Wednesday, November 26, 2008
Although they collected enough data to begin their analysis, one of the members is concerned that the stores that they visited are not representative enough of where the residents of New Brunswick shop, and therefore won't give them a clear idea of what kind of food is being consumed. Although the supermarkets offered a good selection of food, the members felt that it would be more useful to look at more corner stores and to see at how accessible the supermarkets are in comparision to the corner stores, to really determine what kind of foods residents can buy.
They hope that when their data is compared to the research that the infrastructure groups are doing they will have more clarity as to how to address the problem of food availability in New Brunswick.
In the meantime, group 5 has been analyzing the data that was collected in Trenton. There have been no updates from the Camden group, and group 8 has a trip planned to Newark on December 5th; once these two groups have collected their data it will be interesting to compare their experiences on the field with those of groups 5 and 7.
Tuesday, November 25, 2008
Interview #1—Wyliena Guan (Group 3)
Q: What has been the most challenging part of the project so far?
A: It has been using the program, the technology, to get this project completed. To use this program on my own, finding the info (where to get it on the internet)... having to refind, re-set the data, trying to use the program on my computer… has been a little bit of a pain. Besides that, it’s not so bad. I really like it.
Q: What city will you be traveling to, and what do you hope to find there?
A: I will be traveling to New Brunswick, or Newark, with my entire group…. (When I go to the city) we will be looking for basic infrastructure elements. What we have been trying to map out using the GIS programs.
Q: Why are the infrastructure elements you are researching important?
A: When you try to implement any project, plan, etc, it all goes back to the infrastructure. If a plan isn’t working, you resort back to (analyze) the infrastructure. For example (as in one of our readings) when trying to provide health care to Puerto Rican women, a big problem was having convenient (health care institution) hours for the women, providing a place where they could go for childcare… little things like that. Even though you don’t think of it as that important, and think of them as pretty minor, it is those sorts of details that can make or break a program…any endeavor that you are going to go after.
Interview #2—Alexandra Satty (Group 4)
Q: What has been the most challenging part of the project so far?
A: Utilizing the mapping program that the GIS librarian showed us has been pretty difficult. The programs look like they can do some incredible things, but it’s very complicated to figure out. In addition, trying to figure out how to combine all the data sets we are finding in the most useful way seems like it will be rather challenging.
Q: Do you think anything that you have learned thus far in “the Politics of Race and Health in America” has changed the way you think about elements pertaining to this project? If so, what and how?
A: I think the idea of race being a social construct is really interesting to consider when looking at census data, and specifically maps based on this data pertaining to racial distributions. When looking at a map, race seems very black-and-white (or, in the case of the maps we looked at today, red-and-yellow) – red areas have a high percentage of blacks, while yellow areas have a low percentage of blacks. However, after considering the idea of race as a social construct, you start to think about how all this data is not as clear cut as it sometimes seems, which was something I found rather interesting.
Monday, November 24, 2008
Let's hear what they said...
Group 1 - Food as a Public Health Issue
History of food availability in the US (Carine Davila)
“I've decided to write about the history of food availability and its correlation with aggregate health outcomes (e.g. longevity). I became interested in the topic because longevity in the last century has increased due to advances in medical technology and other public health measures. This project has prompted me to consider whether food availability may have actually played a role as well. I'm eager to learn more about the impact of food availability. I think it will be interesting to see exactly how I can measure food availability over time, and whether or not studies have been done along these lines. Furthermore, I think the question may be a tricky one, because food availability does not necessarily correlate with consumption choices made by individuals, so it may not lead to a correlation with health outcomes. Nevertheless, since we wish to look at aggregate health outcomes, this may be the only level to see any kind of impact.”
History and contemporary politics of school lunch programs (Lauren Bartholomew)
“I specifically chose to do research on school lunch programs, because I remember hearing on the news debates over the healthiness of food provided by school lunch programs. I was interested in the topic but did not have time to pursue researching it. Therefore, I figured that this [CBLI project] would be a good way to learn more about the topic while fulfilling our class's paper requirement.”
