Healthy Food &
Laurie M. Tisch Illumination Fund April 2016
There are vast disparities in the prevalence of diet-related diseases across New York City’s neighborhoods. The city's poorest neighborhoods are also its least healthy, with limited access to affordable and nutritious food.
Where healthy food is unavailable or unaffordable, diet-related diseases like diabetes and heart disease follow, concentrated in areas where need for emergency food is highest.
Residents experiencing poverty:
Residents experiencing food insecurity:
Upper East Side
7% of Upper East Side residents reported that they hadn’t eaten a single fruit or vegetable the previous day
compared to 33% of residents of Hunts Point and Longwood, Bronx
Nutrition-related health problems like obesity, diabetes, heart disease, stroke and cancer devastate individuals, their families and whole communities.
18% of residents of East New York suffer from diabetes, compared to 3% of Upper East Side residents
Life expectancy in East Harlem is 9 years shorter than in the Upper East Side
Obesity-related illnesses cost New York City residents
$4 billion annually through higher Medicaid and Medicare costs.
Improving access to healthy food is critical, but access cannot occur in a vacuum.
We need to create an environment that is conducive to making healthy choices, with:
- Affordable, convenient and quality healthy options
- Greater awareness and knowledge of healthy choices
- Community engagement and ownership
A stronger, healthier New York, realized by increasing access to healthy food and awareness around healthy options.
To make this vision a reality, in 2013 we launched Healthy Food & Community Change, a $15 million, five-year commitment to strategically support healthy food and nutrition access and education programs in New York City.
Change must be local, inclusive and holistic. We work with people and organizations that are embedded in their communities.
Government has to be at the table. We support public private partnerships to encourage cross-sector collaboration.
We must continue to advance knowledge and practice, build evidence to inform public policies and develop human capital. We partner with institutions of higher learning that are deeply invested in New York communities.
In addition to grants, we bring grantees into our network to connect, communicate, learn and work with each other to advance shared goals.
I believe that every New Yorker should have access to healthy, affordable food. Zip code and circumstances of birth should not limit the possibilities for good health.
Addressing stark disparities between neighborhoods is one of the greatest challenges in food policy today. There's no quick-fix, but healthy food has a major role to play in building more vibrant communities.
Healthy Neighborhoods Initiative
City Harvest’s Healthy Neighborhoods Initiative
City Harvest’s Healthy Neighborhoods Initiative (HNI) is a geographically targeted plan to alleviate hunger, engage residents in healthy choices and enhance the local food landscape. HNI integrates four complementary program strategies:
- Supplying free, fresh produce through food pantries, soup kitchens and Mobile Markets
- Offering evidence-based “hands-on” nutrition education courses and classes
- Providing technical assistance and equipment for corner stores and supermarkets to improve displays and equipment in order to sell more fresh produce
- Convening neighborhood-based networks to engage residents in all programs
HNI targets five communities with high rates of food insecurity, poverty and diet-related diseases: Bedford Stuyvesant, Northwest Queens, Washington Heights/Inwood, the South Bronx and neighborhoods in Staten Island’s North Shore.
The Healthy Neighborhoods Initiative has seen considerable expansion since our funding began. In three years, the initiative has more than doubled the number of Mobile Market sites and residents reached, increased the number of multi-week nutrition education workshops by 50%, tripled the Healthy Shopping workshops, and expanded its Healthy Retail work to include corner stores. Last year, City Harvest completed a two-year evaluation of its Healthy Retail program and found that monthly produce sales increased by 10% at participating stores, more shoppers purchased fruits and vegetables after store makeovers, and produce sales increased as a percentage of the stores’ revenues. These results demonstrate an increase in demand, which encourages retailers to stock more healthy foods.
By the Numbers
In the past year, City Harvest has:
- Increased Access: Opened two new Mobile Market sites – at the Mariners Harbor Houses public housing development in Staten Island and at Prince Hall Masonic Temple near Audubon Houses in Washington Heights – bringing the total of free produce markets to nine, holding more than 180 market days, reaching 27,000 residents in or near public housing 6,500 more than the previous year (versus FY14), and distributing 2.8 million pounds of fruits and vegetables. Provided technical assistance and produce section makeovers to 30 supermarkets and 37 corner stores and bodegas, impacting some 300,000 shoppers in low-income neighborhoods.
