How is Fort Worth, TX Getting Healthier While the Rest of the Country is Getting Sicker?

In 2014, Fort Worth ranked almost dead last for health and well-being at 185th among 190 metro areas in the Gallup-Sharecare Well-Being Index. By 2017, the city had jumped from 185th to 31st—putting them on track to realize their goal of being one of the healthiest cities in the nation.

For a long time, one of the best-known things about Fort Worth was its proximity to its more well-known neighbor. But Fort Worth has quietly and determinedly become a city that’s defying the odds. While health and well-being has been declining across the country, Fort Worth has shown impressive gains in the last five years.

1 Power of Policy in Improving Population Health

2 Smoking Ban = Better Business or Business as Usual

3 A Better Built Environment: Streets, Roads, Urban Villages

4 Corner Store Makeover: A Model for Food Deserts Across the Country

5 Neighborhood Intervention: Unique Partnerships Create Change

6 Engaging the Faith Community

7 The Purpose Connection

8 Innovations at Work: Reducing Healthcare Costs and Empowering Employees

9 People: Individuals Reversing Prediabetes and Chronic Conditions

10 You Are Where You Eat

11 You Are Where You Shop

How Fort Worth is Defying the Odds During America’s Healthcare Crisis

As one of the fastest-growing cities in the country at almost 900,000 residents, Fort Worth’s leaders are determined to get in front of the boom. Mayor Betsy Price, now in her fourth two-year term as mayor, has thrown her considerable clout behind making Fort Worth a better place to live. A Fort Worth native and businesswoman of two decades, Price is known as a straight shooter who epitomizes hard work.

Price’s interest in making Fort Worth a healthier community is both pragmatic and personal. She has cited how important health is to economic development: “We will attract and retain more business and industry as Fort Worth raises its profile as a great place to live, work, and play.” But she has also brought it home: “Kids spend far too much time in front of screens. They eat fast food. Their diabetes rate is incredible. Estimates are this is the first generation that will live shorter lives. And that’s really worried me as a mother, a grandmother, and as a community leader.”

In 2014, Mayor Price, Barclay Berdan, the CEO of Texas Health Resources, and Bill Thornton, CEO of the Fort Worth Chamber of Commerce, joined forces to improve their city and make Fort Worth a Blue Zones Community. These forward-thinking leaders wanted to make a dent in the crippling cost of health care and to stem the seemingly unbreakable tide of rising obesity, loneliness, and chronic disease.

As innovators in the public health space, Blue Zones had already achieved unheard of goals in other cities in moving the needle on the current health crisis. Blue Zones Project is based on research by founder Dan Buettner, who identified the blue zones regions of the world where people live extraordinarily long and healthy lives. Residents of blue zones make healthier choices every day because they live in communities where these are the norm. So instead of just focusing on individual behavior change (trying to get people to eat less and move more), Blue Zones Project focuses on improving people’s Life Radius, or the area close to home where we spend 90 percent of our lives. Blue Zones takes a systematic, environmental approach to well-being which focuses on optimizing policy, building design, social networks, and the built environment to make the healthy choice the easy choice.

Mayor Price was the most visible champion in the initiative to bring Blue Zones Project to Fort Worth, but funding came from lead sponsors Texas Health Resources, the largest hospital system in North Texas, and the Fort Worth Chamber of Congress.

“If we can address obstacles to well-being before someone becomes ill or develops a chronic condition, we can make Fort Worth the envy of cities across the country.”—Barclay Berdan, CEO of Texas Health Resources.

Science has proven that people with higher well-being cost less and perform better. The city’s overall 2018 Well-Being Index score rose to 62.5, a gain of nearly four points since 2014. For a city the size of Fort Worth, this degree of well-being improvement leads to millions of dollars in healthcare savings: as little as one point of sustained well-being relates to a two percent reduction in hospital utilization and one percent reduction in overall health-related costs.

Mayor Price is a mover and a shaker in more ways than one. Each week, the 66-year old mayor hosts a 7-8-mile bike ride to meet residents and chat about their ideas on how to improve the city. She calls them “rolling town halls.”

When any Blue Zones community program starts, it starts with a deep discovery of the local landscape by world-renowned Blue Zones experts like Dan Burden, the nation’s top walkability and active transportation expert. But its launch and execution are dependent on a local Blue Zones Project team (hired for the project for their deep community knowledge) tapping into their network of local experts and go-getters.

