Obesity - A Trend We Should, and Can, Reverse

Imagine: You want to maintain a healthy diet, but you don’t have convenient access to grocery stores that provide a variety of fresh fruits and vegetables, or you live and work where it is far easier to eat high calorie, high fat foods than to eat more nutritious alternatives. Regardless of your good intentions, you may gain weight, increase your blood pressure, develop diabetes, and die a premature death. That’s how social, economic, and other environmental factors influence your health.

In February, in collaboration with the InCommons initiative, we convened a gathering of people who want to empower communities to take control of their health. We shared knowledge with one another about the issue, and we specifically looked at three initiatives.

Columbia Heights School District created an “Edible Schoolyard/Outdoor Classroom” to educate students about good nutrition and to provide a welcoming gathering place for students and the community. The Neighborhood Food Project is a grassroots effort to increase access to healthy food in four neighborhoods in Saint Paul: Dayton’s Bluff, Payne-Phalen, Thomas-Dale/Frogtown, and Summit-University. Dakota County Public Health Department – concerned because of a report published by the New England Journal of Medicine stating that, because of obesity, this generation of children could be the first in the history of the United States to live less healthful and shorter lives than their parents – worked with Wilder Research to conduct a series of focus groups with parents and caregivers of preschool children, and then implemented evidence-based programs in over 200 child care centers to improve nutrition and increase physical activity.

InCommons has begun to connect Minnesotans so they can find and share credible tools, knowledge and resources to solve community problems. Lessons learned in one community can become starting points for addressing similar issues in towns and cities elsewhere in the state. Through InCommons, strangers can become powerful allies in support of common endeavors.

The United States ranks above almost all developed countries of the world in rates of obesity for children and adults. These are rapidly increasing. (See http://www.mncompass.org/health/index.php ) Addressing obesity (and many other issues) requires community will and engagement, informed by solid information on community trends and on what interventions can work to push those trends in a positive direction. Working together, we can make a difference. I encourage you to join our virtual gathering on InCommons and add your voice to making our communities healthier. Join us at:

http://www.incommons.org/en-us/node/3169/gathering

Health Care Policy Development: We can't just call names

In a voice mail last week, a caller stridently informed me that “This is America.” This individual had read comments in my January 1^st blog, regarding health care. The caller stated: “You know, a federal judge in Florida just declared Obamacare unconstitutional.” Undoubtedly skilled in political philosophy, he then informed me of his overall conclusion: “This is not socialism; it’s not fascism. This is America.”

Although I had publicly presented my views, the caller, in the true spirit of free speech, remained anonymous and blocked Caller ID.

His narrow-minded, strident approach – laughable in some ways, sad in others – should concern us. The content of his view on health care does not disturb me, nor does his ignorance. Rather, it’s the style of attack, and the infectiousness of this style, especially if fueled by ultra-partisan, fear-mongering political commentators – that’s what’s scary, at a time when we need multi-partisan efforts to overcome significant challenges which our communities face.

His ignorance – we can dispose of that quickly. He failed to understand what the judge actually did. The Florida judge ruled unconstitutional the “individual responsibility” provision of the Affordable Care Act, which compelled the purchase of health insurance; the judge went on to state that this provision seemed so integral to the legislation that the entire act would have to fall. Other federal judges earlier ruled the opposite way, but the caller did not indicate how those rulings fit into his “this is America” thesis.

In fairness to the anonymous caller, I have reservations about requiring people to purchase health insurance. I do understand the logic of the requirement. Given market forces, it makes sense to require the purchase of insurance, in order to lower overall insurance costs for everyone. We’re stuck with that situation for as long as we fail to provide universal coverage for all. Nonetheless, as the Florida judge and at least one other judge have decided, mandating the purchase of health insurance might go too far, no matter how good the mandate’s rationale.

Disturbing, however – for those of us devoted to informing and working with the electorate and public officials, to promote wise public policy – is the caller’s immediate descent to the level of mischaracterization and “name calling” to draw attention away from rational debate over the issues: “If Paul supports health care for everyone, he must be a socialist or a fascist. Let’s marginalize his opinions with some distasteful labels and make sure nobody pays attention to Paul.”

I do not espouse a partisan view on health care. Universal health coverage for all Americans can come in Republican, Democrat, liberal, or conservative dress, for all I care. My goal is to optimize the quality of life for all and to do so in a collaborative, multi-partisan way. With respect to health care, that requires finding a means to ensure that all people in this country can go to sleep at night, comforted in knowing that they have the health coverage they need.

