Background on the Program
Program Overview
HEAC is a $26 million, four-year program to prevent obesity in children and youth. Bringing together community residents, public officials, and private business, HEAC aims to model effective approaches and to mobilize advocates to promote healthier environments for nutrition and physical activity. HEAC features local partnerships in six communities, a statewide network of technical support, communications and policy advocacy, new tools and other resources, research, and evaluation.
The Problem
Obesity has reached epidemic proportions nationwide. Experts now consider it to be society's greatest threat to health. Hardest hit are communities that face social inequities. Obesity, and complications such as diabetes, heart disease, asthma and certain cancers rob people of their income, opportunities and lives.
Too many environments nurture unhealthy eating and inactivity. Children attend schools where high-calorie drinks and high-fat snacks replace healthy food, physical education is inadequate, and marketing lures young students into poor eating habits. Many neighborhoods lack safe walkways, parks or grocers who sell fresh produce. No wonder childhood obesity is on the rise, when healthy choices are rarely the easy choice. The environments for nutrition and physical activity must change and healthier behavior will follow.
Our Approach
Healthy Eating, Active Communities models a comprehensive approach to obesity prevention that is place based, policy oriented, and community driven.
HEAC works to prevent childhood obesity by changing the environments children inhabit, so that these environments encourage healthy choices. To achieve lasting change, HEAC focuses on improving policies and institutional practices. And to ensure changes that work on the ground, HEAC pursues these goals through fostering partnerships within local communities, and through linking the local work to statewide and national efforts.
HEAC co-sponsor and funding partner, The Kaiser Permanente National Community Benefit Program, is working with The California Endowment to share lessons and develop joint strategies with other funders. Similar in design to HEAC, Kaiser's Healthy Eating/Active Living initiative has sites in Northern California and Colorado.
Youth involvement is an important element of HEAC. Youth serve as peer mentors in school, develop leadership experience, and conduct community assessments. Selected youth participate in the Statewide Youth Board for Obesity Prevention. They gain valuable lessons about government by doing research, and by developing a policy platform that reflects youth priorities.
To support all of this, HEAC has assembled a network of organizations with expertise beyond nutrition and physical activity. These organizations provide technical assistance in: education, medicine, public health, youth organizing, recreation, community design, health law, environmental protection, marketing and advertising, and more.
Modeling Community Partnerships
HEAC builds upon years of research in community-based programs and community-public health partnerships that have accomplished policy and institutional change. The HEAC program design recognizes that organizations and coalitions acting locally can also influence decision makers and shape policies at the state and national levels.
HEAC's work in six communities thus centers on partnership among a community-based organization, a school district and a public health department. These groups plan and implement strategies to improve nutrition and physical activity in five sectors: schools, after school programs, neighborhoods, marketing and advertising, and health care. Rigorous evaluation of the outcomes of the program will augment the body of evidence about the effectiveness of a community partnership model of change.
Efforts are underway to disseminate tools and early lessons from local model sites.
Work in Five Sectors
In each HEAC site, the partners work with other advocates to improve nutrition and physical activity environments in five sectors: schools, after school programs, neighborhoods, marketing and advertising, and health care. Partnership for the Public's Health, a program of the Public Health Institute, serves as HEAC coordinator.
In schools, with technical support from California Project LEAN, HEAC partners are working to implement the new nutrition standards, improve the quality of school meal programs and increase participation, and to eliminate marketing of unhealthy foods and beverages. HEAC sites are also advocating for compulsory, high quality PE at every grade level K-12, and for increased opportunities for non-competitive physical activity.
After school, HEAC partners, supported by CANFit, are working with school-based and community-based programs to adopt policies and practices that promote healthy eating and increased physical activity, and to foster cooperation with parks and recreation.
In neighborhoods, HEAC partners, with technical support from PolicyLink, are working with local businesses, elected officials, environmentalists, and other advocates to improve access to affordable fresh produce, safe walkways and parks, to improve community design, and limit promotion of unhealthy food.
In the healthcare sector, HEAC partners, with technical support from Kaiser Permanente, are training health care providers to engage in community prevention activities, and to incorporate more prevention and promotion into clinical practice.
