Place Matters: Eliminating Health Disparities in Prince George’s County, Maryland

May 1, 2014, 2:19 PM

The Prince George's County, Maryland Place Matters team is addressing food inequity by establishing a Food Policy Council and working with the county's recreation department to design and implement after-school healthy eating and active-living programs.

The project is beginning with the waterfront towns of Bladensburg, Colmar Manor, Cottage City and Edmonston, which have drafted a Community Action Plan with strategies on how to reduce chronic disease in Prince George's County. Partners on the Community Action Plan included Kaiser Permanente, the Consumer Health Foundation, United Way of the National Capital Area and the Meyer Foundation. Place Matters plans to replicate the initiative in other county municipalities.

Prince George's County is the most diverse in Maryland; 80 percent of the population is made up of minority groups. According to the 2010 Census, 8 percent of households live below the poverty line, but some of the towns have higher rates of poverty. Cottage City has a 21 percent poverty level, Bladensburg has a poverty level of 12 percent and Edmonston has a poverty rate of 9 percent.

Key Team Objectives:

  • Improve healthy food access and wellness for all through food policy and action.
  • Create reliable public transit, bike and pedestrian access to schools and recreational facilities.
  • Enhance community capacity to lead and support the Community Action Plan.

“What we decided to do was instead of trying to address the full county is to build a model which the county could replicate,” said team co-leader David Harrington. Harrington said the project, which started seven years ago, has “had some good success in helping to address some policy issues and system change issues.”

Place Matters is building a team around stakeholders called the Community Implementation Team and a countywide team called the Policy Development Team, which consists of the county agencies that influence policy and can provide support for help in doing the community work. They were engaged early in the conversation “so that they would consider administrative and other policies that will help them buttress the community work, and then the community work would help then influence their work, so this becomes a supportive concentric circle of activity that helps systems change, as well as change at the community level,” said Harrington.

Recent initiatives include:

  • A peer organization called Youth Ambassadors which advocates changes in curriculum, school activities and school policy around physical education and distribution of sugary drinks. It also engages in community activities such as community gardens.
  • An urban farm in Edmonston has been instrumental in looking at food production and access to food issues to help the community become engaged in growing its own food. The group was able to win a zoning amendment that would allow a similar farm to be located at a housing project in Bladensburg.
  • A faith-based effort with churches called Ecumenical Health Council recently signed a memorandum of understanding on change patterns in churches on issues such as serving high-calorie foods and other things that can lead to obesity and high blood pressure. They will also take on health as part of their ministry.

One exciting outcome, noted Harrington, is the fact that African American and Hispanic churches in the county are now working together to address health. At the same time, one major challenge is that the Place Matters teams are working with very small nonprofits to help effect change.

“It is always a daily challenge to keep a partnership together because they have the worry of trying to sustain their own efforts as well as then trying to be in a partnership,” he said.

Another challenge is that unlike some Place Matters teams that operate out of a health department, the Prince George’s County team is working on developing an anchor organization.

“I think it’s still going to be a challenge to then build this organization as the backbone and see how the teams come together as a collaborative,” Harrington said, adding that there has also been overdependence on the county by nonprofits “and there has to be a cultural change within Prince George’s County to reward collaboration as a way of sustaining the work.”

And a critical goal is to expand and replicate throughout the county, using public/private partnerships to scale up the work.

“It’s not just about having farmers markets, but really beginning to demonstrate and broaden our reach in a way that people are seeing a kind of moving of the needle from having some major chronic diseases in the poor towns and in the county to seeing a movement where these strategies are actually working,” he said. “That’s where evaluation is going to come in—it’s going to help us build a narrative that these communities are worth investing in.”

“We’re now looking at what strategies we’re most likely to see outcomes from and to set up what we need to measure, and then see what story we can tell and what outcomes we can see,” said team co-leader Celeste James. “Over the next two years we hope to be able to share stories of the impacts of the projects on peoples’ lives.”

Harrington said the team will also be building a comprehensive online engine to provide citizens with information on where they can apply for food assistance, contact health agencies and provide updates on work in the towns.

The county also has received two community transformation grants from the U.S. Centers for Disease Control and Prevention for a total of $4 million, one applied for by the Institute for Public Health and one by the county health department. Both team leaders said the work of the Place Matters teams showed the county was ready to be able to administer the grants, and that they are the only county in the country that received two.

“There’s collaboration now and we think that that collaboration is becoming engrained so that it’s not necessarily going to be about healthy eating and active living next time; it could be about crime and violence, it could be about housing, but there’s an infrastructure and a mindset that we think that we've helped to shape in this county,” said James.

This commentary originally appeared on the RWJF New Public Health blog.