Why is this important? Notwithstanding any ethical opinions we might have regarding whether or not people deserve health care, the fact is that, among the developed nations of the world, we do not look as good as we should on health outcomes. Our rates of obesity and overweight exceed those of almost all other developed countries. People live longer elsewhere, e.g., in several European countries. Because of health care? Not necessarily; research evidence provides mixed findings, at least regarding the past. However, in the U.S., our fastest growing populations have the poorest health outcomes (higher mortality rates, higher diabetes rates, higher obesity rates), and they have the lowest rates of access to health insurance and health care. We must pay attention to this.

My response to the caller: I understand “this is America”. I have concern not about the status quo, and maintaining what is America, but rather about the future, and what will be America. To create the future we want in the 21^st century, our debate about issues has to rise above name calling; our progress must include multi-partisan give and take.

Should Martin Luther King Day be a "Holiday"?

Depending on your definition of "holiday", maybe not.

For about 10 of the past 20 years, I've started Martin Luther King Day early, with the privilege of attending the annual MLK Breakfast, in Minneapolis. I've listened in person to luminaries such as Harry Belafonte (more than just a singer, believe me!), General Colin Powell, Andrew Young, Cornel West, Julian Bond, and others. In addition, twice, I attended neighborhood breakfasts, watching the annual event on a large screen, alongside others from my Saint Paul neighborhood and from the broader community. Each year, such events offer time to reflect on the principles and the values which Dr. King espoused, the inspiration he provided to us in the sixties, before his assassination, and the continuing relevance of his words to the challenges of the 21st century.

Nonetheless, in the nineties, as many organizations debated whether to offer their employees a three day weekend, or to retain Martin Luther King Day as a work day, I expressed some concerns. Might Martin Luther King Day become no more than an opportunity for recreation, with no time spent on reflection about the importance of this great human being and about the effect of all that he accomplished for our country?

Other holidays don’t have much effect on us, do they? How many of our nation's residents take time on Presidents Day to reflect on the presidency and the importance of our Constitution, the Executive Branch, and the separation of powers? How many use Washington's Birthday as an opportunity to remember the history and principles of the American Revolution, the original "Tea Party", the evolution from monarchy to democracy? How many pause on February 12 to remember the man who led our country through the struggle to free slaves and promote equality?

I suggested that we might produce more benefits by having people report for work, but requiring workplace education and discussion of the life and values of the Reverend Dr. Martin Luther King, Jr. Needless to say, such a provocative suggestion lacked political correctness; it garnered little support.

My concern returns every year, including this one. Consider this:

• Several colleagues noted less traffic during their Friday commutes. They guessed that some commuters had likely begun their weekend early, turning it into a four-day occasion. Had people left for the weekend to visit the King historic site in Atlanta (an excellent museum; as you know if you have been there)? Had they traveled to Washington, D.C., or to any other place with special events this weekend? I think I know your answer.
• This year, in contrast to the early years of the Minneapolis MLK Breakfast, some organizations which purchased one or more tables’ worth of tickets had trouble finding enough employees willing to attend. Why should someone get up and get out of bed at 6:00 a.m. on their “holiday”?

In fairness, Martin Luther King Day does bring out crowds to events in Minnesota – true to our deserved reputation as some of the most engaged people in the country. (See www.tccompass.org) However, is it enough?

At the 2010 MLK Breakfast, the keynote speaker, Dr. Joseph Lowery, encouraged us to move from “charity” to “love”. He suggested that we not just focus on occasional, episodic endeavors to work for the good of our fellow humans, but rather that we apply ourselves continually to empowering all members of our communities to do more to increase our quality of life.

Doing what’s necessary to make this world a better place requires more than taking a “day off” on Martin Luther King Day. It requires making each of the 365 days of the year a “day on”, living out the values and vision of Dr. King, and encouraging others to do so. Let’s all make this third Monday of January 2011 a day to work hard to “transform the jangling discords of our nation into a beautiful symphony of brotherhood”. We all deserve relaxation, fun, and time with family and friends; but let’s do the work of the holiday, before we play.

Top National News Events, with Local Implications

What happened in our nation in 2010 that will undoubtedly have implications at our local level?

Merriam-Webster’s identified “austerity” as the word of the year. That single word may well encapsulate the major themes underlying my “top 7” list.

