County Project To Provide Access To Healthy Lifestyles

San Diego, with it's wonderful weather, would seem to be the ideal place for people to be out and about living a healthy lifestyle. But apparently a high percentage of San Diegans suffer from obesity and it's a serious health problem for the community.

San Diego landed a major federal grant to combat obesity - in fact, at $16 million, it was the largest grant handed out in 2009 to combat obesity part of the federal stimulus funding.

Sounds like the perfect opportunity to turn a problem into an opportunity. A program called "Healthy Works" was launched - and it's time to see what's become of all that money - is it making a difference to our community?

Guests

Tracy Delaney, project director for San Diego County's Health and Human Services Department

Dr. Wilma Wooten, San Diego County Public Health Officer

Read Transcript

ST. JOHN: You're listening to These Days on KPBS, I'm Alyson St. John in for Maureen Cavanaugh. San Diego with its wonderful weather would seem to be the ideal place for people to be out and about living a healthy lifestyle, but apparently a high percentage of San Diegans suffer from obesity, and it's a serious health problem for the community. San Diego County landed a major federal grant to combat obesity, and backed at 16 million, it was the largest grant handed out in 2009 to combat obesity in federal stimulus funding. Sounds like the perfect opportunity to turn a problem into an opportunity. A program called Healthy Works was launched, and it's time to see what's become of all that money, is it making a difference to our community. So here to tell us more are my guests doctor Wilma Wooten, the public health director for San Diego County, thanks for coming in, Wilma.

WOOTEN: Thank you for having me.

ST. JOHN: And Michelle -- I beg your pardon. Tracy Delaney, project director for San Diego County's department of Health and Human Services.

DELANEY: Hi.

ST. JOHN: Good morning. We'd also love to hear from you, if you have any questions, suggestions, comments, you can call us at 1-888-895-5727. So let's start with you, Wilma. Why is San Diego the biggest recipient of this grant in the nation? Was there something this we have more of these people anywhere else? That seems unlikely.

WOOTEN: Not because we have the largest prevalence of obesity, but because of the foundation, infrastructure that we had already in place. This particular grant was just for two years and we had to have certain relationships in place so that we could hit the ground running once the award was given. So the county has a great private partner -- public private partnerships in place, including our childhood obesity initiative that has been -- actually this is our 5th year anniversary for that initiative. We also had a chronic disease agenda that had been in existence for the past two years, and the board of supervisors passed a nutrition security plan in 2008 as well. So with those three components -- and they also fed into an overall larger strategic initiative that the county has recently implemented, which is live well San Diego, the first leg or component of that being our building better healthy initiative. So with all of that in place, if really paved the way and showed that we had a strong foundation for kicking this off. And also a strong foundation and relationships with our office of education, UCSD, and San Diego state.

ST. JOHN: So two-year grant. So you got the first money, what? Last year, and this year, is this going to be spread 16 million over two years?

WOOTEN: That is correct. 16 million over two years. When it was awarded, we had to be up and going in 90 days, so again, the relationships that we forged with UCSD, the office of education, and San Diego state, we had to be able to implement those contracts within 90 days. So they were also governmental entities, and it allowed us to do that.

ST. JOHN: And this year, I guess, San Diego association of governments also is one of your partners.

WOOTEN: Exactly. SANDAG is the fourth partner, that's correct.

ST. JOHN: A new one. So do we know exactly what obesity costs us? Our public health here in San Diego, is that a question that you have an answer for.

WOOTEN: Well, actually obesity related medical spending costs in the nation are about $147,000,000,000 each year. In San Diego we are -- are faced with the same task, or problem of escalating costs associated with obesity and other chronic diseases. We are focusing through the CPPW, we are focussing on the 3450 principle, three behaviors that contribute to chronic diseases that account for over 57 percent of death or mortality in San Diego. And that costs us about $4 billion a year.

ST. JOHN: Whoa. When you look at it in those terms, perhaps it makes sense, throwing $16 million at this. Yeah. So Tracy, there have been obesity programs already. We've just heard about some of them, how is this program different? Are you doing anything new that you're never done before?

DELANEY: We are taking things into new territory. I would say that we have three basic focus areas that we're working on. One is the neighborhood, and looking at increasing physical activity through the neighborhood, and we're building on things that we have done, but we're really taking it to the next level. We're also doing quite a bit of work in terms of access to healthy nutrition, and there's many types of activity that we have along those line, and then the third kind of key corner stone to this is working with our schools.

