From water crisis to food sovereignty

Flint Fresh Mobile Market, purchasing blue berries

From water crisis to food sovereignty

Genesys Regional Medical Center - Michigan
Once the nation’s automotive epicenter, Genesee County and the city of Flint experienced economic decline, poverty, and health crises but today it is a “community in recovery.”


  • Genesee County, Michigan and the city of Flint experienced a historic economic shift resulting in rapid population decline, high unemployment, high rates of poverty and negative health outcomes.
  • During the water crisis, the population was exposed to an urgent public health emergency with lifelong consequences. 
  • This crisis helped galvanize community health organizations focused on food work, breaking down silos and aligning needs with opportunity. 
  • A collaborative community health needs assessment process revealed that the underlying top community health needs —  obesity, diabetes, overweight, even the Flint water crisis — was food insecurity. 
  • Genesys invests in efforts to address food security at a number of levels. Genesys also advises and participates in the Regional Food System Navigation initiative, an effort led by the Community Foundation of Greater Flint. These investments and efforts resulted in several collaborative community projects including:
    • The Women in Agriculture Farm Development Center
    • Genesee County Food Rescue Program 
    • Flint Family Summer Nutrition Program 
    • Flint Fresh Mobile Market
    • Flint Fresh Veggie Boxes
    • Nutrition in Community program 
  • Efforts have impacted the community, increasing healthy food access:
    • 1,184 pounds of food from the local high school was rescued and redistributed to more than 330 families in need.
    • The summer nutrition program distributed 3,000 food boxes, providing over 78,000 nutrient-rich meals focused on lead-mitigating foods such as fruits and vegetables to community members in need.
  • Hospital name: Genesys Regional Medical Center
  • Hospital type: Private, nonprofit
  • Hospital size:    Large (400 beds)
  • Geographic area: Urban
  • System/Network: Genesys Health System; member of Ascension Health 
  • Network coverage: Mid-Michigan
  • White: 74.5%
  • African American: 20.7%
  • Hispanic/Latino: 3.0%
  • Community health needs assessment region: Genesee County, Michigan 
  • Population: 412,895
Health indicators

Adult obesity: 35.7%
Adult overweight: 34.7%
Diabetes: 11.6% 
Adult high cholesterol: 42.41% 
Food insecurity rate: 18.02%
Poverty: 21.7% in Genesee County, 41.1% in Flint
Unemployment: 5.4% Genesee County, 9.7% Flint

Genesys Regional Medical Center serves the residents of Genesee County, Michigan, and its urban core, the city of Flint. Located 70 miles north of Detroit, Genesee County is the birthplace of General Motors (GM) and was once the national epicenter of automotive production. In the late 1970s, GM employed more than 80,000 workers in Genesee County. National deindustrialization — beginning in the 1980s — and a rapid decline of the automotive industry led to a period of disinvestment. By 2010, less than 8,000 GM jobs remained in the county.

This historic economic shift led to high unemployment and rapid population decline. Nearly 200,000 people lived within Flint during its peak in the 1960s and 1970s; today only 99,002 residents remain, 56.6 percent of whom are African American. Out-migration led to urban decay, neighborhood blight, decreased home values, and falling tax revenues. Poverty rates in Flint and Genesee County are much higher than state and national levels, and the percent of households receiving public assistance exceed state and national benchmarks. Consistently high unemployment rates and growing intergenerational poverty have contributed to poor community health factors and health outcomes. 

Residents in the city of Flint, particularly those who are low-income or minority, are disproportionately impacted by social, economic and environmental factors such as pollution, crime, property abandonment, neighborhood blight, and lack of access to healthy foods. These factors have led to significant disparities in life expectancy, health outcomes and health status among low-income and minority populations in the community.

In April 2014, the city of Flint switched its water supply source as a cost-savings measure under the direction of a state-appointed emergency manager. As a result, a series of water contamination problems occurred culminating with lead leaching into public drinking water. Nearly 100,000 residents may have been exposed to high levels of lead before a state of emergency was finally declared in January 2016. Between 6,000 to 12,000 children were likely exposed to lead through Flint’s water supply. Childhood lead poisoning has serious health consequences and disproportionately affects vulnerable children and pregnant mothers. Lead poisoning is irreversible and affects many developmental and biological processes. Lead exposure is linked to lowered IQ (intelligence), reduced academic achievement, behavior problems such as Attention Deficit Hyperactivity Disorder (ADHD), lack of impulse control, aggression, and more. The Flint Water Crisis will have lifelong, multi-generational consequences. 

Today Flint and the Genesee County is a “community in recovery.” The Greater Flint area has a long history of ingenuity and grit. Strong community, citizen, and institutional leadership are dedicated to building a healthier, vibrant community. Over time this leadership has successfully developed infrastructure to support the alignment of diverse community-based partners around a shared community health agenda. This framework and commitment to collectively address community health challenges is a national model for coordinated community change and a valuable community asset. 

