Nassau County, an adjacent eastern suburb of New York City that extends 25 miles from New York City to Suffolk County and an average of 12 miles from the Long Island Sound to the Atlantic Ocean, has a population of approximately 1.3 million residents. The majority of people live in close proximity. Eight communities have been designated as core/target communities with 4.7% or more of the population living at or below federal poverty levels. These identified communities are Freeport, Hempstead, Inwood, Long Beach, New Cassel/Westbury, Roosevelt, Uniondale and Elmont.One public health issue, among many, that is evident in these core/target communities, which by the way, are also for the most part communities of color, is poor diet which can lead to obesity and other health related issues like diabetes or cardiovascular disease. The goal and objectives of this pilot program movie screening of "Soul Food Junkies", an award-winning film by New York filmmaker, Byron Hurt, was to take the opportunity to educate 30 -50 community residents at each program, in a setting where they could learn the implications and risks of poor diet and eating habits depicted in the film in a culturally identified way. We would also begin to implement ideas and methods to improve health outcomes during the panel discussion that would immediately follow the film.
As a part of the newly formed Nassau County Health Department’s Bureau of Minority Health and in recognition of Minority Health Month, the pilot film screening program was scheduled for the month of April 2013. The bureau collaborated with local academic partners as well as cultural / community centers within the target communities and choose three locations, dates, and appropriate panel members for the panel discussion that would follow each film screening. Three communities selected were Roosevelt, Hempstead, and Westbury/New Cassel. In addition to the panel discussion, each program featured a local restaurant who agreed to prepare a few menu items in as a healthier option and serve samples to those who attended the program. Finally, evaluation forms and the current community health assessment forms were distributed to attendees for feedback, evaluation and data collection.
At each film screening there was attendance of more than 60 residents, with the highest attendance of 93 at the Hempstead program. This attendance objective exceeded our goal of 30-50 attendees which was the target number set for this program. Also, all age groups were represented at each screening as individuals as well as families attended.
During the panel discussion the attendees expressed personal health stories that related to diet and health risks associated in the film presentaion and spoke about how the film depicted such a true picture of the cultural eating habits they were accustomed to throughout their lives. The panelist were able to answer questions relating to the audiences concerns regarding ways to begin to create new eating habits while understanding the benefits of doing so.
The success of the program was due to the non- traditional educational approach through a film that not only the African-American community could connect with, but other cultures also found a connection with as well. The overall message was about health risks connected to poor diet and eating habits and the program Public Health Impact created new ideas regarding healthy eating options within the community.
Nassau County is a suburban county on Long Island and is east of New York City. As of the 2010 census, the population was 1,339,532. The Nassau County Department of Health, located in Uniondale, serves the entire population of Nassau County. Eight communities have been designated as core/target communities with 4.7% or more of the population living at or below federal poverty levels. These identified communities are Freeport, Hempstead, Inwood, Long Beach, New Cassel/Westbury, Roosevelt, Uniondale and Elmont.The U.S National Library of Medicine describes obesity as having too much body fat. It is not the same as being overweight, which means weighing too much. A person may be overweight from extra muscle, bone, or water, as well as from having too much fat. In both cases, it means a person's weight is higher than what is thought to be healthy for his or her height. As described by New York State Department of Health (NYSDOH), being overweight or obese increases the risk of chronic diseases and conditions including type 2 diabetes, high blood pressure, high cholesterol, stroke, heart disease, certain types of cancer. According to a 2008 report by the former NYS Comptroller DiNapoli, New York State ranked second among U.S. states in adult obesity-related medical expenditures, with 81% paid by Medicaid and Medicare. The New York State Health Fund also estimated that New York State had spent approximately $9.9 billion on adult obesity-related health problems in 2011.
According to the Office of Minority Health (OMH), in 2011, African Americans were 1.5 times as likely to be obese as Non- Hispanic Whites. OMH also reported African American women as having the highest rates of obesity compared to other groups in the U.S.
