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Creating a Culture of Wellness: Healthy Eating Amidst Poverty and Food Insecurity

Monday, September 17, 2018   (0 Comments)
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   Kristin Kuenz-Barber, Strategic Partnerships Manager, Northwest Human Services

Those of us working in a Community Health Center are likely all too familiar with patients who struggle with food insecurity due to living at or below federal/state poverty levels.  A recent example was a patient at our local clinic who mentioned in conversation that she is disabled, has limited income, and essentially has no means of transportation.  As a result of these barriers, she often purchases what she can with her SNAP benefits at the convenience store that is just three blocks away from her home.  These purchases often include processed, high calorie laden foods that can negatively impact blood pressure, cholesterol levels, blood sugar, and weight gain.  As a result, over time, many patients end up with chronic health conditions simply because they have limited access to (or funds for) fresh foods and produce.

Food insecurity, as defined by the United States Department of Agriculture (USDA), means “lack of consistent access by all people at all times to enough food for an active, healthy life.” On a daily basis, 14 million children under the age of 18 are going to bed, and to school, hungry in the United States.  This number represents about 19% of all children in the U.S. in 2015, compared to 22%of children in Oregon.   The Oregon Center for Public Policy published an article in 2016 reporting nearly 1 in 6 Oregon households are food insecure.   Northwest Human Services is working to address food disparities through a number of projects aimed at ensuring that our patients and clients have access to nutritious food.  These include the addition of the West Salem Farmer’s Market, the Homeless Outreach and Advocacy’s Peer to Peer Produce Project at Evergreen housing, the Consumer Supported Agriculture “farm share” program (Spring of 2019) and the Neighborhood Fresh Connect Program with Marion Polk Food Share and Oregon State University Extension Service.   
In January of 2018, shortly after an Oregon Primary Care Conference, Northwest Human Services administration began discussing how to improve and encourage healthier eating and lifestyle behaviors amongst our clients.  They asked, “How can we provide something similar to a local Farmer’s Market where both our patients and local community members could benefit?”  Knowing that nearly half of our patient population live at or below the 100% federal poverty level (5,985 out of 12,165), being able to find a way to offer affordable, healthy, food options for our clients would be a “win-win” for all.  Knowing NWHS is also dedicated to treating our patients as a “whole being”; it was natural to explore ways to bring proper nutrition to our patients in hopes of continuing to work towards individual wellness through increased access to food.  From here, the journey began.

The initial intent was for Northwest Human Services to attempt to do this solely on their own, but it soon became apparent that it would take the work of a collective partnership to achieve our goal. We were eventually able to reach the Executive Director of the Salem Saturday Market (a very successful market in the downtown Salem areas) to discuss our vision. Ideally we hoped to locate the market directly across from our West Salem Clinic where there is plenty of green space— property that is owned by the City. Our goal would be to offer a large portion of home grown produce and breads so that our clients visiting the clinic would have very easy access to purchase these items.  Knowing that the Saturday Market Board of Directors sponsors a “Market Match” program where individuals utilizing WIC or SNAP benefits receive a special discount, this seemed like a perfect partnership.  After engaging with leaders from a local neighborhood association, Edgewater Partners, and with OSU Extension Service, we agreed collectively to enter into this endeavor together, with the end goal being to benefit the community as a whole, as well as our clients, through increased access to fresh fruits and vegetables and improved community vitality. Four months later, after hours of dedicated work to gain sponsorships, tireless planning meetings and promotional distributions, the new weekly Thursday Salem Market was ready to launch.


The West Salem Thursday Market opened on July 5th directly across from our West Salem Clinic with twenty-four vendors selling fresh produce or handmade goods. Northwest Human Services was the title sponsor along with others which enabled the “Market Match” program to be offered to our low income, food impoverished clients. Two and a half months in, the market has been an overwhelming success.  An unanticipated benefit for us has been that our clinic team members have developed an interest and desire to be better role models for patients, and they have also started focusing more on their own personal wellness.  More importantly though, was the joy expressed by so many of our patients who were able to make healthy purchases they can afford and finally feel as if they truly are a part of a greater community, all striving to better their health and lifestyle outcomes.



In the midst of creating the weekly summer market, NWHS was also approached by our local food share (Marion Polk Food Share- MPFS) to join efforts in one of their food assistance programs. They heard of our mission to create a culture of wellness and healthy eating and wanted to help us ensure that our patients have continued access to fresh produce year round— thus adding an additional layer of support throughout the non-market months of the year.  Marion Polk Food Share values never letting food go to waste, and due to the excess amount of perishable goods they have donated, this program is a way for them to get perishable goods out into the community.  Therefore, on August 23rd, NWHS joined forces with MPFS and OSU Extension Service (once again) to begin a program called The Neighborhood Fresh Connect (NFC).  NFC is a supplemental program geared towards any Federally Qualified Health Center/low income clinic or organization who helps individuals struggling with food insecurity. The program gives participants an “extra helping” of produce twice a month year round, while providing participants an opportunity to come together to build stronger and healthier bonds when they gather to “shop”.  OSU Extension Service agreed to add to this program by offering food demonstrations, food preservations techniques and easy low cost fresh produce recipe ideas.


Two times per month a group of NWHS employees pick up eight ten crates of produce/ breads from the MPFS warehouse, transport it to the West Salem Clinic, and make it readily available to our patients/clients during the two hour designated time frame.  The food is set up and distributed “market style” with portion allowances based on the number of individuals in the client’s home.  Patients receive handouts and reminders at appointments to be sure to participate. On Fresh Connect days, patients check in at reception, obtain a “produce pass”, and visit whenever there is a need.  Although we are not compiling personal information with this particular program, at this time, we are tracking the number of individuals and families utilizing the program over the calendar year to better understand the needs of our patients so that we can continue to provide them with opportunities to better their health and lifestyles.  Ultimately, our goal will be to create measurable outcomes based on a designated group of individuals willing to provide information regarding health issues such as A1-C levels, weight loss, and overall mood or feelings of security as a result of having access to healthier food options.



In summary, it is clear that food insecurity is a reality for many individuals and families in our country. In Salem Oregon, however, Northwest Human Services and our community partners are determined to work together to identify and implement strategies that allow individuals to continuously have access to all that they need to lead a healthier lifestyle—thus creating a “culture of wellness in our community."




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