ST. JOHN: Okay. So, now, access to nutrition, that, I guess, is the thing. You would have thought that healthy food is available everywhere issue it's more a matter of changing people's habits, as to what they would buy rather than making them more accessible. But is it true to say that in some places healthy foods are not that accessible?

DELANEY: Exactly, and I think that's kind of the change in the focus that we're looking at in this grant, is that we really need to look at the neighborhoods and what's accessible. So that we can make the healthy choice the easy choice. In some neighborhoods there are not grocery stores. So it's difficult to get fresh produce. A lot of neighborhoods, if you're trying to walk to school, you may not actually have sidewalks. So that it's actually the focus here, which is a bit unusual, is focusing on the actual environment, and to make those choices easy for folks. As far as the food, one of the other interesting things is that the people may not know is that San Diego County has more farms than any other county in the nation. We have over 6000 farmers, but yet we do not have a central food hub. All the food that we grow here locally gets shipped up to Los Angeles, aggregated, and then comes back down here to San Diego. So we're not getting the freshest produce that we could, we are not really supporting and working with the local economy for the farmers, and our residents aren't getting the freshest produce that they could. So this is one of the over all projects that we're actually looking at, is a regional food system, and having a local food hub here in San Diego.

ST. JOHN: That's interesting. I mean, I've -- I'm aware there's a lot of farms in San Diego. What progress are you making to get a regional food hub here?

DELANEY: Well, we're making quite a bit of progress, we're doing assessments at this point trying to identify sites, both one that would be an aggregation site in North County, which is where most of the farms are located, and then us having a central hub here which would be a distribution to most of our neighborhoods.

ST. JOHN: What kind of sites are you coming up with?

DELANEY: Those right no, we're talking with the real estate people, and we don't have that settled yet. But that is part of what the economic report is looking at. I think what's of particular interest in this is the new relationships that we've forged in this discussion. And a lot of that is now that we're working with the farmers and different be institutions to directly bring that produce into schools, into work places, and into hospitals. And one of the kind of exciting things that we have going on that's through the healthy works project is having farmers actually connect with those schools, and have a harvest of the month. And something that we did just last month was over 8000 pounds of broccoli came to the schools through Suzie's farms.

ST. JOHN: So you've got the broccoli coming to the school, is it being eaten?

DELANEY: It's being eaten, yes. And not only that, it's really changing the relationship that the students have in terms of understanding where does food come from, and who grows it. And we're actually creating almost a celebrity group with these farmers, because they come and meet the kids, they understand who's actually growing their food, and we've created even farmer trading cards so that the kids can see who is that farmer that's growing the food that you're eating.

ST. JOHN: Interesting, farmer, trading cards. So you mean this is hike a new game that you're introducing?

DELANEY: It's like baseball cards.

ST. JOHN: And this is being done with the county board of education?

DELANEY: Yes.

ST. JOHN: We'd like to hear from you, if you've got any questions for our guests here Dr. Wilma Wooten and Tracey Delaney from the San Diego County health department, and Daniel is on the line from Clairemont, thanks for calling, Daniel, go ahead.

NEW SPEAKER: Thank you very much. I would just liege to suggest, I have a meet up group, and we meet up for free at least weekly, membership times more than once a week, we do easy hikes, and we also do some difficult one, but some of them that anybody can do, it's free, our group is San Diego outdoor enthusiasts, but there are a lot of different mete up groups that you can get involved with, and there are minimal charges from free to $10 a dollar, and you can get out and help to have other people motivate you, and also see places that you don't even realize are in your city or county.

ST. JOHN: That sounds like a great idea. Is that something, doctor Wooten, that you're hearing expanding more, these kinds of groups? Is it something that the county is actually aware of and encouraging, or how --

WOOTEN: I've recently become aware of meet up groups, and they're -- whatever issue or interest you have, there's a meet up group for it, I understand. And I particularly appreciate the caller's suggestion. That's one of the things we want people to do is to take the initiative, to find out about how they can utilize their communities to increase their physical activity. San Diego is rich in highballing trails and parks, and locations throughout the county. So people can discover new locations and routes to be more physically active.

ST. JOHN: Okay. Well, we're -- that sort of transitioned us to talking about exercise. What do some of your partners, Tracy, doing things to encourage exercise?

