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Affording a Healthier Future

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Lately, Sheryl's kitchen has become much more colorful -- blue potatoes, purple string beans. Red and green were the only kinds of apples she knew to buy until recently. Thanks to her 10-year-old daughter, Alaijah, Honeycrisps are the new favorite on their shelf.

Alaijah has struggled with her weight for a number of years. When the pair visited her pediatrician, Dr. Sundari Periasamy, at Harlem Hospital Center in early September, they learned about a new program being tested in New York City hospitals for the first time.

Wholesome Wave's Fruit and Vegetable Prescription Program (FVRx) enables doctors to write fruit and vegetable "prescriptions" for children at risk of diet-related diseases, including Type 2 diabetes (from which Alaijah's grandfather suffers). Through FVRx, a partnership with the New York City Health and Hospitals Corporation (HHC), the patients receive nutritional counseling as well as Health Bucks -- coupons from the NYC Health Department that can be redeemed for fruits and vegetables at local farmers markets, including the markets right outside of each hospital's doors. In order to help the whole family make healthier choices, each family member receives the Health Bucks, benefiting approximately 550 residents of Harlem and the South Bronx.

Only months into the program, Alaijah stays full longer, her energy is higher, and her pants fit a bit looser. But Sheryl says her entire household benefits. She often takes her four children to the farmers market and encourages them to ask questions. This curiosity carries over into their home -- her kids are already brainstorming ways to make their Thanksgiving menu healthier this year. Her next challenge will be finding a good recipe for pumpkins.

As we've seen in the headlines recently, and as Sheryl has experienced, the fight against obesity is at a pivotal crossroads. Earlier this summer, the American Medical Association officially recognized obesity as a disease.

And while the obesity epidemic affects all populations, the fact is that it disproportionately affects low-income communities. In New York City, the neighborhoods with the highest poverty rates are the neighborhoods with the highest obesity rates. Lincoln Hospital is located in the South Bronx -- in the poorest Congressional district in the U.S. -- and the neighborhood's obesity rate is more than triple that of some of Manhattan's more affluent neighborhoods.

My foundation was built on the principle that your zip code and circumstances of birth shouldn't define your destiny.

Given the magnitude and complexity of factors that underlie issues such as obesity, I often wonder how far the programs we fund are moving the needle. But recently I've been encouraged by new data and success stories. According to the Center for Disease Control's (CDC) latest report, obesity rates for low-income preschoolers dropped in 19 of the 43 states examined, including New York. In the past, isolated findings have shown encouraging trends in a handful of states, but this is the first study -- according to Dr. Thomas R. Frieden, CDC director -- to show progress across the country.

Part of our city's success can be attributed to a comprehensive, layered approach to prevent obesity, from requiring chain restaurants to post calorie information on menus to bringing fresh produce to city neighborhoods with the NYC Green Cart Initiative, one of our flagship partnerships. By working with the Mayor's Fund to Advance New York City and the New York City Health Department, today hundreds of Green Carts are on the street in neighborhoods like Mott Haven, Bushwick, and Bed-Stuy, allowing street vendors to increase access to fresh fruits and vegetables in these "food deserts" that previously had few or no options for healthy food.

But the fight is far from over. Now that we are making gains, we have to hone in on what works and redouble our efforts. We are in need of more creative solutions and public-private partnerships that combine access and affordability with education.

I hope that the incoming mayor will see the value of public-private partnerships such as FVRx and the Green Cart Initiative.

Based on the Green Cart's success, earlier this year we developed a series of partnerships and programs -- "Healthy Food & Community Change" -- as part of a $15 million commitment to increase access, availability, affordability, and knowledge of healthy foods and promote healthy choices. A core strategy focuses on fostering additional public-private partnerships.

Another important public-private partnership is the NYC Summer Meals program. Every summer, low-income families struggle to make up for the nutritious (and free) school lunches that their children would otherwise receive during the academic year. The Summer Meals program is an important way to ensure that students receive nutrition food year-round, but too many families aren't aware of the program. Only 15 percent of kids who get free or reduced price meals during the school year participate in the summer meals program.

While Summer Meals is a government program -- run by the NYC Department of Education and funded by the USDA -- new partnerships with nonprofit organizations and private donors are helping to increase awareness and opportunities for families to gain access. The New York City Office of the Food Policy Coordinator collaborates with the Department of Education, Share Our Strength, the New York City Coalition Against Hunger and other groups to increase participation.

One creative strategy that caught our attention was the use of three food trucks to distribute nutritious lunches (each with a serving of whole fruit) in high-need, public locations. One mobile truck at the Queens Library in Flushing, Queens served more than 2,500 meals per day. Due to the high demand, this summer we and Share Our Strength funded a fourth truck that will become a part of the Department of Education's permanent fleet. Preliminary estimates indicate that hundreds of thousands of additional meals were served this summer compared to last summer.

However, the role of private philanthropy -- from foundations to corporations to individuals -- can only go so far. Contrary to popular belief, philanthropic donations represent a very small percentage of the support needed for food-related issues in the country. And with the looming potential of $40 billion in cuts for the federal food stamp program, we can't possibly fill the gap.

Ultimately, government has not only the size and scope, but the responsibility, to address core issues like nutritional access.

What funders can do is seed innovation. We can try new ideas. We have the flexibility to test potential solutions that can eventually be implemented on a broader scale.

The new mayor should continue driving the momentum we've seen to date. Only through ongoing collaboration -- especially via public-private partnerships -- can we move toward shaping a healthier future for communities throughout New York and hopefully the country.

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