policy Barriers • Introduction of public policies that discourage use of public benefits • Underfunding and inefficiencies of the public benefits system (SNAP, WIC, etc.) and programs that support food access in communities of high need • Outdated reimbursement models for organizations providing services Access Issues • Limited shared understanding of access, affordability and availability • Households eligible for benefits that are not enrolled • Lack of tailored interventions for specific populations (people with diabetes, older adults, working parents etc.) and communities (taking into account cultural differences, etc.) • Transportation barriers related to availability, accessibility, and reliability Capacity Limitations • Capacity of the healthcare system to promote food as medicine, and to implement, utilize and track consistent food insecurity screening and referral • Capacity of the emergency food system to provide healthy foods, nutrition education, and track service utilization Economic development programs for local food businesses Economic equity (Social determinants of health) Engagement of healthcare providers and institutions in local/regional food systems and food justice initiatives Healthcare and corporate procurement strategies Policy AIM: A sustainable, just food system with equitable access to the foods needed for good health Public policies to: • Encourage local healthy food businesses and distribution • Establish strong public benefits systems with adequate funding • Allow for reliable funding of programs and reimbursement through the healthcare system Public policy and funding Institutional policies that increase patient, staff, and community access to healthy foods Relevance to local context and culture through community-driven solutions GOALS: to be added Equitable Access Screen, Refer, Partner: • Direct partnerships between healthcare orgs & healthy food access points (food pantries, farms, local food businesses, schools, etc.) • Reliable and consistent screening tools, processes, and staff capacity • Data systems that allow for closed loop referrals and tracking of service utilization Access to healthy foods and food security in communities Development or expansion of tailored food access programs for specific populations Patient and community voice in planning and implementation Consumption of healthy foods Data and Evaluation: • Common definitions and metrics to understand and measure individual and community food security • Measure impact across initiatives

20. Food Access Workgroup Action Agenda Economic Entrepreneurship for healthy food: Share best practices from healthcare partnerships supporting community entrepreneurship to launch and run local food businesses Food-related minority-owned businesses (MBEs): training, capacity building, certification, opportunities to connect to food distribution networks Procurement: Explore strategic coordination across Chicago Anchors for a Strong Economy (CASE) and CFPAC for procurement strategies to support local food businesses Policy Develop a shared policy agenda across food access and healthcare partners Screen, Refer, Partner Healthcare Orgs: At least X healthcare organizations across Chicago/Cook County screen patients for food insecurity, including the following core components of screening and referral. Other Food Orgs/Businesses: At least X food access points (food pantries, farms, local food businesses, schools etc.) have an established healthy food partnership with healthcare organization(s), including core components of food provision. Support community-driven solutions Develop an aligned or interconnected referral system across Chicago/Cook County Scale VeggieRx programs to serve more Cook County communities & engage more local growers Develop & disseminate a training curriculum/materials for food insecurity screening & referral Develop structures for shared learning and for communicating innovations

21. MY Lessons Learned • Community Voice is VITAL as the air you breathe • Share the Burden-Share the Reward • Collective Impact is the KEY to moving the needle forward • Go Big-Go Small (rinse and repeat) • Always be thinking of what’s the next step • Aim High- Try to work yourself out of job

22. Contact Information • Genny Turner • Illinois Public Health Institute • Genny.Turner@iphionline.org • 312-786-5356 • Illinois Public Health Institute • www.iphionline.org • Alliance for Health Equity • www.allhealthequity.org