Recently, I wrote the first post about where markets began and some of the barriers we have encountered along the way to healthy food for all. I hope that those who read it understood the distinction I was making between individual, institutional and structural racism. The point was and is that any organizing done at the grassroots level can address individual and some institutional examples of racism, but that partnerships across sectors and systemic strategies are necessary to address those structural examples that reduce the effectiveness of these interventions. Markets are just being allowed into those conversations in the last decade and so have much work to do to achieve their goals.

In Part 1, I gave my version of the chronological history of markets in order to show the intentional and thoughtful work done by leaders so far. One of those milestones was the work with public health advocates, starting in the early 2000s and one of the examples I use of that is Kaiser Permanente’s creation of farmers markets. This began around 2003 when ob/gyn Dr. Preston Manning had an idea to put a farmers market on the Oakland  KP campus and begat a movement of “market champions”around the U.S. during their shift to wellness rather than crisis care. This report on their markets came out a few years ago and has some very interesting analysis of market interventions.  The evolution of the “campus” market type in the emerging market typology spectrum is illustrated in there as is some data on the marked increase in the consumption of fruits and vegetables among surveyed marketgoers, and (what I remember as the surprising outcome to the KP folks) of the increase in social capital for their staff.

The KP markets marked one of the first long-term partnerships with a health care provider interested in them as interventions for their target audience. In other words, it seems to be the beginning of the era of partners realizing markets were more nimble than they had previously seemed and so could be added into new communities for multiple reasons, including those with complex public health goals. The KP/market relationship seemed strained at times -(full disclosure: back then, my organization was in discussion to help KP with their market strategy, but the New Orleans levee breaks of 2005 took precedence for our time. We did continue to discuss markets with them and even included their staff in some of Market Umbrella’s trans•act research into market evaluation)- even with the tension between market leaders and their team,  KP remained thoughtful about how they supported markets and constantly offered some good critical thinking about the capacity of markets and what success measures that they thought were appropriate.

I became fond of saying that the relationship between markets and public health was a match made in heaven as markets had been all energy with little discipline and public health discipline with little energy. These health partnerships have led to many things, like the incentive strategy and the expansion of the voucher programs. There is no doubt that markets have adopted a wider view of good food and done an amazing job at encouraging those with benefit program dollars to come to their markets.
Most importantly, markets gained a better understanding of the social determinants of health paradigm.

Social determinants
The CDC definition:

“the conditions in the environments in which people live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. Conditions (e.g., social, economic, and physical) in these various environments and settings (e.g., school, church, workplace, and neighborhood) have been referred to as “place.” In addition to the more material attributes of “place,” the patterns of social engagement and sense of security and well-being are also affected by where people live.

http://www.cdc.gov/socialdeterminants/data/index.htm

It is important to address the safety, transportation needs, housing etc of a person who is at-risk in order to offer solutions to repair their health, but without also addressing how that environment ended as less safe or without decent places to live, that individual will remain at risk. What is also important to note about these indicators is that they rely on community wealth being available. Before we tied our market balloon to these pillars of health, many of our initiatives were seen as elitist and obsessed with a construct of local that had no relevance to the larger world. Now, of course, it is clear to markets and their partners that addressing inequities cannot be completed by outside funders swooping in, and that entrepreneurial activity is a necessary aspect for empowerment; efforts across the globe in micro-investing or Slow Money here in the U.S. have shown the trend is appealing even to big-time money folks. So economic power at the local level is key to this shift and in food systems, and currently, no one does that better than farmers markets.

Kellogg Foundation’s shift about the same time to a continuum of health for families encapsulated beautifully at one of their conferences as”first food, early food, school food, community food,” allowed them to lead the discussion on this overarching strategy. The foundation focuses on “three key factors of success and their intersections: education and learning; food, health and well-being; and family economic security. Lots of good language to seek out as well viewing some of the work from Kellogg and its partners. Check out their resources.

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So place and civic engagement could be the two buckets to consider. How do markets address either of these? Place is pretty simple, isn’t it? Let’s say that your market is working to add at-risk shoppers using an incentive and EBT program and finds that one chief barrier is the lack of public transportation options around your location. It may help to advocate for a bus to alter its route for the market day. Or to add more bike parking to encourage non-drivers or to set aside a few parking spaces close to the entrance for drop-offs, shuttles, jitneys or uber. One great way to look at the place around you is to use PPS’ Placemaking audits and tools and see how inviting your area is.

Clearly, civic engagement is another area that markets are using to do amazing work. The Power of Produce (POP) program offered by FMC is a lovely way to offer this. Some success has been noted by markets work with newly arrived citizens through expanding language choices or adding more culturally significant products. Shady seating for visiting and constant community information is also good. But how about market leaders showing up to a housing meeting in their city? Or working on a micro-investment strategy with shoppers and local banks to encourage new producers or other community solutions?

So, the work to include all of the social determinants into our food work is not fully realized. That issue of where we are currently in health and wealth work at the local level is at the heart of these 2 posts and why (I think) the divide between whites and people of color seems wider and deeper than ever. It is commendable for us to rid our language and actions from individual racist attitudes, and to add institutional partners and programs that add access, but we must go beyond that. If we use our power and privilege to explore and address inequities within the larger physical and political environment, we will start to see better outcomes, and the social determinants framework is as good of a way as any to do that in organizing terms.

Star assessment of community health

 

Related statement from National Young Farmers Coalition.