Photovoice: A Tool for Community Empowerment and Action

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Photovoice A Tool for Community Empowerment and
Action
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Did you know?

• Many chronic diseases including diabetes, stroke,
  heart disease and many cancers can be prevented
  by
• Eating a healthy diet,
• Being active,
• Maintaining a healthy weight, and
• Getting adequate medical and dental care.

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About this Project

• 10 women, equipped with digital cameras, spent a
  year exploring answers to questions such as What
  is missing in this community that would help
  people lead healthier lives?
• Three key findings follow, in photographs with
  their comments, along with a few statistics.

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Finding

• Many Healthy Foods are too Expensive for People
  to Buy

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Fruits and vegetables are healthy but theyre
expensive. People tend to buy cheaper food that
is more filling, but not so healthy.
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Its hard. . . its hard. Some vegetables are
more expensive than meats!
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Where are the vegetables in this community
garden? Is more funding needed?
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Former site of the St. Martin school When the
school was here, everybody who lived in the
projects had access to a section in a community
garden.
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If you have a house you can have your own
vegetable garden.
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When people, including diabetics, dont eat
breakfast, they stop and grab something here. We
need to make people more aware of diabetes. In
2004, 53 of CT adults with diabetes were obese.
That was up from 48 in 2001. http//apps.need.cd
c.gov/ddtstrs/statePage.aspx?stateConnecticut
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Do I pay rent and have a roof over my head, go
to the doctor, or do I put food on my table?
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The community is responsible for feeding
everyone. At some food pantries people can pick
out what they want, others bag things ahead of
time. When pantries get food donated, they have
no choices.
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You have a choice, but sugar-free is always more
expensive, and coupons are not offered.
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This 10 lb. bag of sugar cost 4. The bag of
Altrern (use the same amount as sugar) cost 6
for just over ½ of 1 lb.
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Did you know?

• African Americans are diagnosed with type 2
  diabetes almost twice as often as whites.
• In CT Blacks with diabetes are hospitalized 4
  times as often as whites, and have more than 3.5
  times the amputations.
• Blacks in all income categories are affected.

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• Type 2 diabetes is preventable up to 90 of the
  time by being active, eating well and controlling
  weight. 
• The surest way to achieve both safe and perfect
  control of type 2 diabetes is not to get it in
  the first place.
• Katz, David L. Blood Sugar Control in Diabetes
  the Enemies of Good Preventive Medicine Column
  written for New York Times Syndicate, February
  10, 2008.

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Finding

• Being active requires safe and affordable places
  to exercise.

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An example of a good place to play. No safe
place for kids when its dark.
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Kids are jumping out of their seats. Theyve
been sitting all day in school. Need someplace
safe to run around and play.
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Parents dont want to let their kids out.
Theyre afraid they wont come back.
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Goffe Street is the only park in that area of
Hew Haven that kids have to do any exercise and
its not that safe there. There has been
multiple shootings. We need safe places for
kids to exercise.
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They used to have YWCA and YMCA with lots of
programs for children, and a swimming pool. Now
theres just a small part of the building for
youth, and theres a half-way house.
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George Clutcher Blackmon field - National
teams used to come here to play softball, but
they dont anymore because of the violence.
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Fears about safety
A shooting happened during a daytime softball
game in the field across from Hillhouse High
School. Adults need safe places to exercise too.
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Are there too many of these in the community?
Communities and neighborhoods that have more
bars and liquor stores per capita experience more
assaults. Scribner, R. A., MacKinnon, D.P., and
Dwyer, J.H. "The risk of assaultive violence and
alcohol availability in Los Angeles County".
American Journal of Public Health 3(85)335-340.
1995.
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Underage alcohol use is more likely to kill young
people than all illegal drugs combined. Grubaum,
J.A., et al. Youth risk behavior surveillance
United States, 2001. MMWR Morbidity and
Mortality Weekly Report 51(SSO4) 1-62, 2002
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They should make the Q. House into a community
center with a gym and a swimming pool, and
classes for adults. The residents all need
this.
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Hamden Lanes just closed and the closest now are
in East Haven, Milford and Amity. Skating rinks
have closed too. Thirty-three percent of CT
adults with diabetes reported being physically
inactive in 2004. http//apps.need.cdc.gov/ddtstrs
/statePage.aspx?stateConnecticut
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This roller skating rink has been gone for about
1 year.
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Timing is important, some times of the day its
okay, but at other times you dont want to be
walking.
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Its important to have comfortable shoes, but
theyre costly-good sneaks can cost 165.
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Curves is 40 per month. When you have
diabetes you have to make sacrifices. Compared
to whites, Black women in CT are twice as likely
to be obese. Black men are 25 more likely to be
obese than white men. http//www.ct.gov/dph/LIB/dp
h/hisr/pdf/Diabetes_surveillance_2006CT
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George Rose is 78 years old. He has had his
diabetes in control for 20 years. He rode his
bicycle 2.5 miles to my office to take this
picture. He tests his sugar 4 times a day. He
runs 3.5 miles most mornings. He is a diabetes
superstar. He is an inspiration to me and many
others. -State Sen. Toni Harp
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Finding

• 3. Getting adequate care requires affordable
  access to physicians and dentists.