Blue Zones Project is based on the lifestyles of the world’s most extraordinary populations. But it succeeds because it uses best practices from other Blue Zones communities and because it’s deployed hand-in-hand with the city’s best and brightest people and organizations. Building a broad coalition of people and programs from different sectors is part of the reason Blue Zones Project has been successful in cities around the country. By partnering, connecting, and investing in a community’s organizations and programs with the shared vision to make Fort Worth better and brighter, Blue Zones Project has helped to ignite the community and effect widespread change in just a few years.

Power of Policy in Improving Population Health

Fort Worth was one of the last large cities in Texas to allow smoking in bars and bingo parlors when Blue Zones arrived in the city. Despite decades of research and outcomes linking smoking to poor health, people in Fort Worth were still lighting up in bars and bingo parlors.

Blue Zones joined local coalitions and concerned citizens in pushing for updated citywide smoking policies. Along with Texas Health Resources, Smoke-Free Fort Worth, the American Heart Association, and concerned citizens, Blue Zones Project backed a new smoking ordinance. It passed, including the use of e-cigarettes, and was soon after expanded to include a ban on smoking in public parks. It also prohibits retail smoke shops from opening within 300 feet of schools and hospitals.

The new ordinance will positively impact the health of Fort Worthians for decades and generations to come. Tobacco is the number one preventable cause of death in the United States, and even secondhand smoke causes about 49,000 deaths per year in this country. For children, denormalizing smoking reinforces what they learn in school, that smoking is a deadly habit. Already, the smoking rate in Fort Worth has dropped 31% since 2014, resulting in better health for the entire community and a significant healthcare savings as well.

Gallup estimates that Fort Worth has saved $268 million in healthcare savings and lost productivity due to the reduced smoking rate of its adult residents in 2018 compared to 2014.

Smoking Ban = Better Business or Business as Usual

Steve Steward, a non-smoking bartender at the Boiled Owl, a popular late-night spot on West Magnolia Ave which used to be known as the “smokiest bar in Fort Worth,” is one of the locals breathing a sigh of relief. Although some bars were worried the smoking ban would have an impact on business, Steward said it’s the opposite was true: “I think we’re busier than before. There were people that came in after the ban and said they always wanted to come in, but that it was always so smoky.”

The owners of the Boiled Owl were ready to ban smoking even before the ban was already in place, and Steward comments that although the ban was the topic of conversation during its first week, their regulars just went outside to smoke. As a non-smoker and musician himself, Steward said he feels a lot better after having to breathe in smoky air every day for six years.

Photo by David McLain

“My sense of smell is a lot better. I definitely feel like I have more energy and am not quite so tired. It definitely takes a toll on you.”—Steve Steward at the Boiled Owl

Just like with smoking policies, decades of research shows that being healthy is not just about individual choices. That’s why Blue Zones Project zeroes in on the policy and environmental changes that will have broad and powerful impact on the health of entire communities.

A Better Built Environment: Streets, Roads, Urban Villages

Unlike the smoking ordinance, which was a change to outdated policy, Fort Worth is also looking forward as they create new policy. It’s good timing: Fort Worth is in the middle of an explosive growth as one of the fastest growing cities in the nation with currently almost 900,000 residents By 2030, it’s expected to have a population of 1.2 million.

Fort Worth is attracting new businesses and residents every day, but success comes with its own challenges. Transportation is one of the most visible and daily ones: as people come, whether it’s residents or tourists, so does traffic congestion, parking problems, safety problems, and road rage.

Walkable streets and effective public transit are important for the health of communities, and are part of the reason that coastal cities, settled first and developed before the automobile age, do better, healthwise, than Southern and Midwestern cities that were planned for automobiles. Higher walkability is associated with lower rates of obesity and diabetes, and for school children, walking to and from school will give them most of the recommended physical activity they need in a day. Thirty years ago, almost 60% of children living within 2-miles from their school walked or biked to and from school; today, that number is less than 15%.

Even people that don’t live in walkable neighborhoods can benefit from living in a city or town with different walkable areas: For every 12 blocks you walk, your risk of obesity drops 4.8% and just 25 minutes of walking a day can add up to 7 years to your life.

