Strengthening Community with Meal Support, Healthy Eating & Empowered Youth

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1 C E R E S C O M M U N I T Y P R O J E C T Strengthening Community with Meal Support, Healthy Eating & Empowered Youth How Healing Meals for Healthy Communities is Benefitting People, the Local Food Economy, and Our Future so much more than a meal

2 OVERVIEW Ceres Community Project taps the power of a nutritious meal delivery program to improve eating habits, strengthen social connections, create a more vibrant local food system, and empower the leaders of tomorrow. Ceres Community Project addresses some of the most pressing issues we face as individuals and communities. We bring organic foods to new audiences. Ceres is the only meal program in the country providing 100% organic foods to those with illness and 75% of the clients we serve have household incomes below $45,000 a year. We believe organic food must become the safe affordable choice for everyone to help reduce toxic exposures, reduce cancer and other illnesses linked to pesticide and herbicide exposure, and make the planet healthier for all. We empower the healthy, engaged leaders our world needs by placing youth at the center of our work. Teens gain life- and work-ready skills, develop leadership, become more connected, improve their eating habits, become advocates for healthy eating and take their place as contributing members of the community. We address the epidemic of chronic disease and obesity by educating the whole community about the vital link between what we eat and our health. And our teens, clients and even our adult volunteers eat better and cook more often. We support a vibrant local food system through our purchasing and even more importantly through the purchasing we inspire by our clients, teens, adult volunteers and by their families. We strengthen the fabric of social relationships across the community, a key to better health for all of us. $481,000 increased annual spending on fruits and vegetables from all Ceres teen and client participants 100% organic food youth a year from schools More fruits & vegetables Clients 16% Teens 23% How it Works 47% of Adult Volunteers eat more Ceres Healing Meals for Healthy Communities provides nourishing, organic and whole food meals to primarily low-income people struggling with a health crisis and their families. 85% of the meals are provided free of charge with 15% provided at a subsidized below-market price. Clients receive nutrition information, and the caring support of our volunteer Delivery Angels and Client Liaisons. As clients rotate off our meal service, we educate them on how to eat well on a budget, and are working toward a collaboration that will extend their purchasing power for fresh produce at Farmers Markets. Our meals are made from 100% organic whole foods, sourced locally whenever possible. All of the meals are prepared by teen volunteers working at our ¾ acre organic food garden and 3 commercial kitchen sites in Sebastopol, Sonoma and San Rafael in Northern California. Working under the guidance of adult mentors, youth learn to grow, prepare and eat healthy organic whole foods and about the connection between what they eat and the health of people and planet. We support national replication of our model with a free Start-up Tool Kit, a 4-day training, Operations Manual, a customized integrated data base system, and regular support and training calls.

3 FOOD AS MEDICINE Ceres is creating a healthier generation of young people while advancing the triple aim of improved patient experience, better health outcomes and lower health care costs. The Centers for Disease Control and Prevention reports that 56% of deaths in the United States from heart disease, stroke, cancer and diabetes are now directly related to poor eating habits, lack of physical activity and maintaining a healthy weight. The research is crystal clear that our diet including high amounts of processed food, unhealthy trans-fats, and too much sugar is at the root of obesity, diabetes and a host of chronic illnesses. Changing how we eat is notoriously difficult. Ceres tackles that problem by focusing on two populations more open to dietary change than almost anyone else. The teens we engage are beginning the transition to adulthood, bringing their curiosity and idealism to the garden and kitchen. Becoming familiar with healthy foods, discovering they taste good, and understanding their food choices can shape their own health and the health of their world, are all part of the equation that helps young people develop healthy new food habits. About every ten weeks, the teens meet with one of the clients they are cooking for. Hearing about the difference the food has made for the client s health and recovery reinforces for teens that what we eat has a big impact on our well-being. A serious illness often motivates changes in eating habits, and having healthy, nourishing food during illness can literally be a life-saver. Malnourishment which effects the majority of cancer patients lessens the body s ability to fight illness, impacts quality of life, reduces the effectiveness of treatment and makes recovery more difficult. And yet eating well is often the first thing that goes out the window when a family is confronted with a serious illness. If money is tight, it s even less likely that a patient will get the food they need. Providing high quality meals along with nutrition education and the caring support of the community is a cost-effective strategy for preventing malnutrition, improving treatment effectiveness and lowering health care costs. A study by MANNA, a nutrition service agency in Philadelphia, found that average monthly health care costs dropped by $10,754 per patient after they began receiving meal delivery. And at Ceres those meals also help improve eating habits so that our clients and teens are healthier for the long term. AVERAGE MONTHLY HEALTH CARE COSTS $50,000 $40,000 $30,000 $20,000 $10,000 $0 Mean pre-manna $38,937/month Mean post-manna $28,183/month 6 months prior to service 6 months after beginning service Results from a study by MANNA, a nutrition service agency in Philadelphia, PA Gurvey J et al. Journal of Primary Care & Community Health Program Sites: Sebastopol 21 teens 28 families 550 youth hours 4,500 meals History $247 Cost of 4 weeks of organic meals from Ceres $10,754 Drop in monthly per person health care costs for low-income patients receiving nutritious meals in Philadelphia study 2014 Program Sites: Sebastopol, Marin, Sonoma Valley 450 teens 550 clients 18,000 youth hours 82,000 meals National replication in 8 communities 7+ Eating 7+ servings of vegetables reduces your risk of heart disease by 31% and cancer by 25%

