Healthy FoodEducationResidentsParks and ActivitiesHousingEconomic JusticeBuilding Blocks:We each have a roleChildcarePreschoolTransportationPolicy MakersJobsSafe Neighbor-hoodsClean AirMedical Care

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All Children Deserve the Best Start in Life We Believe

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1 in 3 newborns start life in povertySource: CAPE with vital statistics data, 2006

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What is the Building Blocks Collaborative (BBC)?7000 infants born in poverty each year in Alameda CountyWhat are the structural conditions that result in health inequities?What weve been doing separately has not been enough.A multi-sector partnership of organizations working together to create equitable community conditions that support well-being from the earliest stages of life.Underpinning our work is the Life Course PerspectiveConvened by the Alameda County Public Health Department

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Building Blocks Collaborative:Statement of PurposeIn response to inequities in health, wealth, and education that limit the ability of Alameda County children to all realize their potential, Together we will ensure a sustainable multi-sector commitment to improved overall well-being for communities and the people who live in them, from the earliest stage and throughout all stages of life.

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Bill of Rights be believed in live, play and grow in a clean, safe place receive a quality education be loved by a caring adult eat healthy food explore nature enjoy economic opportunity and financial security access health care that promotes well-being be free from discrimination and violence be included & valued by a supportive communityAll children in Alameda County have a right to be born healthy,and to:Building Blocks Collaborative, April 2010

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Context: Why we exist

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Health starts where we live, learn, work, and play

Place Matters

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Race and Racism Matters

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and Income Matters.

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The Problem:What weve been doing separately isnt making enough of a difference

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Top 30 Census Tracts Receiving Public Health Services

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Top 30 Census Tracts Receiving Social Services

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Top 30 Census Tracts Receiving Parole Services

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Top 30 Census Tracts Receiving Probation Services

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13 Census Tracts With the Highest Concentration of Services

Are where we see the lowest life expectancy.

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Bus doesnt come; late to schoolMold found in houseDiscriminationYMCA summer program full nothing to doDrug dealers live next doorPoor air quality gets asthmaNot enough textbooks this yearPhysical and Mental Health ImpactsYour neighborhood or job shouldnt be hazardous to your health

No fresh food nearbyStressStressStressStressStressStressStressStress

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Stressed = Protective

Increased cardiac output

Increased available glucose

Enhanced immune functions

Growth of neurons in hippocampus & prefrontal cortex

Stressed Out = Toxic

Hypertension & cardiovascular diseases

Glucose intolerance & insulin resistance

Infection & inflammation

Atrophy & death of neurons in hippocampus & prefrontal cortex vs. Stressed Out Stressed

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How inequities get into the body:The Life Course PerspectiveHow do place and opportunity impact your health?toxic stress can wreak havoc in the body.Research shows:1. Experiences during critical times in development can have an impact much later in life.Not just health education, community, physical environment, economic environment all play a rolePre-pregnancy, pregnancy, early childhood, adolescence2. Impacts of these experiences accumulate to determine your health.

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...and transfer through generations

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Everyone in Alameda County, no matter where you live, how much money you make, or the color of your skin, has access to the same opportunities to lead a healthy, fulfilling and productive life. Health Equity

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The Solution: Working Together to Develop New Strategies

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The groundwork for good health requires the contributions of many sectorsPHYSICAL ENVIRONMENT Experience in the wilderness = higher grades

ECONOMICSNeighborhood poverty = lower early school readiness and poorer long-term academic attainment.

Family savings of as little as $3,000 = higher odds of high school graduation.

A 1% increase in wealth = a 5% boost to a young mans chance of escaping a low-wage job.

EDUCATIONKnowledge of the alphabet at the end of kindergarten = higher SAT scores.

Mothers college education = a child twice as likely to recognize letters in kindergarten (vs. Mothers HS graduation)

COMMUNITYMore social support = better health

Neighborhood education = higher life expectancy

HEALTHBeing born healthy weight = healthy physical, social, and intellectual development.

Low birth weight = heightened risks for problems in school as early as kindergarten.