The good news is that even though Texas cities are known for spreading and sprawling over acres and acres, Fort Worth has good bones. Its charming downtown is anchored by historic Sundance Square, a 35-block shopping, eating, and entertainment area that sees millions of visitors a year. It was an “urban village” before we even had a special catchphrase for a “city within a city.” Creating urban centers is part of Fort Worth’s master plan to create a vibrant, thriving city. Improving streets and thoroughfares to connect these points is essential to pulling it off.

To get ahead of the city’s expansion, the city adopted a master thoroughfare plan with the goal of providing: “a complete and connected, context-sensitive transportation system for all users that supports mobility, healthy living and economic benefit.” Blue Zones experts including Dan Burden aided in the 2016 update to the plan after conducting walking audits in the Fort Worth. Burden was named by Time magazine as one of the six most important civic innovators of the world and is the nation’s top expert on walkability, traffic flow, commuter safety, and road design.

One of the roads Burden called out as an important opportunity was West 7th Street, the busiest and fastest growing street in Fort Worth. It’s the main drag between the Cultural District with nationally recognized museums and the downtown area. It’s a flurry of new development and an essential roadway between two hubs of Fort Worth and is also a major roadway out of town across the Trinity River. It can be party central at night, and a mix of residents, cyclists, commuters, shoppers, students, and tourists at any time of day. Good restaurants, interesting stores, and high-density residential buildings make it a densely populated “urban village.” It looks like it just sprang up yesterday, but even still construction crews are building at a furious pace.

The planned $8.5 million redesign of West 7th is part of Fort Worth’s new master plan that will transform the road that it’s become (big, bloated, and impossible to cross) into a flowing thoroughfare with room for pedestrians, bicycles, and the city’s new Dash buses. These new all-electric buses, also part of the new initiative, will run in 15-minute intervals up and down West 7th Street, bringing people between downtown and the Cultural District all day. By increasing mobility and connectivity between important hubs of the city, living, working, and visiting in Fort Worth becomes a more enjoyable experience.

Mobility means more than just public transportation. It also means having the space to walk and bike safely. At W.J. Turner Elementary, students started a Walking School Bus as part of their transformation into a Blue Zones school. This new initiative demonstrated that despite the fact that many students lived nearby, it’s difficult to walk to school since a major multi-lane road separates residential neighborhoods from the school’s entrance. The school then applied and was one of eight Fort Worth schools to receive a Safe Routes to School grant. The $730,00 grant will be invested in sidewalks, crosswalks, ramps, signals, and traffic calming improvements by 2020 so that students can walk to school safely.

In 1969, 41 percent of children in grades K–8 lived within one mile of school, and of those kids, 89 percent usually walked or biked. By 2009, 31 percent lived within a mile of school — and only 35 percent of them walked or biked.

Engaging schools, where children spend the majority of their waking hours, is a core part of Blue Zones Project work in all communities. The benefits, like with smoking policies and street overhauls, will unfurl over the next many decades as the students grow up and become part of the adult population and workforce.

YWLA, a public all-girl’s school, is another one of the 37 certified Blue Zones Project schools. The only Blue Ribbon secondary school in Fort Worth, YWLA is also 90% students of color and the majority of the student body receives reduced or free lunch. They are also the only Blue Ribbon secondary school in Fort Worth, the best ranked high school in Fort Worth, and has a 100% college acceptance rate. They are doing great things despite tremendous odds. YWLA is a microcosm of Fort Worth’s formula for success: a forward-thinking and disruptive leader, impressive goals, creative strategies, and a dedicated team.

Tamara Albury, the school’s Principal, explains that “one of our goals is to raise successful women of color that are healthy. So we were excited about Blue Zones Project.” The school’s three pillars are college readiness, health and wellness, and responsible leadership. So Principal Albury (pictured below, center left), school nurse Cassandra Miles (pictured below, center right), teachers, and administrators didn’t have to be sold on the important of health and well-being to student performance and development.

Their efforts to become a Blue Zones certified school were impressive: they installed new water bottle filling stations, they applied for and received a grant for a salad bar in the cafeteria, they changed all their vending machines to have healthy options, and they incorporated stress relief and mental health into their classes and programs. Nurse Miles involved the students in some of the changes: “We wanted to change the vending machines and get rid of the candy and soda. So I got some samples from the companies and did taste tests so the students could vote. I wanted to get buy-in from the students to decide which vendor to switch to.” It’s been a success so far. Even the salad bar, installed with grant funds, was a hit. They sold out of produce the first week.