DELANEY: Probably one of our strong evaluate partners is with San Diego County office of ed. And the work that that they're doing in terms of school wellness and eight school districts that they're partnering with for implementing healthy works. Along those lines is looking at the PE programs in schools. What this work is doing is making sure that which kids are actually in the classroom, that they're physical he active. I don't know but you can sometimes have seen some PE programs where the kids are off to the sides, and not everyone is active. The goal here within healthy works is that this is moderate to vigorous activity during the PE period so that the kids really are getting the help they need to have the health benefit.

ST. JOHN: So the county office of education is encouraging more exercise within PE classes. We're hearing so much about classes that are not just teaching the basics being canceled for bottoming cuts. Is this perhaps partly just being used to keep PE classes going all together 1234.

DELANEY: I think it's definitely helping in a definite -- in a difficult economic time. But what's different is that they're actually changing and refocusing how PE programs are out in the community, so it isn't just doing what we've don 234 the past. It's really training teachers and the PE personnel to really make that an active experience for the stunts.

ST. JOHN: Okay. Now, we heard about bike riding. And that is obviously something -- I know that the SANDAG, and designing its new transportation system around the county, one of the main changes in progress that they're taking to try to people -- get grid lock, less grid lock, is creating bike paths. Is this money being used to increase that in some Kay? I know it was already happening, and part of my concern here is how much is this program doing things that weren't already happening?

DELANEY: I knowledge what was very unique about this partnership about SANDAG was being able to synergize on things that may have been happening, but taking it to another level. One example is SANDAG having to do their regional transportation plan recently, and the opportunity with SB377 which has to do with the green house gases, well, what we've been able to do with this grant is actually work with SANDANG in terms of getting policies related to health that would not have been happening without that's funds of we've also beg your pardon working on creating with SANDAG a headlight impact assessment. And so what this is going to do at the end of this grant is provide a forecasting tool, where decision makers can actually look at projects that are being proposed, 30 years out and to see what are the health implications of these types of project asks to make that a part of the decision making. Because at this point, they may have parallel different types of projects that are being produced. But how that is protecting health is not really into the consideration. So these funds are really helping people to make these long-term decisions, as well as providing funds for these short term projects. We're really looking across a spectrum of time with these funds to have an impact on health.

ST. JOHN: Okay. I was wanting to find some examples of specific things that people might be able to actually see, like I like your playing card example, that the $60 million has actually already made a difference to people. And I see that SANDAG here is awarding grants of $50,000 to support safe routes to schools. Tell us I bit about that.

DELANEY: So what's happened is a portion of these funds we really wanted to make sure were getting out into the communities to make a difference in people's lives. So within the last few weeks through these funds, SANDAG has awarded $30 million, and 22 grants to our local communities and to some tribal governments as well, and what the requirement there, is they were telling, they would in the proposal say how they were building health within thirds requirement community. So that's a variety of ideas, very unique and customized each community, they include biking paths, they also include different levels of quality of life, in terms of when planning and community planning is taking place within basic communities as well. So we want to make sure that these funds are being spread around particularly to high need areas that are having a focus on health.

ST. JOHN: So Dr. Wooten, safe routes to school, we have had some pretty scary stories in the last couple of years --

WOOTEN: Sure.

ST. JOHN: About people running, for example, where you've gotta wonder, I see people taking their kids to school where they never would have in the past because they're afraid. Is this a trend that is really difficult to over come?

WOOTEN: Well, I think with the community involvement, I think we can over come it. One aspect of the grant is our intergenerational program where seniors that are retired live in a given community. We're trying to get that involved and helping to walk kids to school. That's another part of this entire project.

ST. JOHN: Have you actually got some programs where that is now happening?

WOOTEN: Well, actually our aging and independence services branch has an intergenerational project already. So we are now in the developmental phases of creating this particular project that I've just mentioned. But I want to go back to comment on the 16 million over the two years is really to focus on policy systems and environmental change, changes that occur where we live, work, learn and play. So if we learn and play. So if we recommend to people to get more physically active or to eat better, we have to have community wide changes or policies in place so that people can do what we recommend that they do, and so that they can make the right choice, the easy choice, as has heard been stated of so all of the projects that we're talking about focus on changes either in the work place, at schools, in businesses, and throughout the community so that we can eat more healthy, and so that the community can be more physically active.

ST. JOHN: Okay. Now, what about farmers markets? That must be one element of that, because that's one of the places that fresh foods are definitely getting out, and they seem to be proliferating anyway. Is that part of your policy program? Tracy.

