REACH renewed with focus on nutrition, physical activity and healthcare

November 16, 2018

Farmers Arthur Shavers and Shantae Johnson handed out vegetables to families in North and Northeast Portland, using the produce picked at their 19-acre Mudbone Grown Farm to build a relationship with residents on a low income and those without access to fresh food.

Public Health Director Rachael Banks, right, speaks alongside REACH Principal Investigator Tameka Brazile, center, and Evaluation Services Director Julie Maher, Ph.D..

Those families weren’t the customers most farms seek when looking for investors in their Community Supported Agriculture program. Most people with whom the Mudbone Grown team talked had never heard of a “CSA” and couldn’t afford the up-front cost for a seasonal supply of organic produce, which commonly run upwards of $400 for a 15-week share.

But Shavers and Johnson were determined. In additional to providing fresh produce to clients at Multnomah County primary care clinics, they hosted markets with reduced cost produce for families connected to programs like Women, Infants, and Children. They invited people to their farm. And they did it with support from Multnomah County’s Racial and Ethnic Approaches to Community Health (REACH) program, funded by a three-year grant from the Centers for Disease Control and Prevention.

“We partnered with them to get the word out about growing fresh food,” said Shavers. “It was motivational.”

This week, Public Health Director Rachael Banks and REACH Principal Investigator Tameka Brazile presented the Board of Commissioners with a plan to expand the program with a new 5-year REACH grant, which will allow them to build their partnership with Mudbone Grown Farm, other community groups and government agencies to narrow health disparities for black residents.

Black residents are more than twice as likely as white residents to be diagnosed with diabetes and obesity; and more likely to die from heart disease, stroke and cancer. Genetics play only a small role in those disparate health outcomes; social, environmental, economic and educational factors are the main drivers of physical health.

“These disparities didn’t show up overnight and they won’t be addressed overnight,” said Public Health Director Banks. “We know this is not the fault of individuals. It’s not fair, and we can do something about it. It does take a complex range of solutions and courageous leadership, but we have those.”

The initial REACH program focused on tobacco and nutrition; partnering with local shops to supply fresh produce in neighborhoods with few options and teaming with the African American churches to support programs that helped congregants stop smoking or learn new eating habits.

The next phase will continue to emphasize nutrition, allowing partners like Mudbone Grown Farm to offer a robust CSA to families who otherwise might not be able to afford it. Mudbone Grown will pair cooking classes with the CSA, introducing new recipes using traditional ingredients.

Farmers Arthur Shavers and Shantae Johnson, right, with their team from Mudbone Grown Farm deliver produce to clients at North Portland Health Center

Take collard greens for example. “Traditionally they’re boiled really hard,” Shavers said. “You add oils and salts and fatty meat. It’s delicious.”

But they’ll introduce new techniques, such as flash frying the greens, using the sturdy leaves as wraps, or using lemon juice and vinegar to break down the tough fibers.

REACH will also work to increase community support for breastfeeding by training more black residents who want to work as lactation consultants, and working more closely with other county programs including the Healthy Birth Initiative to support moms breastfeeding beyond the first three months.

SUN schools and WIC offer nutrition programs for families that do not earn a living wage. But few black residents who are eligible use those services. The new REACH program team will examine and address any barriers families might have to accessing those programs.

The next phase of REACH will expand to also address physical activity, and access to safe pedestrian, bicycle, and transit transportation systems. It will be no small task, said program manager Brazile.

“We want folks to get to and from where they work, play or pray by walking, bike or public transportation,” she said. “This is an area that will need a lot of development. We want to look at power analysis. As we’re sitting around the table at transportation planning committees, is our voice going to really make a difference?”

The third area of focus for the five-year grant will be improving the relationship between black residents and their primary care clinics. REACH will help with training and placing additional community health workers in partnership with clinics and community groups that offer health and preventative care programs to help clients manage chronic illness, stop smoking and more easily navigate the healthcare system.

Commissioners Thursday thanked the REACH program for its work and praised the emphasis on narrowing the most glaring health disparities — those between white and black residents.

“Everyone will benefit from these investments,” said Commissioner Sharon Meieran. “But we need to start where those disparities are the starkest.”