In Fort Worth, 45 schools from four school districts have became Blue Zones Project Schools. Well-being improvements include water bottle filling stations, removing soda and adding healthy choices to vending machines, campus gardens, mindfulness exercises, additional after-school programs and clubs, and adding salad bars to cafeterias.

One of the students we met at YWLA, a radiant sophomore, spoke on the influence of Blue Zones Project in the school and mentioned that she lived in Stop Six neighborhood. As a magnet school, YWLA draws from a variety of Fort Worth neighborhoods.

Take a short drive from the gorgeous historic Fort Worth downtown that draws the tourists and you’ll enter neighborhoods where the crime rate is higher and salary rates are lower. Residents here have also have lower life expectancies, with higher number of years of disability and risks of chronic afflictions like type 2 diabetes and heart disease.

Stop Six is one of these neighborhoods—the crime rate here is among the highest in the city, the unemployment rate is double the city average, and locals often describe this predominantly African-American area as “tough area.” You’ll drive past some abandoned lots and boarded up homes. Fort Worth, as part of their revitalization program, has dedicated $2.5 million to Stop Six: they’ve started to tear down some old buildings, fix street lights and sidewalks, and install street cameras to reduce crime in the area.

Living in either food swamps and food deserts are predictors of lower health outcomes; both groups have higher risks of chronic diseases and obesity than those populations living in “regular” neighborhoods. Food swamps have many places to eat, but all of them are high-calorie and low nutrition; in food deserts, there is little to no access to healthy foods and convenience stores are often the only place to buy food. Food swamps benefit from policy (i.e. Limiting the number of fast food restaurants per square mile), but food deserts are tricky. It’s often hard to convince grocery chains to move into food deserts, as they don’t see the financial incentive to do so.

Corner Store Makeover: A Model for Food Deserts Across the Country

There is a convenience store called Ramey Market in the middle of Stop Six. It’s a couple blocks from both a local middle school and high school, and is one of the only stores in the neighborhood. Students might be dropped off there to hang out before school begins and often do the same hanging out in the wide parking lot after school. For many years, it carried the customary mix of packaged snacks, cigarettes, candy, lotto tickets, and beer that you find in most corner stores, convenience stores and gas station marts around the country.  It’s a familiar inventory that’s convenient, fast, inexpensive, and terribly unhealthy.

After realizing that they wouldn’t be able to court a large grocery chain to open up somewhere in the neighborhood, the local team had a new idea: work with Ramey Market owner Samuel Moulegiet to increase his healthy options. Its central location and gathering place for students made it the ideal place to begin in the neighborhood.

The store makeover did include some cosmetic changes (improvements to shelves and organization), but they were not just surface improvements: the local Blue Zones Project team convinced Moulegiet to remove the cigarette advertisements from the window and to showcase his healthy options at the front of the store with a new grab and go case. He also added water as a drink option instead of just stocking sodas, sweetened drinks, and alcoholic drinks. There is also signage up throughout the store that points to healthier options.

Photo by David McLain

Samuel Moulegiet, owner of Ramey Market in the Stop Six neighborhood in Fort Worth

Neighborhood Intervention: Unique Partnerships Create Change

Blue Zones Project enlisted the help of students from one of the schools in the neighborhood, Dunbar High School, to paint a mural at Ramey Market. The neighborhood students transformed an entire empty side of the Ramey Market building with a colorful mural to celebrate the store’s makeover with a welcoming, colorful public art that takes a “busy streets” approach to improving a neighborhood.

Ramey High School students celebrate the new mural and produce selection at Ramey Market

Community partnerships made the corner store makeover a model for other food deserts where gas station stores or convenience stores are the only place to buy food. Blue Zones Project worked with Tarrant County Public Health, Dunbar High School, the Plan4Health food access program, the Historic Stop Six Initiative, and Ramey Market on this innovative project to create some meaningful change in the neighborhood.

