Public health experts have assumed that living close to a supermarket is linked to a better diet and lower obesity. The closer you lived to one, the theory went, the more likely you were to eat more fruits and vegetables.

But a new study, conducted in Seattle and led by researchers in the , finds that distance from a supermarket doesn’t matter when it comes to diet quality. What counts most is exactly where a person decides to shop.

“Clearly, people tend to bypass a multitude of supermarkets, grocery and ethnic stores near their homes to get to their primary supermarket of choice,” said lead author , a research associate at UW’s .

Choices on where people shopped were likely based on individual factors ranging from economic necessity to lifestyle, culture and attitudes about healthy foods, she added.

The American Journal of Public Health published March 13.

The study was based on data from nearly 1,400 Seattle-area supermarket shoppers and the 2008-2009 Seattle Obesity Study. Using telephone surveys and King County government records, researchers in the UW geocoded locations of all food sources in King County, including respondents’ nearest and primary supermarkets. Primary supermarkets of choice were categorized by price (low, medium and high) based on the cost of a basket of 100 goods.

Diet differed according to preferred grocery stores. The researchers also found that shoppers at lower-cost supermarkets ate significantly fewer fruits and vegetables – nearly a serving less per day – than those who shopped at higher-cost supermarkets.

“Fruit and vegetable consumption was higher when people shopped at Whole Foods than when they shopped at a Safeway,” said co-author , professor of epidemiology and director of the UW’s .

Drewnowski added that the debate over access to healthy foods needs to be shifted from physical proximity to ensuring people in lower-income groups have greater purchasing power. Whether a higher minimum wage would achieve that is one possible question to explore, he said.

Read more about the research on UW School of Public Health’s .

Three faculty members from the UW School of Public Health were elected to the prestigious Institute of Medicine, one of the highest honors in the fields of health and medicine. Their election brings the total number of UW faculty members in the Institute of Medicine to 56.

The inductees are among 70 new members and 10 foreign associates announced Monday, Oct. 15, during the Institute of Medicine’s 42nd annual meeting in Washington, D.C. The distinction recognizes outstanding professional achievement and commitment to service.

New members are elected by current active members and are chosen from diverse fields for their major contributions to advancing medical science, healthcare and public health.

The Institute of Medicine, founded in 1970, is the health arm of the National Academy of Sciences. It is both an honorific membership organization and an advisory group. It is considered to be a national resource for independent, scientifically informed analysis and recommendations on health issues.

During the past year its expert panels have addressed environmental factors in breast cancer, health IT and patient safety, nutrition rating systems and graphics on food packaging, chimpanzees in research, standards of care during catastrophic disasters, improving care for epilepsy patients, and treatment of post-traumatic stress disorder.
The School of Public Health inductees are:

• Chris Elias, a clinical professor of global health and president of global development for the Bill & Melinda Gates Foundation

• Thomas Fleming, professor of Biostatistics and professor of Statistics

• Andy Stergachis, professor of epidemiology and of global health, adjunct professor of health services, and adjunct professor of pharmacy.

“It is, of course, an honor to receive such a prestigious recognition from my peers,” said Elias, who earned an M.P.H. degree from the School of Public Health in 1990. “The Institute of Medicine has long provided expert advice on the most pressing national health and health care issues. Increasingly, the Institute is also playing an important role in shaping global health policy and practice. It will be my pleasure to help the Institute fulfill its essential mission.”

Elias received an M.D. degree from Creighton University in 1983.  He became a School of Public Health Distinguished Alumnus in 2010. At the Gates Foundation, Elias leads efforts in integrated and innovative healthcare delivery. His group is seeking creative new ways to ensure healthcare solutions and treatments are available to  people in developing countries who need them most. Previously, he led PATH, a Seattle-based international non-profit working to improve health in more than 70 countries.

Fleming is the former chair of the Department of Biostatistics in the School of Public Health, where he has worked since 1984. He completed a Ph.D. degree in probability and statistics from the University of Maryland in 1976. He is also a member of the Fred Hutchinson Cancer Research Center in Seattle.

“I am pleased about the opportunity this provides to call attention to the remarkable quality of the UW, and its Department of Biostatistics and School of Public Health,” Fleming said. “I have been inspired by my collaboration with colleagues in the academic and scientific communities at UW and at the Fred Hutchinson Cancer Research Center, and by those with whom I have worked nationally and internationally in the science and regulatory oversight of clinical research for the prevention and treatment of diseases.”

