September 2007 Issue Guide

CABWHP publishes issue guides with thorough analyses of health policy issues addressing mental, emotional and physical health. Our Issue Guides are distributed via mail to Policy Advisory Group members and to over 1,000 colleagues and organizational collaborators.

Eliminating the Barriers to Healthy Living

Our health is largely determined by where we live, work and play. Research shows that how neighborhoods and cities are designed affects numerous health conditions such as heart disease, asthma, diabetes, osteoporosis, depression and some cancers. According to the Institute of Medicine, improving health in the 21st century will require new approaches to environmental health, including strategies to deal with unhealthy buildings, urban congestion, poor housing, poor nutrition and environmentally-related stress. Barriers to healthy living include our lack of access to healthy and organic foods, areas where we can exercise and alternatives to fast food and traditional "soul food."

In his book Health and the Built Environment: The Effects of Where We Live, Work and Play, Henry Louis Taylor explores the role played by the built environment in causing health problems among "inner city" residents, with a particular emphasis on the African American community. The environment produces many barriers to wellness for Black women who are already impacted by the intersection of racism and sexism. These barriers to active living and a healthy lifestyle include crime, violence, fear, inadequate food security, dilapidated housing, and poorly maintained sidewalks and streets. These conditions are stressors which are exacerbated by poverty, joblessness, difficult work situations, the struggle to make ends meet, and cultural and financial obstacles to accessing quality health care.

Studies have found that grocery stores in predominantly Black neighborhoods carry less fruits and vegetables, more processed foods, little or no organic offerings and higher fat dairy and meat products. There is a high concentration of fast food chains in Black neighborhoods. A study published in July 2003 in the Journal of International Medicine found that only 38% of grocery stores in Black neighborhoods in Los Angeles sell skim milk, as compared to 80% of stores in white areas. Black women (who are primarily responsible for family food selection, purchase and preparation) must be actively engaged in policy advocacy designed to change our living environments and further healthy lifestyles. We must advocate for healthier, active lifestyles in our communities, which includes putting policies in place that provide us with the tools to live healthier lives.

Important policy and advocacy developments have been proposed this year which would impact the health of Black women and our families.

Planning for A Healthy California

The Health Places Act (AB 1472) would provide community organizations with an opportunity to shape a state program to support their work on planning. Community organizations would be able to inform and participate in the development of guidance for a health impact assessment and also take leadership on conducting health impact assessments on priority local issues and decisions.

Access to Nutrition Information

SB 120 would require each food facility in the state that is part of a chain that includes 15 or more franchises to provide calorie content information on menu boards and nutritional information including calories, saturated fat plus trans fat, carbohydrates, and sodium and a statement about the daily recommended intake on menus. On Sept. 10, 2007, the Assembly passed SB 120. As this Issue Guide went to press, the bill was headed to the Senate for a concurrence vote.

Healthy Neighborhood Markets Planned for South Los Angeles

In July 2007, Tesco, England's largest retailer, announced plans for Los Angeles area Fresh & Easy Neighborhood Markets, including several markets in South Los Angeles and Compton. Community residents were excited to learn of this development given the absence of popular healthy food markets like Trader Joe's and Whole Foods from predominantly Black neighborhoods. The Alliance for Healthy and Responsible Grocery Stores (which is comprised of 25 community groups) has proposed negotiating a legally binding agreement in which Tesco's Fresh & Easy Neighborhood Market chain would commit to pay "livable" wages, provide access to affordable healthcare, hire people who live near the stores and guarantee its workers the right to join unions without company hindrance. Other coalitions have negotiated similar agreements on wages and local hiring with major developers in Los Angeles. Tesco is spending $2 billion to build hundreds of small grocery stores in Southern California and the Southwest. As this Issue Guide went to press, Tesco had yet to state whether it would meet with the coalition. According to the Los Angeles Times, the company said in a statement that it would be "a good steward of the environment" and a "great place to work."

Healthcare Reform

On Sept. 10, 2007, the California State Legislature passed possibly the most comprehensive set of reforms to the state's healthcare system since the adoption of Medicaid. The current proposal on the table, Assembly Bill 8 (co-authored by Speaker of the Assembly Fabian Nunez and Senate President Pro Tem Don Perata), makes significant improvements to Medi-Cal and Healthy Families, expands financing options for health insurance, and assists low income adults to purchase affordable health insurance. Although the Governor will likely veto AB 8, the Legislature has agreed to meet in a special session to enact some major improvements to healthcare this year. Senator Sheila Kuehl and other proponents of universal healthcare legislation (SB 840) are opposed to AB 8. In Senator Kuehl's most recent statement from the Senate Floor she stated, "I praise those who have been working on this bill for trying.....I know that my colleagues on the other side of the aisle have problems different from my own and will not vote for it. For those who will vote for it on my side, I understand you are voting your hopes. Many of you also have told me you know that 840 is the only real solution." Many advocates remain hopeful that healthcare reform will be enacted this year. They believe that AB 8 is an ambitious plan that does so much good for public benefits and affordability for consumers.

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