- Built Awareness: Reached nearly 56,000 people through nutrition education programming – 50% more than the previous year – by conducting 375 cooking demonstrations, 98 multi-week hands-on cooking-based nutrition education courses and 187 in-store workshops.
- Continued Collaboration & Partnerships: Continued five Community Action Networks, with representatives from more than 90 nonprofit and community organizations, local retailers, city agencies, resident associations, community gardens, faith-based organizations and health care providers.
- Developed Leaders: Engaged NYCHA residents and other community members in neighborhood program strategy and implementation. Built capacity within neighborhoods to increase awareness about food issues, empower residents to advocate for change and help realize the long-term vision of Healthy Neighborhoods: communities that encourage and support healthy diets.
- Advanced Knowledge & Practice: Convened the inaugural City Harvest Leadership Summit, Beyond Hunger: the City of Tomorrow, a thought leadership conference that brought together public, private and nonprofit leaders to share expertise and foster new, holistic thinking to address the increasing challenges of feeding an urban population, and to envision a sustainable future of cities without hunger.
City Harvest is in the fourth year of our Healthy Neighborhoods program plan, and we’ve learned a lot about the men, women and children who we serve and the communities where they live. At the core, we know that people want to feed themselves and their families with healthy food. Unfortunately, affordability and accessibility are barriers.
One way that City Harvest works to help increase access to affordable fresh produce in low-income communities is by working with local bodegas and supermarkets. Key to this work is building trust. City Harvest’s Healthy Retail team serves as a constant resource, visiting regularly to tackle new projects with store operators, side-by-side. It takes a lot of facetime, a lot of listening, and a lot of combined efforts to help a bodega or small supermarket embrace change and increase their produce offering. But with a consistent – and persistent – investment of time, relationship-building and support, we’re seeing positive results.
Local Initiatives Support Corporation
New York City (LISC NYC)
Communities for Healthy Food
LISC NYC's Communities for Healthy Food
LISC NYC’s Communities for Healthy Food is a place-based initiative that works in four economically challenged neighborhoods—West Harlem, Cypress Hills, Bedford Stuyvesant, and Mt. Eden—to address the interrelated issues of obesity, poverty and unemployment. The program’s partners are community development corporations (CDCs) with deep roots in their neighborhoods, who own and manage affordable housing and commercial spaces and deliver an array of social and economic development services.
2015 was the second year of implementation for Communities for Healthy Food. Building off needs assessments and “asset mapping” conducted in 2013, LISC and its CDC partners have been successful in integrating healthy food access into every aspect of comprehensive community development work through resident outreach, nutrition education, cooking classes, new or improved healthy food outlets and development of food-sector jobs. In two years, the initiative has provided approximately 650,000 pounds of emergency food to approximately 53,000 pantry clients, enrolled 1350 families in public nutrition assistance programs, and doubled the number of residents trained or employed as farmers, community chefs and outreach coordinators. These results demonstrate the importance of an integrated place-based approach to health promotion and neighborhood improvement.
By the Numbers:
In the past year, LISC and its partners have:
- Expanded Access: Supported two "client-choice" food pantries and community food hubs that served 35,000 pantry clients, two farm share programs with 122 shareholders, four bodegas and supermarkets, three farmers markets and one youth market. Facilitated enrollment of 750 families for SNAP benefits.
- Built Awareness: Connected directly with nearly 8,000 residents through neighborhood outreach and awareness campaigns. Trained close to 800 neighborhood residents, staff, and partner organizations on healthy food resources and services in the neighborhood, the importance of healthy eating, and nutrition and gardening skills. Trained 27 residents to become Community Chefs and created 20 Community Chef positions. Hosted close to 100 nutrition education workshops and roughly 250 cooking classes for over 1,500 youth, adults, families, and seniors. Held more than 200 free cooking demonstrations reaching approximately 5,000 residents.
- Continued Collaboration & Partnerships: Worked with partners in government agencies, community-based organizations, health care providers, food justice organizations, policymakers, and academia, including City Harvest, the NYC Department of Health, GrowNYC, Corbin Hill Farms, United Way and Hunter College.
- Developed Leaders: Trained residents, AmeriCorps members, community development fellows and CDC staff on healthy food access resources, food justice/advocacy, and leadership and management development. Trained and hired 25 youth to become urban gardeners, farmers market staff, interns, and healthy food leaders and educators.
