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2019 Dallas Hunger SummitBui ld ing a health ier environment:
pol icy inf rastructure and system
D r. M y r i a m I g o u f e ,V i c e P r e s i d e n t o f P o l i c y D e v e l o p m e n t a n d R e s e a r c h
DHA | HOUSING SOLUTIONS FOR NORTH TEXAS 2
AGENDA
1. LANDSCAPE OF OPPORTUNITY
2. OUR APPROACH
3. CURRENT INITIATIVES
4. MOVING FORWARD
DHA | HOUSING SOLUTIONS FOR NORTH TEXAS 3
3
GEOGRAPHY OF INEQUITY
LANDSCAPE OF FAIR HOUSING:
UNAFFORDABILITY IN AFFORDABLE HOUSING
Racially/Ethnically Concentrated Areas of PovertyLow-Income Low-Access to Food
HCV families are disproportionally residing in R/ECAP census tracts and are facing
cumulative barriers to upward mobility and access to opportunity. R/ECAPs
neighborhoods are characterized by:
▪ Extreme poverty level
▪ Severe racial segregation
▪ Low access to healthy grocery stores
▪ Low vehicle availability
▪ Lower access to jobs via transit
Residual Income for Transportation
TransportationCosts
After meeting non-transportation needs, results show that HCV families do not have sufficient resources to afford transportation.
Given the very likely need to travel to access food, school or employment, the results shed light on a potential recourse left to these families to meet their transportation needs: having to forego a nutritious diet, medical care or other necessities.
Igoufe, Mattingly, and Audirac (2018)
North Texas Regional Assessment of Fair Housing (2018)University of Texas at Arlington
DHA | HOUSING SOLUTIONS FOR NORTH TEXAS 4
OUR APPROACH
CHALLENGES:• Geography of inequity • Racial and economic disparities• Multi-generational barriers to self-sufficiency • Cumulative barriers to opportunities• Informational power/gap• Disparate access to resources
POLICY AND PROGRAMMATIC APPROACH
• Data-driven actionable strategies• Connect and bridge gaps• Build pathways to self-sufficiency • Capacity building and advocacy• Inclusive methodology
OUR MISSION IS TO PROVIDE AFFORDABLE QUALITY HOUSING AND ACCESS TO SUPPORTIVE RESOURCES ACROSS NORTH TEXAS
DHA | HOUSING SOLUTIONS FOR NORTH TEXAS 5
CURRENT INITIATIVES
FOSTER HOUSING CHOICE AND ACCESS TO HIGH-OPPORTUNITY NEIGHBORHOOD
RESEARCH AND POLICY ADVANCEMENT
BUILDING PATHWAYS TO OPPORTUNITIES, TOGETHER
DHA is participating in two studies analyzing the impact of housing conditions on children’s development and health over time.
Development of software designed to put neighborhood quality of the forefront of the housing search process.
DHA and Workforce Solutions are in discussions to share data that will help us explore employment services, training opportunities, child care, etc. that will ultimately link DHA families directly with opportunities.
2019 Dallas Hunger SummitBui ld ing a health ier environment:
pol icy inf rastructure and system
D r. M y r i a m I g o u f e ,V i c e P r e s i d e n t o f P o l i c y D e v e l o p m e n t a n d R e s e a r c h
Why healthcare must address food
insecurity
Patient outcomes
Children- poorer overall health, increased hospitalizations, anemia, decreased bone mass, high cholesterol, cavities, poor academic performance, school suspensions, aggression/behavior problems, depression
Adult- asthma, COPD, heart disease, high blood pressure, diabetes, high cholesterol, anxiety, depression, arthritis
Healthcare Costs
Increased ER visits/hospitalizations for diet related diseases
$1800 increased healthcare expenditures/year
18% increased healthcare costs for adults with chronic illnesses
Organizational Level Change
Screening and Intervention in clinical settings
Recommended by the American Academy of Pediatrics, Academy of
Nutrition and Dietetics, Academy of Family Practice Physicians
Toolkits
AAP toolkit
AARP toolkit
Healthcare/Foodbank Partnerships
Partners in Health
Healthy Pantry Initiative
Summer Food Program feeding sites
Clinic-based pantries
Healthcare Finance Change
Adding screening and intervention as covered
benefit- private insurers, Medicaid, Medicare
Food as a covered benefit
Medically tailored meals
Produce prescriptions
Supplemental foods for food insecure patients
Coding Changes
Challenges with current coding
Z59.4 Lack of adequate food and safe drinking water
National workgroups
Hunger Vital Sign Community of Practice
Robert Wood Johnson sponsored Gravity Workgroup
2019 Dallas
Hunger Summit Innovating the Women, Infant
and Children (WIC) Program
September 13, 2019
CPAL AIMS TO REDUCE CHILD POVERTY BY 50% IN 20
YEARS.
