Communities improving access to food, health services via initiative: Teamwork pays off
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* Aaron Warnick

![Figure1](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/51/5/1.1/F1.medium.gif)

[Figure1](http://www.thenationshealth.org/content/51/5/1.1/F1)

AmeriCorps members serving as community health empowerment navigators with the Cleveland challenge team put together care packages for new mothers at MetroHealth Hospital.

Photo courtesy Baldwin Wallace University

Rochester, New York, is like many other rust belt cities. It thrived for decades in the 20th century, largely thanks to large employers such as Kodak. But as its industries waned, so did its urban center, bringing poverty and health inequities with it.

A group of local public health leaders had been hoping to make change, but the project was having trouble getting off the ground. Then last year, their work received a boost when Rochester was selected as one of 20 U.S. communities to participate in the Healthiest Cities & Counties Challenge.

The initiative is aimed at accelerating systems level approaches to improving community health equity, with participants working through September 2022. Now in its second round, the Healthiest Cities & Counties Challenge is funded by the Aetna Foundation and led in partnership by APHA, the National Association of Counties and Healthy Places by Design. Each of the community organizations in the 10 cities and 10 counties in the initiative was awarded $100,000 and technical assistance to improve access to health services and foods that support healthy eating patterns.

In May, Healthiest Cities & Counties Challenge leaders released community snapshots and a highlights report showcasing the first six months of progress. Initiative teams reported strides in community engagement, policies, relationships and knowledge, as well as direct connections with residents. For example, as of December, initiative teams had helped provide nutritious foods to 300,000 people, with about 6,700 people receiving food and nutrition education and support services thanks to the teams’ work.

“Our communities are making great strides in shifting policies, practices and power dynamics at the local level,” Brittany Perrotte, MPH, Healthiest Cities & Counties Challenge project director at APHA. “There are some real, practical nuggets of wisdom that I think other public health professionals and partners working in local settings would be enthusiastic to learn about them.”

Rochester is one of the initiative teams that has been able to make significant progress already. Access to nutritious food can be difficult in the city, particularly for minority urban residents, Mike Bulger, MAFS, Rochester’s Healthy Communities Project coordinator, told *The Nation’s Health.*

“The grocery stores with nutritious, fresh fruits and vegetables are outside of the city,” Bulger said. “We’re talking maybe an hour bus ride for someone who lives in the city of Rochester to access higher-quality foods. In the city, the most convenient options are often the least healthful.”

With support from partners across sectors, Bulger and his team were able to lay the foundations for the Rochester Food Policy Council. They recruited members from the community and held online forums to gather information and buy-in. The resident-led group is well-positioned to give the council and the people it represents an authentic role in shaping the city’s food policy and championing their views, he said.

“Community ownership of this process and its plans will impact the policies that are made in the future,” Bulger said. “This gives people space to listen and identify barriers to their health.”

![Figure2](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/51/5/1.1/F2.medium.gif)

[Figure2](http://www.thenationshealth.org/content/51/5/1.1/F2)

Access to food and health services have been persistent problems for many U.S. communities, even before the COVID-19 pandemic amplified existing inequities. Cleveland, Ohio, which hosts another Healthiest Cities & Counties Challenge team, is one of the cities that has faced such barriers.

As part of its work for the initiative, a Cleveland team has hired and integrated 12 community health and empowerment navigators. The debut navigator squad comprises six public health students and six community members working across three host sites. In just the first six months of the initiative, Cleveland and other participating communities reached 800,000 individuals with public communications that promoted advocacy, transparency and awareness of the food system, and project teams have continued to do so through the remainder of the first year.

“The entire purpose of our program is to bridge the gap of knowledge or access between the tremendous resources and organizations that exist in our communities and the individuals or residents that they intend to serve,” Laura Hopkins, PhD, RDN, LD, part of the Cleveland team, told *The Nation’s Health.*

The navigators embed themselves in the communities and respond to their needs. They help wherever possible, from food access to emergency COVID-19 vaccination clinics. Their on-the-ground presence has earned the Cleveland team regular access to local leaders and recognition.

“I have been working in community health for years, and the strength of partner-ships and collabo-rations within commu nities has always been the root of success,” said Hopkins, an assistant professor of public health and prevention science at Baldwin Wallace University. “This past year has truly highlighted the value of partnerships outside of the community in which we are working as well.”

Partnership is key to the success of other Healthiest Cities & Counties Challenge participants as well. In Tompkins County, New York, the success of the team’s program is organizing. The Childhood Nutrition Collaborative is described as a coalition of coalitions, a cross-sector concert for improving the county’s food system.

“We have been working closely with multiple coalitions who are, as a collective effort, mapping the food system and analyzing for systemic leverage points,” Chris Kai-Jones, PhD, academic partnerships and community well-being coordinator at Cornell Cooperative Extension, who is part of the Tompkins County team, told *The Nation’s Health.*

The project, organized by the Cornell Cooperative Extension of Tompkins County, used its reach to survey residents throughout the county and interview front-line workers to assess systemic needs. The collaborative is improving the food system by studying its failures and creating a robust network of resources, primarily to increase access to federal nutrition programs.

Strong community ties have also been valuable for the Healthiest Cities & Counties Challenge team in Kerrville, Texas. The Hope4Health team has worked to improve community health by connecting residents to food and health resources, using the community center in Kerrville’s Doyle neighborhood.

In its first year, the team has connected neighborhood residents directly with food through its pantry and helped residents get often-neglected dental care. The Hope4Health team is improving health one person at a time, according to organizers.

“One patient told me she was hesitant at first to keep her (dental) appointment because she could not afford a babysitter and would have to bring her child,” Theresa Standage, RN, a Wesley Nurse at Kerrville’s First United Methodist Church, who is on the Hope4Health team, told *The Nation’s Health.* “She was afraid she would be treated differently because she couldn’t pay and didn’t have insurance.”

Standage was able to persuade her to go. After the appointment, the patient called the center to express her gratitude, saying that she was more likely to seek dental care for herself and her child in the future.

The Doyle center is connected to the community and its residents, and it has contact information for people who use its services. When the city began to distribute COVID-19 vaccines, Kerrville Mayor Bill Blackburn suggested replicating the Hope4Health model to reach residents who were disconnected from the internet or newspapers.

“The model we are using in the Doyle community, if used citywide, would mean more residents gaining access to available resources,” Standage said.

Kerrville is not the only Healthiest Cities & Counties Challenge team to garner attention from local government. In May, the Rochester City Council voted to recognize the new Food Policy Council and to send a representative to join it as a liaison.

“This victory is a signal that the city is taking our council seriously, it means sustained engagement and a great potential for change,” Bulger said.

For more information on the Healthiest Cities & Counties Challenge, including updates from its Communities4Health Blog, visit [www.healthiestcities.org](http://www.healthiestcities.org).

*   Copyright The Nation’s Health, American Public Health Association