First grader Aryanna Smith looks back as the Hispanic Health Council SNAP-Ed nutrition educators perform part of a puppet show about food groups at Burns Latino School. Photo by Bailey Wright
Working with and for
The Hispanic Health Council combats food insecurity
The Mobile Market
By Amar Batra
Fresh Food on Wheels
Brought to young and old
Vegetables offered at the mobile market counter set up at Community Health Center in Hartford, Conn. The mobile market provides inexpensive fresh vegetables and fruits throughout Hartford daily. Photo by Bailey Wright
By Annabelle Orlando and Karla Santos
Lisset Holandes credits the Hispanic Health Council with helping her eat healthier.
“I remember I used to come on Tuesdays,” said the Hartford resident who is a mother of two. “They always used to give me a recipe of how to make the food they were giving me. It was pretty cool. I started eating kale, which I never ate kale before.”
Holandes, a former HHC client who is now an employee, is among the many city residents the agency helps in a variety of ways. A non-profit organization founded in 1978, the HHC has a three-part mission: to listen to community members to learn their needs, to work independently and with other groups to develop and evaluate services, and to advocate for changes that will eliminate health disparities. It is supported primarily by state, federal and foundation grants.
Much of its work centers around food.
At its headquarters at 175 Main St., it helps low-income clients secure food benefits through the Supplemental Nutrition Assistance Program, and helps pregnant women and mothers with small children get food and health benefits through Women, Infants and Children. With another non-profit agency, Hartford Food System, it also supports a food bus that brings fresh fruits and vegetables to neighborhoods throughout the city. When a client’s food, money and benefits run out before the end of the month, HHC helps them find emergency provisions.
HHC reaches about 50,000 clients in Hartford and beyond, associate unit director of nutrition Sofia Segura-Perez said. In a city with high poverty and limited access to fresh, healthful and affordable food, the agency fills a major need.
About one-in-four Hartford residents lives in an area classified as a food desert by the United States Department of Agriculture. There is a Stop and Shop and a Walmart Superstore near the West Hartford border, but for residents in the core city without cars, the stores are not easily accessible. Although there are many small grocery stores in the city, most “do not offer a lot of healthy food choices,” Segura-Perez said, adding “also, the prices are high.”
“The definition of a food desert is usually a place where there is a lack of access to healthy foods such as fruits and vegetables, and very high accesses to processed foods, which are usually high in fat and sodium,” Segura-Perez said. “Hartford does not have a simple supermarket within the city, a large supermarket where the residents can buy an array of fruits and vegetables.”
HHC worked with Hartford Food System to establish Hartford Mobile Market, a converted school bus that brings healthy foods to residents who don’t have the means to get to a suburban supermarket. The bus makes 10 stops weekly in neighborhoods throughout the city. Customers can use SNAP or WIC benefits, as well as cash, credit or debit cards to purchase fruit and vegetables. Although most farmers markets in the city operate seasonally, the bus runs year-round. It reaches some 200 residents weekly in the winter and double that during the warmer months.
“They’re a big support system,” Holandes said, referring to the parenting support and other assistance HHC also provides. The agency, which she said she first contacted when she was pregnant, helped her set life and educational goals and assisted in her search for daycare providers, for example.
Segura-Perez said the HHC’s philosophy is to reach out to all age groups.
“This program follows a lifecycle approach,” she said. “So, we work with kids, with school children, with their parents, with [the] elderly, with pregnant women and a lot is with preschool children.”
In 1995, for example, the HHC began a series of puppet shows for young children. The shows promote good nutrition and physical activity among children, Segura-Perez said. Each show in the series of six has a different theme. One is about heart health, another about exercise and the dangers of smoking, and another focuses on farms and the food they provide. There also is a show about diabetes prevention and another about how to keep food safe from bacteria, she said.
Magaly Castro of Hartford, a mother of five, said HHC not only showed her how to use her phone to get information about food pantries at local churches, it also helped her become a better parent.