- Advanced Knowledge & Practice: Presented Communities for Healthy Food work at conferences including Healthy Housing, Healthy Communities, Healthy Lives at the NYU Furman Center, and the Rhode Island Health Equity Summit. Featured in articles in the National Housing Institute’s Shelterforce, Next City, The Huffington Post and other media.
Through Communities for Healthy Food, LISC and our neighborhood-based partners have learned that food-related issues and disparities are interrelated with other community challenges, and that we need multi-pronged strategies based on community assets and needs. We’ve also seen the power of investing in multiple, coordinated programs within a single location, such as West Harlem Group Assistance’s Community Food Hub and NEBHDCO’s Golden Harvest Pantry.
Moving forward, Communities for Healthy Food will expand to an additional two neighborhoods with Banana Kelly Community Improvement Association in the South Bronx and Ocean Bay Community Development Corporation in the Rockaways, Queens. We’re excited to be able to apply what we’ve learned from the original four sites.
Fruit and Vegetable Prescription Program (FVRx)
Fruit and Vegetable Prescription Program (FVRx)
Working in New York City Health + Hospitals sites, the Fruit & Vegetable Prescription Program (FVRx) provides patients affected by diet-related diseases with prescriptions and coupons that can be spent on fruits and vegetables at local farmers markets. By combining medical advice and counseling regarding healthy eating with the provision of resources that make fresh fruits and vegetables affordable, this innovative approach to increasing access to fresh, affordable and local food aims to inspire and enable underserved families to make healthier choices.
FVRx has been implemented in New York City over three years, with annual growth in the number of patients and families served and refinements in the program to make it easier for hospitals to implement. Evaluations in 2013 and 2014 demonstrated positive impacts on patients’ knowledge, attitudes and behaviors related to fresh fruit and vegetable access, preparation and consumption. A number of food security indicators improved significantly over the course of program implementation, but households’ needs for healthy food resources remain a pressing concern and underscore the importance of long-term solutions to address household food insecurity. The FVRx model, if implemented on a longer-term basis and integrated into health systems, could be a method of meeting this need.
By the Numbers:
In the past year, Wholesome Wave has:
- Increased Access: Worked in three Health + Hospital sites: Elmhurst Hospital, Harlem Hospital, and Bellevue Hospital, serving 192 patients and approximately 904 family members. Over three-fourths (77.8%) of Harlem patients completing the program reported increased fruit and vegetable consumption between the first and last clinical visits. Indicators of food insecurity also improved; by the end of the FVRx program, 62% of households reported that they had enough of the kinds of foods they wanted to eat (up from 39% at the beginning of the program).
- Built Awareness: Almost all patients (91.4%) reported that they were told about the importance of fruits and vegetables in children’s diets at every clinical visit or more often. By the program’s end, approximately 80% of patients reported that they “Know a Lot” about the importance of fruits and vegetables, compared to 56% before starting FVRx. Of the 94 patients who completed FVRx and had BMI measured at their first and last visits, 42.6% decreased their BMI.
- Expanded Collaboration & Partnerships: Currently engaged with New York City Department of Health and Mental Hygiene, Mt. Sinai Hospital in partnership with Corbin Hill Food Project, LISC NYC, and Memorial Sloan Kettering Cancer Center. In discussion with Saint Barnabas Hospital, Wyckoff Heights Medical Center, Bronx Health REACH/Institute for Family Health, and a handful of others to adapt the program.
- Developed Leaders: Developed customized training toolkits and program resources for each hospital. Twenty-four hospital staff were trained on FVRx program operations such as screening patients for food insecurity, conducting nutritional assessments and data collection and evaluation. The FVRx program helped health providers attain a greater understanding of community-centered barriers to healthy eating.
- Advanced Knowledge & Practice: The FVRx program in NYC provides a critical demonstration of how incentive-based programs and clinical collaborations can be successful in one of the largest and most complex public health systems in the country. Outcomes of this project will directly inform strategies for institutionalizing FVRx through policy change.
It’s exciting, inspiring and humbling to see a large hospital system, in a city with some of the most forward-thinking public health programs in the country, take such a simple, common-sense approach. What we’ve done here is just the beginning.
If we can prove that this approach works in a place like NYC, it can be very broadly replicated. To paraphrase the song – if we can do it here, we can do it anywhere.