In the marketing and advertising sector, HEAC partners are working to eliminate marketing of unhealthy products to children, and to encourage promotion of healthy nutrition and physical activity. With guidance from Berkeley Media Studies Group and others, messages, materials, and strategies are being developed to push for policy change at the local, state and national levels.
The Community Partnerships
HEAC's only rural site is in the Anderson area of south Shasta County and consists of the South Shasta Healthy Eating, Active Communities Collaborative, Anderson Partnership for Healthy Children South County Consortium (representing area schools), and Shasta County Department of Public Health. Shasta has achieved early implementation of improved school nutrition standards, and is working to gain more parks and trails for physical activity.
In Oakland, the San Antonio Neighbors for Active Living, East Bay Asian Youth Center, Oakland Unified School District, and Alameda County Public Health Department are partnering in HEAC. With an urban population of 36,334 predominantly Asian/Pacific Islanders, African Americans, and Latinos, the partnership put early efforts into improving opportunities for PE in Oakland Unified School District high schools.
The Childhood Obesity Brain Trust, the Accelerated School, Los Angeles Unified School District, and LA County Department of Health Services are partnering in an area of South Los Angeles with a population of 146,235, predominantly Latino and African American residents. Work includes developing a model elementary school PE program that can be implemented throughout the school district.
In Baldwin Park, the 57th Assembly District Grassroots Nutrition and Physical Activity Team, California Center for Public Health Advocacy, Baldwin Park Unified School District, and LA County Department of Health Services are partnering to serve a suburban population of 75,837, predominantly young Latinos. Baldwin Park is building on a successful record of civic accomplishment that includes a new youth recreation center.
West Chula Vista, with a mixed but predominately Latino population of 80,000, features the South Bay Partnership, Sweetwater Union High School District, and San Diego County Health and Human Services Agency, South Region. They have already been instrumental in the adoption of new city policies to provide 100% healthy options in vending machines on city property and to provide breastfeeding facilities in city buildings.
In the 92071 zip code of Santa Ana, Latino Health Access, Santa Ana Unified School District, and Orange County Health Care Agency are partnering to serve the 61,363 predominantly Latino residents. With a severe shortage of open space the partnership is working hard to gain recreational areas and facilities for physical activity through public financing mechanisms.
Building Local, State and National Momentum for Policy Change
HEAC's overarching goal is to build momentum at all levels for policy changes that will improve environments for nutrition and physical activity. HEAC and other sources have provided selected tools and lessons to the Central California Regional Obesity Prevention Program. CCROPP serves six largely rural, high need counties in the Central Valley. Like HEAC, it is working to improve nutrition and physical activity environments through policy change.
The Endowment and HEAC provided much of the impetus for the California Governor's high-profile 2005 Summit on Health, Nutrition, and Obesity. This event brought together industry and government leaders to address the obesity epidemic. During the event, the Governor signed landmark legislation that improved standards for school nutrition.
In January 2007, HEAC also joined teams from six other major obesity prevention initiatives in California for the first California Convergence meeting. California Convergence aims to promote learning and synergy across programs, to accelerate improvements in food and physical activity environments across the state.
Building Local Public Health Department Capacity
Public health departments have a special role as "anchor institutions," responsible for monitoring and controlling conditions that lead to risks for obesity and poor health status. Health departments involved in HEAC are developing internal capacity and skills to strengthen cross-sector partnerships in their communities; to improve community planning and built environments; and to encourage and support community groups to advocate for policy changes that will improve community health.
Evaluation
HEAC's rigorous, multi-modal evaluation aims to measure the program's impact on local policies and systems, and other environmental factors that influence healthy eating and physical activity. Samuels & Associates leads the evaluation team, with support from UC Berkeley Center for Weight and Health, UCLA School of Public Health, and nationally prominent consultants. The evaluation seeks to capture successes and promising models at all stages of progress.
HEAC is working to create and disseminate models for sustainable improvements in policies, practices, and institutions; and to develop "a sea of advocates" to shepherd these changes into the future. Ultimately, HEAC hopes obesity prevention will serve as a catalyst for building healthier communities.
