Using the Farmers' Market as a Health Intervention: A community-based model for integrating food system change and health services provision in low income urban communities

East Palo Alto (EPA) is situated on the San Francisco Peninsula within the county of San Mateo, California. The city encompasses ~2.5 square miles and hosts a diverse population of over 30,000 residents who struggle to improve their health, environment, and economy. EPA residents exhibit disproportionate rates of chronic health problems such as obesity and cancer, a statistic hypothesized to result in part from lack of a full service grocery store offering high quality fresh fruits and vegetables. A survey of EPA residents conducted in September, 2007 indicated the dearth of local produce vendors as the number one reason for low fruit and vegetable consumption in EPA and revealed overwhelming community support for the establishment of a permanent farmers' market as a potential solution to this barrier. In response, in collaboration with city residents, elected city representatives and leaders from the health, education, recreation, and youth sectors, Collective Roots is currently leading the organization of the EPA Community Farmers' Market (EPACFM). The EPACFM initiative promotes the concept of a farmers' market as a platform for health intervention and promotion. In addition to fresh produce, the EPACFM will provide a recurring forum for consumers to receive health education and gain access to health services. The sustainable integration of health services into a community farmers' market poses multiple challenges. The lessons learned from the EPACFM experience will contribute to the development of a model for using farmers' markets as entry-points for healthcare and health education in low income urban communities nationwide.