Moving Health Care Upstream

Healthy Food Access: Healthy Tarrant County Collaboration

Connection to Moving Health Care Upstream

Healthy Tarrant County Collaboration brings together hospitals, public health, universities, and other community partners to work together to improve the health of our community.  We seek effective ways to reduce obesity and chronic disease through policy, systems and environmental strategies that can impact the social determinants of health.   We participated in the MHCU Policy Learning Lab in 2017.

Our Community & Need

One of the fastest growing urban/suburban counties in the U.S., Tarrant County, Texas is home to more than 2 million diverse residents and growing quickly at a rate of 1.62% per year.  The county seat is Fort Worth, currently the 15th largest city in the US.   Across our county we have a number of areas with a combination of low incomes and limited access to stores selling healthy foods.  Not surprisingly, these areas also experience disproportionate rates of obesity and chronic disease.

In 2014 we facilitated meetings with the community leaders in East and Southeast Fort Worth to learn what they believed to be the most important barriers to improving health in their neighborhoods.  They pointed out that while many organizations offer nutritional education and cooking classes, too often the foods that these programs recommended were not readily available for purchase in this area.

East & Southeast Fort Worth measure approximately 72 square miles, and in 2014 area had just 6 supermarkets, plus over 100 convenience and dollar stores.  Today the number of supermarkets has reduced to 4.  Most of the convenience stores stock beer, wine, lotto tickets, unhealthy snacks, and pretty often, gaming tables.  Most of the dollar stores offer some dairy foods and grocery staples but lack fresh produce.

Our Solution

We have been developing and testing a suite of strategies aimed at providing retail access to at least some healthier foods within 1 mile of the majority of households in East and Southeast Fort Worth, with the aim of eventually replicating the best strategies in the other low income / low access areas across Tarrant County.  These include:

  • Food Environment Scan. Using a healthy foods availability index (HFAI) tool, we are surveying 100% of the stores selling food one zip code at a time, in order to identify all of the existing retail opportunities for buying healthy food.  We are finding that while there aren’t many supermarkets offering one-stop shopping, there are other bright spots where residents can buy part of what they need.  Connecting the dots between these bright spots provides some options for grocery shopping.  This information can be used by health providers and educators to help patients know where they can go to buy the recommended foods.  Between May 2018 and April 2019, we will complete surveys in approximately 1/3 of the county, powered by student interns and class service learning projects from UNT Health Science Center, University of Texas at Arlington, Sam Houston State University, Texas Wesleyan University and the American Heart Association.
  • Healthy Corner Stores. We have also worked with some convenience stores to expand their product lines to include fresh produce, healthier dairy, and shelf stable foods.   As an incentive for more store owners to consider doing this, we are promoting the City of Fort Worth’s pilot Healthy Foods Financing Initiative program, which offers low cost microloans of up to $50,000 to owners of stores located in food deserts who agree to stock and sell healthier foods.  The loans have a 6-year payback with no penalty for early repayment.  We hope that a successful pilot will lead to a larger program in the future.
  • Mobile Produce Sales. In 2016 Fort Worth adopted an ordinance amendment which allows mobile sales of fresh produce.  Prior to this it was legal to sell ice cream and frozen treats from trucks, but selling apples, bananas and lettuce was illegal!  Through this we are replicating a successful model from Northwest Tarrant County that entails mobile sales of $5 bags of fresh produce in the areas with the least access to fresh produce.  The model uses the buying power of the hospitals to obtain fresh food at the best possible price and using volunteer networks to bag and sell the food.  Imagine this – someone could go to the local dollar store to pick up dairy, frozen, and canned and other shelf-stable foods and then stop by the Gardens on the Go stop to finish off their shopping with a bag of fresh produce!
  • Urban Agriculture. We are also helping grassroots groups start urban farms.  Across Southeast Fort Worth we have met four passionate individuals who have land that they would like to farm.   The sizes of the future farms range from roughly ½ acre to several acres.  The City of Fort Worth passed an urban agriculture ordinance in 2016 which makes it legal for urban farms to exist on land zoned for other uses, such as residential or commercial, with a special permit.  We believe that as these farms develop, others will also emerge with an interest in growing and selling fresh produce in the neighborhoods.
  • Communications Campaign.  In 2009 Tarrant County Public Health created as award winning communications campaign that proved effective in encouraging people to increase their fruit and vegetable purchases – Live A More Colorful Life.  In 2016 we freshened and redeployed this campaign as part of our Plan4Health project – the Power of Color campaign.  Using multiple and layered strategies, the campaign promoted awareness of the importance of consuming colorful fruits and vegetables, and also linked this to healthy food stores.  Strategies included direct mail, door hangers, billboards, bus bench ads, mobile digital ads, banners, posters, flyers, sidewalk decals, and more.  All pointed toward LiveAMoreColorfulLife.org.

Community Partners for our work with MHCU

Member institutions include:

Other community partners include:

For more information:

If you would like more information about the upstream work happening in our community please contact Linda Fulmer at [email protected]

Get Moving Health Care Upstream updates