1 IN 3 CHILDREN IN DALLAS LIVES IN
POVERTY.
● For children to grow up with so little in a
region where affluence is so visible
challenges our most basic principles of
fairness.
● Poverty exposes children to devastating
levels of trauma that undermine a child’s
future by stunting physical, cognitive,
and behavioral development, thereby
producing a lifetime of health and
economic challenges.
● Economists estimate that childhood poverty
costs the U.S. economy over $1 trillion per
year, or 5.4% GDP.
● Each child growing up in poverty has an
average net-cost to our economy of $1.6
million throughout that child’s life.
● The cost of inaction is much higher than the
cost of action. Every $1 spent to fight child
poverty lowers future costs by $7.
● Dallas has the 3rd highest rate of child
poverty in the nation.
● The long-term economic cost of the
95,000+ local children growing up in
poverty exceeds $150 billion.
● Over the past 15 years, the poverty rate
in Dallas has increased by 42%, while
the population has only increased 4.4%.
● All systems-level CEOs have signed on
with CPAL to help solve this problem.
The Value of the WIC Program
● Reduces food insecurity
● Alleviates poverty
● Supports economic stability
● Improves dietary intake
● Protects against obesity
● Improves birth outcomes
● Improves health outcomes
● Supports learning and development
● Reduces health care and other costs
● Improves retail food environments
Declining WIC Participation, a National Trend,
Worse Locally
Source: U.S. Department of Agriculture, National- and State-Level Estimates of Special Supplemental Nutrition
Program for Women, Infants, and Children (WIC) Eligibles and Program Reach in 2016 (Published 2019)
WIC Coverage Rates for Total Eligible Individuals by State, 2016
In Dallas,
the
coverage
rate is only
39%15
Declining WIC Participation,
a National Trend, Worse LocallyWIC Coverage Rates for Total Eligible Individuals by State, 2016
The WIC User Journey
Creating a
Cycle of
Impact✓ Decrease Hurdles
✓ Increase Value
✓ Create an Experience
that is Empowering
and Seamless for
Users, Stores, and Staff
A life-long practice of positive-nutrition,
starting with the child
Habits and new skills make families feel
confident and proud.
A positive experience leaves families
feeling supported and empowered
Families see clear value in WIC benefits
and services.
USERS: Redesign Income Guidelines • Concierge Assisted Online Forms • Clearly Articulated and
Visualized Process • Templates and Support for High Friction Moments • Mobile WIC Center • Online
Check-in Forms • Staggered Enrollment and Benefit Refills • Neighborhood Champions • Care Toolkit •
Real People & Stories • Proactive Communication • Stronger Digital Presence • Redefine Waiting Spaces
• Newborn Welcoming Ceremony • Breastfeeding Spas • Community Picture Walls • Knitting Abuelas
• Tête-à-tête Style Nutrition Sessions • Cooking Classes • Mom Groups • Home Visits • Chat Bot
STORES: Shopping Buddies • WIC Ambassadors • Online Ordering • WIC Clinics Inside Stores
• Shopping Assistance App • WIC Store Champions • Self-Checkout Stations • Flyers • Text-a-Manager •
Confusion Cards • Checkout Experience
STAFF: Staff Innovation Program • Staff Strategy Offsite • New Mission-Driven Onboarding Experience •
Experience Team • Leadership and Coaching Workshops
AARP
Hunger to Health
19
Susan J. WilliamsAssociate State Director
AARP Texas
2019 Dallas Hunger SummitSeptember 13, 2019
20
The Face of Senior HungerThe 5.5 million adults 60 and older are food insecure. That represents 7.7 percent of all the people in
that age group.
