In the summer of 2013, the Madelia Community-Based Collaborative (MCBC), a community-based collaborative whose aim is to improve the health and wellbeing of Madelia citizens, completed a community assessment which indicated obesity, diabetes and cancer were among the top health concerns impacting Madelia residents. MCBC began looking at evidence-based, proven strategies to combat chronic disease and obesity in the community. One of the ideas MCBC identified was to work on strategies to increase consumption of healthy beverages. MCBC partnered with FMW SHIP to apply and receive an innovative grant to implement the project. Evidence shows that sugary beverages have played a big role in the epidemic of obesity that has swept the nation and the state, and that by encouraging the consumption of healthy drinks, such as water, there can be a direct, positive impact on obesity and subsequent chronic diseases. This project will focus on providing education to the community about the effects of drinking sugar-sweetened beverages on their health as well as work with community partners to implement voluntarily efforts to encourage drinking healthier beverages.
Initiative Goal:
To improve the health of the citizens of Madelia by working to increase access to healthy beverages and educate citizens about the health effects of consuming sugar sweetened beverages. About Madelia:
Madelia, MN is located in South Central Minnesota, in Watonwan County. According to the 2010 Census, the community of Madelia includes a population of 2,308, of which 27% identify as Hispanic or Latino. Twenty-six percent of the community is under the age of 17 and 18% over the age of 65. The community faces distinct challenges based on their demographics. The school district reports a free and reduced lunch rate of 54% and there continues to be high rates of uninsured individuals, especially within the Latino community. According to the County Health Rankings, 31% of adults in Watonwan County report a BMI above 30 and 25% of people report no leisure time physical activity. 15% of people residing in Watonwan County are uninsured and 17% of children are living in poverty.
What are Sugar Sweetened Beverages (SSB's)?
Sugar- Sweetened Beverages contain caloric sweeteners and include soft drinks ("soda" or "pop"), juice drinks (not including 100% fruit juices), sports drinks, tea and coffee drinks, energy drinks, sweetened milk or milk alternatives and any other beverage where sugar has been added.
- Consumption of sugar-sweetened beverages has more than doubled over past 30 years.
- Since 1977 both serving size and number of servings per day have increased by over 50%.
- Children who consume just 1 or more SSB/day are 55% more likely to be overweight or obese than children who do not consume any.
- Adults who consume just 1 or more SSB/day are 27% more likely to be overweight or obese.
- SSB’s account for at least 20% of the increase in weight in the US since 1977.
Success Stories
Over the past two years, Downs Food Group demonstrated their commitment to worksite wellness by working to reduce access to and consumption of sugar sweetened beverages (SSB). Given the company’s long-term partnership with SHIP, the decision to integrate SSB education and
resources with ongoing wellness efforts was an easy one to make.
Downs Food Group - Tony Downs Foods, Madelia
Downs Food is a meat processing plant with two locations in Watonwan County including Madelia.
The wellness initiatives made possible by SHIP are particularly critical because they impact a diverse
group of employees. Approximately 80% of the 320 Madelia plant employees are Latino and about 35% of employees are low-income. In their work with SHIP, Downs Food considers ways to make efforts culturally appropriate by not only overcoming language barriers, but also acknowledging culturally-driven perspectives about health and behavior change. Downs Food Group began developing their worksite wellness initiative years before receiving funding from SHIP. Their first public health initiative was implemented though a dual partnership with Watonwan County Public Health and Madelia Community Hospital. The organizations share a health educator and interpreter who provides
bilingual health education at the Downs Food Group plants every month on a variety of health topics,
including sugar sweetened beverages. Downs Food has worked to create a culture of healthy choices
through monthly wellness meetings with volunteer employee members and providing educational
materials like posters, brochures, and newsletters placed in the breakroom to encourage healthy beverage consumption. As part of their work with the Rethink Your Drink campaign, Downs Foods made environmental changes to the worksite by adding water fountains in newly rehabbed areas of the plant. For employees working in hot sections of the plant, water is now offered as the first choice in beverage with Gatorade as an alternative option. The company also has policies to ensure healthy vending options are available. For example, at least 50% of food and beverages need to be healthy items, including non-sugary beverages like water, coffee, tea, and 100% fruit juices with smaller portion sizes. However, vending machines are still dominated by beverages like sports drinks, soda, and fruit juices, many available at the same price as water. Jarritos Soda, a popular, high-sugar option with Latino employees, is also available. Downs Foods Group will continue working towards implementing their policy and reducing reducing sugar sweetened vending offerings.
Madelia Schools
Instead of simply removing sugary beverages, Madelia Schools challenged students and staff to take another look at the beverages they drink on a daily basis. As part of a community-wide Rethink Your Drink campaign, Madelia Schools worked in partnership with the Statewide Health Improvement Plan (SHIP) staff and others to increase awareness about sugar sweetened beverage (SSB) consumption.
