REACH Sustainability

Sustainability is at the forefront of REACH programs as it creates momentum to maintain community-wide change by organizing and maximizing community resources.

When a community collaborates with local groups working in and outside of public health (i.e. education, transportation, parks, and recreation), it mobilizes a community and leads to lasting change.

REACH works with African American, Hispanic, Asian American, American Indian, Alaska Native, and Pacific Islander populations to encourage physical activity, healthy eating habits, and prevent tobacco use to address diabetes and heart disease.

“Hope Zone”, Kent County Health Department, Grand Rapids Michigan

Kent County, Michigan continually ranks among the top counties in the County Health Rankings and Roadmaps. However, racial and ethnic minority populations in the City of Grand Rapids, as in most of the Country, bear a disproportionate burden of poor health and do not have access to environments supportive of a healthy lifestyle.

Through REACH 2014 funding, Kent County focused its efforts on “Hope Zone” neighborhoods with the goal of increasing tobacco-free environments, access to healthy foods, access to physical activity opportunities, and opportunities to prevent and reduce the risk for chronic disease. They promoted healthy corner stores so that residents can purchase fresh produce. Built on an existing community relationship with the YMCA, healthy foods were brought to the communities through a mobile produce vehicle known as the “Veggie Van.” They also established a “Prescription for Health Program,” that provides supportive information, such as walking route maps, and basic health education information for health care providers to equip patients in achieving goals.

Based partially on the successes of the REACH initiative in establishing key relationships in the community, the Kent County Health Department established a new department, the Center for Community Health Strategy. Kent County provided funding for establishing a permanent public health program supervisor position in the center to scale up the efforts of the REACH grant throughout the county. The position was specifically focused on community/partner engagement and policy, system, and environmental strategies. Although the center is no longer a REACH grantee, they continue to work closely with the neighborhood coalitions with which partnerships were established during the REACH initiative.

The efforts to raise awareness of health equity and social justice, educate decision-makers on health in all policies and focus on cementing a community-based participatory approach as the foundation for the Center for Community Health Strategy are key to the future of this community’s health. The REACH initiative made it possible to work closely with the community to shift the way Kent County approaches health improvement.

REACH and The University of Alabama at Birmingham

Birmingham, Alabama, known as the Magic City, the Pittsburgh of the South, and the hotbed of the Civil Rights Movement, is also known for food and physical activity deserts.

Approximately 70% of Birmingham residents live in food deserts or in food imbalance areas and due to conventional sprawl, which causes people to use motorized transportation, Birmingham is the 16th most dangerous metropolitan area in the country for pedestrians. Compounding these social determinants of health challenges is the fact that chronic diseases and obesity rates continue to soar.

An implementation-ready coalition known as Birmingham REACH for Better Health through the University of Alabama (UAB), set out to address these issues by building on their existing infrastructure that included past CDC-REACH initiatives spanning from 1999 to 2018 and Communities Putting Prevention to Work. Through these CDC-funded initiatives, and under the direction of Dr. Mona Fouad, the coalition made tremendous strides such as ensuring comprehensive protections for all workers from secondhand smoke exposure in select cities; creating the Red Rock Ridge and Valley Trail System Masterplan; developing childcare regulations that included obesity prevention policies and, much more.

Although the University of Alabama Birmingham was not funded in 2019, the successes of the program prepared the university to successfully compete for the university’s Grand Challenge, which is part of the university’s strategic plan (Forging the Future) to energize outstanding talent to identify and solve complex societal problems. Dr. Mona Fouad’s Healthy Alabama 2030: Live HealthSmart proposal was selected as the university’s inaugural Grand Challenge winner.

Leveraging the successes and lessons learned from REACH, the coalition plans to elevate the state out of the bottom 10 in national health rankings by the year 2030 through policy, systems, and environmental approaches. Past CDC-REACH funding not only prepared the university to successfully compete on this large-scale but also produced new opportunities for growth, exposure, and sustainability.