4 YOUTH FINDINGS Youth who participate in Ceres program cook more often, eat better, and become advocates for healthy eating. They also gain self-confidence, develop leadership and feel more connected to the community. Youth volunteer at Ceres because they re interested in learning about growing, cooking and eating healthy food and about the relationship between food and health, and to help others. Many youth start the program already eating a healthier diet than the average person their age. Despite this healthier diet to begin with, program participation supports significant positive changes for teens in three areas: cooking behavior, diet, and advocacy about healthy eating. We re encouraged by the changes that youth report after just six months. Cooking Behavior I come to Ceres because of the person I am when I walk into the kitchen. It allows me to show up fully as the best person I can be. ~ teen chef 98% of youth are either somewhat or very confident that they can prepare a healthy meal from scratch. 28% The share of youth who say they cook full meals at home from scratch increases 28%, to 60% of all youth. Healthy Eating 16% Consumption of fresh vegetables increases 16% from 3.2 to 3.7 servings daily and there is a 29% increase in the share of youth who report eating at least 3 servings of vegetables each day. All varieties of vegetables show an increase in consumption and the average number of different vegetables that youth report eating increases from 15 to % Consumption of nearly all categories of unhealthy food decreases, particularly sodas and fast food. The share of youth who say they eat fast food daily, frequently or occasionally drops 54%, to 13% of youth. The share of youth who drink sodas daily drops from 47% to 29% of youth.

5 Advocacy Youth are 50% more likely to be encouraging their friends to make healthier food choices on a daily or frequent basis. Youth are 44% more likely to be encouraging their family to make healthier foods choices on a daily or frequent basis. Connection to Community, Self Esteem & Leadership Development I have stronger faith in a community. It has never been so easy for me to build up a community like it has been at Ceres, and I think that is because Ceres motivates our best selves. We re not in competition; we re just doing good and having fun while we do it. It s one of the most relaxed and loving atmospheres I ve ever been in. What therapy for young people, especially high schoolers who live in so much drama. ~ teen survey response Ceres has helped me be more confident in my cooking. Being able to communicate better with people and having a sense of leadership are two things that have changed me for the better. ~ teen survey response

6 CLIENT FINDINGS Thanks to what they learn, clients cook more often and eat better. 100% say that the healthy meals helped them recover more quickly and 93% say that the meal program helped them feel less isolated and alone. Not surprisingly, the vast majority of clients at Ceres are in treatment when they begin the program. Our demographic profile shows that 88% of these clients have a cancer diagnosis with the remainder facing a wide range of other health challenges. Most clients are low-income with 75% having household incomes below $45,000 annually and about 25% having household incomes below $10,000. Nearly 80% of clients are 50 or older. Ceres has worked hard to educate health care practitioners about our services and about the importance of good nutrition so we were encouraged that 45% of clients say they were referred by a healthcare practitioner. Another 45% learn about Ceres from a friend or family member. Clients are surveyed when they begin the program and again three to four months after they complete meal delivery. This allows us to compare the eating habits clients have established for themselves after program participation with those when they began receiving the meals. Cooking Behavior 47% The percentage of clients who report cooking full meals from scratch either daily or frequently increased 47%, to 87% of all clients. 59% The percentage who describe their dinners as only from scratch with lots of fresh vegetables increased 59%, to 33% of all clients. Healthy Eating The following percentage of clients report that they are eating MORE of these healthy foods: 65% 48% 48% vegetables fruit whole grains The following percentage of clients report that they are eating LESS of these unhealthy foods: 74% 73% 72% packaged/ sugar fast food processed foods 25% Fruit consumption increases 25% from 2.4 to 3.0 servings daily; there is a 29% increase in the percentage eating at least three servings daily. 21% Vegetable consumption increases 21% from 2.8 to 3.4 servings daily; there is a 27% increase in the percentage eating at least three servings daily.