“All of the information has helped me to learn how to understand them [her children] more,” Castro said. “I have two kids at home that are ADHD, so along with the parenting there have been a lot of changes in my house.”
Children with ADHD, or attention deficit hyperactivity disorder, can demonstrate impulsive behavior, an inability to focus, hypersensitivity and forgetfulness, requiring special parenting skills. For these children, eating a healthy diet is important – just as it is for any child.
Annabelle Orlando is a senior at the University of Connecticut majoring in journalism and Africana studies.
Karla Santos is a 2017 University of Connecticut journalism graduate.
By Frank Greenwood Jr.
The bright blue 39-foot bus with Mobile Market written in bold letters on both sides is hard to miss as it pulls into the parking lot of Immanuel House, an assisted living complex in Hartford’s Asylum Hill neighborhood. Once the bus is parked, the three-person market team hauls the day’s supply of fruit and vegetables into the lobby.
As the team sets up tables and stacks crates of produce, a couple of customers watch, waiting to be the first to peruse the apples, oranges, bananas and other fruits and vegetables.
The elevator’s arrival is announced with a ding. Larry Switzer, a regular customer, steps out with the help of his cane. The market team smiles and calls to him.
“They know what I want – tomatoes and bananas every week,” Switzer said. He adjusts his cap as he waits for his bag to be filled.
As a longtime resident of Hartford he understands the struggles many people face in acquiring healthful food in the city. “It’s a good program to have,” Switzer said, chuckling as he added that the senior citizens, “can’t go out, so they come to us.”
Switzer is one of about 25 people who stock up on fresh fruit and vegetables on this winter afternoon. Without the Mobile Market, these residents might eat more processed, canned or junk food. Fresh produce is otherwise not readily available close by.
The Mobile Market began operating in December 2014 as a way to combat a dire need: the lack of affordable, fresh food in many city neighborhoods. Hartford is a city without a major supermarket in its core population area, although it has an abundance of fast and junk food options.
The mobile market is a collaboration of the Hispanic Health Council and Hartford Food System. It originally was funded by two local agencies that regularly support programming aimed at healthier lifestyles: Harvard Pilgrim Health Care Foundation and Hartford Hospital. It began with just two stops - the Hispanic Health Council at 175 Main St. and Community Health Services at 500 Albany Ave. Now, it makes 10 stops, serves most city neighborhoods and brings fresh food to some 200 people weekly during the winter and more than double that during warmer weather as more people are willing to venture outdoors to shop. It welcomes all customers, regardless of income level.
The bus also now receives additional financial support from the City of Hartford,
Bank of America, Mass Mutual Financial Group, the US Department of Agriculture
and NBC Universal Foundation. It costs about $35,000 annually to operate, about
$15,000 going to maintain the bus and the remaining money for wages, said
Shana Smith, program coordinator for both the mobile market and North End
Farmers markets for the Hartford Food System.
“You go exactly where the need is, and where you can have parking –
that’s a pretty big deal in a 39-foot bus,” Smith said. “All the places we stop
are places where there is a lot of foot traffic, so even if a person wasn’t intending
upon buying something at the Mobile Market, they may stop in. I would love to
have everybody come on the bus and shop,” Smith said.
Jim Dombroski, the bus driver who also is a local farmer, said the bus provides
personal service. Dombroski said he “stumbled into the job,” as a friend mentioned
the position to him because he has the specialized license necessary to drive the bus.
“There is a lot of interaction with regular customers,” he said.
Switzer, for example, chatted with Nikki Knowles, a member of the market team, as she bagged his weekly order.
“It’s very personal,” he said, before walking away smiling and carrying his bag of produce.
Dombroski said he enjoys talking with customers about what crops they would like him to grow. “I can see what people want in the city, and base what I grow off of what is popular,” he said.