Ramey Market is right next to Jacquet Middle School and a short walk away from Dunbar High School. Between the two schools and adjacent to the market sits Bunche Park, a 10-acre vacant plot which has sat empty and gated off for 40 years. This past April, construction crews started working to remake the green space into a community park, complete with a new playgrounds, walking trails, benches, fitness stations, and security lighting. Blue Zones Project, City Council member Gyna Bivens, Texas Health Resouces, North Texas Healthy Communities, and CBS EcoMedia came together in a multi-sector and multi-organizational effort to secure funding and approvals for the new park. The master plan for the park will cost $15 million.

After 40 years, ground is broken in Bunche Park to install a new playground (rendering below) as part of the plans to re-open to the public.

It’s just the beginning of the Stop Six revitalization, but it represents many steps in the right direction with multiple neighborhood interventions. The Ramey Market corner store makeover is a model for addressing health disparities in food deserts. The re-opening of Bunche Park, previously closed for decades, provides a safe place for children, families, and residents to gather, play, be active, and exercise.

Addressing health inequities is a must for any successful public health program, and the Ramey Market re-do is a start in the Stop Six neighborhood. Fort Well’s recent well-being gains came from those that needed it the most.

Fort Worth’s neighborhoods and sectors where citizens showed the highest well-being disparities in 2014 now show the greatest gains in well-being.

Higher risk populations have lower health outcomes and higher-than-average rates of healthcare costs; this significant achievement comes at a time when most cities see widening gaps in health disparities.

Engaging the Faith Community

Blue Zones Project work is based on research done by Dan Buettner and the original expedition teams that identified and did research on blue zones regions of the world, places with high rates of centenarians and healthy, long-living populations. There are nine common lifestyle characteristics (Power 9) that are shared in the blue zones cultures, and one of the nine is belonging to a faith-based community. Although they were all different religions, Blue Zones centenarians had spiritual practices and belonged to faith communities. These spiritual practices provided community, stress relief, friendships, and the regular social interactions that boost longevity. Taking a Sabbath Day and religious fasting also provided science-backed health benefits.

Blue Zones Project creates movement by tackling everything from large-school policy changes (smoking, roads and transit) to individual self-improvement (personal pledges), and everything in between to improve the health of communities. Faith-based communities are a natural place to engage: in many communities, the advice of spiritual leaders is more important than that of elected leaders. Ministers, rabbis, priests, imams, and other leaders are trusted messengers.

Over the last 3 years, thousands of Fort Worth residents engaged in Blue Zones Project through their faith-based communities. Congregations implemented Blue Zones activities and principles in a variety of ways: they created walking moais (groups that meet regularly, providing friendship and fun) or healthy potlucks, invited chefs in to do plant-slant cooking demonstrations, led purpose workshops for their members, or started new yoga and movement programs within their regular spiritual schedules.

Faith-based organizations are a tremendous example of the social determinant’s approach at work. Where people worship and pray is often a place where people also have strongest social networks, and often receive information that can be of value to the health of their families and their neighborhoods.—Dr. Howard K. Koh, the U.S. Assistant Secretary for Health 

The Purpose Connection

Bill McMullen, A financial aid officer at Tarrant County Community College, took a Blue Zones Project purpose workshop at his church. He said, “I immediately thought that we needed to do this for some of the students I counseled at my job as financial officer at Tarrant County Community College. I implemented it as a requirement for students struggling and at risk of losing their aid to get them back on track. It’s been a great success.” Although Tarrant County Community College is a Blue Zones Project campus,  this was McMullen’s own initiative. He thought the purpose workshop was a powerful tool to use to make a different in his student’s lives.

Photo by David McLain

One of McMullen’s students, Adriana Castro Romero (pictured above), says: “The purpose workshop helped me find the kind of person I am and the skills I contain that can be useful for my life.”

Purpose is not a frivolous pursuit. A strong individual sense of purpose boosts your community and enriches your own life.  In the blue zones, this concept of purpose, this idea of “why I wake up in the morning” is an integral part of their culture. Okinawans call it ikigai and Nicoyans call it plan de vida.

Knowing why you wake up in the morning makes you healthier and happier, and research shows it can add up to seven years of extra life expectancy.—Dan Buettner

It is community groups, purpose workshops, volunteer opportunities, and other socially centered interventions that sets Blue Zones Project work apart from other wellness programs (mostly diet and exercise). Getting people moving and getting people eating better is important, as are non-smoking initiatives and walkable and bikable streets, but getting people happier, more engaged at work, in school, and in their community makes it easier for them eat better and move more too.

