Collaboration with LGBTQIA+ Pacific Islander Leaders Addresses Intersecting Health Needs

Behind the more visible drivers of food insecurity, like the rising cost of healthy foods and supply chain disruptions, are systemic issues that perpetuate health inequities. Oppressive practices do not happen in a vacuum; Queer and Trans Pacific Islander (QTPI) communities continue to experience the legacy of generations of transphobic discrimination, violence and criminalization which has impeded access to nutritious food, quality health care and economic security.

The combination of these systemic factors leads to high levels of chronic stress which has been linked to an increased likelihood of heart disease and stroke risk factors.

Recent statistics confirm the communities' lived experiences; food insecurity is higher among LGBTQIA+ BIPOC (Black, Indigenous and People of Color) individuals in King County. And according to a recent statement from the American Heart Association, "transgender men are twice as likely to have a heart attack as cisgender men and four times as likely as cisgender women."

The American Heart Association's multifaceted collaboration with UTOPIA Washington helps address these disparities. As a grassroots organization led and founded by women of color, identifying as transgender and/or fa'afafine (a cultural gender identity native to Samoa translated to “in the manner of a woman”), UTOPIA Washington is uniquely positioned to build community-informed pathways that uplift the health and well-being of QTPI and other LGBTQIA+ communities of color. Collectively, our efforts increase access to nutritious, culturally inclusive foods that prevent and treat diet-related chronic diseases for over 1,400 Seattle area residents.

Rooted in UTOPIA's understanding that food can be a powerful, holistic, and cost-effective intervention in the prevention and treatment of disease, we developed a nutrition policy that formalizes their commitment to the provision of foods that support positive health outcomes and reflect the cultural needs and dietary preferences of their diverse communities.

The nutrition policy was adopted in December 2021 and will formally guide UTOPIA Washington's purchasing, procurement, community donations and distribution of food.

"For the past two years, our organization has been extensively working to fight food insecurity by bringing fresh and non-perishable food to the broader community. This nutrition policy is both timely and important as it supports our goal to encourage healthy living and reduce chronic illness by guiding us to provide healthier options to our community," said Diana V. Krishna, Community Care Programs Coordinator.

Our team worked with UTOPIA Washington to identify community needs and develop a policy to emphasize the role that access to nutritious, culturally relevant food plays in health equity. The policy utilizes the Healthy Eating Research (HER) Nutrition Guidelines to guide community donations, food procurement and the assembly of over 200 food boxes delivered to vulnerable community members per month, including older adults and those experiencing houselessness. It also references USDA’s MyPlate as a tool to help staff build healthy, balanced hot meals.

To prioritize the health of their community, UTOPIA's policy highlights items that meet nutritional needs, including whole grains and locally sourced produce as well as staples in the Pacific Islander culture like taro, fresh fish, yams and bok choy. It also directs staff to avoid purchasing items that detract from good heart health, such as sugar-sweetened beverages and candy.

To support the sustainability of the nutrition policy, the American Heart Association uncovered an opportunity to increase UTOPIA Washington's capacity to procure and distribute fresh produce. Without the equipment to store perishable food, the food pantry was forced to turn away nutritious donations from community partners. By providing funds for a commercial refrigerator in March 2022 through Puget Sound Energy Foundation, UTOPIA is able to accept more donations from their existing relationships and connect with, and source produce from, local farms. UTOPIA chose a refrigerator with a glass door display to invite community members to select the healthy produce they prefer, similar to a grocery store.

To sustainably increase the abundance of fresh produce in UTOPIA Washington's food pantry, our team facilitated a community supported agriculture (CSA) gleaning and purchasing agreement between UTOPIA Washington and Living Well Kent's local farms, led by immigrants and refugees. By developing a gleaning relationship within a five-mile radius, UTOPIA reduces their environmental impact by decreasing air and traffic pollution while supporting the local food ecosystem and other community-led efforts.

“The addition of a commercial refrigerator gave us space to store fresh, organic produce that is locally grown by Living Well Kent," said Diana. "This fridge adds so much value to our Makeki, an accessible market where community members enjoy a personalized experience to choose fresh produce and healthy food options."

Through this relationship with Living Well Kent, UTOPIA has secured their own plot of land that their wellness team tends to and harvests during weekly farm visits. This allows UTOPIA to select the varieties of produce that are grown and provided to the community and supports their cultural organizing initiatives by cultivating ties back to the land.

While UTOPIA Washington provides a robust in-house food access program, recent Public Health data underscored the need for a formal protocol to screen community members for food insecurity, and provide referrals to sustainable sources of assistance beyond UTOPIA’s on-site food pantry.

"During the height of the pandemic, when we first started food distribution, we noticed an influx of community members seeking food access. As we’ve expanded our response to food needs, we've noted the importance of screening to ensure that every community member who walks through our doors knows that we have food resources and connections readily available,” said Fania Sipili, Community Care Program Manager.

The program launched in November 2022 after a training to equip UTOPIA's wellness team with tools to screen community members using a two-question survey and connect them to local, sustainable food sources. These resources include produce vouchers to shop for fresh fruits and vegetables at Living Well Kent’s East Hill Farmers Market, made possible by American Heart Association funding, as well as enrollment support for SNAP and other government food programs through navigators at WithinReach. The training emphasized the disproportionate impact of food insecurity among QTBIPOC (Queer, Trans, Black, Indigenous, People of Color) communities and how to navigate difficult conversations about food needs. To meet population specific language needs, we provided translated food resource referral materials in Samoan.

The screening is integrated into UTOPIA's existing intake process by including screening questions on all department forms, available by QR codes posted throughout the office. Including on all department forms ensures that UTOPIA casts a wide net and addresses the overlap of basic needs.

These collective efforts support UTOPIA Washington's ongoing efforts to address the unique health challenges affecting LGBTQIA+ individuals of color. Their comprehensive services include basic needs like food and gender affirming clothing through Hale Kōkua, translated to "house of support" in Hawaiian, legal and immigration guidance, financial and peer support, and a monthly health clinic which brings free services and case workers directly to community members in need.