Initially, Madelia Schools decided to focus on employee wellness by providing education about the effects of SSB consumption and promoting healthy alternatives to sugary options. The schools worked with SHIP staff to present on the topic and purchase flavor infusion water bottles for staff members. The school also received a boost in their efforts from a U Care grant allowing them to install a hydration station for filling water bottles. As the SSB campaign took off in Madelia, the school had the opportunity to partner with other organizations and also focus on teaching and modeling healthy behaviors to students. Members of the Madelia Community Based Collaborative (MCBC) including Mankato State University—Mankato , Madelia Community Hospital & Clinic, and Watonwan County Human Services lent their time and talents to this effort. For example, nursing students from MNSU visited school early childhood and health promotion events to interact with parents and students, sharing information about the sugar found in everyday beverage and foods.
With guidance and support from SHIP, Madelia Schools and their partners were excited to reach community members of all ages with the Rethink Your Drink message. The environmental changes at the schools that increase access to and consumption of water will have a lasting impact on the health of the community.
Aspiring filmmakers at Madelia High School were invited to use their skills from a multi-media class to shoot a video for the Rethink Your Drink campaign. High School students also worked with MSU nursing students to present skits to elementary students about nutrition and sugary beverages.
Elementary students created works of art inspired by Rethink Your Drink during their regular art classes. Students had opportunities to learn about nutrition labels and sugar content in beverages through presentations at school events and educational displays. Students were also featured in an MDH sponsored video talking about how they have changed their behavior and attitudes about their beverages.
Staff and students received water bottles to encourage increased water consumption throughout the school day. Through additional funding, schools were also able to install hydration stations in all three school buildings to make it even easier to drink water during the day.
Madelia Community Hospital
After completing a community health needs assessment in 2013, the Madelia Community-Based Collaborative (MCBC) learned that residents’ top health concerns included diabetes, obesity and cancer. By exploring evidence-based strategies to help combat these chronic diseases, the MCBC prioritized work to reduce the consumption of sugar-sweetened beverages (SSB) and partnered with Faribault, Martin, Watonwan (FMW) SHIP to apply for an innovative grant to support the work. Madelia Community Hospital & Clinic (MCHC), one of the key members of MCBC, took a lead role by making internal policy changes, as well as promoting water and healthy beverage choices to residents of Madelia.
Over the years, the city of Madelia has built a culture of health with community members. The Rethink Your Drink project follows a successful community-wide “Fight the Fat” weight loss campaign that evidenced residents have a desire to continue participation in health-focused initiatives. With SHIP as a project leader and promoter, MCHC was able to devote additional resources to finding innovative ways to improve the health of residents. For patients and visitors of MCHC, policy changes were made to reduce access to sugary beverages. Pricing changes and point-of-sale nutritional information was added to vending in order to highlight healthier and more affordable alternatives to pop. MCHC was also involved in community outreach and creating social supports through their presence at Madelia Park Days—where they partnered with local schools and businesses to provide education and assistance with making environmental changes.
An early success for the MCHC was passing a policy to limit the types of beverages available to patients on the menu. SSB like pop and chocolate milk were removed from the dietary department. Instead, water and other unsweetened beverages are now offered. To communicate to staff and patients about the policy, MCHC drew from SHIP and MDH training that highlighted strategies on how to respond to negative reactions by framing the change as making healthy choices rather than taking sugary beverages away. The policy does not prohibit patients and guests from bringing in sugary beverages, but commits to the Rethink Your Drink efforts by not making them available through patient tray service.
MCHC also supports the policy by changing practices for National Hospital Week each year. Instead of having free pop available all week, water and flavor-infused waters were offered. While the initial response was not positive, education and consistent messaging from staff leading the effort have helped with the transition. Staff commented that more people have started drinking water since rolling out the policy. MCHC supports staff wellness by offering water and coffee or tea in the breakroom at no cost.
Continuing the focus on education and making the healthy choice an easy choice, MCHC made changes to public vending machines in waiting areas. MCHC staff worked with SHIP to change out the front signage on the vending machines to advertise water and machines now have information about the caloric value of items at the point of sale. MCHC also worked with the vending company to increase the price of pop by $0.25 to $1.75 making it more expensive than water ($1.50). In the future, MCHC staff hope to monitor sales of water and pop to see if behavior has changed since making the price change.
MCHC recognized the importance of getting buy-in from the broader community by reaching out to different organizations with the Rethink Your Drink message. Madelia Park Days, one of the city’s largest events, was a great opportunity to provide education and foster positive interactions with community members. During the 2014 and 2015 summer events, the MCHC staff and MCBC members hosted a table with flavor-infused water tasting and displays showing how much actual sugar is in common sugary drinks. MCHC staff felt this was a particularly effective method for reaching kids. MCHC also sponsored a sidewalk chalk contest where local businesses decorated their walkways with Rethink Your Drink inspired art.
Additionally, MCHC led an effort to increase water consumption at Madelia Schools. Water bottles were distributed to school staff at a luncheon. The event helped the MCHC foster relationships with teachers at the school who were interested in the project and found ways for them to get involved. MCHC was particularly excited about getting kids thinking about healthy behaviors through a poster contest in elementary school art class. The contest was featured in a video created in partnership with the Minnesota Department of Health.
MCBC partnered with a popular local Mexican restaurant to provide water dispensers and created a variety of vegetable and fruit infused waters. Different options were sampled, and community members provided feedback on the recipes. Winning recipes were added to the restaurant menu.
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