Posts Tagged: Christina Hecht
Partnering for California
As the gravity of the COVID-19 pandemic hit communities across the U.S. in mid-March 2020, the policy team at UC Agriculture and Natural Resources' Nutrition Policy Institute received an urgent email from a longtime partner in the San Joaquin Valley.
“It was simply entitled 'Help' in the subject line – with multiple exclamation points,” said Christina Hecht, NPI senior policy advisor.
The colleague was writing on behalf of community groups concerned that pandemic-related school closures would jeopardize school meal programs – a nutritional lifeline for children in a predominantly agricultural region with many low-income households.
Hecht immediately contacted a frequent collaborator, Anisha Patel, an associate professor of pediatrics at Stanford University. To help school districts continue those essential meals during the fast-approaching spring holiday, they quickly produced a fact sheet, “Kids' Hunger Doesn't Take a Spring Break,” sharing resources on how districts could use new program flexibility to continue meal distribution.
Then, as the pandemic evolved throughout 2020, the U.S. Department of Agriculture and California Department of Education continued to issue a flurry of waivers and guidance updates. To keep pace, the authors produced three more fact sheets to help districts digest the information and adapt and sustain their school meal programs.
“We tried to make a really user-friendly resource that would help districts sort through everything they needed to do, and easily discover resources for best practices,” Hecht said.
The fact sheet information, paired with advocacy by local partners, encouraged districts to take steps to make more meals more easily accessible to students by taking advantage of USDA waivers: for example, allowing parents to pick up meals without children present, providing multiple meals in one pick-up or implementing bus delivery of meals.
These efforts attracted the attention of the School Nutrition Association, a prominent nonprofit representing more than 50,000 members who provide meals to students across the country. The organization co-branded general versions of the fact sheets and distributed them widely through its website.
Gathering community perspectives on school meals
Those resources represent just one way that lessons from the San Joaquin Valley experience are shaping the national conversation on school nutrition programs. Cultiva La Salud and Dolores Huerta Foundation – health equity and social justice organizations based in Fresno and Bakersfield, respectively – approached the researchers to study ways to boost participation in school meal programs and address food insecurity in their largely Latino communities.
“Working alongside Stanford and NPI is crucial in expanding our capacity and ability to use data and research as a tool to empower parents to advocate for improved health and wellness policies and practices,” said Cecilia Castro, deputy director of Dolores Huerta Foundation, which works in Kern, Fresno and Tulare counties, as well as Antelope Valley in Los Angeles County.
To better understand the “barriers and facilitators” to meal program participation, Hecht, Patel and their collaborators – including student trainees who were eager to learn about community-based participatory research and wanted to help their local communities – sought the perspectives of school district administrators and staff, community groups and parents.
Through the relationships nurtured by Cultiva La Salud and Dolores Huerta Foundation, the researchers convened focus groups of parents with children in six school districts across the San Joaquin Valley.
“We needed to understand better what helped and hindered families from getting the school meals,” Hecht said.
According to Castro, parents have leveraged their feedback to advocate for increased access to school meals, through the use of buses for meal delivery and changes to meal pickup times and locations.
“This engagement has validated the lived experience of our communities,” Castro said. “It has provided an additional strategy for parent leaders to use in efforts to engage decision-makers about ways to improve quality and access to school meals.”
Another key takeaway from these conversations is that the parents are deeply concerned about the content and nutritive value of the meals served to their children.
“We learned that although school meals meet nutrition standards, parents are not aware of this,” Patel said. “Parents also worry about the healthfulness of school meals, noting heavy processing and added sugar. Most compelling was that parents want to provide feedback to improve school meal appeal and healthfulness but have no way to act.”
San Joaquin Valley voices go national
The Nutrition Policy Institute played a crucial role in bringing the parents' perspectives to legislative staff members at the state and federal levels, through the production of four policy briefs that center the voices of San Joaquin Valley residents. In the first, “School Meals: Kids Are Sweeter with Less Sugar,” one parent says: “Children cannot sustain themselves on treats that give pure sugar…They give with the best intentions, but less food would be better, but better quality and healthier.”
“One of the most rewarding parts of all this work has been seeing how meaningful it has been for the parents in the San Joaquin Valley to see their voices getting carried all the way to Washington, D.C. by these policy briefs,” said Hecht. “And it was so meaningful for them that Cultiva La Salud had the briefs translated into Spanish so that the parents could actually read their own words.”
Their voices joined a chorus comprising over 200 organizations who called for universal school meals across California. In June, the state became the first in the nation to adopt a policy, starting in the 2022-2023 school year, to provide free meals for all K through 12 public school students, regardless of family income. Momentum continues to build on the national scale.
The next step for the team is to explore ways to make school meals even more appealing to potential program participants in the Latino communities of San Joaquin Valley. Patel said they will draw on the expertise of Szu-chi Huang, associate professor of marketing in Stanford's Graduate School of Business.
