2019 Dallas Hunger SummitBui ld ing a health ier environment:

pol icy inf rastructure and system

D r. M y r i a m I g o u f e ,V i c e P r e s i d e n t o f P o l i c y D e v e l o p m e n t a n d R e s e a r c h

DHA | HOUSING SOLUTIONS FOR NORTH TEXAS 2

AGENDA

1. LANDSCAPE OF OPPORTUNITY

2. OUR APPROACH

3. CURRENT INITIATIVES

4. MOVING FORWARD

DHA | HOUSING SOLUTIONS FOR NORTH TEXAS 3

3

GEOGRAPHY OF INEQUITY

LANDSCAPE OF FAIR HOUSING:

UNAFFORDABILITY IN AFFORDABLE HOUSING

Racially/Ethnically Concentrated Areas of PovertyLow-Income Low-Access to Food

HCV families are disproportionally residing in R/ECAP census tracts and are facing

cumulative barriers to upward mobility and access to opportunity. R/ECAPs

neighborhoods are characterized by:

▪ Extreme poverty level

▪ Severe racial segregation

▪ Low access to healthy grocery stores

▪ Low vehicle availability

▪ Lower access to jobs via transit

Residual Income for Transportation

TransportationCosts

After meeting non-transportation needs, results show that HCV families do not have sufficient resources to afford transportation.

Given the very likely need to travel to access food, school or employment, the results shed light on a potential recourse left to these families to meet their transportation needs: having to forego a nutritious diet, medical care or other necessities.

Igoufe, Mattingly, and Audirac (2018)

North Texas Regional Assessment of Fair Housing (2018)University of Texas at Arlington

DHA | HOUSING SOLUTIONS FOR NORTH TEXAS 4

OUR APPROACH

CHALLENGES:• Geography of inequity • Racial and economic disparities• Multi-generational barriers to self-sufficiency • Cumulative barriers to opportunities• Informational power/gap• Disparate access to resources

POLICY AND PROGRAMMATIC APPROACH

• Data-driven actionable strategies• Connect and bridge gaps• Build pathways to self-sufficiency • Capacity building and advocacy• Inclusive methodology

OUR MISSION IS TO PROVIDE AFFORDABLE QUALITY HOUSING AND ACCESS TO SUPPORTIVE RESOURCES ACROSS NORTH TEXAS

DHA | HOUSING SOLUTIONS FOR NORTH TEXAS 5

CURRENT INITIATIVES

FOSTER HOUSING CHOICE AND ACCESS TO HIGH-OPPORTUNITY NEIGHBORHOOD

RESEARCH AND POLICY ADVANCEMENT

BUILDING PATHWAYS TO OPPORTUNITIES, TOGETHER

DHA is participating in two studies analyzing the impact of housing conditions on children’s development and health over time.

Development of software designed to put neighborhood quality of the forefront of the housing search process.

DHA and Workforce Solutions are in discussions to share data that will help us explore employment services, training opportunities, child care, etc. that will ultimately link DHA families directly with opportunities.

2019 Dallas Hunger SummitBui ld ing a health ier environment:

pol icy inf rastructure and system

D r. M y r i a m I g o u f e ,V i c e P r e s i d e n t o f P o l i c y D e v e l o p m e n t a n d R e s e a r c h

Why healthcare must address food

insecurity

Patient outcomes

Children- poorer overall health, increased hospitalizations, anemia, decreased bone mass, high cholesterol, cavities, poor academic performance, school suspensions, aggression/behavior problems, depression

Adult- asthma, COPD, heart disease, high blood pressure, diabetes, high cholesterol, anxiety, depression, arthritis