The Mobile Market also offers more affordable produce than suburban supermarkets. At a recent market stop, for example, it was selling two apples for $1, three oranges for $1 and mangoes for $1.25 each. This was about half the cost of the same produce at large supermarket chains during the same time period.
“The prices are better here,” Joe Williams, another regular customer said. “Every time they are here I come and shop.”
The bus schedule also is reliable. The Mobile Market runs unless snow and ice prevents it. The general rule of thumb is if Hartford Public Schools close, the Mobile Market does not run.
“We really try to make it, rain, sleet or snow like the post office,” Smith said, “But there are some times where things aren’t adequately plowed and we can’t make it.”
Besides offering food, at each stop a representative of the Hispanic Health Council provides information about healthy eating. At a recent Asylum Hill Boys and Girls Club stop, for example, an interactive display showed the sugar content of soda, juices and energy drinks, along with an example of a balanced meal. Most of the balanced meal plate was filled by vegetables, with the second largest portion occupied by grains, and fruits and proteins each occupying smaller portions. At Immanuel House the educational display focused on the relationship between salt and blood pressure.
“We try to do different things every week to show what is good and what is bad,” Lisbet Chaves, a health representative from the Hispanic Health Council said.
Chavez also said it’s crucial to expose children to this information.
“If you don’t get that information to them at an early age, it’s difficult to change the bad habits as adults,” she said.
Even when residents understand the importance of healthy eating, the low cost and ready availability of junk food in the city can make it easier and cheaper to eat poorly.
“Everybody shouldn’t be forced to eat McDonald’s every day,” Knowles said.
The Mobile Market gets its produce from two main food suppliers -
FreshPoint and Restaurant Depot. FreshPoint is a leading fresh
produce distributor and Restaurant Depot is a members-only
wholesale cash and carry food service supplier. Both national chains
have distribution centers in Hartford. The market also carries
local produce when it’s available.
Dombroski’s Simsbury and Hartford farms, both certified organic,
help supply the Mobile Market. In Hartford, Dombroski farms at the
KNOX community gardens whose main greenhouse is at 75 Laurel St.
KNOX also has 20 community gardens throughout the city.
In Simsbury, he farms at the community gardens on Sand Hill Road.
In recognition of the city’s cultural diversity, the
Mobile Market tries to accommodate special food requests.
“Each site host sends me a list of things that they recommend for their stops, and at any given time we will try to incorporate those into each stop,” Smith said. “We take great pride in trying to provide, maybe, malanga to the South End, and the North End is big on greens.”
Malanga, a root vegetable similar to a potato, is popular with the city’s many Hispanic and Latino residents.
The Mobile Market also is flexible about payment, accepting cash, credit, debit and Supplemental Nutrition Assistance Program benefits better known as SNAP. In an effort to entice more low-income residents to buy fresh produce, the bus provides SNAP customers with three extra dollars to spend for every five dollars worth of purchases.
In the future, the Mobile Market team hopes to reach even more Hartford residents. It plans to add weekend stops, for example.
“The bus can be a rolling Whole Foods, a Trader Joe’s,” Smith said. “It’s all about the money and funding. We already have the audience.”
Frank Greenwood is a sophomore majoring in journalism and political science at the University of Connecticut.
Nickolle Knowles, a mobile market volunteer, assists a woman buying produce at the mobile market counter in the Community Health Center. The mobile market provides inexpensive fresh vegetables and fruits throughout Hartford. Photo by Bailey Wright
The High Price for
How Type-2 Diabetes takes a
toll on the impoverished
By PaulMichael Mullally
Comalita Elliott is dedicated to helping people prevent or better manage their diabetes. A registered nurse and certified diabetes educator with the diabetes and endocrinology team at the Connecticut Children’s Medical Center, Elliott also leads a church-based diabetes support group in Hartford’s North End and frequently teaches about the importance of eating fresh, healthy foods and exercising regularly.
Yet in a city where both poverty is common, she knows her lessons are difficult for many patients to carry out.
