The Build-Healthy Ontario Initiative: Battling Obesity

Nationally, obesity is one of the leading causes of death, and costs the medical care system upwards of $147 billion. Estimates on the indirect costs of obesity, primarily workplace absenteeism and lost productivity, range from and additional $79-$132 per obese individual. In Ontario, California, 67 percent of adults are overweight or obese, and four of the 10 leading causes of death are nutrition-related. The causes are social, environmental, and policy-driven. For example, Ontario contains food deserts, where residents live more than a half-mile from a grocery store or other healthy food outlet.

Partners for Better Health is the lead and conveying agency for the BUILD-HOI initiative

The Healthy Ontario Initiative

is a multi-disciplinary partnership of public, private and nonprofit organizations working to increase prevention and wellness among individuals and families who face a variety of economic, social and language barriers when it comes to good health. Our strategic approach is facilitated by a high-level of collaboration and investments from San Antonio Regional Hospital, the San Bernardino Department of Public Health and the City of Ontario. These partners value the impact that prevention and education have across our singular jurisdictions. Over time, the Healthy Ontario Initiative seeks to reduce the number of lifestyle-related illnesses and deaths by expanding Health Hubs and environmental solutions across the City of Ontario.

The Healthy Ontario Initiative’s Target Area

The Healthy Ontario Initiative has focused its efforts on a 5-square-mile area within one of Ontario’s lowest-income neighborhoods, with a poverty rate of 96.3 percent, high numbers of English-language learners, and low parent educational attainment. Two of the neighborhood elementary schools in and adjacent to the BUILD Health Zone experience elevated levels of health disparities. They are located in food deserts, and over 96.3% of the school age residents have high poverty levels, while more than 90% are Hispanic.

Research by the project partners has revealed that several factors compound the opportunity area’s obesity problem, including poor utilization of existing health centers, a shortage of primary care physicians, the perception of unsafe parks and streets, and an environment that promotes poor food choices. While regular or preventive healthcare utilization lags, residents from this geographic area of Ontario represent the majority of emergency room readmissions at San Antonio Regional Hospital.

The Approach in Ontario

Local and up-to-date data represent the foundation of the Healthy Ontario Initiative, so the partners’ first step was to create a data platform that defines Key Performance Indicators, establishes baseline metrics, and tracks progress over time. They will use BMI metrics to measure their success in their primary objective: to decrease the rate at which adults are diagnosed as overweight or obese. San Antonio Regional Hospital has been invited to implement its “know Your Numbers” program across health hubs throughout the City of Ontario, including our newest health hub within the Ontario Montclair School District.

Over the next two years, the Healthy Ontario Initiative is working to strengthen community well-being by creating “health hubs” anchored by two city parks with community centers, two family health centers, a community garden, four places of worship and an elementary school. Future steps include:

  • Finalize and implement the Healthy Ontario data platform.
  • Improve the type of fresh food that the Ontario Montclair School District provides to students through a locally grown produce distribution model.
  • Implement city systems and policies to promote farmers markets.
  • Implement policies that incentivize local food partnerships between local farmers and restaurants that allow restaurants to incorporate a variety of healthy options.

For example, at one of the Healthy Ontario’s newest health hubs, the Holt Community Health Center, Healthy Ontario has layered its partnerships (Department of Public Health, San Antonio Regional Hospital, the City, PBH, El Sol Neighborhood Educational Center and Huerta Del Valle), resources and data collection strategies to enhance clinical services by:

  • Aligning City, Clinical and hospital data metrics and collection through the designation of a one-mile Opportunity Area
  • Aligning medical, social and economic referrals
  • Offering the Know Your Numbers program
  • Providing free Zumba and nutrition classes to patients and community
  • Designing the hub as a healthy food access point for Community Supported Agricultural and healthy procurement models
  • Designing a Clinical Community Health Worker who will support Know Your Numbers outreach, education and case management

Example

Rosa Santana is an Ontario resident who has navigated health hub services to become a health champion for herself and her family. Rosa suffers from a heart condition and has struggled with weight management due to her formerly hectic work schedule and life stressors. Before Rosa was layed off, she worked at a factory located in Fontana, CA and would awake before dawn to walk to the bus stop and begin her hour-long, one way commute to her job. She was often absent from her family due to her work schedule and long commute. Her health took a back seat to the needs of her family. Then Rosa began participating in the free Zumba and nutrition classes at the Healthy Ontario Bon View health hub. Health hubs have enabled her to find and participate in daily fitness, nutrition and healthy lifestyle programs-without needing a car. They have “made health the easy choice” for her and also surrounded her in effective environmental solutions to combat chronic disease. In September 2015, Healthy Ontario invested in Rosa to become one of its newest, certified resident Zumba instructors and health leaders. She has lost 22 pounds, takes daily Zumba classes, participates in the community empowerment meetings and nutrition classes and will soon be paid to teach at our newest health hub. Rosa attends regular medical appointments for her heart health and has learned how to take ownership of her chronic conditions. She has taken a leadership role in Ontario to teach other residents to become health champions in their homes and community. Her newest focus is on healthy food preparation and food access and she shares her success and wisdom with other health hub participants and the Healthy Ontario partners to improve our upstream strategies to combat overweight/obesity and their co-occurring chronic conditions.

The BUILD Health Challenge

is a national awards program supporting “bold, upstream, integrated, local, and data-driven” (BUILD) community health interventions in low-income, urban neighborhoods. Founded by The Advisory Board Company, the de Beaumont Foundation, the Colorado Health Foundation, The Kresge Foundation, and the Robert Wood Johnson Foundation. The BUILD Health Challenge strengthens partnerships between local nonprofit organizations, hospitals and health systems, and local health departments to improve health and well being of their communities.

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Project Contacts:

Communication Contacts:

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Sources:

Centers for Disease Control and Prevention; costs in 2008 dollars
http://www.cdc.gov/obesity/adult/causes.html

San Bernardino County Community Vital Signs Report
http://communityvitalsigns.org/Portals/41/Meetings/2013Stakeholder/CVS_data_report.pdf

U.S. Department of Agriculture
http://www.ers.usda.gov/data-products/food-access-research-atlas/about-the-atlas.aspx