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Building Blocks Collaborative:We Each Have a Role

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Building Blocks Collaborative:Launched in September 2009Key Objectives: Develop shared vision for diverse partnersApply the Life Course Perspective in our daily work On-going collaborative actionPlanning Framework

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Building Blocks Collaborative:Very committed, diverse organizations

First 5 Alameda County, East Bay Regional Parks District, Mandela Marketplace, Museum of Childrens Art, Oakland Housing Authority, Berkeley Food & Housing Project, Interactive Parenting Media, Urban Strategies Council, Community Financial Resources, Brighter Beginnings, Lotus Bloom Family Resource Center, Girls, Inc. of Alameda County, Kaiser Permanente, Oakland Unified School District, Alameda Health Consortium, Youth Uprising, Lifelong Medical Care, Safe Passages, Oakland Childrens Hospital & Research Center, Centering Pregnancy, Alameda County Sheriff Department, Oakland Parks & Recreation, City of Oakland, Head Start Program, Attitudinal Healing Connection, Operation Hope, Peoples Grocery, Alameda County Child Care Department, Board of Supervisors; East Bay Asian Local Development Corporation, California Family Health Council, Alameda County Juvenile Probation Services, Hayward Recreation, Alameda County Health Care Services Agency, Lucille Packard Foundation for Childrens Health, Alameda County Community Development, PolicyLink, Eden Family Services, Tiburcio Vasquez Health Center, The Link to Children, West Oakland Health Center, Alameda County Public Health Commission, Contra Costa Health Services, Alameda County Community Food Bankand growing!Full group meetings monthly rotating sitesWhat can we do together with the resources we have?

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BBC Leadership Steering Committee is composed of ACPHD staff and partners involved in the Building Blocks Collaborative. Open meetings are held monthly.Members from multiple sectorsLisa Forti (Urban Strategies, Alameda County Community Asset Network)Barbara McCullough (Brighter Beginnings)Dana Harvey (Mandela Marketplace)Elizabeth Hales (East Bay Regional Parks District)Aeeshah Clottey (Attitudinal Healing)Anita Siegel (ACPHD)Kiko Malin (ACPHD)Marge Deichman (ACPHD)

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BBC Strategy AreasIdentified January 2011The Building Blocks Collaborative will engage community members, leaders, and organizations to improve health over a lifetime. We will we will leverage our partnerships, resources, and networks in the following areas: Healthy FoodHealthy EconomyHealthy Youth and Families

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BBC Focus Communities: West Oakland & Ashland-Cherryland

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Developing Community ProjectsParameters Suggested By Steering Committee

BBC Projects will:

Have a clear link(s) to the Bill of RightsBe sustainable and build capacityWork toward systems changeProvide opportunity for broad buy-in and involvement for community and BBC (driven by community need; building on BBC partner strengths) Be achievable, with greatest likelihood of demonstrating success

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Projects: Food to FamiliesYouth-led businesses improve the healthy food environment in West Oakland and Ashland-CherrylandMandela Marketplace youth stocking corner stores with produceDig Deep Farms youth grow produce and distribute food boxesLocal health centers write healthy food prescriptions to refer pregnant women to these resources, and provide healthy eating educationAddresses Bill of Right #1: Be Believed In, #5: Eat Healthy Food, #7 Enjoy Economic Opportunity and Financial SecurityLaunched January 2011; Funded by Kresge Foundation

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Why Food to Families?Based on expressed community need, existing momentum, and BBC strengthsMeets families immediate needs while also working to improve community food landscapeCreates jobs and keeps money in our communities which impacts health!Leverages trusted health provider relationship through written prescriptionsInnovative partnerships

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Projects: BBC Healthy Eating, Active Living ProjectBrighter Beginnings provides parenting teens with Food Smarts nutrition educationNiroga Institute provides pregnant women with tranformative life skills yoga, breathing, meditation Funded by Kaiser Permanente Southern Alameda County

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Projects: Alameda County Prosperity ProjectThe issue: If 10% of West Oakland residents (2000 people) Borrow $500 using a Payday Loan and it costs them $675 in interest thats $1,350,000 being leached from West Oakland.The Collaborative: ACPHD (Place Matters Local Policy Initiative, Life Course Initiative), Alameda County Community Asset Network, and Base Building OrganizationsThe solution: The Prosperity Project will:Advance policies to expand non-predatory financial services in underserved neighborhoodsRaise awareness about fair financial products and sound banking practicesIntegrate financial empowerment curriculum into existing health programs (Family Health Services pilot)Launched October 2011 Funded by Robert Wood Johnson Foundation

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Why Prosperity Project?Meets families needs and works to improve community financial landscapeIncreases availability of healthy financial productsKeeps money in our communities which impacts health!Leverages trusted health provider relationship for financial educationCreates innovative partnerships

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Building Blocks Collaborative Key ValuesHealth Equity through a Life Course PerspectiveRacism, Classism, Place-ismEvery voice is important, each member can see their roleEach sector brings important expertiseNot exclusively tied to a health outcomeTransparency & shared ownershipSystems ChangeHow can we work differently using the resources we haveACPHD Strategic Plan & Life Course Systems Design Committee

