Cultiva La Salud
Fresno, San Joaquin Valley, CA
Cultiva La Salud (translates to Cultivate Health) is a community-based grassroots organization in Fresno, CA. Cultiva La Salud (Cultiva) works to promote healthy eating and active living in communities with high levels of disinvestment, such as Southeast Fresno and similar neighborhoods throughout California’s Central Valley. Cultiva organizes and advocates for health-related efforts addressing a wide range of systemic issues and barriers to healthy living, such as improving equitable investment in community initiatives that support biking and walking, as well as trying to unlock school gates so that residents who live in neighborhoods without safe and quality parks have access to a safe place to play.
This Communities Building Power for Health Case Study (CBPH) features Cultiva’s “Vendors for Health” program: mobile bike vendors that sell fresh fruits and vegetables in targeted neighborhoods. Through this initiative, Cultiva is not only improving healthy food access and options, but they are also changing city and state policies to create business opportunities for residents in communities with high levels of disinvestment. Cultiva hopes to expand and inspire others to embrace business models that promote health throughout the Central Valley, and more broadly, to reduce the economic barriers contributing to health inequities.
What Sparked the Vendors for Health Program?
Cultiva’s staff created the program to address the following health challenges in Southeast Fresno:
A lack of access to healthy food, such as fresh produce, in food insecure neighborhoods and the overabundance of unhealthy food choices
Economic insecurity in the Central Valley
Systemic health and wellness issues disproportionately affecting Latinxcommunities
Despite being the heart of California’s farming industry, over a third of households in the Central Valley live in a “food desert”, or experience food apartheid, which means they lack access to grocery stores that sell affordable and nutritious food and have an overabundance of fast food options and convenience stores. A California Department of Food and Agriculture report compiled data gathered by Map the Meal Gap noting that “while food insecurity is prevalent throughout the Central Valley, specific populations often face higher rates of food insecurity, including children, the elderly, the homeless, and college students. For example, almost 1 in 3 children living in Fresno County is food insecure, putting Fresno in the top 10% of US Counties for child food insecurity.”
Cultiva La Salud actively works to improve health in their local community and beyond. A large proportion of Southeast Fresno’s Latinx, African American, and Asian communities are disproportionately impacted by higher rates of diabetes, heart disease, and obesity. Statistically, it is more likely for communities of color to be impacted by higher rates of adverse health outcomes in general. One recent study from the Lancet found that the lifetime risk of developing diabetes has risen for Black and Latinx children to exceed 50 percent. The fact that Southeast Fresno experiences food apartheid reinforces the unhealthy food choices that result in such disproportionately high rates of chronic disease. Data from a recent Communities of Excellence in Nutrition, Physical Activity and Obesity Prevention survey highlighted:
“[N]ot a single store in this neighborhood [Southeast Fresno] met the state standards of a quality store. Of the eight stores that were surveyed, a majority of them promoted unhealthy foods, many did not offer a variety of fruits and vegetables and/or priced their produce above the state's affordable rate.” - Cultiva La Salud
According to a CDC Report assessing disparities in access to healthier food:
“Several strategies might improve community access to retailers that sell healthier foods. Such strategies include incentives to bring healthier food retailers into underserved areas, transportation improvements so that residents in underserved areas can reach the food retailers, and upgrading facilities to enable stocking of all forms of fruits and vegetables and to increase shelf space dedicated to fruits and vegetables, ultimately increasing the availability of high-quality, affordable fruits and vegetables in existing venues.”
As demonstrated in our video above, Cultiva’s Vendors for Health program addresses each of critical needs to improve the availability of healthy options and promote positive health outcomes in the Fresno community and beyond. Mobile bike vendors sell fruits, vegetables, prepared salads and fruit bowls directly to the community as a way to provide residents with access to affordable fresh produce. Additionally, Vendors for Health provides the opportunity for residents who live in these food insecure zones to create micro-businesses that they own and operate themselves, thus driving community involvement in solutions.
Through their Vendors for Health program, Cultiva is addressing, at multiple levels, an unjust food system that prevents the very people who work in the fields from accessing the fruits and vegetables they harvest. Cultiva understood that members of the community were interested in selling fresh produce through a micro-business model, but they were prevented from doing so by existing city ordinances—specific sanitation requirements for food preparation and limitations on time spent in a given area—that made it difficult to work as a mobile bike vendor.
Cultiva La Salud worked to change these city policies and procedures by identifying barriers to accessing the food economy and then finding solutions, beginning with addressing the language barrier. Despite half of Fresno’s population being Latinx and a large number of Spanish speakers, many city documents were only available in English. Cultiva staff translated city documents to make them accessible to Spanish literate residents. In addition, staff helped residents navigate the business license process, explained fees, and simplified the permit process to have a vendor cart.
Cultiva staff also lobbied to change laws that unfairly targeted mobile bike vendors. One such ordinance limited the time mobile bike vendors could be in an area to ten minutes, effectively barring them from setting up shop outside of community events or building a consumer base. Cultiva successfully changed the local ordinance to allow mobile bike vendors the opportunity to provide a fresh food option to food insecure neighborhoods and the broader community.
Even with a substantial policy shift, it remained difficult for mobile bike vendors to get involved in the food economy as another law stated that the food must be prepared in a city-approved kitchen. To make it easier for mobile bike vendors to obtain a business permit and comply with health codes regarding a sanitary space to prepare their produce, Cultiva found a home that serves as a kitchen and commissary facility. Opening this facility came about after collaboration with Food Commons Fresno, a community partner that sources produce from local farmers to build food access and business opportunity in Fresno. Cultiva partnered with Food Commons Fresno to share their space and allow mobile bike vendors to utilize the kitchen to prep food in compliance with the Environmental Health Department regulations.
Outcomes and Impact
Before Vendors for Health, many residents of Southeast Fresno had limited options for affordable, fresh produce. Cultiva’s solution of building community power through the mobilization of supporting local micro-businesses not only created another option for healthy food, but did it in a manner that centered community members as the solution, with an added bonus of generating economic opportunities and jobs.
Cultiva staff listened to community concerns and successfully lobbied for change in the City of Fresno’s Development Code. Building off of this success and in response to community input, the city of Fresno adopted a Healthy Eating Active Living (HEAL) Resolution in 2015, which acknowledges the health impacts of city policy on promoting good health.
Best Practices and Insights Gleaned
If your organization or foundation is interested in creating a program similar to Vendors for Health, Cultiva recommends performing a community survey as a first step to see what the residents of your community need. While Cultiva identified mobile bike vendors as an effective solution in Fresno, it is not a one-size-fits-all solution. Understanding the community perspectives and context, and how community members want to address their own issues, will result in stronger solutions over the long-term.
A valuable approach, however, ensures that programs resulting from your community survey empower your residents, the local businesses, as well as the overall community. The solution to areas of public health concern are always remediable by the communities themselves, by partnering authentically and ensuring that the community has the resources they need to begin to address their own health.
Supplemental Materials from Cultiva La Salud
Cultiva La Salud Influencing the Public Health Narrative
1 The Oxford Dictionary defines "Latinx" as a gender-neutral alternative to Latino or Latina. Praxis uses this more inclusive language in support of the movement's Latin LGBTQ community, and the greater LGBTQ community, who often feel invisible in this work.
2 Many communities are transitioning from Food Desert to the term “Food Apartheid”. Deserts are a thriving, natural ecosystem, and, by nature, are unchangeable. Food Apartheid is more fitting, as a system of apartheid is the direct result of poor decision-making, and thus can be addressed and changed.