With our partners, we are beginning to realize this vision.
In the last year, we worked in 12 neighborhoods around the city.
Our grantees have demonstrated results improving access to healthy food, increasing awareness of healthy choices, collaborating across sectors, developing future leaders and advancing knowledge and practice.
- LISC NYC with West Harlem Group Assistance
- LISC NYC with West Harlem Group Assistance
- New York City Food Policy Center at Hunter College
- United Neighborhood Houses with SCAN New York
- City Harvest
- LISC NYC with New Settlement Apartments
- City Harvest
- City Harvest
- United Neighborhood Houses with Queens Community House
- City Harvest
- United Neighborhood Houses with Jacob A. Riis Neighborhood Settlement House
- LISC NYC with Cypress Hills Local Development Corporation
- City Harvest
- LISC NYC with Northeast Brooklyn Housing Development Corporation
- City Harvest
- City Harvest
- City Harvest
- City Harvest (including Mott Haven, Melrose, Morrisania and Crotona)
- LISC NYC with New Settlement Apartments (Mt. Eden)
- City Harvest (including Mariners Harbor and Stapleton)
The Laurie M. Tisch Illumination Fund is a leader in promoting healthy food choices and ensuring equitable access to fresh and affordable food in every community in New York City. The Fund’s sustained and substantial commitment has made it possible for community-based organizations, neighborhood-based collaborations, and academic institutions to test and implement creative new approaches to our access challenges.
They are also an invaluable partner to the City’s public agencies, including the Department of Health, NYCHA, Health + Hospitals, and the Department of Education. The Illumination Fund doesn’t only make grants to individual programs and organizations, but they are active partners, and this form of substantive engagement amplifies our collective impact. We are so fortunate in New York City that we have the Laurie M. Tisch Illumination Fund.
Supporting and working with grantees and partners over the past three years has been enormously gratifying, and we all have learned a great deal about how to maximize impact. The learning is far from over, but some highlights include:
Changing the way we think about evaluation as not the end goal, but as a process to hone goals and inform program decisions. Every foundation faces the question of how to measure the impact of its work, both with regard to the impact of individual grants and the cumulative impact of its grants, programs and initiatives. But the reality is that the world’s most complex, systemic challenges are not easily evaluated. Instead, we should consider building a picture of progress, adding layers over time. Those of us at the Illumination Fund are starting with what grantees are already tracking, and integrating that information into our rubric: access, awareness, collaboration and partnerships, leaders, and knowledge and practice—the fundamentals needed to drive collective change. Programs that are designed with measurement in mind are primed for success.
The importance of strategic communications to organizational success. Investing in internal communications pays dividends in amplifying organizational and program reach. As we all know, funders, policymakers, reporters and other stakeholders are inundated with information and often have limited time to absorb it. Staff are critical spokespeople for every organization because they are engaged, passionate and in many cases the organization’s first or only touch point with stakeholders. At our 2015 Grantee Convening, we practiced giving the “elevator speech” and found it was harder than expected to articulate an organization’s mission and activities, the spokesperson’s role and the “ask” in 30 seconds or fewer. But practice helps!
How Foundations Can Add Value
Foundations can expand their impact by serving as a connective thread for their larger network.
- Convening: Foundations can enable the sharing of best practices by convening grantees. We held an inaugural forum when we launched Healthy Food & Community Change in 2013 and have since convened grantees annually to discuss their work, share successes and challenges and learn new skills from each other.
- Connecting: We facilitate network-building by connecting grantees with each other for research, counsel and collaboration.
- Communications: Through press coverage, digital and social amplification and events, we elevate the visibility of programs and organizations.
- Community building: By participating in philanthropic and food policy networks, we monitor trends, identify opportunities to build collective impact and serve as a resource to other funders and organizations.
- Cross-sector collaboration: Because we often are at the nexus of a variety of organizations, institutions and policymakers, we learn about the valuable work done by many diverse nonprofits and have insight into the priorities of the policy sphere. Where we see synergies, we can draw connections, enable collaboration and help to bring innovative ideas to scale.
We’re excited about the progress made to date in pursuit of our vision for
a healthier New York.
But we and our partners still have more work to do.
There are no easy answers. But we are inspired and determined by the commitment and passion we see every day to continue to learn and evolve Healthy Food & Community Change to be stronger partners to our grantees, and to our city that we love.