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Kaiser Permanente Helps Supermarket Bloom in Food Desert

 |  By John Commins  
   April 30, 2014

Part of the integrated health system's strategy is to complement "clinical prevention work with environmental strategies that increase access to healthy, affordable food and safe physical activity," says the executive leading the effort.


Loel S. Solomon, PhD
Vice President for Community Health for Kaiser Permanente

The term "food desert" is not new. It's been around for a couple of decades and it succinctly describes patches in urban and rural settings where people don't have access to healthy foods.

In the past few years the term has gained usage in the United States as we come to recognize that access to healthy food is a critical component of population health management, which itself will also become a key metric for provider reimbursements.

Kaiser Permanente already supports a network of farmers markets outside many of its medical centers and clinics. So it's not surprising that executives from the giant California health system were in the crowd earlier this month to mark the grand opening of a new 40,000-square-foot, full service supermarket in a South Los Angeles neighborhood that is served by the integrated health system.

Loel S. Solomon, PhD, KP's vice president for community health, says providers can no longer improve population health without looking beyond their own walls.

"Good clinical prevention is necessary, but insufficient to help our members eat better, which is critical to addressing obesity and diabetes and all sorts of chronic diseases," Solomon says. "We know we have to make the healthy choice the easy choice and that means we have to address the lack of access to healthy food in too many of our communities. So, it's part of our strategy to complement our clinical prevention work with environmental strategies that increase access to healthy, affordable food and safe physical activity."

The April 14 opening of the Northgate Gonzalez Market was 17 years in the making and was facilitated by a $50,000 workforce development grant from the California FreshWorks Fund, which describes itself as "a $272-million impact investing fund that provides loans and grants to grocers and other food enterprises to improve access to healthy food, spur economic development, and foster innovation in healthy food retailing."

Quality Food and Jobs
Northgate Gonzalez Market will bring fresh fruits and vegetables and other healthful foods into the neighborhood and it won't sell alcohol or cigarettes. It also used the workforce development grant to recruit, hire and train people living in the neighborhood, which suffers from high unemployment.

Solomon says the market created 153 new jobs, of which 111, or 73%, were new hires. Of those new hires, 74% are from adjacent zip codes and the vast majority live within two miles of the store. The workforce is 79% Latino, and African Americans predominate the remaining 21%—ratios that reflect almost exactly the demographics of the community served by the market.

"The idea is two-fold. One, we come at it from a health perspective. If we are serious about addressing people's health issues we need to create more access to healthy food," Solomon says.

"But, a good solution solves many problems. The other major driver of health and a major social determinative of health is whether people have jobs or not. So, the healthy food financing initiative and the California Fresh Works fund is an effort to create more and better employment for people who don't have access to it. It addresses health from that factor too. It is what we call a co-benefit—improving access to quality food and increasing well-paying jobs for people who often don't have access to good jobs."

A Few Questions
There is a lot to like about this project, but it also raises questions. For example, will the Northgate Gonzalez pay a living wage for its workers, or will it copy the business model used by a certain big block retailer and many fast food chains that cover labor costs with employee canned food drives and government subsidies in the form of food stamps and Medicaid?

"For this project, every job [pays a] fulltime, living wage in accordance with LA City's Living Wage Ordinance and with benefits—health, dental, vision, 401k," Solomon says.

If the demand is so great, why is a subsidy needed? Why hasn't the free market responded?

"It's called market failure and there are countless cases of when the market left to its own devices doesn't always produce the socially desirable results," Solomon says. "How else would you explain that there are large concentrations of people who are not served by a full-service grocery store and who have money to spend."

And Solomon insists that the new market is not some pie-in-the-sky do-gooder scheme that will require a permanent subsidy or go out of business.

"The important thing to understand is that there is this workforce development grant but it is a loan they got based on an economic analysis that that loan can be replayed," he says. "Those investors in the Fresh Works Fund include banks and people who want a return on investment. That is the opportunity. How can we, with a little bit of grant money and a lot of technical assistance and communications with the market operators and the Fresh Works Fund folks, create a new economically viable model that produces health and wealth for an entire community that has been left out of the economy? It's not a free lunch."

Encouragement for Other Communities
Of course, KP is not your typical community hospital. It is a massive, deep-pocketed integrated health system with resources that most providers can only read about. Solomon says that a lack of immediate resources shouldn't stop any providers from pushing for healthy food in their communities.

"It requires partnership. Nobody can do it alone. But every single hospital is an anchor institution in their community," he says. "Every single hospital is a major employer in their community. Every single hospital has important relationships with the business community. Every single hospital CEO is a civic leader. It's not about the dollars. It's really about your civic leadership and understanding the nature of the problems we confront and be willing to roll up your sleeves and be willing to address the complexity and the bigger solutions we need to bring to bear."

Maybe your community hospital can't land a 40,000-square-foot supermarket for the people you serve. But you could probably find a way to get a weekly farmers' market trucked into your food desert.

"That is the real opportunity for every single healthcare leader and every single hospital executive," Solomon says, "to think about what is really driving health and illness and work with others to find solutions."


John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.

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