“The veggies, the fruits, the lean-meats (are all) the foods that you really need and they’re going to be a lot more expensive,” Elliott said.
It’s also difficult for Hartford residents to grow their own fresh foods because most have no space to do so. Even for those whose incomes are not so tightly limited, Elliott points out there’s simply no full-service supermarket within the center of the city.
Then there are the barriers to exercise, which can reduce insulin resistance and help battle obesity – a leading risk factor for adult-onset diabetes.
“We do not have a plan in place for walking spaces,” Dr. Gary Rhule, the city’s director of health, said. “Walkability of environment is an issue. Public safety… and perception of public safety is also an issue.”
The Centers for Disease Control and Prevention estimates 8.5 percent of Hartford’s residents are living with diabetes. While that’s about average, Elliott said other residents do not yet know they have the disease.
According to the American Diabetes Association, people who are black or Hispanic are 70 percent more likely than white residents to have diabetes. This places Hartford’s population particularly at risk. A demographic compiled by the city in 2014 says that 78 percent of Hartford residents are black or Hispanic.
Elliott said there are “really no advantages” for diabetics living in the city. Besides a lack of exercise space and affordable fresh foods, she argues that Hartford diabetics also face cultural barriers, unequal access to healthcare and a lack of education about their diagnoses.
There are two types of diabetes. Those with Type 1 diabetes do not produce insulin, so sugar builds up in the blood rather than producing energy in the cells. In Type 2 diabetes, the body is unable to use insulin in the correct way. Type 2 is the more common form, particularly in adults, Elliott said.
One of the largest problems Type 2 diabetics in minority communities face is just getting diagnosed, Elliott said. About a decade ago she worked on a research task-force in Hartford that found that diagnosis came latest for African-American residents, and Hispanics were the second-latest. This is problematic, she said, because by the time individuals discover they have diabetes, they can already have serious complications, such as cardiovascular disease or nerve damage. At that point, their diabetes is harder to treat, she said. Diabetes is also typically more aggressive in African-Americans, she said.
Elliott also points out that there is unequal access to healthcare. A 2014 report called Healthy Connecticut 2020, found that “health insurance coverage is lower in Connecticut’s largest towns and for Hispanics. Hispanics are also less likely than other racial or ethnic groups to have a usual source of care. Preventable emergency department visits and medically undeserved and health professional shortage areas are more common in and around Connecticut’s largest towns.” In Hartford, Rhule said, even when care is available, many patients can’t afford to go home and fill their prescriptions.
In addition, language and cultural barriers sometimes prevent patients from appropriately discussing treatment options with their healthcare providers, Elliott said. Doctors may delay treatments that are time-consuming, expensive and require more frequent follow-ups, she said, such as starting a patient on insulin injections.
Rhule acknowledged there is more the city can do to help residents prevent or better manage diabetes. With obesity a major contributing factor to diabetes, Rhule said, for example, the city could work more closely with local restaurants.
“We have to do a lot more outreach to fast food restaurants,” he said. The establishments should “be more mindful of their meals,” Rhule said, referring to the often sugar-saturated, high-fat, over-sized meals that some fast food restaurants serve.
The city could more effectively partner with all the city’s restaurants to encourage them to make smaller, healthier meals for their customers, he said.
Elliott works directly with patients. Besides her hospital job with children, she oversees a monthly support group for diabetics called “Each One, Teach One.” Established in 2004, it meets at the Mount Calvary Baptist Church, 2 F.D.Oates Ave., and reaches older patients.
The group’s aims are two-fold: to teach everything people need to know about living with diabetes, and to provide community support. She teaches lessons on topics such as portion control, how to administer medication, and how to exercise better.
Charlotte, a 76-year-old city resident who asked that her full name not be used in this article, is one of the group’s original members. She was diagnosed with Type 2 diabetes 20 years ago, but said she still has to work hard to manage her disease. In the support group, Charlotte says, she learns to better manage her food portions and how to cook healthier, and gets social support from medical professionals and other diabetics.