History of the USDA food pyramid, food safety regulations, and changing government assertions about what is healthy (Carol Shih)
Group 2 – Health in New Jersey
Lung cancer, cirrhosis and AIDS (Sara Peters)
“I chose lung cancer, cirrhosis and AIDS because I was motivated to find how illnesses relate to choice-based behaviors in different races. There is definitely a positive correlation between acquiring these diseases and performing what many people see as “morally questionable behaviors”. Although the jury is out in the question of whether these behaviors do relate to negative lifestyle/health choices, I became curious to see which race would have a higher prevalence. It is unknown to us that among people who engage in these behaviors, which racial group would have a higher association with lung cancer, cirrhosis, and AIDS.”
Diabetes, obesity, and heart disease (Emily Hankin)
“I am very interested in childhood obesity and the diseases that are often associated with it. Especially in the last year, the various initiatives across the country to combat obesity have met with enthusiasm from some [people], and skepticism/disbelief from others. I am interested in whether these initiatives actually have any effect, or whether reducing obesity is something that needs to be addressed within the family, rather than imposed by the government.”
Infant mortality and maternal health (Rosalynd Upton)
“I am researching infant mortality and gestational diabetes. I am interested in this topic because I am thinking about becoming a perinatologist, which is a doctor who deals with high risk pregnancies. I thought this topic would be a good way for me to start thinking about women's and infant's health.”
Childhood vaccination, childhood asthma, and childhood injuries (Alexandra Douwes)
“I have always been very interested in pediatrics. I shadowed a pediatric surgeon for a day in high school once, and love to work with children. Moreover, I believe that in order to solve the many health disparities and health issues currently troubling the U.S, we will have to focus on children's health first, as they will grow up to set the health norms and precedent for future generations.”
Unintentional injuries and resulting deaths (Yuna Sakuma)
Friday, November 21, 2008
There is a natural pause as groups wait for final approval on their full question lists from CBLI and CHE, but group members are still actively discussing logistics and how to divide up reporting on interviews. Groups can either have each individual member report on a single interview, or each group member can report on a particular question across all interviews. The groups were also officially assigned to interview either specific people or a specific category of stakeholder, based on feedback from CBLI and CHE.
A quick glance at some groups and their assigned interviews:
Group 17 (Trenton): Mayor, United Way Director
Group 18 (Camden): Osborn Family Health Center Director Marge Cofsky, Representative from Camden County Chamber of Commerce
Group 19 (Newark): Mayor Corey Booker, Executive Director of Newark Department of Health and Human Services Dwight Peavy
Group 20 (New Brunswick): Hospital administrator, food pantry administrator
Group 21 (New Jersey): Commissioner of NJ Department of Health Heather Howard, Representative of New Jersey Hospital Association
Groups must finalize their interview lists (which includes identifying specific individuals to interview within some of the broader categories listed above) by Monday, and interviews will begin soon after that.
Thursday, November 20, 2008
This week the project really started to come together for the residents speak groups. The Trenton and Camden groups each sent a few representatives to their respective cities to carry out interviews last Friday. The Newark and New Brunswick groups continued preparations for their travel days, which have been pushed back until after Thanksgiving, December 3rd and 5th.
From the Camden group, only one member, Monique McDermonth, was able to go out and participate in the fieldwork due to the other group members constricting class schedules on the day of the trip. She reports that she was able to get some great footage. In the weeks to come hopefully the group will get together to review and analyze the data collected.
The Trenton group still has yet report back on how the fieldwork interviews went. However, I am sure they were able to collect a substantial amount of useful information and will soon be processing the interviews into transcripts for analysis.
The Newark and New Brunswick groups solidified their questionnaires for the upcoming interviews through meetings and email exchanges. The New Brunswick group made a point to outline what main aspects of residents' experiences they hope to hone in on throughout their interviews: culture, spaces (in which residents eat), the meaning of food, background information and the expense of food. These groups also verified which group members would definitively be able to travel to their cities to conduct the interviews in the coming weeks. As of now they are just waiting for the date of their the future fieldwork to arrive.
