Health Bucks Program Alyson Abrami, MS, RD Manager, Farmers Market Programs New York City Department of Health and Mental Hygiene Physical Activity and.

Health Bucks Program

Alyson Abrami, MS, RDManager, Farmers Market ProgramsNew York City Department of Health and Mental HygienePhysical Activity and Nutrition ProgramFarmers Market Federation: March 4, 2011

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Physical Activity and Nutrition Program,

Bureau of Chronic Disease Prevention and Control,

Division of Health Promotion Disease Prevention

Mission: Make it easier for at-risk populations to eat healthier and exercise more

Developed in 2005 to develop and implement programs and policies around physical activity and nutrition

Interventions target areas with highest rates of obesity and other chronic disease, and least access to healthier foods and opportunities for physical activity

Policies and social marketing staged citywide

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Examples of PAN Programs & Policy Work

Food Retail Initiatives Calorie Labeling Regulation Are you Pouring on the Pounds Social

Marketing Campaign Water in school cafeterias Day Care Regulations Physical activity in schools and day cares

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Prevalence of Adult Obesity, NYC (2009)

57% of NYC adults are overweight (34%) or obese (23%)

In some neighborhoods, as many as 70% of adults are overweight or obese

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District Public Health Offices

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Increasing Access to Fruits and Vegetables in Food Retail Venues in

Target AreasCorner Stores: Healthy Bodegas InitiativeSupermarkets: FRESH Supermarket Initiative Healthy Supermarkets ProgramMobile Food Vending: Green CartsFarmers Markets: Health Bucks and EBT promotion at farmers

markets Stellar Farmers Markets Nutrition Ed/Cooking

Demos

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Health Bucks Program

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Initial Concept

Certain areas of the City have less access to healthy foods like fresh produce

We need to support the existence of all types of healthy food retail in these areas, including farmers markets

Farmers may be unwilling to come to poor neighborhoods because of perceived lack of demand

Financial incentives for customers thereby support both supply and demand

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Program History

2005: Piloted in South Bronx with approximately 3000 Health Bucks

2006: Expanded to all three DPHO areas

2007: EBT incentive added

2008: Funding secured to expand EBT incentive

2010: Over 130,000 Health Bucks distributed to over 160 CBOs and 60 farmers markets

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How Health Bucks Are Distributed1: To community groups to incentivize first time visitsOnly organizations and sites in DPHO areas can apply for Health Bucks (application avail. online)50-200 given per org based on previous redemption rates and needsMust be distributed as part of a nutrition education programIn 2010, over 160 orgs distributed ~30,000 Health Bucks

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How Health Bucks are Distributed2. As an Incentive for using SNAP BenefitsFor every $5 spent in EBT, customer gets a $2 Health Buck (unlimited), representing a 40% increase in purchasing powerCustomer approaches market manager, decides how much EBT to spend, receives EBT $ in tokens and corresponding Health Buck couponsEBT can be used for any non alcoholic food, Health Bucks only for non processed produce

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How Health Bucks are Distributed

In 2010, ~100,000 Health Bucks were distributed as an EBT incentive at 60 participating markets in all 5 boroughs

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How Health Bucks are Used

Customers bring their Health Bucks to the market or receive them upon spending EBT at the market

Customers use Health Bucks at individual farm stands to purchase fresh produce (no change given)

Health Bucks can be used at any participating market over the course of the season

Unlike EBT tokens, they expire every year

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How Farmers Are Reimbursed Farmers collect Health Bucks and mail them

to the Farmers Market Federation for reimbursement

They do this on their own schedule, must be mailed in by mid December

All reimbursement complete by early January

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How Health Bucks are Promoted & Supported Promotional materials including maps and posters provided to

distributing organizations, markets, and nearby sites offered free of charge

Website updated annually with all materials, downloadable via PDF

Press releases Mailing sent to all SNAP recipients in DPHO areas Banners, buttons, and aprons provided to all participating

markets promoting EBT incentive Stimulus funds for mini-grants to markets to ensure they accept

EBT (29 markets awarded grants in 2010) Interns stationed near markets directing people to their location

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Complimentary Program: Stellar Farmers Markets

Empower Food Stamp (SNAP) eligible New Yorkers to make healthier food choices

Enhance nutrition knowledge and improve skills in purchasing and preparing simple recipes using locally grown, seasonal produce.

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What does Stellar Farmers Markets Provide

Practical nutrition information Quick and easy recipe

demonstrations, taste sample and recipe handout

Tips and ideas for planning and preparing delicious, healthy meals

Food safety information Nutrition handouts Free gift for each participant

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Program Administration Each year Health Bucks are printed in a

different color to differentiate between years Unique serial number identifies each Health

Buck to limit fraud and enable tracking Farmers remit coupons to Farmers Market

Federation who trains all farmers and sends them reimbursement checks over the course of the season

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Health Bucks Distribution and Redemption2006-2010

Note: includes both EBT and organization distribution data from all three boroughs

Health Bucks Distribution and Redemption2008-2010

EBT 66,735 83% 73,639 86% 99,247 89%CBO 46,184 53% 39,815 54% 29,818 62%

2008 2009 2010

Distributed Distributed DistributedRedemption

Rate Redemption

Rate Redemption

Rate

Health Bucks Incentive Increases EBT Use at Participating Markets (2009)

Total EBT Sales at Greenmarkets 2009

$66,261.45

$166,209.35

$0.00

$20,000.00

$40,000.00

$60,000.00

$80,000.00

$100,000.00

$120,000.00

$140,000.00

$160,000.00

$180,000.00

Greenmarketswithout Incentive

Greenmarkets withIncentive

To

tal

Valu

e o

f E

BT

Sale

s

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ABT/CDC Evaluation

Health Bucks selected by RWJ/CDC as a promising national practice

CDC funding evaluation conducted by ABT Associates

Multi pronged evaluation effort conducted in 2010 to assess impact and feasibility for national implementation

Results and toolkit should be available soon

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Thank you!