Ryan Holeywell: Just how big of a public health crisis is there in Brownsville?
Rose Gowen: Eighty percent of our residents are either obese or overweight. That’s what drives the fact that one in three people here have diabetes. The national average is one in 10. And half of them don’t know they have diabetes. To top all of that off, 70 percent of the people are uninsured.
RH: What factors have caused Brownsville to struggle with obesity? Is it socioeconomic?
RG: I don’t think it’s different from many other communities. We know the whole country really moved away from walking and bicycle riding in the 1950s and 1960s, and everything became car-oriented. People stopping living close to retail and schools. The suburbs were developed so you’d need to have a car. It really decreased the number of people walking. I think those things are true, just as much here as any place else.
Here, perhaps it’s been accentuated by the poverty. And there’s a cultural overlay. (Editor’s note: 93 percent of Brownsville's population identifies as Hispanic, and 28 percent of its residents were born in Mexico.) Mexican food is delicious, but it’s high in carbohydrates, and Tex-Mex is even higher in carbohydrates that the diet from the interior of Mexico. So you have all of those things, compounded over the years, and we ended up where we are today.
RH: Politics is a rough business in South Texas. What made you run for office?
RG: I was involved with the UTHealth School of Public Health, trying to make a difference fighting diabetes. As a practitioner working one-on-one with patients, you see 20 or 30 people a day. But in a community of almost 200,000, it doesn’t really put a big dent in reducing the rates of diabetes.
I began writing a weekly column on wellness in the newspaper, and we started an initiative to create a farmer’s market to bring fresh fruits and vegetables that would be affordable and accessible to all. In that process, there was always a need to go to the city government for permits or permission to use the park. I was the one who’d reach out to the city. I had never really done that before. As a health practitioner, you don’t really interact with the city government directly. But I realized there was a lot of red tape and personalities you had to navigate in order to do something that was seemingly easy – a farmers market.
That motivated me to want to make a difference on a city government level. If it was hard to just start up a farmers market, how were we ever going to succeed at programming and events and all the things we wanted to do to turn the city around, beyond the farmers market?
RH: Public health issues don’t often come up in local elections. Did you focus your campaign on health?
RG: Our slogan was ‘it’s time for a healthy change.’ We defined that as many things. It could be a healthy economy, healthy development, or personal health. We began to make people think health doesn’t live in a silo. It overlaps and insists into everything that goes into the making of a city.
RH: You’ve been in office since 2009. What have you been able to do to address public health – beyond the farmers market – now that you’re a city leader?
RG: We’ve had several policies that support health, including a sidewalk ordinance that requires sidewalks in commercial and residential areas. There’s a complete streets resolution. Whenever a street is built or is resurfaced, consideration has to be made for cyclists and pedestrians. And there’s a safe passing ordinance. Pedestrians and cyclists are supposed to be given at least three-feet of leeway. We also passed a smoking ban. We’ve reserved 10 percent of street funding to be earmarked for pedestrian and bicycle infrastructure, and we’ve used that money with matching grants. We’ve started other key programs, like a springtime weight loss challenge for the whole community and CycloBia. We were able to pass funding for a citywide bicycle plan.
RH: Has anyone accused the city of pushing the health agenda too hard? Michael Bloomberg famously got a lot of push-back when he tried to ban trans-fats and sugary soft drinks in New York.
RG: We try really hard to focus on terms like ‘vibrancy.’ We want to build a vibrant Brownsville, which is economically and educationally rich. And if you do that, then health has to be a piece of the puzzle. But the bottom line is there are no vibrant cities filled with sick people. When we challenge people to think of it in those terms, it’s pretty hard to disagree.
We try not to use the word ‘health’ as much as the word ‘vibrant.’ In the beginning, we did things that were under the radar and didn’t get much push-back. As we started to layer in other programs and become more visible, there was a little more. We’ve gotten some criticisms, people saying ‘you can’t tell me how to live my life.’ That’s why we focus on ‘vibrancy.’
We actually practice talking about our message without using the term ‘health’ on purpose. That’s how you have to get your message across. We also try hard to make the programming we do fun. If you’re a naysayer and you come and try a CycloBia event and you have a blast, you’re not going to complain about it. It becomes something you can adopt.
RH: What sort of reaction did people have to the farmers market?
RG: The city wanted it once a month, at most, but we said if you’re going to have behavioral change, it needs to be done over and over again, and once a month isn’t enough. So we fought the battle to get it in a park, on a bus route, on a weekly basis. On opening day, all the produce sold out within an hour and a half.
RH: How did you decide what types of programs to implement?
RG: We began with the science. The UTHealth School of Public Health, in my estimation, has been the best thing to happen to our community in a long time. They focus on evidence-based strategies. Farmers markets have proven to be effective. We don’t have a lot of money, so we didn’t have the resources to try things. The ideas came from evidence-base strategies in other communities, and we put a cultural tweak on them as we went along.
RH: What sort of culture tweaks?
RG: Our nutrition classes are very rich in Hispanic foods. We don’t try to take away your enchiladas or your chiles rellenos. But we give you a healthier recipe for the same product and different ingredients.
RH: What do you need to see, in terms of numbers, for you to know these programs are making a difference?
RG: We want people to be controlled in their diabetes, but the real goal is to just not have diabetes at all. We know that Type 2 diabetes is a preventable condition for a lot of people. For me, I want being healthy to be the norm.
We already feel we’ve been successful. We went from having one bicycle shop to having four. We've gone from one hike-and-bike trail used by a couple hundred people to registering hundreds of thousands of trips. And people are coming to meetings asking for more infrastructure, saying they want trails in their neighborhood. We wouldn’t be hearing that if this change wasn’t happened and if people weren’t choosing more active lifestyles.
Can we prove the rate of diabetes is dropping as we speak? No, of course not. It will take a long time to measure that. But we know something is happening and we’re on the right track.
RH: So what’s next?
RG: We’d like to attract sponsors to create a bike share. We have two university campuses, one here in Brownsville and one in Edinburg (about 60 miles away). Students may have classes in one place in the morning and the other in the afternoon. We want to have a connection so there’s a nonstop bus from one campus to the other, and a bike share on each end would be a logical place to start.