Workplace Innovations at Work: Reducing Healthcare Costs and Empowering Employees

Employers choose from a menu of Blue Zones changes and strategies to implement at their companies; it’s not a one-size-fits-all solution. What works at one employer may not work at another and what works at a large corporation might not work at a small start-up. When leaders put Blue Zones principles into action, they can move the needle on health and healthcare costs in a meaningful way.

Dallas Fort Worth Airport (DFW) is one of the largest employers in Fort Worth with over 2,000 employees. Linda Valdez Thompson, their Executive Vice President of Administration, Dr. Ollie Malone, Vice President of Human Resources, and other company directors have embraced Blue Zones initiatives and integrated them into their already robust wellness incentive programs. They had already invested in state of the art fitness facilities and an employee reimbursement to improve the health of their employees.

Of all the Blue Zones Project activities, Alex Rivera, a Health and Wellness Coordinator at the airport, is most excited to speak about how much of an impact the purpose workshops have on the employees he sees.

“The purpose workshops, which we do monthly, have had a big impact. There are so many people here, and we are all so busy. As we share tears and share stories, it gives us a deeper connection to each other than we’ve ever had before. I can have more personal conversations with the people I see.”

The airport has also integrated the Blue Zones Personal Pledge into their onboarding process. Along with other health and fitness activities and the purpose workshops, taking the Blue Zones Pledge counts towards their wellness incentive program. Each “apple” equals one paid vacation day up to 4 apples, and the Blue Zones Pledge or purpose workshops counts as one apple each. About 85% of DFW employees have signed the Blue Zones pledge. Along with these integrations, DFW now also allows volunteer hours to count as “apples,” they allow families to also use employee fitness centers during hours, they’ve changed over to healthier vending machines, and they have a weekly on-campus farmer’s market for employees (where vendors bring their goods to the airport).

These high-touch integrations have paid off in this large company. In August and September of 2018, employees received the good news that their health costs were so low, the company was covering their premiums for two months. For a family, this can equal a savings in the thousands.

Meet Doug Rogers, a DFW Airport employee who lost  75 pounds in 9 months, improved his autoimmune condition, and reversed his high cholesterol and type 2 diabetes by participating in Blue Zones Project.

People: Individuals Reversing Prediabetes and Chronic Conditions

Although many smart leaders sign onto Blue Zones Project to save money with lowered premiums and more productive employees, the changes radiate outwards from the workplace. Tim Paul, the facilities superintendent at Richardson Aviation, was tasked with implementing Blue Zones Project at work. It was part of his to do list that he faithfully executed: he removed soda and unhealthy vending machines, ordered cases of water, organized the cooking demonstrations, and started the company container “salsa garden.”

But when he was diagnosed with prediabetes and high cholesterol and his doctor wanted to put him on meds, he started to implement Blue Zones principles into his own life as well. He started to eat more veggies, beans, and fruit, cut back on meat, and walk more. Between the walking he does at work between hangars and the increased evening walks he does with his dog, Tim now walks over six miles a day.

Tim brought Blue Zones principles home, and not just to his kitchen or his medicine cabinet. Part of Blue Zones Project work is connecting people and tackling the very modern affliction of loneliness. His fiancee was part of an informal weekly women’s group called LEGS (Ladies’ Evening Golf). He started his own version and dubbed it ARMS (Almost Retired Men). Once a week, LEGS and ARMS play 9 holes of golf separately and then come together to do a group dinner.

He also started volunteering at his church and weekly with First Tee, an organization that teaches golf to underprivileged children. Since beginning his Blue Zones journey, Tim has lost weight, reversed his prediabetes, and has avoided going on prescription meds. But it’s the social engagement and life spark that he loves to talk about most:

“Volunteering has given me the sense of community that I never had and has brought new people into my life. Everything is a gift and life is a lot more fun if you share gifts with others.”

Mother Parker’s tea and coffee, Canada’s top private-brand coffee supplier, has a a $25 million roasting and distribution facility in Fort Worth. It’s a Blue Zones Certified company that has seen positive changes: More than half their employees have taken the Blue Zones Project Personal Pledge and their employee medical and pharmacy claims have dropped from 2017 to 2018. The company added healthier choices to their menus, now encourage walking or standing meetings and stretching before shifts, created a new downshift room for employees to take stress breaks, added a new laundry service for uniforms to lighten the employee load, added Blue Zones parking spaces furthest from the entrance, created an outdoor pavilion for coworkers to eat and connect, and added Blue Zones education, research, and recommendations to their company culture and signage.