The eight identified core/target communities in Nassau County have a population of 4.7% who are living at or below federal poverty levels. For the most part, these communities have a large demographics mostly made up of African-American, Hispanic, and Caribbean cultures. These cultures or target populations are people who are overweight and are more likely to suffer from high blood pressure, high levels of cholesterol and have all the risk factors for heart disease and stroke. In the past, through health education provided by the LHD, community health fairs were how residents received information about obesity, and various chronic conditions. Unfortunately, most health education programs have been eliminated due to government reductions but chronic conditions continue to increase.
The LHD in Nassau County in early 2013 formed the Bureau of Minority Health. The Bureau immediately began developing a calendar of programs aimed at educating the identified communities on topics that impact the health of those communities in an effort to improve health outcomes and decrease health disparities. The Bureau would also collaborate with existing community and academic partners to conduct outreach and awareness activities as well. For the month of April, 2013, the Bureau of Minority Health along with both community and academic partners created a program to be used for both Minority Health Month and Public Health Week using an already existing documentary film called “Soul Food Junkies”.
In the documentary “Soul Food Junkies”, the audience is taken on a historical and culinary journey to learn about the soul food tradition and its relevance to black cultural identity. The one hour film includes interviews with soul food chefs, historians, and scholars, as well as with doctors, family members, and everyday people. The film takes a close look at the soul food tradition to examine both its positive and negative consequences. The filmmaker also explores the socioeconomic conditions in predominantly black neighborhoods, where it can be hard to find healthy choices, and meets some people who are challenging the food industry and encouraging communities to create sustainable and eco-friendly gardens, advocating for healthier options in local supermarkets, supporting local farmers markets, avoiding highly processed fast foods, and cooking ways of preparing traditional soul food. The filmmaker, Byron Hurt, also speaks in the documentary from personal experience. He talks about growing up with his father and his weight issues and about his eating habits. Eventually, his father made some small changes to his diet and began to exercise more, but the changes came too late in his life. In 2004, doctors diagnosed his dad with terminal pancreatic cancer, a disease that disproportionately affects black people. Statistically, black Americans are more likely to die of the disease than whites; figures for 2001 to 2005 from the National Cancer Institute show that blacks had a 32 percent higher death rate. One of the risk factors for developing pancreatic cancer is a high fat, meat-based diet. Hurt’s father died in 2007 at the young age of 63, also talked about in film. This is sadly a common story in the lives of many African American families in the U.S. — losing loved ones too soon from a nutrition-related illness.The use of this documentary as an educational tool is creative in the sense that the audience is identifying with the natural elements of the film as if the filmmaker is talking about their own family. The food looks good, the family stories are funny, but so is the truth about the consequences of continued traditions of cooking and eating the food depicted in the film. The subsequent panel discussion that followed the film immediately engaged the attendees in a discussion about some commonalties in their eating traditions like in the film as well as their health issues they were experiencing. The selected panelist for each program answered various questions from the attendees, depending on their area of expertise. The attendees were so engaged and they had so many questions about how they can change their diet and how they can eat better and exercise. Many wanted to know if the film could be shown to their church members or at school PTA meetings.
Finally, the last element of this creative learning experience was the healthy food sampling which was provided by a local restaurant. The owner/chef of the restaurant agreed to change a few menu items that would normally be high in calories and fat and prepare them in a healthier way. He/she distributed samples to the attendees and shared how the dishes were prepared either verbally or with recipe cards to take home. One chef decided to add the healthier option (grilled fish) to his menu as a permanent item.
Nutrition, Physical Activity, and Obesity
The goal and objectives of the pilot program movie screening of "Soul Food Junkies", an award-winning film by New York filmmaker, Byron Hurt, was to educate community residents at each program, in a setting where they could learn the implications and risks of poor diet and eating habits depicted in the film in a culturally identified way. Immediately following the film, we would start a dialogue, led by a panel of medical and health professionals, and begin to implement ideas and methods to improve health outcomes.In order to achieve these goals and objectives, the Bureau of Minority Health collaborated with local academic partners as well as cultural / community centers within the target communities and choose three locations, dates, and appropriate panel members for the panel discussion that would follow each film screening. There were three of the eight target communities selected during this first timeframe of one month. Next year the goal is to select three different communities and the following year the remaining two.
The primary stakeholders were the local health department, a local academic partner, medical professional partners, cultural/community centers, and the communities at large.
