Market on the GreenToledo, Ohio-based ProMedica’s attention to hunger as a health issue has spurred on an ambitious effort to end food insecurity and poverty in one of the city’s most disadvantaged neighborhoods.

Near downtown Toledo, ProMedica – supported by philanthropist Russell Ebeid – opened in December 2015 the Market on the Green – a ground floor grocery store in a 6,500 square foot, four-story building that had been vacant for more than two decades.

The facility also provides free programs and services that include financial coaching – partly to help clients avoid becoming targets of predatory lending practices – job training for low-income residents, tax services, classes on cooking and nutrition, health screenings and other educational workshops.

It’s part of ProMedica’s Ebeid Institute for Population Health, a deep plunge into addressing issues, such as a lack of access to primary care services, a faltering economy, high unemployment and homeless rates, low educational attainment and poor health that afflict vulnerable communities.

ProMedica wants the Ebeid Institute to become a community hub where healthy living takes root in Toledo’s Uptown District, a 284-acre neighborhood of about 1,380 residents. Of those, nearly 500 live in temporary housing facilities, such as the YWCA, Cherry Street Mission and the Lucas County juvenile detention center. Most residents are apartment dwellers.

“It’s not just about what happens inside the four walls of the hospital but in the community,” observes ProMedica President and CEO Randy Oostra, who also is an AHA board member. He notes that social determinants of health – where people are born, grow, live, work and age – affect a wide range of health risks and outcomes.

“One of the best things we can do to improve someone’s health is to help provide them with the tools, education and resources to help lift them out of poverty,” he says. 

 That is the thinking behind the Market on the Green and Ebeid Institute. ProMedica located the market in the Uptown District, because it fit the U.S. Department of Agriculture’s definition of a food desert. While there are markets in nearby neighborhoods, they are several miles away, making shopping for those without transportation difficult.  

The idea of a health system getting into the grocery business may seem curious – if not daunting, but ProMedica saw an opportunity to tackle hunger and food insecurity as community health issues. A yearlong planning process, guided by a community advisory committee, helped build trust and relationship within the neighborhood before the grocery store opened.

The initial plan was to form a joint venture with an area grocery store. But no stores were willing, due to perceived risk. “Health care has a lot of assets and resources, but the grocery business is a different speed and we were stretched to think and work in a new way,” says Kate Sommerfeld, ProMedica’s director of advocacy and community relations. The health system hired a grocery expert to help its team adjust to the pace of the grocery business.

The full-service grocery market offers fresh meat, produce, dairy products, locally baked goods, frozen food and other personal necessities, such as toiletries. Market on the Green hires hard-to-employ Uptown residents. A 12-month training program offers them a pipeline to eventual full-time employment with ProMedica or one of its partner organizations. 

“We hire people who are unemployed or underemployed,” Sommerfeld says. “Some have experienced domestic violence. Some were living in shelters before they started working for us.” 

The grocery is bringing about a more culturally vibrant community by attracting residents from more upscale areas of the city and the suburbs, observes Julie Champa, executive director of the Uptown District Association, a community development corporation.

“It is unusual to see a health care organization get involved in the retail end of economic development, but that is ProMedica’s mission” in broadly defining community health, says Champa, who is a member of the Ebeid Institute’s community advisory board. “It is changing the perception of the neighborhood for the better.”  

  The Uptown District includes about 20 social service agencies, and Sommerfeld says the institute can “help provide links to those services and programs and identify where gaps exist.”

To fill one of those gaps, the Ebeid Institute has a Financial Opportunity Center (FOC) – a career and personal finance service center designed to help the Uptown District’s low-income residents establish smart money habits, improve their financial outlook and move out of poverty. Local branches of the United Way and Local Initiatives Support Corporation (LISC), a national community development organization, jointly operate the FOC.

While there are more than 80 FOCs in more than 30 cities across the country, ProMedica is the first health care organization to support one, according to LISC. The program so far has served more than 200 clients.

“FOC clients can access a full array of services to grow their earnings and secure their finances in one convenient neighborhood, thanks to ProMedica,” says Valerie Moffitt, a Toledo LISC senior program officer. She adds that the FOC program can be a “journey from poverty to prosperity” for clients.

Moffitt says those residents who take full advantage of the program’s coaching services and counseling tend to have higher job placement and retention rates and earn significantly higher incomes. “ProMedica has moved beyond talk about the need to address the social determinants of health into action that has transformed a formerly blighted property,” she adds.

The health system has engaged the University of Toledo and Gretchen Swanson Center for Nutrition for a long-term study on the market’s and the Ebeid Institute’s impact on Uptown District residents.

The evaluation includes changes in dietary behaviors, food access and affordability, and perceptions of the local neighborhood, says University of Toledo professor Joseph Drake, one of the researchers. 

“These outcomes are being explored by a variety of factors including income, race, age, sex, housing, employment and use of nutrition assistance programs,” he says. “We want to be able to share how impactful Market on Green and ProMedica Ebeid Institute are on the health and well-being of the local community.”

As part of its commitment to the economic revitalization of Toledo’s urban core, ProMedica later this year will begin relocating more than 1,000 employees to downtown neighborhoods – a move that Sommerfeld says will bring the largest influx of employees to the city’s downtown area in decades.

“We have to think differently about health care, because the traditional model is not sustainable and is not meeting the needs of the community,” she says.

Adds ProMedica CEO Oostra: “As our focus shifts to population health, the health care field must go beyond its four walls and collaborate to address basic needs. By starting with hunger as a health issue through strategic, purposeful and intentional initiatives, we can create an improved model to deliver better health care.” 

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