The First 5 Years of Life, Critical to Health Equity

Last updated on: Published by: Tonya Love 0

In May 2018, the Robert Wood Johnson Foundation released a report entitled, “Early Childhood is Critical to Health Equity.”  As defined in the report, health equity means that “everyone has a fair and just opportunity to be as healthy as possible.” As stated in this report, it says that the conditions in the first five years of life are critical to shaping health for the rest of our lives.  We all want good health for our children but then why is it that certain groups go on to live healthy, productive lives while others go down a pathway of lifelong hardship, ill health, and piles of medical bills?  The report outlines the multiple pathways that show how the effects of poverty and racism experienced in early childhood can lead to poor health in adulthood.  For example, a family of color may experience racial discrimination when it comes to housing.  They may be forced to live in low-income areas with poor living conditions.  This causes chronic stress in parent(s) and in the child leading to suboptimal cognitive development, poor academic performance, lower educational attainment and lower income in adulthood.  Ultimately, this leads to poor health in adulthood and the downward cycle perpetuates itself to the next generation.

So, how do we stop this perpetual downwards spiral of poverty, racism, and health inequity?  Fortunately, there is hope for the future but it will require us to take a broader approach that goes beyond just programs, services, and education.  As stated in this report, there is evidence that intervening in early childhood has the potential to interrupt this cycle linking childhood inequity with lifelong poor health.  Current knowledge and evidence suggests that there is a need for “multiple, mutually reinforcing efforts” and that effective solutions will require changes at the structural, institutional, and policy level.  At Healthy & Active before 5, we do just that.

At HAB45, we recognize the importance of early childhood in shaping health equity and call to this plea by focusing our efforts on two main areas of policy and environment.  HAB45’s Pledge the Practice, Pass the Policy Program works with groups to adopt healthy policies, breaking the chain of unhealthy institutional norms and practices along the way.  When employees adopt healthy habits, they become role models to their children and families who likely follow suit.  By advocating for better parks, children will have more opportunities to play and socialize with other children.  While we acknowledge that changing institutional norms and culture won’t cure epidemics like obesity overnight, we recognize the tremendous power of policy and environment level changes to influence health in the places where we live, work, and play.

Housing for Contra Costa Families – Spring 2018 Leadership Council Convening

Last updated on: Published by: Ali Uscilka 0

Our Spring 2018 Leadership Council Convening was a huge success! Based on input from our members and other partners, we decided to focus on the current housing crisis and its impact on families. At our last convening, one of the groups created this beautiful prototype of what a community that supported health and affordable housing would look like. This was our inspiration for the event.


We spent the morning reflecting on the importance of housing security for Contra Costa families, and assessing our capacity to take action. We heard engaging and informative presentations from Will Dominie of BARHII and Mariana Moore of Ensuring Opportunity. Our panel of representatives from Contra Costa Interfaith Housing, La Clínica, and Raise the Roof Concord provided many examples of how Leadership Council members can support families by incorporating housing support into their work and advocating for policies to stabilize housing for current tenants and increase affordable housing in Contra Costa (Materials from the presentations can be accessed using the links below).

Table 1

After the presentations, attendees worked in groups to create a roadmap for action with ideas for how to get involved in the short, medium, and longer term to support families and add our voices to ongoing housing advocacy. We look forward to continuing this work with our amazing partners! The next Leadership Council event will be held in the fall. Please contact us if you would like to be added to the invitation list.

Roadmap Raz

BARHII HAB45 May 2018

Ensuring Opportunity HAB45 May 2018

EO Housing Snapshot

EO Town Hall Findings

Interfaith Housing HAB45 May 2018

La Clinica HAB45 May 2018

Spring 2018 Message from the Chair

Last updated on: Published by: Ali Uscilka 0

Viola Lujan, HAB45 Executive Chair


Dear Leadership Council members and community partners,

2017 was an exciting year for Healthy & Active Before 5!  Building on a decade of successes in the area of early childhood obesity prevention, we formally made the shift to focus on overall health equity for children ages 0-5 in Contra Costa.

While our work has always been grounded in equity and informed by the social determinants of health, this expanded focus will allow us to tackle a broader range of issues affecting our communities. For example, in 2017 we worked to prioritize the protection of immigrant communities’ rights and continued access to services.

As we prepared to take on these new challenges, we also continued to carry out core activities to strengthen partnerships and expand access to healthy eating and physical activity.

