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Three-Year Longitudinal Study of an Ohio Food Desert:

Longitudinal study of ProMedica’s Ebeid Institute in Toledo, Ohio

In late 2015, a nonprofit health care system with locations in northwest Ohio and southeast Michigan opened the Ebeid Institute in the UpTown area of Toledo, Ohio. The UpTown neighborhood has limited access to grocery stores and many residents live in poverty. The new Ebeid Institute facility includes a neighborhood grocery store, called Market on the Green, on the street level with classroom space on the second floor for financial education training, nutrition/healthy cooking classes and other programming.

Our Role:

The Center for Nutrition & Health Impact (CNHI) and University of Toledo (UT) conducted a multi-year longitudinal study to track economic and nutritional impacts of the Ebeid Institute on its low-income neighborhood, previously identified as a food desert.

The Need:

According to baseline data collected by CNHI in 2016, most of the respondents were food insecure and many engaged in hunger-coping behaviors, such as forgoing paying for utilities to have enough money to pay for food. They also reported low fruit and vegetable access in the UpTown area. Participants in the UpTown sample had poor overall health. About 70% of the sample were overweight or obese and over one-third reported poor or fair general health, and hypertension, high blood sugar, diabetes and cardiovascular disease rates on par with or higher than rates for the rest of Lucas County.

Recommendation Provided Based off 2016 Baseline Data:

CNHI recommended Ebeid Institute focus on four main areas, food security, economic development and employment, nutrition and enrichment of the area, to improve food security UpTown, Toledo, Ohio.

Food Security 

• Increase utilization of governmental assistance programs (e.g., SNAP).

• Lower price barrier to healthful foods at the Market on the Green.

• Provide practical household budgeting and financial skill building classes.

• Increase partnership among local assistance organizations to address problems collaboratively.

   

Economic Development and Employment 

• Create and/or promote a website for UpTown residents seeking employment to upload resumes/ profiles so businesses in the area can easily find local residents to hire.

• Provide training for job skills such as customer service and computer skills.

• Provide opportunities for G.E.D. classes and training in vocations/skilled trades.

• Assist residents reentering the job market with training opportunities in areas such as resume building and interview skills.

• Provide transportation assistance/bus cards, or referrals for services that provide these.

• Convene an expert group to develop strategies to spur economic development, and address crime and homelessness.

• Advocate that the city act to promote economic development in UpTown (e.g., tax incentives for business development).

Nutrition 

• Provide practical nutrition education and cooking classes.

• Use price differentials to encourage shoppers at the Market on the Green to purchase healthful alternatives to common foods (e.g., price whole grain bread lower than white bread and water lower than soda).

• Increase the variety of healthful foods offered at the Market on the Green.

• Convene an expert group to discuss marketing and promotion strategies for the Market on the Green.

• Lower prices, increase the perception of safety and promote the Market’s already high quality and healthful selection.

• Increase advertising efforts.

• Use a mobile truck (similar to a food truck) to sell fruits, vegetables and other healthful food in various parts of UpTown (the truck would also double as promotion for the Market on the Green).

• Use green space near the Market on the Green to host a farmer’s market, health fair or other similar events which would also double as promotion for the Market on the Green.

Enrichment 

• Promote home gardening with classes taught at the Ebeid Institute.

• Create a community gardening program, perhaps using the green space near the Market on the Green.

• Advocate that the city improves the parks in the area.

• Engage residents in beautification efforts to promote development.

• Partner with the city and/or fitness companies to build a gym/recreational center in the UpTown area.

• Use the green space near the Market on the Green as a place for community events to promote neighborhood cohesion.

Findings:

In general, this impact evaluation indicated mixed progress from the intervention, still in its early stages, thus far. The sub-group of participants who were directly exposed to the intervention saw greater improvement than the whole, which indicates that an increased intervention reach would likely lead to greater impacts.

Economic Indicators

• Frequent shoppers at Market on the Green had lower levels of economic strain.

• Job skills/financial class participants had the perspective that their neighborhood economy had improved.

• Job skills/financial class participants had higher vehicle ownership rates.

Nutritional Indicators

• Frequent shoppers at Market had improved food security.

• Frequent shoppers had lowered their consumption of sugar-sweetened beverages, fast foods and sweet and salty snacks.

• Healthy cooking/nutrition class participants had improved knowledge of nutrition.