Wednesday, November 19, 2008
The students, Carolyn Smith-Lu and Anthony Loring were surprised by the great variety and quality of food in the two big supermarkets - Supreme FoodMarket and the Food Bazaar – and noted the extensive section of ethnic foods in both stores. Although in Supreme FoodMarket we were not warmly received, the manager of Food Bazaar met with Carolyn and Anthony, and emphasized the importance of taking into account the ethnic composition of the population that the store was marketing to. He also clarified that the reason for which the supermarkets seemed rather empty had to do with the fact that most of the shoppers tend to come at the very beginning of the month and late at night. The Farmer’s Market also offered a variety of affordable, fresh and healthy food.
At the 7-11, not surprisingly, there were a few Thrifty Food Plan items missing from the store, and most of the products did not have price labels, or were incorrectly labeled. The store employees were more than willing to ring up each item for them, and interestingly, one of the workers approached me to comment on the importance. of checking for expiration dates and correct prices at least once a month. However, it is not clear how useful the data from this store will be seeing that it is located in Lawrenceville and not in Trenton.
Their findings led Carolyn and Anthony to wonder if it would have been more helpful to look at the food offered in corner stores in residential neighborhoods as well as problems related to accessibility to the supermarkets. Given the data collected, the quality of the food sold in these stores is not a problem in Trenton. Carolyn also commented that there have been many proposals to modify the thrifty food plan, and that the study that groups 5-8 are doing may show that this indeed needs to be done.
During the upcoming weeks, the other three groups will visit their respective cities. All of them are using the same measure - the Thrifty Food Plan. The group doing research in Camden will also be taking advertisements, coupons and discounts into account. After having heard Catholic Health East’s CEO speak about the problem of diabetes in immigrant population, they will also be looking at the availability of healthy ethnic food. One aspect of their research that differs from the other groups' is that they will also be looking at what kind of restaurants are found within a three block walking distance of supermarkets.
Tuesday, November 18, 2008
This week, the two infrastructure groups met to discuss their plans and strategies for tackling their infrastructure goals when they travel to the cities. Both groups took time out to sit down and redefine exactly what it was they were going to be looking for. For example, what exactly constitutes a “vacant lot?”
The students also reflected on what Professor Harris-Lacewell mentioned in lecture last week. She challenged us to think of models while conducting our research. One of the groups I met with asked each other to think about what food meant to each of them, personally, by the next time they meet. This will aid them in better-connecting with the project. I will hopefully have the results of the combined answers next time I post.
Lastly, I traveled with Wyliena Guan, a member of the Infrastructure Part I group (group 3) to visit with the GIS librarian to learn about mapping out infrastructure. While there, he asked us some thought-provoking questions. Some of which were: “How are you defining your infrastructure elements?” “What does transportation include? What does it mean to you?” “What do you mean by “residential areas”? Does this include urban, rural, etc.?”
These questions caused us to stop and think about what it is exactly we are studying, and how we define what those things mean to us, and to other people. It also caused me to think about how I personally saw these things as well. In general, however, he gave us a very informative lesson on map-making, using the software, searching the databases and finding infrastructure elements. Map-making is a lot more difficult than I first imagined. So, I wish the groups the best of luck with their final projects!
Monday, November 17, 2008
Here is a sample of the questions they are going to answer through their research:
1. What is the incidence of this condition in New Jersey and in the United States as a whole?
2. Are there racial, gender, SES, and regional inequalities in the incidence of this condition in the United States?
3. What can be said about racial, gender, SES, and regional inequalities in the incidence of this disease within the state of New Jersey?
4. What can you say about the cost and effectiveness of treating this condition vs. the cost and effectiveness of preventing this condition? What tradeoffs would a shift from treatment to prevention pose to New Jersey lawmakers?
Their findings will help to map the overall status of health and racial disparities in New Jersey.
1. Review of international questions of food and health, as well as international hunger programs (Sarimer S. )
2. Review of contemporary activism around local food movements and/or organic food availability, with a focus especially on organic food (Aba O.)
3. History of the USDA food pyramid, food safety regulations, and changing government assertions about what is healthy (Carol S.)
4. History and contemporary politics of school lunch programs (Lauren B.)
Their findings will shed light on why food is a public health issue.
Friday, November 14, 2008
Working independently, each group arrived at interviewing more or less at the same types of stakeholders, which included mayors, doctors and nurses, owners of grocery stores and municipal health officials. The basic strategy that most group members indicated they want to employ is to ask the same basic core questions to all stakeholders that they interview, with a few questions then tailored directly to the individual.
