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In low-income communities across the nation, the scarcity of nutritious options contributes to poor diets and high rates of chronic conditions. But that is changing in East Los Angeles and Boyle Heights, where scores of young people educated through a Fielding School initiative have become public health leaders.
Lilybeth Hernandez (above) traces her transformation from shy teen to public health activist to the moment she agreed to march in a Mexican Independence Day parade dressed as an avocado.
The parade is a major annual event in Hernandez’s predominantly Mexican American community of East Los Angeles, and she had attended with her family as a spectator for as long as she could remember. Now she was a junior at Esteban Torres High School’s East Los Angeles Renaissance Academy (ELARA), where a new elective course – offered as part of a larger effort by a Fielding School team to improve cardiovascular health in East L.A. and Boyle Heights – was teaching students about the perils of their food environment, and empowering them to change it.
“I’m not a social person,” says Hernandez, recalling her trepidation about wearing the costume and handing out fresh produce to promote healthy eating. “But I danced, I engaged with the community, and it was really nice.”
More than anything, Hernandez’s involvement in “Corner Store Makeover in East L.A.: Proyecto MercadoFRESCO,” a project of the Fielding School’s UCLA-USC Center for Population Health and Health Disparities, served as a wake-up call. It introduced her to the concept of a “food desert” – an area with an abundance of fast food, a scarcity of fresh produce and other healthy options, and high rates of obesity and obesity-related chronic conditions as a result. “This is what I always saw growing up, so I didn’t think it was noteworthy,” Hernandez says. “A lot of people in my community still don’t.”
As she learned more and became an active participant in the student-led activities, Hernandez no longer hesitated to make the case for change. In the autumn of her senior year, she presented on Proyecto Mercado-FRESCO at the national conference of the Community Food Security Coalition in Oakland. She learned about gardening and, with a classmate, successfully pitched the idea of offering a gardening class at the local elementary school, focusing on the need for fresh produce in low-income communities and growing in limited space. After three years with Proyecto MercadoFRESCO – the last as a community liaison, mentoring the high school students who were following her path – Hernandez is a freshman at NYU, majoring in global public health with a concentration in food studies.
Farmers markets, comprehensive grocery stores and other sources of healthy foods have historically been in short supply in low-income communities. All too typical is the story of East Los Angeles, where fast-food establishments reign and groceries are often purchased at one of the ubiquitous corner stores – mostly dark and unappealing spaces where chips, candy, beer and lottery tickets are front and center and fresh produce is rarely found.
Proyecto MercadoFRESCO, led by Drs. Michael Prelip, Deborah Glik and Alex Ortega of the Fielding School and part of a larger UCLA-USC Center for Population Health and Health Disparities initiative headed by Ortega and Dr. William McCarthy, represents a multi-pronged effort to transform the narrative – and serve as a model for similar communities across the nation. The National Institutes of Health-funded project employs a business consultant to assist the owners of mom-and-pop stores in converting their establishments into more physically inviting environments, with healthy foods prominently displayed while unhealthy items are relegated to the back.
But this is no “build it and they will come” approach. Instead, a critical piece of the Fielding School team’s effort involves community-based promotion of the revamped stores, and increasing the demand among East L.A. and Boyle Heights residents for the stores’ healthy products. That’s where Hernandez and the scores of other students who have participated in the project fit in.
To oversee the educational, community and social marketing efforts, the Fielding School team brought in Public Matters, a Los Angeles-based social enterprise that designs and implements neighborhood-oriented new media, education and civic engagement projects for social change. Since 2010 Public Matters has trained students at two partner high schools in the area – ELARA at Esteban Torres High; and the School of Communications, New Media and Technology at Roosevelt High in Boyle Heights – to be food justice advocates.
Students are given a year-long curriculum in issues such as nutrition, food justice, media production and social marketing as juniors, then take to the streets their senior year as agents of change – supporting the stores they have helped to transform while promoting healthy eating and improving the community’s access to nutritious foods. What started as a high school program has expanded, as graduating students have embraced the opportunity to continue with the project while in college. Thanks to funding from the Goldhirsh Foundation, more than a dozen now work as paid community liaisons, assisting the high school students in the implementation of their activities.
Whether the young people are speaking at community events, performing healthy-cooking demonstrations at the stores, producing promotional videos or donning costumes to make themselves visible at parades, one thing is always clear: “The students and community liaisons are out in front of everything,” says Mike Blockstein, principal at Public Matters. “They’re responsible for conceptualizing, organizing, promoting and running the events. This gives them agency, and it turns them into passionate advocates for making their community healthier.”