7 Value of Ceres Service I didn t have to cook. I felt less isolated. 87% 13% 84% 9% The healthy food helped me recover more quickly. Learning about nutrition and healthy eating. Learning that eating healthy food makes me feel better. Learning that healthy food tastes good. Meals encouraged me to eat when I didn t want to. Meals saved me money. 67% 28% 64% 29% 59% 32% 56% 28% 54% 22% 83% 17% extremely important somewhat important It helped me survive. All my money was going to medical bills. I would have starved without Ceres. ~ client survey response I learned to cook in new ways. I learned to eat vegetables I didn t know I liked -- like kale -- so delicious!` ~ client survey response

8 WHAT S NEXT Healing Meals for Healthy Communities is a cost-effective and innovative strategy for improving eating habits and strengthening social connections two cornerstones at the foundation of better health for people and communities. At the same time it helps clean up our environment by increasing demand for organic food, strengthens the local food economy, and empowers a generation of healthy engaged leaders. Here s what s on the horizon Food as Medicine We re working with a collaborative group of health care providers in Sonoma County to gather data on how meal support for patients with cancer, Hepatitis C and a variety of other illnesses can reduce hospital readmission rates and support the triple aim of improved patient experience, better treatment outcomes and reduced health care costs. Reaching the Underserved In 2015 we intend to launch a program in Oakland, California that will serve very low-income women with cancer, and bring Ceres unique form of youth engagement to underserved Alameda County teens.

9 Engaging at-risk Youth Ceres is partnering with Social Advocates for Youth at the new Dream Center opening in Santa Rosa in We ll offer community service and vocational training programs to help former foster and other at-risk youth learn about healthy eating, gain life- and workready skills, and discover their belonging as fully contributing members of the community. Healthy Eating Education in School We ve applied for funding from the National Institute of Food & Agriculture to develop a high school class called Healthy Eating & Local Food Systems that will tie together culinary, agriculture and health education. The class will use project-based learning to support youth in improving the healthy eating environment in their school and community. Replication: Syracuse Veterans Medical Center A team from the Syracuse Veterans Medical Center will complete our four-day training in late 2014 with the intention to launch a Ceres-inspired program in partnership with Syracuse University serving the needs of veterans going through cancer treatment. The program will offer research and internship experience for undergraduate and graduate students, while providing organic foods and healthy eating education to another vulnerable segment of our population.

10 ABOUT THIS STUDY Thanks to what they learned the 740 clients and 465 youth who participated during this study will consume nearly 4,000,000 additional servings of fruits and vegetables over the next ten years... with an added benefit of $2,000,000 to the local food system. This program evaluation study was undertaken as part of a California Specialty Crop Block Grant awarded to Ceres Community Project in October The two-and-a-half year grant falls under the Healthy Eating category of the Specialty Crop Block Grant program and hence our focus was on measuring changes in consumption of specialty crops (fruits and vegetables) as a result of program participation by both clients and teen volunteers. The goal was to increase consumption of fruits and vegetables by 20% among youth participants and by 30% among client participants. These goals were speculative as we had no baseline data. What we found is that youth increased consumption by 16% and clients increased consumption by 23%. These results stem from a fairly short-term investment of time and resources. Clients, on average, receive 14 weeks of meals at a cost of about $862 per person. Youth in the survey had participated for six months, most often alternating between 3-hour shifts in the garden and kitchen on a weekly basis, at a cost of about $2,300 per youth. Because Ceres Client and Teen Programs are integrated, each of these costs also supports outcomes in the other program. For example, the $2,300 investment in six months of mentoring per youth also supports 14 weeks of meals for nearly three clients. These investments also produce broader benefits than the easily measured increase in fruit and vegetable consumption. They include increases in cooking from scratch, reductions in unhealthy eating like fast food and sodas, reduced social isolation for clients, increased self-esteem for youth, and a stronger local food system as both teens and clients move purchasing from fast and processed foods to fresh fruits and vegetables. Fruit & Vegetable Consumption Clients up 23% Average Cost $862 Ceres restored my faith in the goodness of people. I think it is amazing that teens grow the vegetables and prepare the meals. The lessons they are learning about nutrition and compassion are huge life lessons that they will take with them. ~ client survey response Fruit & Vegetable Consumption Teens up 16% Average Cost $2,300

11 THANK YOU We are grateful to the California Department of Food & Agriculture for funding through the California Specialty Crop Block Grant that supported this program evaluation study. More Information The full report Healing Meals for Healthy Communities Client & Teen Program Evaluation is available from our website at You can learn more about the work we re doing to build healthier communities by visiting us at Join Us On

12 so much more than a meal 7351 Bodega Avenue Sebastopol CA info@ceresproject.org Tax ID