Ofelia Valencia, a Mexican immigrant and 13-year resident of East Palo Alto, doesn’t shop at the grocery store that’s closest to her house, or the store that sells the freshest produce.
“I pick up the newspaper and I see the chicken is on special at Mi Pueblo, or at Mi Rancho or at Foods Co.,” she said. “Where the food is cheapest, that’s where I go.”
So throwing away perfectly good items from her refrigerator is not what you’d call a natural tendency for the full-time housekeeper and mother of three. But one Saturday morning in mid-November, that’s just what she did.
“No más,” she said, as she discarded half a gallon of Tampico fruit juice.
Valencia’s decision to sacrifice a tasty, if sugary, beverage for the health of her family wasn’t just a personal victory. It took an intricate web of collaboration among local, regional and national players, all struggling to curtail skyrocketing rates of childhood obesity in low-income areas like East Palo Alto.
Navigate this if you can: Valencia learned to limit her daughters’ juice intake in a cooking and nutrition class offered at the East Palo Alto Charter School and taught by the nonprofit Collective Roots, a partner agency of the Pacific Coast Farmers Market Association. The San Francisco-based association obtained a federal grant to administer the curriculum, which was created by a national nonprofit called Share Our Strength.
“It’s so bizarrely complicated,” said Nicole Wires, food system change coordinator at Collective Roots, who helped teach Valencia’s class.
But with a small tax base and limited public funds, “that’s the only way we can do it in East Palo Alto,” said Pamela Reliford, the city’s recreation services supervisor.
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Ofelia Valencia is a conscientious mom. She thought she was doing everything right as a parent – until her 9-year-old started gaining weight, and Valencia recognized a trend in her family. “When my nieces and nephews were young, they were thin. But when they’d get to a certain age, they all started gaining weight,” she said.
Nearly 20 percent of the nation’s children were obese as of 2008, according to the U.S. Centers for Disease Control and Prevention. Though no recent data exists for East Palo Alto, public health officials say the percentage is much higher in the city because of its ethnic mix and level of poverty.
Only 7 percent of seventh-graders who attended city schools met fitness standards in 2006, compared with 37 percent across San Mateo County. Nearly half of all East Palo Alto fifth-graders were overweight or obese in 2008, according to Luisa Buada, chief executive officer of the Ravenswood Family Health Center.
It’s not just the overall number of obese kids that’s growing; the very heaviest are getting heavier.
“When I was a kid – and I know it sounds rude – there weren’t many fat kids. Now, it’s everywhere,” said Saree Mading, a lifelong resident of the city and dean of students at East Palo Alto Charter School (EPACS). “I see kindergartners come in, only 5 years old, who are very overweight. Like, if I had to pick them up, I couldn’t.”
If patterns hold true, about half of these children will grow into obese adults, making them susceptible to serious mental and physical health consequences, according to Dr. Thomas Robinson, director of the Center for Healthy Weight at Lucile Packard Children’s Hospital.
Already, East Palo Alto’s Ravenswood clinic has seen a doubling of patients with Type 2 diabetes, from around 500 in 2008 to more than 1,000 today, said chronic disease program manager Wilfredo Cerrato. (The recession also could account for more people visiting the free clinic.)
In the grocery stores near her house, Mading said, “Every aisle when you first hit the door is filled with sweets and serious, high-calorie junk food. You combine that with parents who don’t know how to say no to their kids, and the problem persists.”
What used to be a majority African-American population in East Palo Alto has transformed over the past two decades into a mostly Latino one, with a small but growing number of Pacific Islanders. For those populations, cultural traditions around eating make unhealthy weight a risk, but when you combine that with poor access to physical recreation and nutritious food, the result can be disastrous. As of 2008, 39 percent of seventh-grade Latinos in California were overweight or obese, along with a staggering 44 percent of Pacific Islanders.
Valencia grew up in Mexico with seven sisters and five brothers. “We were poor,” she said. “We didn’t have a lot of options. We ate what we could.” Breakfast, lunch and dinner would often come from one chicken; apples were a beloved dessert. Without a car, she walked wherever she needed to go.
In East Palo Alto, she has a greater selection of food and a car to take her everywhere she needs to go – but until recently she was still hanging onto the cooking traditions of her mother, incorporating a lot of grease and sugar. “So, yes,” she said, “it’s easier to gain weight.”
Valencia learned about the free cooking class offered by Collective Roots through an EPACS announcement. She and 10 or so other moms and their children met over a series of six Wednesday evenings. In classes, they learned how to avoid certain familiar foods – chips and soda, for example – and take others they’d never seen before, like yams and eggplant, and turn them into delicious, healthy and affordable dinners.
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Teaching parents how to buy and prepare healthy meals for their families is essential, said Cerrato of the Ravenswood clinic.
“Food is very important in our culture,” he said, “so we need to pay attention to that particular aspect.” But it’s far from the only front in the city’s push for a healthier population.
East Palo Alto was recently awarded a San Mateo County Get Healthy grant to start a walk-to-school program in at least one neighborhood. In recent months, the city council passed a bicycle and pedestrian policy, and the public works department has been improving streets as part of a Safe Routes to School campaign.
Reliford, the recreation services supervisor, said the city is drafting initiatives that will form a de facto public health policy, establishing a plan to encourage employee leadership around fitness and getting more people engaged in recreation programs, especially in the parks. The staff is hoping for council approval by the end of January or beginning of February, in time to solicit community partners for the projects at the next meeting of the East Palo Alto Community Health Roundtable.
The city is not interested in addressing obesity as an isolated, short-term problem.
“It’s not just about having people physically fit and making nutritious choices,” Reliford said. “It’s also about mental health and creating a mindset where they’re ready to even take on the challenge.”
That approach seems to be the consensus in East Palo Alto.
“The philosophy is that anyone who’s providing support, whether it’s tutoring or legal aid or homeowners support, they’re all working with a population that’s dealing with the same constraints,” said Wires of Collective Roots. “Those constraints are so immediate and so visceral that they need to be addressed holistically. There’s not a great model for what we’re trying to do in East Palo Alto. We’re not importing something. We’re all just kind of learning as we go.”
Valencia is awed by the number of free programs offered through her daughters’ school and other organizations in the community, which have taught her the importance of spending time as a family and limiting access to television. Taking advantage of the programs is not always easy.
“It’s not that we don’t care about our families. It’s that we work hard, and we get home tired,” she said. Making it to the Wednesday cooking class with her daughters after a full eight hours of cleaning houses was something she had to force herself to do.
Moreover, some of the programming clashed with her cultural heritage – at least on first contact.
“The first time I heard about the nutrition class, when my daughters were enrolled in a different school, I ignored it,” Valencia said. “I thought, ‘They’re crazy; what do they know?’ I didn’t understand the importance of it. The next time I heard about it, I was interested, and it occurred to me that they were saying was right. But I still didn’t want to put it into practice. Then, I heard it one more time. And the third time, I realized that what they were saying was true: Nutrition is important.”
Without help from the people and institutions in East Palo Alto, Valencia said, she wouldn’t have changed her behavior. Now, she’s cooking food that’s “sano y rico” – healthy and delicious.
Nzinga Regan’s Story (English)
Ofelia Valencia’s Story (Spanish)