Navajo Families in New Mexico Now Enjoy a Healthy Dose of New Produce Options

At A Glance

As of fall 2015, more than 9,050 members of New Mexico’s Navajo Nation have increased access to healthy produce. Community Outreach and Patient Empowerment (COPE), the Navajo Nation-based site of Partners In Health, started a Fruit and Vegetable Prescription (FVRx) program. Families with limited access to healthy foods receive FVRx vouchers to buy produce when they attend nutrition education sessions. After five months, child participants’ body mass index decreased. Participating stores restock produce more often to meet customer demand.

By Memarie Tsosie

Public Health Challenge

Navajo Nation is considered a "food desert" by the United States Department of Agriculture because of widespread poverty and limited access to fresh produce. The Dine' Policy Institute has documented how centuries of U.S. foreign policy led to the reservation’s current food system. Given the low population density, limited infrastructure, and high poverty rates on Navajo Nation, many families do not have access to healthy food that’s affordable. High obesity rates among Navajo adults and children are linked to a dependence on inexpensive, high-calorie foods with little nutritional value. A 2013 Centers for Disease Control and Prevention (CDC) Epidemiology Assistance report found that small stores on Navajo Nation sold limited produce at high prices. While many retailers wanted to sell more of these healthy foods, customers could not afford to buy fresh fruits and vegetables.

Approach

To improve access to affordable produce on Navajo Nation, Partners In Health/COPE Navajo worked with Wholesome Wave. The nonprofit helps communities across the U.S. set up FVRx programs. With CDC funding, the partners recruited local clinics and small stores to join the initiative. Community health teams invited local families at risk for obesity and diet-related diseases to nutrition classes. For attending, they received FVRx vouchers to buy fresh or frozen produce at nearby participating stores. Vouchers equaled $1 per family member per day and could be redeemed at five stores and one farmers’ market. Retailers tracked use, and families “refilled” their FVRx prescriptions as needed.

I'm glad the store offers more fruits and vegetables. We get to have more salad. And instead of choosing soda, candy, or chips, my daughters choose bananas, apples, or oranges when they go to the store!
- Navajo Nation Parent

Results

The FVRx program has increased access to healthy produce for more than 9,050 residents on Navajo Nation. Over a five-month period, 26 families in five communities participated in the program and increased their fruit and vegetable consumption by 48%. Additionally, child participants’ body mass index decreased. Most retailers have added 6-8 fruits and vegetables to their produce selection. Prior to the FVRx program, one store manager said she restocked fresh produce twice a week. Now, to keep up with customer demand, she restocks the fruits and vegetables section every other day. Items include salad greens, cucumbers, bell peppers, chilies, corn, melons, cassavas, strawberries, blueberries, and grapes. Another store manager noticed families’ snack purchases have changed from buying candy to apples and avocados.

What's Next

Over the next two years, Partners In Health/COPE Navajo plans to work with the Navajo Nation to increase healthy food options from 42% to 75% in Navajo-based small stores. With assistance from community partners and Wholesome Wave, the group is working to increase participation among local food retailers, clinics, and residents. A manual and healthy store toolkits are in development to help explain how the FVRx process works for each stakeholder. Community Health Teams made up of clinicians and community health workers have also been formed to implement and expand the FVRx initiative in other areas of Navajo Nation. Local stores plan to host cooking demonstrations and support groups to help their customers shop and eat healthy as well.

Find Out More

Community grocery stores can encourage healthy eating by providing a variety of fresh fruits and vegetables to customers. To learn more about the Fruit and Vegetable Prescription program model designed by Wholesome Wave, visit www.wholesomewave.org.This project is supported by CDC’s Racial and Ethnic Approaches to Community Health (REACH) cooperative agreement.

Contact

Memarie Tsosie
Partners In Health - COPE Navajo Nation
210 E Aztec Ave

Gallup, NM 87301
Phone: 505-787-0276

Centers for Disease Control and Prevention

Web site

http://nccd.cdc.gov/nccdsuccessstories/

CDC-INFO

https://wwwn.cdc.gov/dcs/ContactUs/Form

The findings and conclusions in this success story are those of the author(s) and do not necessarily represent the official position of the funding agencies or the Centers for Disease Control and Prevention (CDC).