Stergachis recently served on the Institute of Medicine Committee on Strengthening Regulatory Systems in Developing Countries, and directs the UW’s Global Medicines Program. Through his affiliation with the School of Public Health’s Northwest Center for Public Health Practice, he works on emergency preparedness with public health agencies. He also is affiliated with the UW Pharmaceutical Outcomes Research and Policy Program.

“I am extremely honored to be recognized by the Instiute of Medicine members,” said Stergachis, who holds a Ph.D. degree in pharmacy administration from the University of Minnesota and a B.Pharm, degree from Washington State University. “My first involvement with the Institute of Medicine was in 1995 when I served on their Committee to Study the Interactions of Drugs, Biologics, and Chemicals in Deployed U.S. Military Forces. Since then I have been fortunate to be called upon on several occasions to be of service to the Institute of Medicine and see first-hand the lasting impact of its reports and other activities.”

This election brings the total Institute of Medicine membership to 1,732 active members and 112 foreign associates. An additional 84 members hold emeritus status.

Timor-Leste, one of the world’s newest and poorest countries, has one of the world’s highest rates of maternal death, and many infants die within a month of birth.

To improve the odds for mothers and their newborns, , a non-profit affiliated with the UW School of Public Health, has launched a first-ever mobile phone project there to send important health messages by text to expectant mothers.

Many women in Timor-Leste live in remote, mountainous villages, lack land lines and electricity, and rarely visit medical clinics. About 70 percent of women give birth at home, and most do it without help from a midwife, according to Susan Thompson, Health Alliance International’s director of Timor-Leste programs. After birth, women are often secluded in the home for up to six weeks.

Mobile phone use has rapidly increased in recent years, offering a new way to reach expectant mothers. Women taking part in the program will receive two messages a week reminding them to take iron pills, eat well and have regular prenatal visits. Women will also be able to call for an ambulance or trained midwife when they go into labor.

The messages, in the local language of Tetum, will be tailored to each woman’s estimated due date. Phones and messages will be in place for six weeks after birth for follow-ups and to help mothers monitor signs of illness in their newborns.

“It’s all about improving the quality and access to maternal care,” said , Health Alliance International’s maternal and child health adviser and a senior lecturer in the school’s departments of and . The mobile phone service will allow health workers to “bridge bad roads and long distances with messages.”

Mobile Moms is supported by a four-year $1.75 million grant from the U.S. Agency for International Development. The first messages are scheduled to be sent out about Oct. 1.

Health Alliance International is working with the Ministry of Health and , a non-profit agency building the mobile phone platform. The project will be a first of its kind in Timor-Leste, according to Catalpa, and has the potential to change the way people interact with their local health professionals.

Timor-Leste, also known as East Timor, was a longtime Portuguese colony that was occupied by Indonesia. It achieved independence a decade ago. The small island country north of Australia has one of the highest rates of maternal mortality, at 557 deaths for 100,000 births (in the U.S., the rate is only eight per 100,000). In Timor-Leste, more than 2 percent of infants die within a month of birth.

Health Alliance International has been active in Timor-Leste since 1999, and partners with the Ministry of Health. The organization works to raise awareness about health services, screens movies with messages about family planning, and strengthens skills of district health-care workers. Access to maternal and newborn services has steadily increased since the organization began working in Timor-Leste, Thompson said. So far, nine UW students – from Global Health and the Community-Oriented Public Health Practice programs – have carried out research projects and assessments there.

One of the greatest challenges? The large number of children the typical Timor-Leste woman bears – up to 6 or more. “It’s concerning that many couples don’t understand that spacing their children is healthier,” Thompson said.

The Mobile Moms project ignited the passion of young Seattle-area professionals looking for a global health project to support. The group formerly known as Party with a Purpose – now renamed – dedicated its annual fund-raiser in July to Mobile Moms. More than 700 people attended, raising $20,000 to pay for texting services, said Kristen Eddings, program associate for the Washington Global Health Alliance. (See a of the party.)

(See page 18 for project vision)

The residents of an impoverished neighborhood on the outskirts of Lima had a choice: Did they want a library, perhaps, or a health facility first?

The answer was surprising.

They really wanted a green space,” said Leann Andrews, a ����Ӱ�Ӵ�ý graduate student of landscape architecture.

So Andrews, seven other UW students and two faculty members rolled up their sleeves and made it happen – with the help of volunteer labor from local residents.

Before fall quarter, the students and faculty spent a month in an informal settlement in Puente Piedra, a district north of the Peruvian capital. They held workshops, designed a plan for green space at a school, and then converted a barren, sandy hillside into a 600-square-meter park with walkways, trees and shrubs.

They also designed a system to recycle water from a hand-washing station and pipe it to the park to irrigate vegetation.