“Using a participatory approach, we will work with parents and school officials to design an intervention focused on communicating the benefits of school meals, and test strategies to improve the appeal of school meals,” Patel explained. “Then we will examine how that intervention affects parents' satisfaction with school meals, students' participation in meals and food insecurity.”
Those insights will be another valuable result of a unique partnership – spurred by a call for help and galvanized by the ongoing health crisis – that continues to benefit families across California.
“Our partnership has been very unusual and very fruitful because we had policy experts, we had research experts and trainees, and then we had the organizations actually working in the community,” Hecht said. “And as we look back on it, it's hard to imagine working that successfully without that kind of partnership.”/h3>/h3>/h3>
The first study of California law that requires schools to test tap water for lead found that the majority completed the testing on time, and only 3% reported any tested taps with lead in the water higher than the state's 15 parts per billion (ppb) limit. About 30% of the 240 randomly selected public schools in the study didn't report their results within three months of the deadline.
The study, Water Safety in California Public Schools Following Implementation of School Drinking Water Policies, was published in the January issue of Preventing Chronic Disease, a Centers for Disease Control and Prevention online publication.
“Because we strongly encourage people to drink water rather than sugary beverages, we need to have confidence that tap water is safe,” she said. “But this is a complex issue with shared responsibility among public water systems, school administrators and regulating agencies.”
Access to safe drinking water in schools is essential to help avoid the developmental and health consequences for children associated with consuming contaminated water, under hydration or excessive intake of sugary beverages.
Schools that get water from public utilities can expect the water they receive to meet federal and state water quality standards. However, 16% of study schools received water from a utility that violated health-based standards, such as elevated levels of contaminants or failure to adhere to disinfectant protocols. When water flows into buildings through pipes that contain lead – such as those made entirely of lead, or galvanized iron or leaded brass, or connected with lead solder – and especially when water sits stagnant in lead-containing plumbing, lead may leach into the water before it flows from the tap.
In October 2017, California passed Assembly Bill 746, which mandated that public water utilities sample and test for lead in tap water of public schools that were built before 2010. The law is designed to identify and mitigate sources of lead in water. Funds to upgrade school drinking-water plumbing were also earmarked in the state budget. Working with their local water suppliers, the schools selected taps for sampling. The number of taps that released water with lead was very low, and even those sources are not necessarily unhealthy for drinking, Hecht said.
“When we test tap water, we're not talking about every drop of water that comes from the tap,” she said. “We test the first water that comes out of the tap after it has been stagnant in the pipes. Once the taps are in use and water is flowing, the lead level should drop dramatically.”
Although few schools (3%) had even one tap in violation of California state standards for lead, violations increased to 16% when the federal Food and Drug Administration standard for bottled water was applied. The FDA requires that bottled water not exceed 5 ppb of lead.
The 174 schools in the study collectively tested 1,238 independent water sources – such as playground, hallway and gym drinking fountains, classroom faucets, food service areas and restroom taps in 2019. Some of the tests took place in locations that serve staff, such as teachers' lounges, nurses' stations, distribution sources and maintenance areas. Without detailed guidelines to follow, some schools tested only 1 tap; others tested as many as 76.
“Testing only a subset of taps in a facility prevents full identification of which schools need to undertake lead remediation actions,” Hecht said.
Hecht and her co-authors – Isioma Umunna, Anisha Patel and Lauren Blacker of Stanford University, Marc Edwards of Virginia Tech, and Emily Altman of UC Berkeley – conclude that, in the future, states should require schools to test to nondetectable levels of lead for maximum data collection and require that at least one water source in food service areas be tested.
The information and recommendations from the study are already informing California legislation designed to protect children from lead exposure from water. A new law, Assembly Bill 2370, will require all licensed childcare centers to test taps for lead by 2021 and every 5 years thereafter. The inconsistencies experienced in AB 746 compliance revealed the need for detailed guidelines on the number of taps facilities should test, the required locations for testing, clear naming conventions to identify taps and reporting procedures.
Now more than ever, California is full of heroes: front-line workers in our hospitals, farm fields and essential businesses. And even though schools are closed, they are full of heroes, too: teachers implementing distance learning and kitchen workers who have stepped up to the heroic task of providing meals for children in their communities, despite the challenges that have come with the COVID-19 pandemic.
School nutrition professionals continue to provide nutritious food that meets dietary standards, the kitchens provide employment, and the hungry students provide a multi-million dollar market for California's agricultural products.