1. Health care reform: significant movement forward; a missed opportunity. On the positive side, the nation made progress on health care. An overhaul of the health care system did occur. New legislation makes care more affordable and eliminates restrictions based on pre-existing conditions, for example. This will help to reduce health disparities and promote greater effectiveness of care for everyone. However, failure to provide free, universal health coverage to all Americans puts us behind other first-world countries. In the U.K., where I lived for a year and visit frequently, everyone, from poorest to richest, goes to sleep at night secure in the feeling that they have health coverage. What a difference it would make if everyone in the U.S. had the same reassuring feeling. What if all of our children’s physical and mental health needs received attention, and did not detract from their ability to learn at school? I don’t care whether we adopt a Democrat plan or a Republican plan. My vote would go to a referendum to require Congress and their families to go without health insurance until all of their constituents have coverage. We could have free universal health care in a very short period of time!

2. National and state elections; the “shellacking” of the President. Voters delivered a message; the President, in his own words, said he was “shellacked”. With a House Republican majority (242 to 193) and a Senate Democrat majority (53 to 47), can we expect any bipartisan cooperation, or only endless, partisan stalemate? If the latter, we will have to do more on our own at the local level to promote education, jobs, and housing initiatives that will maintain our quality of life.

3. Economy perhaps gaining; jobs not. We seemed to begin to emerge during 2010 from a bad recession. However, job creation has not rebounded; unemployment remains high; the housing market has not recovered. (What little job growth we experienced in the first part of the year became insignificant in the face of cuts and a slowing of the job growth rate for much of the rest of the year.) Jobs are crucial; economic stability is vital for families. For many of the issues we encounter in education, for many of the problems that confront our communities – a healthy economy, including an adequate number of jobs, provides prevention and solutions. Efforts to improve our communities in 2011 will fare better if we can improve the economic infrastructure.

4. Arizona immigration controversy. Arizona’s law, the strictest in the nation, requiring people to carry their registration cards, drew intense attention to the topic of immigration. Heightened attention can have many benefits, if informed by facts. Our immigration research and public seminar this year, with the Minneapolis Foundation, convened people who understand that, in our globally interdependent modern world, we cannot simply put up fences, literally and figuratively. We must understand immigration within the larger context of our changing demographics, our desire to remain competitive in the world economy, and the necessity of forming positive relationships with countries throughout the world. The future of our nation and neighborhoods depends on it.

5. “Racing to the top” in education (but not yet winning the race). In 2010, our federal government committed billions of dollars to promote the “race to the top”. Nine states and the District of Columbia won grants to develop new standards to promote student success, to develop data systems to promote and measure progress, to recruit and retain effective principals and teachers, and to turn around their lowest performing schools. “Waiting for Superman” broadened the awareness of the general public regarding the quality of our nation’s schools. However, also in 2010, international data showed that we’re slipping. The United States ranks far from the top in Science, Reading, and Mathematics – well below places such as China, Korea, Japan, Canada, and Australia, on all measures. On some measures, the U.S. could not outperform much smaller countries like Iceland, Poland, Slovenia, Finland, and Estonia. Secretary of Education Arne Duncan commented: “The United States came in 23^rd or 24^th in most subjects. We can quibble, or we can face the brutal truth that we’re being out-educated.”

6. Tea Parties. Whether you participated or not, whether you love the partiers or despise them, you must acknowledge that the tea party movement constitutes a strong, clear manifestation of what it means to live in a democratic society. The movement emerged, and then drew energy from the grassroots. It profoundly influenced the 2010 elections; it will continue to influence policy. We who care about human services and community development must recognize that the movement offers another dimension to the broader, less strident, and less partisan concern among voters of many different political persuasions that we must show tangible results from the money we raise in taxes and spend on programs.

7. Poverty rates announced as highest since 1994. The Census Bureau issued this announcement in September of 2010, for 2009: an overall poverty rate of 14.3% (43.6 million people in poverty in 2009, up from 39.8 million in 2008 — the third consecutive annual increase). We had higher rates of poverty in this country in the 1960s, especially among older people. Nonetheless, this is a new peak for the past couple of decades. Meanwhile, the Census Bureau reported that the number of people without health insurance coverage rose from 46.3 million in 2008 to 50.7 million in 2009, while the percentage increased from 15.4 percent to 16.7 percent over the same period. Let’s hope that changes in a positive direction, as a result of the 2010 health care legislation.