  • We held two Leadership Council convenings, where we shared up-to-date information about changes to the social safety net, and discussed what health equity means for the populations we serve.
  • We continued to support healthier environments through our Pledge the Practice, Pass the Policy Initiative, providing technical assistance and mini-grant funds for four new policies in 2017.
  • As a key partner in the Contra Costa Parks Equity & Improvement project, we celebrated ribbon cuttings at several renovated parks and completed an assessment of parks in Bay Point.

Last summer, we enthusiastically welcomed our new Director, Ali Uscilka. I want to acknowledge all members of the Executive Committee, who worked tirelessly and collaboratively to keep our work going while we faced staff shortages. It has been my pleasure to serve as Healthy & Active Before 5’s Executive Chair for the past year. Later this month we will welcome Ruth Fernández, MA as the new Chair. Ruth is the Deputy Director of First 5 Contra Costa, and brings a wealth of experience to the table. I am confident that her leadership will be invaluable!

I would like to thank those of you who passed policies, attended our events, and provided your expertise over the past year. It is your participation that makes our collaborative so successful.  We look forward to working with you in 2018!


Viola Lujan

Executive Chair, Healthy & Active Before 5

Director of Business and Community Relations, La Clínica


Survey Results: Pledge the Practice, Pass the Policy

Last updated on: Published by: Ali Uscilka 0

Once a policy is implemented, then what?

Healthy and Active Before 5 (HAB45) decided to find out what happens once a new policy is implemented. In November 2017, we invited all organizations who have passed healthy organizational policies, through our Pledge the Practice, Pass the Policy Initiative, to participate in a survey. Staff from 14 organizations responded to the survey, with each of the major model policies of the initiative represented.



Positive changes

Our respondents shared many positive stories about how their organization’s policies have changed the environment for clients and staff.


 “Our organization only provides water and/or naturally flavored water. We’ve had occasions in which a community member will bring in a juice or soda, and participants typically know and will kindly speak out on it.”


Healthier vending options, outdoor staff meetings, reduced availability of soda, and a well-supplied lactation room are all examples of these positive changes. In some cases, healthy policies served as a catalyst for further activities to promote the health of young children and families.


“Richmond WIC is very breastfeeding-friendly. The breastfeeding room was a catalyst to start breastfeeding support groups, which are the only free public breastfeeding support groups in West County.”


Mini-grant funds

HAB45 provides mini-grants to organizations who pass healthy policies. Survey respondents reported how funds were spent:

  • Activity sets for children
  • Water bottles, containers, filters
  • Breastfeeding room furniture
  • Exercise equipment
  • Outdoor Activity fees
  • Staff training
  • Breastfeeding materials & supplies
  • Landscape architect fees
  • Bikes to go between offices
  • Healthy foods & beverages


Implementing and sustaining positive change

79% of respondents selected “strongly agree” when asked if their organization’s policy had been implemented successfully soon after it passed.

Only 50% of respondents strongly agreed when asked if the changes had been sustained over time.

The most common challenges reflected in the survey responses were related to staff. Staff turnover presents a particular challenge, because new staff may not be fully informed of the healthy policies.

As one respondent at an organization with a healthy food policy said:

 “The policy initially had an impact on the beverages and foods that staff brought to potlucks and staff were eating healthier. Now, we have several new staff who I do not feel are aware of the healthy snack policy.”

 However, another respondent from an organization that does provide information on their wellness policy to new staff stated,

“The wellness policy gives us a clear way to explain our office rules to new staff.”

Breaking old habits

In addition to challenges related to new staff’s awareness of healthy policies, several respondents mentioned resistance from staff or the difficulty of “breaking old habits” as a barrier to successful implementation.

Respondents described several other challenges, such as lack of enforcement from leadership, the ongoing work of maintaining changes to the physical space, and sustaining changes across multiple sites or programs.

Next Steps

Based on these findings, HAB45 will work with respondents and other partners to deepen the implementation of their healthy policies with additional trainings, enhanced documentation & materials for new staff. We will also provide opportunities to share best practices among agencies who have passed policies.

For their part, survey respondents reported that they are working to promote their policies with partners, consistently bring activities in line with the policies, and further their programming, activities, and internal policies to support the health of all staff and clients.

Thank you to all of the organizations who have passed healthy policies! We realize this work doesn’t end when a policy is passed. We appreciate your ongoing commitment to creating healthier environments for children and families in Contra Costa. If you would like support with implementing an existing policy or passing a new one, please let us know.