Healthcare Costs

Increased ER visits/hospitalizations for diet related diseases

$1800 increased healthcare expenditures/year

18% increased healthcare costs for adults with chronic illnesses

Organizational Level Change

Screening and Intervention in clinical settings

Recommended by the American Academy of Pediatrics, Academy of

Nutrition and Dietetics, Academy of Family Practice Physicians

Toolkits

AAP toolkit

AARP toolkit

Healthcare/Foodbank Partnerships

Partners in Health

Healthy Pantry Initiative

Summer Food Program feeding sites

Clinic-based pantries

Healthcare Finance Change

Adding screening and intervention as covered

benefit- private insurers, Medicaid, Medicare

Food as a covered benefit

Medically tailored meals

Produce prescriptions

Supplemental foods for food insecure patients

Coding Changes

Challenges with current coding

Z59.4 Lack of adequate food and safe drinking water

National workgroups

Hunger Vital Sign Community of Practice

Robert Wood Johnson sponsored Gravity Workgroup

2019 Dallas

Hunger Summit Innovating the Women, Infant

and Children (WIC) Program

September 13, 2019

CPAL AIMS TO REDUCE CHILD POVERTY BY 50% IN 20

YEARS.

1 IN 3 CHILDREN IN DALLAS LIVES IN

POVERTY.

● For children to grow up with so little in a

region where affluence is so visible

challenges our most basic principles of

fairness.

● Poverty exposes children to devastating

levels of trauma that undermine a child’s

future by stunting physical, cognitive,

and behavioral development, thereby

producing a lifetime of health and

economic challenges.

● Economists estimate that childhood poverty

costs the U.S. economy over $1 trillion per

year, or 5.4% GDP.

● Each child growing up in poverty has an

average net-cost to our economy of $1.6

million throughout that child’s life.

● The cost of inaction is much higher than the

cost of action. Every $1 spent to fight child

poverty lowers future costs by $7.

● Dallas has the 3rd highest rate of child

poverty in the nation.

● The long-term economic cost of the

95,000+ local children growing up in

poverty exceeds $150 billion.

● Over the past 15 years, the poverty rate

in Dallas has increased by 42%, while

the population has only increased 4.4%.

● All systems-level CEOs have signed on

with CPAL to help solve this problem.

The Value of the WIC Program

● Reduces food insecurity

● Alleviates poverty

● Supports economic stability

● Improves dietary intake

● Protects against obesity

● Improves birth outcomes

● Improves health outcomes

● Supports learning and development

● Reduces health care and other costs

● Improves retail food environments

Declining WIC Participation, a National Trend,

Worse Locally

Source: U.S. Department of Agriculture, National- and State-Level Estimates of Special Supplemental Nutrition

Program for Women, Infants, and Children (WIC) Eligibles and Program Reach in 2016 (Published 2019)

WIC Coverage Rates for Total Eligible Individuals by State, 2016

In Dallas,

the

coverage

rate is only

39%15

Declining WIC Participation,

a National Trend, Worse LocallyWIC Coverage Rates for Total Eligible Individuals by State, 2016

The WIC User Journey

Creating a

Cycle of

Impact✓ Decrease Hurdles

✓ Increase Value

✓ Create an Experience

that is Empowering

and Seamless for

Users, Stores, and Staff

A life-long practice of positive-nutrition,

starting with the child

Habits and new skills make families feel

confident and proud.

A positive experience leaves families

feeling supported and empowered

Families see clear value in WIC benefits

and services.

USERS: Redesign Income Guidelines • Concierge Assisted Online Forms • Clearly Articulated and

Visualized Process • Templates and Support for High Friction Moments • Mobile WIC Center • Online

Check-in Forms • Staggered Enrollment and Benefit Refills • Neighborhood Champions • Care Toolkit •

Real People & Stories • Proactive Communication • Stronger Digital Presence • Redefine Waiting Spaces

• Newborn Welcoming Ceremony • Breastfeeding Spas • Community Picture Walls • Knitting Abuelas

• Tête-à-tête Style Nutrition Sessions • Cooking Classes • Mom Groups • Home Visits • Chat Bot

STORES: Shopping Buddies • WIC Ambassadors • Online Ordering • WIC Clinics Inside Stores

• Shopping Assistance App • WIC Store Champions • Self-Checkout Stations • Flyers • Text-a-Manager •

Confusion Cards • Checkout Experience

STAFF: Staff Innovation Program • Staff Strategy Offsite • New Mission-Driven Onboarding Experience •

Experience Team • Leadership and Coaching Workshops

AARP

Hunger to Health

19

Susan J. WilliamsAssociate State Director

AARP Texas

2019 Dallas Hunger SummitSeptember 13, 2019

20

The Face of Senior HungerThe 5.5 million adults 60 and older are food insecure. That represents 7.7 percent of all the people in

that age group.