“The plant is a symbol of hope, a symbol of moving upward,” said Andrews, 27, a third-year graduate student from Pennsylvania who is also pursuing a certificate in Global Health. “Its really valuable to them. It symbolizes health.”

The creation of green space is the first major project coordinated by UW in the Puente Piedra slum – one of the largest slums in the world, said Joseph Zunt, a UW neurologist and associate professor of global health.

Zunt is bringing many disciplines together at the University and in Peru,  including major non-governmental organizations like Slum Dwellers International, to work with the community to come up with innovative approaches to improving life.

One-third of the urban population in developing regions like Peru lives in slums, and the number is growing by 6 million a year, according to U.N. Habitat, the United Nations department that focuses on urban development. U.N. Habitat estimates that by 2020, 889 million people will be living in urban slums. The collaboration means focusing on many things, from the physical and emotional health of residents to buildings and job training. “Were pulling in more and more disciplines,” Zunt said.

The Puente Piedra Project: Healthy Schools, Healthy Communities includes the universitys Department of Global Health, College of Built Environments, and the schools of Medicine, Environmental and Forest Sciences, Social Work and Public Health. Other partners include Engineers without Borders and Architects without Borders and the National University of San Marcos in Lima, one of the oldest universities in the southern hemisphere.

The project began in 2007, with a Peru-based physician from Uruguay named Jose Viñoles. Viñoles,  a Fogarty International Clinical Research Scholar who started a sex education project in the Pitágoras school, where teen pregnancy was high, Zunt said.

Other health-related programs included testing students for hearing, eyesight and asthma – and then helping those who needed it, such as subsidizing eyeglasses, Zunt said. Three sewing machines were purchased so the school could teach vocational skills.

With more than 1,600 primary and secondary students, the Pitágoras school is said to be the third poorest in Lima. It sits in the Lomas de Zapallal community of about 27,000 people and is part of a mega-slum of more than 1.5 million inhabitants.

Many live in make-shift homes of plywood and corrugated metal. Andrews says the wall of one home was made of plastic soda bottles filled with sand. Another home was little more than stacks of tires.

Many families lacked water, sanitation and steady electricity. “That was really pretty shocking,” Andrews said.

Andrews and the other students were taking part in an Exploration Seminar from mid-August to mid-September led by Susan Bolton, a professor in the School of Environmental and Forest Sciences, and Benjamin Spencer, assistant professor of landscape architecture.

The first two weeks were spent soliciting input from parents, students and teachers during participatory workshops and then synthesizing this input in three designs  for the open-space project.

“We offered several designs, including ones with bending, flowing sidewalks,” Bolton said. “They liked the square one.”

A professional stone-layer with a staff of three was hired. But most of the manual labor was done by parents of students who volunteered, Bolton said. Some women had babies strapped to their backs. Students and faculty put in their share of sweat, too.

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In just over two weeks, the park was constructed and about 200 plants, trees and shrubs – from geraniums to African tulip trees – were planted. Before, the school was on a giant sand dune.

“There were no walkways,” Bolton said. “It was just dry, sandy ground.”

The park, which connects the upper and lower parts of the school, now serves as a gathering place for students and as an “ecological learning landscape,” according to Spencer. Native plants and other species are labeled.

In addition, a gray-water irrigation system was built to recycle hand-washing water. The water passes through a sand filter for cleaning and then into a series of porous clay pots that slowly release it into the park.

Every drop is precious. Although its near the coast, Puente Piedra is a desert, and the region is vulnerable to climate change. “Its one of the driest places on earth,” Spencer said.

The eight UW students were also asked to hold cooking classes for the Pitágoras students. This was an excuse to teach some English, Andrews said, as well as to instruct students on the importance of keeping their hands clean when preparing food.

Students were taught to make brownies, cookies and banana bread, which they could sell to their peers to earn some money.

It was excellent cultural interaction, said Andrews, and the entire project was “the experience of a lifetime.”

The UW students lived about eight minutes away from the school by mini-bus.

Besides the new park, other planned projects for Puente Piedra include collaboration with Slum Dwellers International, to start a micro-savings program. Families would be encouraged to contribute small amounts to a community bank from which they could borrow money at no int
erest.

UW faculty , students and local collaborators are also in the process of building a health clinic and new classrooms. School rooms with good ventilation and adequate daylight could lead to better learning environments, according to Spencer.

Add up these kinds of small-scale interventions, he said, and “you can begin to create healthier environments in disenfranchised urban communities.”

In 2012, the entire project team was awarded a or SEED Award for excellence in public interest design.

Jeff Hodson is a former Seattle Times reporter who specializes in global health news. He can be reached at jeffhod (at) gmail.com.