Michael Edwards (above), a Mother Parkers employee and former Division 1 college basketball player, turned his health around as a result of the program:

“One day I went to the doctor, and after some tests he prescribed me a statin and diuretic for my high blood pressure and my high cholesterol. I knew I didn’t want to go on meds, and I knew what I had to do. I went to work the next day and took the Blue Zones Pledge, and fully embraced the principles. I eat more plant-based meals and less meat—I even eat veggie burgers! I started running again and have improved so much that I have been able to avoid going on prescription meds. Even better, I stepped on the scale one day after just a few months and was surprised to see I’d easily lost 30 pounds. I feel great overall, and have more energy and am eating better.”

A stretch break before a shift at Mother Parkers Tea and Coffee.

At Texas Health Resources, the largest Blue Zones-certified employer and the lead sponsor of Blue Zones Project in Fort Worth, 7,500 have taken the Blue Zones Pledge and many have joined walking groups. Participating employees have lost weight and have created new connections at work.

Since 2013, over 130 employers, from small start-ups to huge multinational corporations, have joined the Blue Zones Project effort in Fort Worth. The city of Fort Worth itself is a Blue Zones certified worksite, as is the Fort Worth Chamber of Commerce. The changes have directly impacted 78,000 members of the Fort Worth workforce.

These employers have implemented policies that improve well-being, such as overhauling cafeteria menus to include healthy meals, changing vending machine offerings, creating well-being reimbursement programs, supporting walking or standing meetings, designating a quiet place for workers to downshift, adding lactation policies, and encouraging frequent micro-breaks for employees to stretch and move.

According to a Quantum Workplace report, employees are 14 percent more engaged when given time off to recharge, 18 percent more engaged when given time for healthy activities, and 10 percent more engaged when given healthy food options.

Adults spend the majority of their waking hours at work, so healthier environments make a big difference to the population as a whole.

You Are Where You Eat

Fort Worth goes by many names, and “Cowtown” is one of its affectionate nicknames for both their cattle industry and their love of beef. So some locals were highly skeptical of the ability for the city’s restaurant industry to get behind Blue Zones Project, but the program has taken off in the growing city’s fast-growing food scene. Again, applying Blue Zones principles is not a one-size-fits-all approach: restaurateurs creatively apply and use the project guidelines, whether it’s by adding new healthy entrees (beyond salads), offering half-size and smaller portions, adding different side dish options, or expanding their use of local produce.

Taco Heads, a Blue Zones approved restaurant, started in 2010 as a bustling taco truck business. Since then, they have frequently made “Best Taco” and “Top 10” lists including Texas Monthly’s “Top 10 Tacos.” The restaurant’s open-air patio and margarita bar make it one of the hippest, prettiest taquerias in town. They were able to incorporate Blue Zones healthy menu options with ease and success: two Blue Zones menu items make up 20% of their overall sales, and their Blue Zones dessert (a pineapple cup with chili and lime) is their most popular dessert.

Blue Zones Approved meals at Taco Heads restaurant in Fort Worth.

It’s not just trendy spots or ethnic eateries that are part of Blue Zones Project. Even the old guard is able to incorporate Blue Zones principles and healthier options. Buffalo West looks like the picture-perfect Texas steakhouse, with dark wood, expansive dining rooms, a big bar, and live bands. It feels like an upscale hunting lodge with a truly Texan ambiance. Without much bother to their kitchen, they were able to improve their business and expand their clientele with some Blue Zones changes.

Chris Pikarski, Buffalo West’s managing partner, said he was skeptical when Clay Sexauer, restaurant coordinator for Blue Zones Project, approached him about taking part in Blue Zones Project. But he was quickly impressed by the data and Sexauer’s menu suggestions. “The new healthy entrees (veggie tacos, veggie sandwich, and portobello entree) and sides are made of things we already use and buy.” When he realized the kitchen didn’t have to do a heavy lift or overhaul of their shopping and buying practices, he decided it was at least worth a try. He took the conversation to his partner and owner Paul McKinney. McKinney (pictured below) responded to the smart business proposition of giving diners more options:

“Chris showed me the data about how other restaurants were doing well, and even sometimes better, with Blue Zones Project menu additions. He also convinced me it was worth a try when he said that groups could easily be swayed to go somewhere else if they had a vegetarian or health-conscious eater in their party,” McKinney recalls.