Community health needs assessment: Priorities and process

  • Food and diet-related disease priorities
    • 2016 CHNA - Obesity, overweight, and healthy lifestyles 
    • 2016 CHNA - Food insecurity 
  • Participation from food-based organizations in CHNA process 
    • Edible Flint, Flint Farmers Market, Food Bank of Eastern Michigan, North End Soup Kitchen and other food-related organizations participate in the Greater Flint Health Coalition, which engaged partners throughout the CHNA process. 
  • How/why did food issues emerge as a priority? 
    • The community has worked on food system initiatives for years, but not in a coordinated or systematic way. CHNA data demonstrated an imperative to directly address food insecurity as a fundamental determinant of health underlying numerous priority health needs. Community input was confirmed.
  • Key community indicators 
    • Adults with inadequate fruit/vegetable consumption: 81.6%
    • Overweight adults: 34.7%
    • Obese adults: 35.7%
    • Food insecurity rate: 18.02%
    • Households receiving SNAP benefits: 23.55% Genesee County, 43.09% Flint
    • Children eligible for free/reduced price lunch: 55.37% Genesee County, 86.54% Flint
    • Low-income population with low food access:  9.41% Genesee County, 9.68% Flint (6.05%MI)

Full assessment: Community Health Needs Assessment Report 2016

Assessing health needs — and how to meet them

Community health needs assessment process

Genesys Health System is a group of affiliated medical campuses, outpatient centers, primary care locations and ancillary health care organizations in central Michigan. Genesys is anchored by Genesys Regional Medical Center at Health Park and is a member of Ascension, the largest nonprofit health system in the United States and the world’s largest Catholic health system.

As one of three local hospital systems serving Genesee County, Genesys Health System comes together in partnership with Hurley Medical Center, McLaren Flint hospital, and the Greater Flint Health Coalition (GFHC) to complete a collaborative community health needs assessment (CHNA) for the city of Flint and Genesee County area.

Established in 1996 the GFHC is a broad cross-sector collaboration between Flint and Genesee County’s leadership in public health, health care, business, education, government, community organizations, committed citizens and more.  Greater Flint Health Coalition works together to improve the health status of Flint and Genesee County residents by establishing a common health agenda, shared measurement systems, mutually reinforcing health activities, and continuous communication regarding the well-being of the community and its residents. 

Flint Fresh mobile market
Flint Fresh Mobile Market, a project initiated through the Regional Food System Navigation program, aggregates produce from local farmers and brings fresh healthy food to neighborhoods lacking access to fresh food each week. (Community Foundation of Greater Flint)

Genesys Health System is a founding member of the GFHC, serves on the Board of Directors, and participates in strategic subcommittees. Genesys leveraged GFHC’s existing infrastructure, networks, and processes for facilitating ongoing cross-sector community engagement in community health by partnering with them for their collaborative CHNA. 

Many community organizations working on food system initiatives such as Edible Flint, Flint Farmers Market, Food Bank of Eastern Michigan, and North End Soup Kitchen are GFHC partners, thus becoming involved in CHNA related activities through association. Greater Flint Health Coalition partners participated in the CHNA process in various ways, including providing input relative to metrics, data interpretation, health needs, and priorities.

The joint CHNA used the GFHC’s Community Data Scorecard, a cross-sector project that includes over 400 health-related indicators with an emphasis on social, environmental and economic determinants of health. Issues such as food insecurity, obesity, overweight, and healthy lifestyles were identified as significant community health needs under this framework. The CHNA also included a community health survey that asked residents about eating habits, food insecurity, healthy food access, and diet-related diseases. Survey responses reinforced quantitative data trends. 

“Underlying a number of the top community health needs identified — obesity, diabetes, overweight, even the Flint water crisis — was food insecurity. It was clear that access to and consumption of healthy foods was key to having a healthy population.”

The community had engaged in food systems work for many years, however efforts were siloed, disjointed, or proprietary. This fragmented approach led to missed funding opportunities for healthy food access initiatives. The community health needs assessment process and strong ongoing cross-sector community engagement therein revealed the need to take a more coordinated and collaborative approach. It also highlighted the importance of focusing explicitly on food issues rather than continuing to address food as an element of chronic disease initiatives. 

Investing in solutions

Implementation strategy

Genesys Regional Medical Center has invested staff time and in-kind resources such as grant writing support, land, facility space and clinical expertise in a range of strategies and programs that promote healthy lifestyles and access to healthy food. 

Genesys Regional Medical Center uses a decentralized model and takes a regional approach to organizing community benefit and community health activities. Community benefit work is organized under the mission integration department. One local community benefit coordinator oversees the work across four hospitals in the mid-Michigan region with oversight from the vice president of mission integration and support from a local community benefit team. Community health needs assessments and implementation strategies are developed by a team of clinical and operational staff to tailor a health system program response to meet identified community health needs.

Wise woman entrepreneurial gardening
Aspiring women farmers learn about agricultural practices in the hoop house at the WIA Farm Development Center at Genesys Health Park during a Michigan Food and Farming Systems Women-in-Ag Network Workshop. (Michigan Food and Farming Systems)

Genesys partners with the GFHC and local businesses to implement Commit to Fit – a community-wide health behavior improvement initiative focused on increasing healthy eating and physical activity among citizens through education, shared messaging and engagement in no-cost healthy living programming. To improve community access to their Diabetes Nutrition Learning Center, Genesys is training more diabetes prevention program providers and increasing community outreach and program availability. The goal of these efforts is to increase knowledge and adoption of healthy behaviors that will help mitigate or delay progression of obesity and diet-related diseases.

In 2015 Genesys partnered with Michigan Food & Farming Systems (MIFFS) to provide a community-based resource sharing and education center focused on providing economic opportunity to women farmers and promoting access to healthy food in the community. Genesys also works to create an equitable, sustainable regional food system by advising and participating in the Regional Food System Navigation (RFSN) initiative, an effort led by the Community Foundation of Greater Flint (CFGF) to improve healthy food access through resource coordination and collaboration. 

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