Throughout the implementation of this practice, the LHD worked together with the stakeholders to first seek commitment of their role in making the program a success. The main goal was to make sure residents knew about the screening, the date and time and that the screening was well advertised. Flyers were distributed throughout the community prior to the date of the screening. Community based organizations were asked to distribute flyers to their clients and staff. Local business owners were asked to hang flyers in their place of business. Overall there was a positive response.
The locations of the screenings were chosen based on local familiar community based sites willing to offer their space at no charge as an in-kind offer. The Hempstead program was held at the African-American Museum. The Westbury/New Cassel program was held at the "Yes We Can" Community Center and the Roosevelt program was held at the Roosevelt Fire Department Community Room.
Nassau County Department of Health has always fostered relationships with community, medical, and academic partners to provide outreach, education, and collaborative efforts. Without these collaborations, many of the communities in the county would be greatly impacted from chronic illness and diseases as well as access to health care. We continue to find new and innovative ways with these relationships to improve the health outcomes of our communities and reduce health disparities.
The first goal and objective of this pilot program movie screening of "Soul Food Junkies", was to educate 30 -50 community residents at each program, in a community setting about the implications and risks of poor diet and eating habits depicted in the film in a culturally identified way. The second objective was to begin to implement ideas and methods to improve health outcomes during the panel discussion that would immediately follow the film.The first source of data to ascertain the number of participants at each program was requested that attendees sign a "sign in" sheet upon arrival or at some point before their departure. At the Roosevelt program, our academic partner collected the data for the collaboration with Public Health Week and reported (86) attendees. For the Hempstead program, we assigned a community partner to greet attendees at the door and request their sign in. The Hempstead program was attended by 94 people. The Westbury "Yes We Can" Center Manager assigned herself to collect attendance signatures as she wanted to ensure she had data for her evening program as well. The Westbury program had an attendance of 64 people.
The attendance at each program was achieved and exceeded our goal of 30-50
The second objective which was to implement ideas and methods to improve health outcomes during the panel discussion, which immediately followed the discussion, was an observed outcome measure. At each program, the attendees had many questions for the professional panelist and felt compelled to share personal health information in order to seek advice regarding improvements they could begin to make.
The attendees at each program were also given a "Participant Evaluation" to complete. 50 evaluations were completed and evaluated The first five questions asked for demographic information. Questions 6,7, and 8 asked if the topic was informative, relevant, and if you were likely to attend a future event. Questions 9 and 10 asked for additional feedback. Based on questions 6,7, and 8, 96% felt the quality of the information presented at the event was informative and 78% felt the topic was relevant to them and their family. 74% would very likely attend a future event. Question 9 asked, What type of health presentations/services would you like to see in your community in the future? Some of the responses were: "presentations beneficial to the community" "Exercise for busy moms" Preparing healthy food" "Show this movie in all communities" "Medical presentations"
The community is interested in learning about how to decrease their risk for chronic diseases as well as begin to make steps to improve their health. As indicated in some of the participant evaluations, residents are looking to learn about ways to prepare foods in a healthier way, exercise, and hear from medical professionals regarding their health. With the current economic and healthcare climate, it is important that the local health department continue to foster relationships and pool resources with community, academic, medical, and the community at large to get the message across.This documentary film screening of "Soul Food Junkies" used as an educational learning tool in the communities had not been done in the past. The buzz that the program created this year in the selected communities has the other communities requesting the film to be shown in their communities next year and therefore planning has begun with our stakeholders who are still committed. Next year we will select three different target communities and present the documentary using the same format with a panel discussion following the film. The following year the remaining two communities will be selected. If there is still a demand, in year four, we can start back at the first three communities with the same film or perhaps a new selected relevant film.
The Nassau County Department of Health and the Bureau of Minority Health will continue to work with community partners and stakeholders to present this film as a learning tool. Along with the film, we will continue the panel discussion format and invite a local restaurant to prepare selected menu items prepared in a healthier manner for sampling. In order to collect data and feedback, we will continue to distribute and collect evaluations and we will take attendance at each program by requesting that attendees sign in.
For this practice we did not do a formal cost analysis as the most if not all of the cost was either in-kind or donated. Future programs will be sustained in the same manner.