Austerity. By the way, you might want to take a look at the Merriam-Webster web site, if you’re curious about 2010’s top words. I used “austerity” in a speech several weeks ago – perhaps contributing to propelling it into first place. As the lexicographers explained: Topping the list is austerity, defined as "enforced or extreme economy." Lookups for austerity peaked dramatically several times throughout the year, as people's attention was drawn to global economic conditions and the debt crises in Europe, but lookups also remained strong throughout the year, reflecting widespread use of the word in many contexts. "Austerity clearly resonates with many people," said Peter Sokolowski, Editor at Large at Merriam-Webster, who monitors online dictionary searches. "We often hear it used in the context of government measures, but we also apply it to our own personal finances and what is sometimes called the new normal."

Happy New Year! I wish you the best; and I look forward to working with you on these issues that face our communities.

Social Change Powered by Data

“You used to be a fun guy, talking about all the cute kids you were helping. Now, all you do is talk about data.” Geoffrey Canada jokingly referred to comments from friends, who noted the transformation in his behavior as he created an important new model for education: the Harlem Children’s Zone.

You might have seen Geoff in the American Express commercials on TV, or in the recently-released movie, Waiting for Superman. His approach to using information represents a new version of the old aphorism, “What gets measured, gets done.” Meaningful measurement can motivate, guide, and enable everyone who works on improving the lives of our children to understand what’s going right and what’s going wrong with the education of those children.

Harlem Children’s Zone has created what they call “a new paradigm for fighting poverty.” It has five core principles:

• · Serve an entire neighborhood comprehensively and at scale.
• · Create a pipeline of support. Provide support that starts with prenatal programs for parents and finishes when children graduate from college.
• · Build community among residents, institutions, and stakeholders, who help to create the environment necessary for children’s healthy development.
• · Evaluate program outcomes and create a feedback loop that cycles data back to management for use in improving and refining program offerings.
• · Cultivate a culture of success rooted in passion, accountability, leadership, and teamwork.

The emphasis on outcomes, data, and the use of information for continuous improvement reminds me of the visit I had with Dr. Beverly Hall, the superintendent of the Atlanta Public Schools. As she told the story, two ingredients for her successful reform of those schools are: (1) making sure that everyone – from the teacher’s aide and the cafeteria worker to the principal and associate superintendent – understands his or her role in educating the system’s children; and (2) using data at all levels to set goals, monitor performance, and continuously improve outcomes (by improving every step that everyone takes toward meeting those outcomes).

Our Saint Paul Promise Neighborhood includes a unique and powerful approach to promotion of children’s success through community organizing, which builds upon data. Neighborhood residents, both adults and youth, designed a community assessment, to understand the needs of the neighborhood’s children and their families. Powered by that information, six Solution Action Groups, totaling 120 or so residents and experts, will identify how this community can support children’s success in school and in life, “from cradle to career.”

Challenges exist in Saint Paul, some of which Geoffrey Canada faced in Harlem, some of which he did not. One challenge, for example: of the 8,500 children 18 and younger in the Saint Paul Promise Neighborhood, barely a few hundred attend schools in the neighborhood. So, the approach to improving their educational achievement is not as simple as creating something at an existing site and expecting that it can help most children in the neighborhood. We will look at solutions which can address all children, some of whom are too young yet to attend school. Another challenge: organizing resources. We will have to produce significant community change without expecting that financial resources will increase. In fact, they might decline. Our approach will build upon the ingenuity of an empowered neighborhood to identify how the formal systems of education, health, public safety, and human services can realign, along with the community systems of families, friends, and neighbors, to create a new environment that supports our children.

Data powers all this: the data from our community assessment; data on educational performance; other data on community conditions. Data will provide the raw material for helping us determine where we want to go, how we will get there, and whether we have arrived.

More on the Saint Paul Promise Neighborhood, as time goes by. For now, I hope I’ve made clear how sound, credible information, placed into the hands of community residents and others who care about the well-being of our children, can fuel a process of highly productive community organizing, to improve the success of the neighborhood’s children in school and in life.

Comments? Please let me know.

Interested in learning more about the Saint Paul Promise Neighborhood? Check the web site:

http://www.wilder.org/promiseneighborhood.0.html

Interested in joining a Solution Action Group? Take a look at the description and the application on the website.

Happy Thanksgiving!