The rates of hunger were higher among people ages 60 to 64 than it was for those who were older.

Among adults over 60 who were food insecure, more than one third (37.5 percent) were ages 60 to

64, while 1 in 10 (9.9 percent) were 80 and older.

-Feeding America Report

More than 10 million older adults are at risk of hunger every day,” “Older adults who are food

insecure are 50 percent more likely to have diabetes and 60 percent more likely to have congestive

heart failure. Research shows that food insecurity costs older adults in the U.S. an estimated $130

billion annually in additional health care expenses. So, senior hunger is not just an individual issue

— it is an issue that has implications for families, communities and society.”

Emily Allen, senior vice president of Programs for AARP Foundation.

AARP Work to Address Food Insecurity

21

Federal and State Advocacy• Prevent benefit cuts to SNAP

• Prevent any expansion to work requirements

• Allow grandparent and other non-parent caregivers to apply for benefits

on behalf of the children

• Provide additional incentives to states to undertake reforms to expand SNAP

• Promote and expand Elderly Simplified Application Process (ESAP)

Expansion – 8 states

Local Communities• Day of Service Meal Pack Challenge

• Invest in community-based initiatives to

assist older adults

• Age Friendly Communities

AARP Foundation is working to end senior poverty by helping

vulnerable older adults build economic opportunity and social

connectedness.

22

AARP Foundation

Pilot Projects with Community Partners

• Screen and Intervene Course for Health Care Providers

• Food Insecurity Intervention Elderly Simplified Application Process (ESAP) - Grants

• Diet-Related Disease Intervention

Fresh Savings Rx

• Grocery Guides

• 11 State Pilot

Use AARP database to connect to

SNAP

• The Whole Plate Concept Currently under development

23

AARP Foundation

24

AARP Foundation

Through Drive to End Hunger, AARP Foundation is helping put an end to hunger for Americans over age 50 by raising awareness about the issue of hunger, donating meals to food banks, building philanthropic support, and developing long-term, solutions.

25

AARP Texas, City of Dallas and 40 + Community Partners

worked together to develop a plan to make Dallas a better place

to live for people of all ages.

Domains of Livability

26

• SNAP Enrollment and Eating Well is a SNAP

• Community Gardens

• Pop Up Markets

• Exploring Other Innovative Solutions

•

City + FoodDallas Hunger Summit

September 13, 2019

Laila Alequresh, Chief Innovation

Officer

Office of Innovation

City of Dallas

Presentation Overview

• What is Innovation?

• Government + Food + Hunger

• Upcoming Initiative

• Next Steps

What is Innovation?

LivingLab Systems

ApproachCollaboration Objective

Partner

Conduct small

scale pilotsand

testing with

analytical rigor

that support

policy, process,

and program

improvements

Take a holistic

view of cross

functional and

cross

departmental

processes and

programs

Break down

siloes and work

across

departments and

sectors

Unbiased and

objective partner

for city

departments that

helps deliver the

“basics” well

Government + Food + Hunger

• Economic

Development

• Planning

• Sustainability

GROW SELL CONSUME WASTE

• Sanitation

• Special Events

• Code

Upcoming Initiative

More locally grownfood

Less foodwaste

Making healthier foodchoices

Less foodwaste

Next Steps/Call to Action

• Participate!

• dallasinnovationchallenge.ideascale.com

• Contact us!

• innovation@dallascityhall.com

City + FoodDallas Hunger Summit

September 13, 2019

Laila Alequresh, Chief Innovation

Officer

Office of Innovation

City of Dallas