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Many seeds have been planted through the work of this collaborativeWhat BBC seeds have taken root?Observing deep and amazing connections and collaborations within a multitude of agencies.Rich dialogue that bridges individual/family needs with changing/broader community conditions.Growing relationships. The BBC has given me the opportunity to meet and come to know so many people representing so many opportunities to enrich and set the right course for our children, their families, and the community.Life Course Bill of Rights brought a broader purpose to our work.September 2010

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Thank you!Bina Shrimali, MPHLife Course Initiative Building Blocks Coordinatorbina.shrimali@acgov.org (510) 268-7078

http://buildingblocksalamedacounty.wordpress.com

1) You are committed toYou have these values2) I(on behalf of BBC)believe we share these same values and vision3) I am excited to share some of these ideas-This presentation represents the knowledge and hard work of many ACPHD staff and partners who compose the BBC*

*1/3 of our newborns start life in poverty in this county 7,000 every year*This has really helped us bond around a shared vision In designing our demonstration projects, we always refer back to the Bill of Rights how is this project upholding the Bill of Rights? And how do we measure success? If children were believed in, how would we know it? > this is where we are now. Developing our indicators and strategiesEach of these speaks to multiple sectors and keeps us all engaged parks and rec cant work on infant mortality

*We believe that all children deserve the best start in life...**Back in 1960 the census only collected data on black and white races. This graph indicates that while life expectancy is increasing for both groups the gap between then has been widening over time.

*So Place Matters because neighborhood conditions shape health.We also see health inequities by income greater neighborhood poverty means lower life expectancy for everyone not just for the richest and the poorest but for everyone in between.And just look where were putting the majority of our resources....**Total service recipients in Alameda County: 284,659

***Despite our best efforts, we are still seeing the worst outcomes in the areas where we are using the most resources.

The definition of insanity is doing the same thing over and over and expecting different results Benjamin Franklin

How do social inequities get into the body? This is especially important to consider in the field of MCH because during pregnancy, the impacts of stress on the unborn fetus can have lifelong impacts*When we think about the communities experiencing the greatest inequities, we think back to the slides on place, race, and income and all the stressors and challenges that come with living in those conditions.

And theres a difference between being stressed and being stressed out. When you are stressed, your body activates a short term protective response When you experience chronic stress with no control over your life, your body can no longer have a healthy response to stress. This results in hypertension and cardiovascular diseases, diabetes, infection, inflammation, and poor learning - making you forget and start to lose your memory if you are under chronic stress.Acute stress results in more cardiac output, energy, immune functioning, and growth in your brains learning center, which can be positive. But chronic stress is toxic. *This is the Barker Hypothesis (connection between low birth weight and future risk of diabetes and heart disease) and weve known it for a long time, but the rest of the world is finally catching up!*Firstwe often talk about health inequities. But what is Health Equity? Or a more formal definitionHealth equity is achieving the highest level of health for all people. Health equity entails focused societal efforts to address avoidable inequalities by equalizing the conditions for health for all groups, especially for those who have experience socioeconomic disadvantage or historical injustices [such as racism]. --Healthy People 2020-LCP shows how and when we should be intervening-critical periods, environment, much more than just health care

What we have learned is that each of our sectors has an impact on healthWhich has really become a cornerstone for how we operate.Many organizations are part of this movement. Our charge is to figure out what we can do together with the resources we have.*Two areas of the county that are experiencing many of the health and social inequities we have been discussing are West Oakland and Ashland-Cherryland. These two communities have been determined to be the focus areas for our work.**Too many Alameda County residents rely on predatory financial institutions to meet their families needs. These families pay more to cash their paychecks, pay their bills and lack a safe place to keep their money. It is easy to get caught in the cycle of dependence on check cashers, payday lenders, rent-to-own stores- where interest rates can reach several hundred percent.The costs to the community of relying on predatory financial products are significant.A healthy and vibrant Alameda County starts with keeping more money in our communities, especially during these tough economic times. Current asset development work is geared toward individual choices, not systemic change in banking policies. This initiative is an opportunity to link service providers, clients, and other residents to influence policy to ensure financial products that meet families needs.

Peralta colleges recently moved its money to support local community banks. One policy that we are looking to advance is Banking Development Districts which is a way to use county funds to incentivize healthy banks/credit unions to locate their services in underserved areas.**Members of the BBC have benefited in myriad ways from their participation in the BBC. Here are a few comments we collected from members when we celebrated our first anniversary.**