Community Health Councils, Inc. (CHC) REACH

Community Health Councils (CHC) became a REACH 2010 grantee in 1999 to address the health disparities that were plaguing under-resourced communities in South Los Angeles.

Specifically, CHC was attempting to understand and address the impact of social determinants of health on chronic disease and develop strategies that would create change not just for the individual but at the broader community level through the impact on policies and systems. CHC continued under REACH US and then the Reach Demonstration grant from 2012-2015 to further address these issues.

During REACH 2010 funding, CHC established the African American Building a Legacy of Health Consortium, a group of community organizations that worked to improve access to quality, nutritious food, and physical activity opportunities through institutional practices, public policy, and local investment. The capacity built among organizations across South Los Angeles has had a continuous impact.

For example, mobilization of community support by members of Neighborhood Food Watch and the Food Policy Roundtable resulted in a plan to develop a new full-service grocery store in the Crenshaw District of South Los Angeles, which was later approved by the City Council. Today, CHC remains a leadership board member of the Los Angeles Food Policy Council and it’s launching its own food-related commercial development to support sustainable wealth building and food access strategies in South LA.

As a result of the REACH demonstration funding, CHC helped to support electronic patient recall systems; Chronic Disease Self-Management Programs; and a referral system for students who failed the FitnessGram across several health care clinics. In addition, CHC developed a Healthy Kids Zone concept in order to create a framework elevating health and safety standards around high-need schools which were adopted as part of the Plan for a Healthy LA. CHC is currently working with the city of LA to pilot test the Health Kids Zone concept in one South LA school to determine best practices for replication.

Boston Public Health Commission

In Boston, the Boston Public Health Commission (BPHC) works to continue the implementation of a smoke-free homes policy and increased access to fresh healthy food and beverages for residents living in low-income housing. The Whittier Choice Neighborhood Initiative supported resident engagement to ensure expanded access to affordable healthy foods, as well as address smoke-free home policies.

Through REACH, BPHC was able to increase the number of supplemental activities to support the continued implementation of smoke-free home policies in public and affordable housing. In the fourth year, they will focus on the evaluation of improved implementation and monitoring of the smoking-violation tracking database. The sustainability of their efforts is seen through the continued monitoring of the smoking-violation tracking database, analysis of data, quality improvement, and the reporting phone line staffing transition from REACH project staff to the Boston Housing Authority Operations team.

In addition, BPHC worked to increase access to low-cost, healthy food and beverage options. By partnering with three non-profit food organizations and four Community Health Centers they were able to build and relationships. They worked to incorporate national best practices around healthy food access, building healthy places, and active designs. A sustainable infrastructure was developed as they developed relationships with community organizations to address the need for access to healthy foods and beverages.

Looking Ahead – A Snapshot from a REACH 2018 Grantee: Gulf Coast Healthy Communities Collaborative & Healthy Families, Mother, and Babies

A REACH 2018 grantee, The Gulf Coast Healthy Communities Collaborative is building partnerships that catalyze data-driven action to impact health. They are working to address a variety of health disparities among African Americans, including heart disease, obesity, food insecurity, lack of breastfeeding, and tobacco use through REACH 2018 in the Mississippi Gulf Coast area. Through REACH they are addressing and creating programs that are long-term and sustainable for the community to continue after the five-year funding cycle ends.

Through this collaborative, they have developed a multisector coalition that brings together all sectors by working together to address all facets of health disparities and create change within the community. Through REACH they are addressing and creating programs that are long-term and sustainable for the community to continue after the five-year funding cycle. They have developed a multisector coalition that brings together all sectors by working together to address all facets of health disparities and create change within the community.

Thus far, through relationships with local hospitals and stakeholders, they have implemented “baby cafes”, which focus on breastfeeding and interpersonal skills for moms of different backgrounds, and baby-friendly hospitals to promote breastfeeding. Through the collaboration with community stakeholders, they also have coolers available at food pantries to increase access to fresh fruits and vegetables. Their hope is that through the community infrastructure that is being implanted through REACH programs, their community investment and effort will continue to improve the overall health of the Mississippi Gulf Coast Area.