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In these stores were a pharmacy, a dentist, and
medical offices. Now theyre all retail stores.
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A lot of people with diabetes do not realize the
importance of having a stable meal or how to plan
a diet according to what they should be
eating. In 2004, 84 of CT adults with diabetes
were either overweight or obese.
http//apps.need.cdc.gov/ddtstrs/statePage.aspx?st
ateConnecticut
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One can come to the library to gain more
information about diabetes.
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Its hard to train people to change their eating
habits. They prepare the food they want to eat.
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The New Haven Health Department offers 3 diabetes
education classes annually. Do we need more? In
2005 48 of adults in CT with diabetes reported
ever having attended a diabetes self-management
class. http//apps.need.cdc.gov/ddtstrs/statePage.
aspx?stateConnecticut
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Eye examinations are important for everyone,
especially if you have diabetes. The percentage
of CT adults with diabetes receiving a dilated
eye exam in the last year was 74 in 2005, down
from 77 in 2002. http//apps.need.cdc.gov/ddtstrs
/statePage.aspx?stateConnecticut
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Take as prescribed by doctor. More than 14 of
Blacks in CT (and 6 of whites) have no health
insurance. http//www.ct.gov/dph/LIB/dph/hisr/pdf/
Diabetes_surveillance_2006CT
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Take charge of your health. In 2003, 57 of CT
adults with diabetes also had high blood
cholesterol 53 also had hypertension.
http//apps.need.cdc.gov/ddtstrs/statePage.aspx?st
ateConnecticut
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Everyone should get a regular health
examination. People with diabetes should have a
primary care provider and specialists. Referrals
are hard to get.
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There is much more we as a state can do to
make it easier for people living with diabetes to
control their disease. From support for group
physical activity options, to access to healthier
food, to translating cultural recipes to diabetes
healthy recipes to making appropriate screening
and better health care available and affordable,
we can and should do more. State Sen. Toni Harp
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• Can we subsidize healthy foods?
• Can we provide everyone access to health and
  dental care?
• Can we make our parks and playgrounds safe again?
  people living with diabetes to control their
  disease. From support for group physical activity
  options, to access to healthier food, to
  translating cultural recipes

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Every Individual Can Help

• Talk about the importance of affordable healthy
  foods, safe places to exercise and access to
  medical care.
• Support legislation and programs that will help
  eliminate barriers to healthy living.

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Photography Exhibits

• Enlargements of these photos were mounted and are
  being exhibited at various locations in CT,
  including New Haven City Hall and the annual CT
  Public Health Association meeting.

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Photography Exhibit

• If you would like to have the exhibit shown at
  your worksite or meeting, contact
• Maurice Williams
• 203-732-1265, ext. 300
• maurice.williams_at_yalegriffinprc.org

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Visitors reaction to the exhibit

• 46 people completed a survey that asked about
  their level of concern on issues raised in the
  exhibit.
• For each of the 8 questions asked, they were
  given three response choices no concern, minor
  concern, and major concern.

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Survey Results

• How concerned are you about
• 1. Walking or jogging after dark?
• Major concern for 65.2 of respondents
• 2. A safe place for children to play?
• Major concern for 76.1 of respondents

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Survey Results

• 3. Having exercise facilities nearby?
• Major concern for 63.0 of respondents
• 4. More neighborhood recreational programs?
• Major concern for 73.9 of respondents

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Survey Results

• 5. Access to support groups?
• Major concern for 58.7 of respondents
• 6. Access to dental care?
• Major concern for 60.9 of respondents

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Survey Results

• 7. Affordable fresh fruits and vegetables?
• Major concern for 71.7 of respondents
• 8. Affordable exercise facilities?
• Major concern for 63.0 of respondents

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Participants

• Photographers Cynthia Alford, Christine
  Burruss, Larissa Broadie, Alice Johnson, Naomi
  Kelly, Sharon Moore, Lillian Richardson, Kouri
  Simmons, Ruby Slade, Pastor Audrey Tinsley
• Photographers for a day State Senator Toni
  Harp, Dr. Laurie Bridger, Alderman Greg Morehead

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Project management

• Staff and Consultants - Georgia Jennings, MPH,
  principal investigator, Maurice Williams,
  research assistant, Mario Edwards, research
  intern, Jean Breny-Bontempi, MPH, PhD, photovoice
  consultant, Harold Shapiro, photography
  consultant
• Advisory Board - Gerald Clark, President, Greater
  New Haven Business and Professional Association,
  Dorothe Shaw, Hill Health Center, Paul Nunez,
  Office of the Mayor of New Haven, and the late
  Leonard Smart

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• The Connecticut Health Foundation provided
  funding for this project, which was led by the
  Yale-Griffin Prevention Research Center.

• The Yale-Griffin Prevention Research Center
  receives core funding from the Centers for
  Disease Control and Prevention.