The rates of hunger were higher among people ages 60 to 64 than it was for those who were older.
Among adults over 60 who were food insecure, more than one third (37.5 percent) were ages 60 to
64, while 1 in 10 (9.9 percent) were 80 and older.
-Feeding America Report
More than 10 million older adults are at risk of hunger every day,” “Older adults who are food
insecure are 50 percent more likely to have diabetes and 60 percent more likely to have congestive
heart failure. Research shows that food insecurity costs older adults in the U.S. an estimated $130
billion annually in additional health care expenses. So, senior hunger is not just an individual issue
— it is an issue that has implications for families, communities and society.”
Emily Allen, senior vice president of Programs for AARP Foundation.
AARP Work to Address Food Insecurity
21
Federal and State Advocacy• Prevent benefit cuts to SNAP
• Prevent any expansion to work requirements
• Allow grandparent and other non-parent caregivers to apply for benefits
on behalf of the children
• Provide additional incentives to states to undertake reforms to expand SNAP
• Promote and expand Elderly Simplified Application Process (ESAP)
Expansion – 8 states
Local Communities• Day of Service Meal Pack Challenge
• Invest in community-based initiatives to
assist older adults
• Age Friendly Communities
AARP Foundation is working to end senior poverty by helping
vulnerable older adults build economic opportunity and social
connectedness.
22
AARP Foundation
Pilot Projects with Community Partners
• Screen and Intervene Course for Health Care Providers
• Food Insecurity Intervention Elderly Simplified Application Process (ESAP) - Grants
• Diet-Related Disease Intervention
Fresh Savings Rx
• Grocery Guides
• 11 State Pilot
Use AARP database to connect to
SNAP
• The Whole Plate Concept Currently under development
23
AARP Foundation
24
AARP Foundation
Through Drive to End Hunger, AARP Foundation is helping put an end to hunger for Americans over age 50 by raising awareness about the issue of hunger, donating meals to food banks, building philanthropic support, and developing long-term, solutions.
25
AARP Texas, City of Dallas and 40 + Community Partners
worked together to develop a plan to make Dallas a better place
to live for people of all ages.
Domains of Livability
26
• SNAP Enrollment and Eating Well is a SNAP
• Community Gardens
• Pop Up Markets
• Exploring Other Innovative Solutions
•
City + FoodDallas Hunger Summit
September 13, 2019
Laila Alequresh, Chief Innovation
Officer
Office of Innovation
City of Dallas
Presentation Overview
• What is Innovation?
• Government + Food + Hunger
• Upcoming Initiative
• Next Steps
What is Innovation?
LivingLab Systems
ApproachCollaboration Objective
Partner
Conduct small
scale pilotsand
testing with
analytical rigor
that support
policy, process,
and program
improvements
Take a holistic
view of cross
functional and
cross
departmental
processes and
programs
Break down
siloes and work
across
departments and
sectors
Unbiased and
objective partner
for city
departments that
helps deliver the
“basics” well
Government + Food + Hunger
• Economic
Development
• Planning
• Sustainability
GROW SELL CONSUME WASTE
• Sanitation
• Special Events
• Code
Upcoming Initiative
More locally grownfood
Less foodwaste
Making healthier foodchoices
Less foodwaste
Next Steps/Call to Action
• Participate!
• dallasinnovationchallenge.ideascale.com
• Contact us!
City + FoodDallas Hunger Summit
September 13, 2019
Laila Alequresh, Chief Innovation
Officer
Office of Innovation
City of Dallas