Researchers at UC Agriculture and Natural Resources's Nutrition Policy Institute received an email earlier this spring with a subject line that simply said, “HELP!!!” Local community groups had learned that some Central Valley school districts would not be providing meals over spring break. Even though that might not be cause for alarm some years, this year it would hurt. In the eight-week period between March 14 and May 14, 2020, the California Employment Development Department processed 4.7 million unemployment benefit claims – nearly seven times more claims than over a two-month period at the height of the 2008 recession. EDD estimates that California unemployment reached nearly 25% by mid-May.
That is why school meals are more important than ever.
On receiving the request for HELP!!!, the Nutrition Policy Institute teamed with a Stanford pediatrician to distill critical information from USDA and the California Department of Education. Connecting with child nutrition professionals throughout the state, they gleaned tips and best practices, and added COVID-19-specific resources from the Community of Practice convened by LunchAssist and the Center for Ecoliteracy. The team produced informational flyers targeted to California school district officials and food service directors:
- Child Hunger Doesn't Take a Spring Break (2-pager)
- Calling all Districts! USDA Summer Meals Can Keep Kids Healthy (4-pager)
The resources provide explanations and resources for operating school meal programs during non-instructional periods through either the Seamless Summer Option (SSO) or the Summer Food Service Program (SFSP).
The alliance aims to make plain water the easy, appealing substitute for sugary beverages – soda, energy drinks, fruit drinks, and sweetened coffee and tea drinks. The alliance is also actively working on the safety of tap water in the nation's schools and childcare settings.
“To make water the beverage of choice will require a movement,” said Christina Hecht, a member of the NPI team. “NPI will build bridges, spearhead the creation of shared resources, align messages, strategies and aims, and coordinate strong external communications.”
NPI was formed by UC Agriculture and Natural Resources in 2014 to conduct, evaluate and share research related to the impact of nutrition and physical activity on public health. The W.K. Kellogg Foundation has awarded NPI a $960,000 grant to coordinate the National Drinking Water Alliance for three years.
“Even when water is available, too many children and adults choose sugar-sweetened beverages,” said Hecht, who will serve as the National Drinking Water Alliance coordinator. “In our American diet, sugary drinks are the top source of added sugars for both adults and children, and, remarkably, they are the single largest source of calories for teens aged 14 to 18.”
But Hecht is quick to point out that if people are to make the switch to water, water needs to be easily accessible and they need to know that it is safe to drink.
High consumption of sugar-sweetened drinks is associated with obesity and other chronic health problems, such as heart disease and diabetes. UCLA scientists reported in March that the diabetes epidemic in California is “out of control.” The study says 55 percent of the state's population has prediabetes or diabetes – many of them are undiagnosed.
“Simply switching to water is a relatively easy lifestyle change that can have a big impact on the intake of added sugar and excess calories, reducing diabetes risk,” Hecht said. “It can also improve oral health.”
The National Drinking Water Alliance includes government agencies, education officials, researchers, water industries, and non-governmental organizations like the Center for Science in the Public Interest, American Academy of Pediatrics Campaign for Dental Health, and the American Heart Association. They believe by sharing knowledge, resources and connections, they will hasten progress toward their common goal.
Fortunately, the current state of safe drinking water in the U.S. is mostly favorable. About 90 percent of Americans get their water from public utilities and 95 percent of those supply safe water. In some areas, however, water can become contaminated on the path between utility and tap, typically with lead. Sometimes other contaminants can leach in through breaks in pipes.
“We all recognize that, if we are going to tell people to drink water, they need to have confidence that the tap water is safe,” Hecht said. “At the moment, we don't know the magnitude of the problem of unsafe drinking water. The alliance is highly focused on policy as the most effective tool to bring about broad change.”
The National Drinking Water Alliance plans a Congressional hearing on national drinking water and is developing best practices for effective access to safe drinking water in schools and childcare settings.
Congress and health groups are looking at a provision of a 2010 child nutrition law to get schools to test their water, and considering how to help schools pay for it.
The Politico reporter spoke to Christina Hecht, a senior policy adviser at the UC ANR Nutrition Policy Institute. The institute is the hub for the National Drinking Water Alliance, a network of organizations and individuals across the country working to ensure that American children can drink safe water in the places where they live, learn and play.
Hecht pointed out that the Healthy Hunger-Free Kids Act of 2010 requires schools to provide potable water during meal times. The act also says that child care facilities that participate in federal meals programs must give kids access to drinkable water throughout the day.
Because of this wording in the law, USDA could issue a guidance requiring schools to test their water to be sure it is potable.
"The beauty of this approach is that the language is there ... the means for oversight is there," Hecht said. "When you look at Flint, where does the buck stop? When you look at schools and child care, we've identified where the buck stops."
The cost to test water at schools nationwide is estimated to be about $7.6 million. For adult and child-care sites it would be about $14 million. In all, the expenditure works out to about 40 cents per child.
"We at the Nutrition Policy Institute encourage Congress to appropriate funds for tap water testing in American schools, and remediation where necessary," Hecht said.