Most groups mainly focused on what questions they wanted to ask and selecting general categories of stakeholders, but a few have already come up with specific names of individuals for at least a few of their stakeholder categories and also spent time fine-tuning questions to avoid biased or leading questions.
Samples of questions include:
1. What are the primary issues relating to food availability and healthcare?
2. What are the health outcomes and effects you see? Who are the most vulnerable populations?
3. What are the governmental policies to address the issue of food availability? What are the non-profit responses to this problem?
4. What is the economic impact of malnutrition on the community and the healthcare system?
5. What kind of food is served in your hospital?
6. Does your store take any initiative to sell healthy food to your customers?
The groups were required to submit their action plans yesterday, and some are meeting again over the weekend to discuss feedback and decide how to best move forward with interviews.
Thursday, November 13, 2008
This week, in anticipation for the upcoming field trips to Trenton, Camden, New Brunswick and Newark, the groups discussed in person or via email what sorts of questions they wanted to include in the interviews with the residents. I was able to meet up with the Camden and New Brunswick groups while they met in Frist to prepare their list of interview questions. Here I got the chance to get a sense from the groups about how they felt the project was going thus far, their expectations for their future research and what aspects of their assigned role within the project were unclear or confusing to them. Their responses to a short questionnaire they filled out helped indicate where they stand.
They all expressed a desire for more guidance and structure within the project, but at the same time seemed to be tackling their prescribed roles within the project quite well and enthusiastically. Confusion over how the actual field trips would be conducted was a minor barrier the groups faced when trying to come up with an appropriate list of questions, as they were unsure of what sort of interview settings to expect. However, this did not bar them from effectively compiling a comprehensive list of pertinent and important questions to ask the residents. Below is a sample of one of the groups working-progress interview list:
1) How often do you come here and pick up food?
2) Do you like the food provided here? What suggestions do you have for food to be added?
3) Do you think that the food provided here is better than what you would get otherwise / ate before?
4) How often do you buy pre-prepared food?
5) Where are your favorite places to eat?
6) What are your main concerns when buying and preparing food?
7) Do you look specifically for fresh fruit and vegetables? How about organic foods?
8) How important is having high quality food to you?
9) What does a “healthy diet” mean to you? Do you think you eat a “healthy diet”?
10) How many people are you buying for?
11) How much time do you have to prepare your food?
12) How do you get to and from the grocery stores?
13) Do you think that poor quality food/ poor access to food? If so, what reasons do you think account for this?
14) Do you think that local representatives need to be talking about the quality of food available in Camden?
15) Where does quality of food access rank in importance do you?
The questionnaire also shed light on the group member’s individual mindsets and backgrounds coming into the project. When asked about their own personal nutritional habits the responses varied: vegetarians, “balanced” diets and packaged food were just a few of the habits cited. Overall, the responses reflected an awareness that food is key factor to what it means to live a healthy and balanced lifestyle. Furthermore, they mostly attributed their current nutritional habits to the environment they grew up in and the nutritional values and access said setting instilled within them. It will be interesting to see how the individual group members own relationships with and opinions about food will juxtapose those of the residents interviewed in the weeks to come.
Wednesday, November 12, 2008
Group 5: Trenton
Group 6: Camden
Group 7: Newark
Group 8: New Brunswick
- and will report on food availability. They will use the USDA’s Thrifty Food Plan (TFP) Survey (found on the USDA website) as a guideline for measuring food availability. The Thrifty Food Plan indicates how much and what kinds of food a family of four needs throughout a week in order to receive a healthy nutritious diet. Each group member will be visiting grocery stores, counting food, and computing the percent of food missing relative to the Thrifty Food Plan. They will later compare the data that they collect among each other, and with the national average. Each member’s final work will include photographs, a report on the specific aspect of food availability that he/she chose to focus on, as well as a short paper and several power point slides. At the end, the groups will produce a collective short paper that will be included as a final chapter of the report.
Although there has been some discussion between groups as to how to adopt a unified method of measuring food availability, distinct approaches to the problem have been emerging in the groups that have been meeting.