“Sometimes you do eat-over that portion, but you have to live a little,” Charlotte joked.
Elliott said that tastings and demonstrating to group members how to cook healthier always go well. For example, she might cook smoked turkey instead of the fattier and sodium-heavy ham hocks or salted pork used in many traditional recipes.
Group members always come with questions in hand, she said. But there is more to the group than education.
“They like the camaraderie,” Elliott said, “to be together, the peer-to-peer education. They really enjoy it.”
PaulMichael Mullally is a 2017 University of Connecticut graduate with majors in journalism and communication.
A Guide to Organizations
End Hunger Connecticut!
End Hunger Connecticut! is a statewide anti-hunger and food security organization that serves as a comprehensive anti-hunger resource for policymakers, community organizations and low-income families. The work of End Hunger Connecticut! is vital to the visibility and coordination of various federal food assistance programs that are meant to lower the prevalence of food insecurity and hunger. End Hunger Connecticut!'s goal is to improve the levels of food security and nutrition among Connecticut families while creating and supporting policies that move families toward self-sufficiency.
For more information visit: endhungerct.org
Foodshare serves Hartford and Tolland counties by getting donations from the food industry and distributing them to 300 food pantries, community kitchens, homeless shelters and other partner programs. It also distributes foods directly to clients through mobile Foodshare trucks, which stop at 71 sites throughout Hartford and Tolland counties every two weeks. More than one-third of the food Foodshare distributes is fresh fruits and vegetables, whole grains, lean meats and dairy.
For more information visit: site.foodshare.org
A collaborative project of The Junior League of Hartford; the Chrysalis Center, a Connecticut-based nonprofit healthcare agency; and Foodshare, a regional food bank, Freshplace is an innovative food pantry designed to tackle chronic hunger and related issues in one of the poorest neighborhoods in Hartford. It provides at-risk families with fresh fruits, vegetables, meat and dairy products in addition to pantry staples. Besides food services, clients also are guided in making selections that accommodate their health, cultural, religious and familial needs.
For more information visit: ajli.org
Hartford Food System
Hartford Food System is an organization that is dedicated to finding long-term solutions for access to affordable and healthy food in the city of Hartford. It implements programs that improve access to nutritious and affordable food, help consumers make informed food choices, advocate for a robust and economically sound food system, and promote responsible food policies at all levels of government.
For more information visit: hartfordfood.org
Hispanic Health Council
The Hispanic Health Council's programs include nutrition education through the public schools in many of Connecticut's lowest-income cities, and one-on-one counseling for pregnant women, breastfeeding mothers, and people with diabetes. The council also provides group and individual support for substance-abusing women at risk for HIV/AIDS and parenting support to build stronger families. Through these programs the council serves thousands of people every year.
For more information visit: hispanichealth.com
National School Lunch Program
The National School Lunch Program is a federally assisted meal program operating in public and non-profit private schools and residential child care institutions. Established under the National School Lunch Act, this program provides nutritionally balanced, low-cost or free lunches to children each school day.
For more information visit: fns.usda.gov
The Supplemental Nutrition Assistance Program (SNAP), offers nutrition assistance to millions of eligible, low income individuals and families and provides economic benefits to communities. SNAP is the largest program in the domestic hunger safety net. The Food and Nutrition Service works with state agencies, nutrition educators and neighborhood and faith-based organizations to ensure that those eligible for nutrition assistance can make informed decisions about applying for the program and can access benefits.
For more information visit: fns.usda.gov
The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides federal grants to states for supplemental foods, health care referrals and nutrition education for low-income pregnant, breastfeeding, and non-breastfeeding postpartum women, and to infants and children up to age five who are found to be at nutritional risk. Most state WIC programs provide vouchers that participants use at authorized food stores. A wide variety of state and local organizations cooperate in providing the food and health care benefits, and 46,000 merchants nationwide accept WIC vouchers.
For more information visit: fns.usda.gov