DELANEY: Yes. Thank you. It is and it's an exciting part that seeds in again with the regional food systems and farmers and getting the fresh food out. But we do have some work around the farmers markets. One is an innovative project that we have is, which is fresh funds, and it's particularly looking at farmers' markets in some high need communities, and making sure that we're linked with some other programs such as Cal Fresh which was also known as SNAP or food stamps, and to make sure that people are able to access and use those benefits at the fresh farms market, in addition we have an incentive program where by participating in these farmers markets that we're able to get a $20 match to enhance the purchase of local produce as well.

ST. JOHN: Okay. Is that one of the programs that UCSD is involved with?

DELANEY: Yes.

ST. JOHN: Okay. Can you tell us what else UCSD is doing as part of this initiative?

DELANEY: Certainly. I think UCSD is primarily looking at the activities that we mentioned in those three focus areas that involve nutrition. So they're looking at community gardens, the fresh funds, the regional food hub. They're also doing work around work site breast feeding policies. So we know that breast feeding is the healthy first food.

ST. JOHN: That's true.

DELANEY: So we're trying to encourage work sites to do that.

ST. JOHN: What exactly are they have doing to do that, to be specific?

DELANEY: What they're doing is engaging work sites, so when mothers come back from having their babies that they have a convenient and safe place that they can breast feed or that they can pump their milk for future use, to be sure that it's in a clean area. There's been studies that have shown that it actually increases not just the health of the mother and the baby, but it makes economic sense for businesses as well. They retain employees longer, there's increased attendance, and decreased illness as well. So it's an exciting other part, in terms of feeding across the lifespan.

ST. JOHN: Okay. And what about the fresh food gardens that they're working on?

RIH1: That's as doctor Wooten was saying, what we're looking at is a combination of policies and actual things that are going to make a difference on the ground. And so with the community gardens, we have different centers that we are funding throughout the county so that they can create community gardens in different areas. But the other part of that, one of the difficulties has been zoning and trying to get through codes and trying to get that to work through a city planning. And so these funds are looking at how do we change the zoning and the codes so that it's easier to create community gardens, as well as the funds to actually implement them.

ST. JOHN: Are they any gardens that are actually about to happen or have happened since the money came through?

WOOTEN: I think we just announced four gardens.

ST. JOHN: Good. Like, in southeast is an area, I know, I've heard -- councilman Tony Young talking a lot about how there's a lack of fresh produce down there. Is that one of the areas where they --

WOOTEN: It is.

ST. JOHN: Okay. We're just looking for that. And while you're just checking that out, I wanted to ask you, Doctor Wooten, is there anything else we haven't talked about that you think is important to this initiative to really change habits here in San Diego.

WOOTEN: Well, I think just to summarize, there are three primary focus areas that compose this grant. Physical activity, which SANDAG has the Grant for that, and we talked about some of the specific activities. Nutrition, UCSD has that grant, and then there's healthy schools. So we have healthy physical activity or healthy places, healthy nutrition and healthy schools. And the office of education has the contract for the school projects, include school gardens as well. And school wellness policies. And the fourth component is related to evaluation.

ST. JOHN: That's important.

WOOTEN: If we're implementing all of these policy changes, we need to evaluate whether these changes are actually making a difference. And San Diego state university has that particular contract.

ST. JOHN: So sometime in the next, what, year you'd have an evaluation? Or would it be more long term?

WOOTEN: It's an ongoing process, actually. We got a small additional grant funding to enhance our evaluation components, and we're looking at, and this is through SANDAG, putting counters in various areas throughout the county of San Diego so we can measure people as they are walking or biking in certain areas of the community.

ST. JOHN: Okay. Interesting. Well, we hope to hear at some point, some of the outcomes of the 60 million dollars, and Tracey, you have a last comment here?

DELANEY: Yes, just would like to encourage anyone out there in the community that's interest indeed this to please check us out on the website, which is healthy works.org, and that's something that's changing and updates are going on all the time to see how you might be able to get engaged or help us with these activities.

ST. JOHN: Good.

DELANEY: In the community.

ST. JOHN: Thank you so much. So I'd like to thank my gets, doctor Wilma Wooten, the San Diego public health director, and Tracy Delaney, project Director for San Diego County's health and human services department. Appreciate you coming in. And stay with us, coming upright in the next segment after the break, we'll be talking about taxes, last minute tax questions answered.