Population Health Implications of the Affordable Care Act: Workshop Summary by Institute of Medicine

Author:Institute of Medicine
Language: eng
Format: epub
Tags: Health and Medicine: Public Health and Prevention
ISBN: 9780309294379
Publisher: The National Academies Press
Published: 2014-04-01T00:00:00+00:00

THE ROLE OF GRASSROOTS LEADERS IN IMPROVING COMMUNITY HEALTH

Genoveva Islas-Hooker began her presentation by describing the San Joaquin Valley, an eight-county region in the center of California that has the largest concentration of farm workers in the state and the second largest number of Latinos overall. Agriculture is the booming economy, but there is a striking number of prisons, which have only recently been outpaced by the establishment of kidney dialysis centers. This region, where a bag of carrots costs more than a bag of chips and where drinking water is more expensive than sugar-sweetened beverages, is the setting in which Islas-Hooker has been working to ensure access to healthy food and physical activity as a way of improving population health. One fact about the area is that although it is the “salad bowl” of the nation, the low-income residents of the San Joaquin Valley often do not have access to healthful food. Perhaps not surprisingly, she said, one in three children is obese and one of every two Latino children is at risk of developing diabetes.

With support from the Robert Wood Johnson Foundation, Islas-Hooker and her colleagues at the Central California Regional Obesity Prevention Program developed a curriculum on leadership development to engage residents as the agents of change in their community. This program targeted residents who usually do not get involved in decision making, but who are connected to their communities. Once engaged, these individuals have become health advocates who have helped spur their communities to raise funds for playgrounds and create weekly farmers’ markets in cooperation with neighborhood schools, which use the markets as a means of teaching children about healthful eating alternatives. One outcome of this program has been that community leaders are assuming leadership positions within their local community, including on the school board and school wellness committees. “With resident leadership, we have been able to increase access to healthy foods for children and increase opportunities for safe places to play,” she said. “What we risk in the absence of engaging these leaders is [retaining] the status quo.” She concluded her remarks by predicting that this type of outreach to improve public health should outlast program funding because it is building capacity and engagement at the grassroots level. By doing so it is generating a passion for improvement that changes the community’s perception of what it can accomplish in improving health.

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