Group 7 will be structuring its research questions around the underlying social, economic and institutional factors that affect community food security in Newark. Each member will focus on collecting data relevant to one of the following four aspects of food availability:
- The presence of Federal Food Assistance Programs such as food stamp programs, National School Lunch programs, or elderly nutrition programs.
- The Accessibility of supermarket and corner stores, as well as the presence of private and public transportation. The infrastructure necessary to deliver Federal Food Assistance Program benefits efficiently will also be examined.
- The types of Food available, and the percent of items missing in each important food category relative to the TFP.
- The Affordability of Food – both the prices of individual items, as well as the cost of the entire TFP market basket will be taken into consideration. The group will also look at how prices vary across stores in Newark as well as at whether or not stores accept food stamps.
After meeting with Jane Weber, the Public Health Coordinator of the Lourdes Center for Public Health, Xinyi Duan from Group 8 decided that it would be best to count grocery items in supermarkets in New Brunswick using a shortened version of the Thrifty Food Plan. She has also added one more component to the TFP: the availability of healthy food substitutes. This is of particular importance given the nutrition-related health problems prevalent among immigrants that were mentioned in lecture by the CEO of our community partner Catholic Health East. Although health food will be the focus of the research, her group will also look at:
- The types of food present in each store
- The affordability of food in the community.
- The type of advertising found in stores.
The data collected in supermarkets in New Brunswick will act as a control for the data collected in the other three cities.
It will be exciting to see what different approaches groups 5 and 6 will choose to adopt, and to observe how the different groups’ findings will give a unified view of the problem of food availability throughout New Jersey.
Tuesday, November 11, 2008
Similar to “Infrastructure Group, Part I,” The main goal of this group is to map out the health and food-related infrastructures in
-Hospitals/Clinics: what effect does the proximity of healthcare, and the patient capacity of each institution, have on community health?
-Community Centers/YMCAs/Recreational Facilities: what role do they play as distributors of health and nutritional information?
-Grocery Stores: how many stores (whether health food, major food, corner store, or farmer’s markets) do the communities have, what foods are available and what alternative foods are available?
-Restaurants: interested in how many fast-food chains and non-chain restaurants in each community, and the availability and diversity of the foods they provide.
-Pharmacies: what role do adequate pharmacies play in the ability of the community to acquire prescribed medications.
-Food Pantries/Soup Kitchens: will use these to further include food sources for any groups of community members who may not get their food from grocery stores, or restaurants.
-Urban Farms: what role do they have in creating a “better” (healthier) food source for community members.
In addition to researching these areas of infrastructure, students will also go to these places, take pictures, and report about on-the-ground realities. In the end, each member of this group will produce a map of his/her specific focus, a short paper, and several power-point slides for the final presentation. The group as a whole will produce a short paper and a comprehensive map that will be included as a chapter of the final report.
The main goal of this group is to map out the infrastructure in
-Transportation: how residents use it to access their food and health care providers
-Playgrounds: the role they play in facilitating exercise and giving children an alternative to other detrimental activities
-Vacant land/Unoccupied Buildings: how it signals lack of wealth in a community and also acts as a prime location for illegal activities
-Liquor stores: what the demand for liquor means (there is only supply if there is demand), what the money could be better spent on and the adverse health effects which result from excessive use.
-Schools: how the quality of the schools reflect the wealth of the area and the health of its community members
-Public Housing/Rental Housing: how they reflect the transience of communities, which often plays a role in health because of a lack of community and interconnectedness
-Banks & Lending Institutions: banks show wealth and investment in a community, but payday lending institutions are more common in poor neighborhoods and prey on the community.
-Government sources/Non-Profit services: how these institutions aid in access to healthcare, social services, and government welfare services.
-Churches & Other Religious Institutions: how they build community cohesion and provide access to services
And, to get a real feel for the environment, students will actually go to these places, take pictures and report about on-the-ground realities. In the end, each member of this group will produce a map of his/her specific focus, a short paper, and several power-point slides for the final presentation. The group as a whole will produce a short paper and a comprehensive map that will be included as a chapter of the final report.
It promises to be a very interesting project.
Sunday, November 9, 2008
- Childhood vaccination, childhood asthma, and childhood injuries (Alexandra Douwes)
- Diabetes, obesity, and heart disease (Emily Hankin)