Steven Cardona reacted with anger when he first learned about food deserts – and realized he lived in one. “I thought, ‘Why does it have to be this way?’ says Cardona, a senior at Roosevelt High now in his second year in the Proyecto MercadoFRESCO program. “When I realized that this affects my whole community – that everybody has these same problems with high cholesterol and high blood pressure, connected to the food we eat and what’s available to us – that really got me going.”
Cardona turned his anger into activism, relishing the opportunity to become “part of something greater than myself.” With his classmates he attends events in the community where they can discuss healthy eating and pass out flyers promoting the revamped corner stores. Cardona also knew he had to embody the change, so over time he broke his own fast-food habit. His friends have noticed. “They still eat the way I used to,” Cardona says. “When they’re having a bag of chips or some fries, they try to get me to eat some. I tell them I don’t do that anymore, and I explain why. It’s a slow process but I think they will get there.”
Cardona thought little of all the unhealthy food he ate through his childhood. His father worked at a fast-food restaurant, and his family took advantage of the free meals when they weren’t enjoying traditional Mexican staples such as rice, beans and carne asada. Now he’s seeing the effects. Cardona’s mother suffers from hypertension and often has to stop for breath after walking any significant distance. “I don’t like seeing that,” Cardona says. Emboldened by what he’s learned through the project and by his mother’s support for his newfound convictions, he has begun to help her shop for groceries in an effort to find healthier meal options. Cardona’s mother has attended the healthy-cooking demos and is looking to change her eating habits. “She’s the main reason I want this,” Cardona says. “I want my mom to be around.”
For nearly every student who gets involved in the project, there is a close family member who is overweight and/or has diabetes or cardiovascular disease. “As we start to talk about healthy eating, the students begin having conversations with their families about what they eat and how that affects them,” Blockstein says. “Most are very active in getting their families to change their shopping, their diet and their cooking practices.”
Darinee (DeeDee) Barba’s experience fits that profile. “Our main food was red meat, we didn’t have many greens or fruits, and we were always eating until late at night,” she says. After Barba began learning about the consequences of unhealthy eating as a student at Roosevelt High, she started a dialogue within her family. “Our eating habits have changed a lot,” says Barba, now in her first year at Pasadena Community College and continuing to work for Proyecto MercadoFRESCO as a community health liaison. “I’m not going to say we don’t eat any more meat but we’ve cut back – we’ll substitute fish, or chicken.”
For Barba and other youths growing up in food deserts, family choices don’t occur in a vacuum. Surrounded by fast-food outlets, street vendors, ice cream trucks and traditional corner stores, it’s hard to eat well. “You walk out of school and you’re hungry, so you get a soda and a bag of chips because that’s what’s available,” Barba says. “But that’s changing.”
In addition to promoting the fresh produce and healthier snacks at the corner stores that Proyecto MercadoFRESCO supports, Barba is among the participants in the cooking demos. “We show step by step how to make healthy meals with recipes that we know families will use, since we’re all Hispanic,” Barba explains. “We want them to see that it’s easy, tastes good and is something they can do at home rather than eating out.”
“The challenge with the makeovers is that everyone has a negative concept about these corner stores – that they’re places to get chips, candy or beer,” says Andy Alvarez, a graduate of Torres High’s ELARA program who has been with Proyecto MercadoFRESCO for more than three years, currently as a community liaison. “You have to transform that mindset so the community thinks of these as places where you can get your fruits and vegetables.”
Through the project, Alvarez experienced a personal revelation about the impact of his food environment. His father had studied to be a nutritionist while in Mexico, but the credits didn’t transfer to U.S. programs and rather than starting over he got a job as a truck driver. He arrived from Mexico with a 28-inch waist; before long he was a size 44. “Even for someone like my dad, who knows so much about how he’s supposed to be eating, it was hard,” Alvarez says. “If you’re a working-class person in this neighborhood, you don’t always have the energy to shop and cook a healthy meal, so you resort to what’s convenient, which around here is fast food.”
As Alvarez began to connect Proyecto MercadoFRESCO with his father’s experience, his interest grew. He assisted with the corner store conversions, attended the store re-openings and took part in the cooking demos. He participated in presentations at “movie nights” in the park, engaging with community members. When he began mentoring some of the project’s first-year students, his confidence soared. And for the first time, Alvarez began to see himself in the career his father had once intended to pursue. Now he is a sophomore at California State University, Los Angeles, majoring in nutrition sciences and considering a public health minor.
Among the many rewarding experiences he’s had since starting with the project more than three years ago, Alvarez says one encounter stands out.
It was the grand re-opening of Yash La Casa Market, the first of the corner stores Alvarez and the project’s other students had helped to convert and promote. An elderly man approached. “He looked to be about 80,” Alvarez says. “And he said he was so thankful for us opening this store close to him, because it was the first time in many years that he could actually shop for his own fruits and vegetables.”