Planting Health

Food grows in the ground. Yet it would be easy to presume our meals spring from the grocery store, drive-through or quick mart. Can reconnecting with food at ground level improve public health? Can nurturing a garden also nurture healthy habits in children, empower impoverished women and strengthen community bonds? Programs throughout the Bloomberg School are finding out.

"When you talk about gardens and food, you touch a light in people, a hope, a promise, a truth," says Kristen Speakman, MA, MPH '06, project manager at the Johns Hopkins Center for American Indian Health (CAIH). "It's the cycle of life. You start with a seed-like we all once were-you have to nourish it, then it sustains you, and then it dies. It's something that resonates with the human spirit. It touches us deeply."

And, Speakman hopes, gardens can have a deep impact on communities that are returning, literally, to their roots. The Santo Domingo Pueblo, who live along the Rio Grande in New Mexico, have a long tradition of agriculture-one largely abandoned to modern times, modern foods and the modern epidemics of obesity and diabetes. According to the CAIH, American Indian children have the highest rates of obesity and diabetes in the U.S.

Now the Santo Domingo and two other Southwest tribal communities (the Navajo Nation in Tuba City, Arizona, and the White Mountain Apache in eastern Arizona) are returning to that heritage through a program called Edible School Garden, part of a larger nutrition program run by CAIH under the guidance of "community visioning" boards. For three years, students have been working in the greenhouses, open-air classrooms and raised beds built into the participating schools' courtyards. They're growing traditional crops including melon, corn and chili peppers, and unfamiliar crops including okra, broccoli and spinach.

"The goals are ultimately to reduce the incidence of obesity and diabetes," says Speakman, who is based in Albuquerque. "You have to start somewhere. This is intuitive." Though, in the public health model, intuition isn't sufficient. Indeed, it's suspect. "So much harm has been done with good intentions," she says. "We want to make sure this program is done right and is effective."

Which is why the garden, with its science-based curriculum for third-, fourth- and fifth-graders and its component of co-teaching by community elders, is being rigorously evaluated before it can be "packaged" for other tribal communities. The team is looking for evidence of improved knowledge about, attitude toward and behavior regarding healthy eating as well as connection to traditional agriculture.

Preliminary data looks promising. As does the anecdotal. Some students have even transplanted their gardening skills from school to home. Kaitlin Mosley, senior research program coordinator, says the students seem more relaxed and attentive in their outdoor classroom. "There was a boy at one of the schools who was totally shut down, he wouldn't talk to anyone," says Speakman. "He came into the garden program and just blossomed. This program is healing work."

Half a world away, in Kabul, Afghanistan, public health workers are healing the land itself. They've carved out a 5,000-square-meter demonstration farm designed to grow one crop: women extension agents. Participants in the Women in Agriculture Training Center, part of the Afghanistan Agricultural Extension Project funded by the USDA, in turn educate some of the country's most vulnerable women. The program focuses on those who are widowed, divorced or abandoned with a goal of improving food security, says Sophia Wilcox of the University of Maryland. Malnutrition is a severe problem in Afghanistan-one that afflicts 70 percent of the country's children, she says.

The obstacles are formidable. The soil is clay-heavy and nutrient-poor. Clean water is scarce. Many of the students cannot read or count. But they are eager to learn.

"We used games and activities that are very visual, no written words," says Christie Balch, an MPH student at the Bloomberg School who has taught gardening on three trips to Afghanistan. "They loved it. In the final test they had to teach a lesson to the rest of the group. They rocked it."

Some lessons easily crossed borders. Last April, the students wanted to try growing cucumbers in socks tacked to walls. "It was desolate," remembers Balch. "There were military helicopters overhead. We were surrounded by these beautiful mountains. We're filling socks with soil, and these women in burkas start making penis jokes. There are some universal truths about women anywhere."

On the Darulaman Demonstration Farm, Wilcox has carved out 100 plots. Once a week, 32 extension agents come to learn drip irrigation, crop rotation, composting and other basic skills. Each takes her lessons back to a Farmer Field School in an impoverished neighborhood, where she teaches 10 students. "They feel empowered," says Wilcox. "They're not afraid to make an extension visit and provide sound advice."

Students in the Field Schools are now tending their own kitchen gardens, growing lettuce, tomatoes and beets in the walled enclaves behind their homes. For women who are often restricted from leaving home and from marketing their crops, it's a direct route to improving family nutrition. And for those who can sell informally in the neighborhood, it's a way to earn money.

Gardens are sprouting up closer to Baltimore as well. The Center for a Livable Future (CLF) is in its fifth year of seeding gardens through the Baltimore Food and Faith Project.

"In faith groups pretty much across the board-whether it be Christian, Jewish, Muslim or Buddhist-care for the earth, care for your neighbor is going to be included," says Darriel Harris, program officer for the Baltimore Food and Faith Project. "It's not a stretch for congregations to say 'this is important to us.'"

Digging those values right into the dirt is a way to get people to rethink the food they eat. "We hope what happens is that congregations and individuals become better stewards of the earth, of food in particular," says Harris. Which might mean a congregation sponsors a CSA drop-off, or an individual chooses locally grown, nutritious foods.

"Gardens literally provide a source of food," says CLF program officer Allison Righter, MSPH '12, RD. "But they also connect people back to the process of growing food and caring for the land."

In 2013 the program made 16 grants to faith community gardens in Greater Baltimore, ranging from $122 to $750. Some 40 gardens have flourished, including one at the Weinberg Senior Village, where the beds are raised to wheelchair-access height. Some congregations shared their harvest with local food banks.

One grant recipient is Epiphany Episcopal Church, which sits on a winding street in suburban Timonium, Maryland. At the far end of the parking lot, a statue of Saint Francis of Assisi keeps watch over a 40-by-20-foot garden plot. Here, members of the congregation-ages 2 to 82-spent last summer tending tomatoes, green beans, sunflowers and zucchini.

The process was simple: "We digged the hole," says 4-year-old Taryn Heist. "We planted the seed and covered it up."

Then magic happened. Daycare students watched over the sprouts during the week. Sunday school students watered them on weekends. One summer Sunday, in the middle of worship, a 7-year-old burst into the sanctuary lugging a huge yellow squash. Rev. Kristofer Lindh-Payne paused to set the prize on the altar.

"It gave our congregation the opportunity to grow together," says Lindh-Payne. "To literally grow food and to grow in relationship with each other and with God."