This article first appeared in the St. Louis Beacon, April 6, 2011 - Amy Stringer Hessel, an official at the Missouri Foundation for Health, likens the efforts by many overweight Missourians to shed pounds to the plight of Sisyphus rolling the boulder up the hill, only to see it roll back down again. She think it's time to give fat Sisyphus a little help by doing something about the hill.
"We can't just focus on changing individual behavior," she says. "We have to address the environment that we live in because it influences the choices we make. The hill is your environment. We want to make it flatter and easier for people to push that boulder and make individual changes."
That's part of Hessel's mission as project lead for a new MFH program called Social Innovation for Missouri. SIM tackles the cardiovascular risk factors of smoking and obesity together in a single program. The goal of each project is to help communities address such issues as access to fresh foods, safer places for physical activity, and effective ways to prevent or stop smoking.
It's easier to help people lose weight, Hessel says, if communities give them incentives -- such as repairing unsafe sidewalks, building or redesigning walking paths to separate pedestrians from cars, and offering stores that stock nutritious foods and vegetables.
"If you don't change the environment, you don't make it easier for people to make changes," she says.
SIM's focus is on developing public-private partnerships to make the public dollars go further. The process began when MFH became one of only 11 groups nationwide to win a Social Innovation Fund federal grant for devising new ways to address food, tobacco and physical activity issues in underserved communities.
With its $2 million grant in hand, MFH matched that money with an equal amount of its own funding. It then gave awards, ranging from $107,000 to $388,000, to seven nonprofits. Each had to raise private funds to match its SIM grant. The seven winners range from local schools like St. Louis University and the Jennings School District, to organizations in Putnam County in the northwest corner of the state. The foundation normally serves only 84 counties and St. Louis, but the federal dollars allowed it to target any place in Missouri.
That Putnam County won a grant is unusual. Small communities seldom are able to compete against large ones for scarce dollars. Putnam County is so small that even if every resident attended a Cardinals game at the 43,000-seat Busch Stadium, there still would be plenty of room to accommodate 39,000 more fans.
"This is a community that's rural and small but tired of not having access to ways to be healthy," Hessel says. "It's a favorite story of mine because the people in Putnam County really came together and built a coalition for a healthier community. "
She says likens their attitude to the attitude in urban communities that says, "Just because I live in old north St. Louis, it doesn't mean I want to shop at a corner store or feed my kids that. But if I live there and don't have a car, the obvious choice is that I'm going to eat horribly and have horrible outcomes."
The obesity rate in Putnam is about 30 percent, average for Missouri but 5 percent higher than the national average. The county's 4,900 residents can find healthy food in only one of the five zip codes in the county, and they report having no access to recreational facilities.
Putnam residents hope to use its grant for activities that encourage people to get out and exercise and to alter public policy so that their roadways are used not only for vehicles but for walking, biking and other physical activity. The county's health department, meanwhile, is focusing on tobacco-free policies among businesses.
Another SIM grant went to St. Louis University to address nutrition and tobacco issues in the Jennings School District. Although St. Louis County has begun a major anti-smoking campaign, there still is a need to target special funding and programs to individual pockets of the county, says Dr. Nadim Kanafani, an assistant professor of pediatrics at SLU's Medical School and coordinator of the grant to Jennings.
Working with young people in the school district might be helpful in understanding tobacco use among young blacks, he says.
"The smoking rate among African-American kids by the time they turn 18 is about half that of white kids," he says. "But the interesting thing is that as we get to smoking data after graduation and in the early 20s, the rates of tobacco use among African Americans is equal to that of Caucasians. Something is happening after graduation. We're not sure what."
In addition to developing programs to stop students from smoking, some funding involves engaging students in more physical activity during and after school and encouraging the district to put fruits and vegetables on the menu everyday.
"We hope the project in Jennings will become a model for improving the health and wellness policies in other districts," he says.
Funding for the Beacon's health reporting is provided in part by the Missouri Foundation for Health, a philanthropic organization that aims to improve the health of the people in the communities it serves.
