Building capacity to reduce racial/ethnic disparities in healthy eating and active living: Lessons learned from a community health initiative in suburban Maryland

Obesity-related chronic health conditions are major concerns for African Americans and Latinos in this Maryland county (suburban to Washington, DC). Adult obesity is at 32% (vs. 25% US, 27% MD) and the childhood estimate is 40%. The county boasts a large proportion of affluent African Americans; and is also characterized by increasing populations of low-income African Americans and Latinos and other residents from the African Diaspora and Latin America. Social determinants such as lower income and lower education have typically been associated with high rates of obesity, but obesity affects all income/education levels in this county. Inequities such as high-density fast food areas, unsafe parks/recreational areas, poorly built environments, and lack of access to fresh produce have also been implicated in this county as targets for intervention. Interventions include systems-level changes (school, workplace and land use policies) that increase healthy eating and active living. This presentation describes a community health initiative in which residents, elected officials, other policymakers, health department/planning officials, faith leaders, nonprofits, schools, an urban farm, and funders partnered to address disparities/inequities that contribute to poor health outcomes in four predominantly African American and Latino towns. A support team provides training and education in social determinants of health, developing community action plans (CAP), selecting evidence-based/promising strategies, developing structures/processes to implement the CAP, and evaluating reach and strength of systems-level interventions. Strategies used in developing the CAP, providing capacity-building assistance and funding the partnership are described. Lessons learned in providing the capacity-building in culturally competent ways are shared.