Both partners express pleasure about how easy adding the menu items were, and also about how it’s expanded their business. Their expansive salad bar is now 70% of their lunch business, drawing a new crowd that isn’t interested in a meat-heavy meal in the middle of the day, and they’ve expanded to now offer a “salad bar” catering option with a build-your-own-bowl type of menu. McKinney said bemusedly, “Some months it’s more popular than our regular catering menu for catered business meals or people having picnics.”

Overall, Buffalo West’s revenues have increased every year since participating, and their average price per person has increased as well. Their orders of french fries as side dishes and soda sales have dropped almost 60%, but customers are making up for it with healthier side dish options like sweet potatoes and drinking water and iced tea instead.

Right now, there are 66 restaurants participating in Blue Zones Project, from small mom and pop stops to fast casual eateries to fine-dining establishments. This also includes dining halls and facilities within school campuses and companies that operate as restaurants. Cafes and corporate restaurants at other Blue Zones worksites such as Bell Helicopter and Lockheed Martin serve more than 10,000 people per day.

Market Square, the main dining facility at TCU, a private Fort Worth University with more than 10,000 undergraduate students, is the busiest Blue Zones approved restaurant in Fort Worth. It’s also Fort Worth’s highest volume restaurant, serving an average of 5,000 meals per day over breakfast, lunch, and dinner. Since the launch of Blue Zones Project in the cafe, the restaurant has seen the consumption of hamburgers and French fries go down by about 65%, despite serving the same number of overall meals. While they used to serve 75 cases of hamburgers per week, they are now down to approximately 25 per week because of lower demand. This decrease equates to approximately 66,000 fewer hamburgers consumed over the school year.

You Are Where You Shop

Grocery stores, where people buy their food, hold a lot of influence on what people choose to eat. Food companies have known and used this for years, but health-promoting businesses have only recently started targeting food retailers as an untapped resource for healthy eating. Blue Zones Project local team works with neighborhood and larger grocery chains in all their communities to show them that promoting health can be good business.

Albertson’s-Tom’s Thumb, the largest grocery chain in the region, partnered with Blue Zones Project in 2016. All of their 14 Fort Worth locations were Blue Zones Approved by May of 2016. They installed Blue Zones checkout lanes in all of their local stores, call out healthy choices throughout the store, provide shopping lists with Blue Zones items, and added other interventions that nudge customers towards healthy options. With Blue Zones recipe printouts available in the produce section,  they also provide some education at the point of purchase.

Just like in restaurants, retail education and improvements influence thousands of Fort Worth residents everyday.

“Parents love going to the Blue Zones checkout line because they don’t have to worry about their kids asking for candy.”—Matt Dufrene, Vice President of Blue Zones Project, Fort Worth

A Critical Mass of People, Programs, and Policy

Along with the interventions, policy work, and improvements summarized here, there are hundreds of other improvements and changes being implemented to improve health and well-being in Fort Worth. A critical mass of great people, programs, and strategic improvements have put Fort Worth on the map. After just four years, the city has jumped from the bottom of the list to the top half of all cities. It’s a meteoric rise by any measure.

At the end of the day, it is people that are helping make Fort Worth a better place to live, work, and play. There are over 1,000 volunteers at work with Blue Zones Project Fort Worth. By encouraging people at the grassroots level and getting them involved, whole communities and neighborhoods got involved in Blue Zones Project events or initiatives—whether it was starting walking groups that meet weekly, starting healthy potlucks, or getting together to form community associations to better their neighborhoods. Almost 90,000 individuals personally took the Blue Zones Pledge or participated in a key activity like a walking group, purpose workshop, or a cooking demonstration, but hundreds of thousands more people benefit from Blue Zones Project improvements across the city every day.

People in Fort Worth have fierce pride, and they came with the energy and the drive to help their community. Their frontier spirit—of adventure and innovation—is still intact in the city’s leadership and in the general population.

Fort Worth is doing well and getting better every day. The city’s story, we think, is just beginning.

By Naomi Imatome-Yun, Editor-in-chief

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