Activate Jacksonville Kickoff Event Q&A


Q: In the age of COVID-19, do virtual “gatherings” or phone calls have some of the same health benefits as meeting in person? Do you believe the inability for people to gather at this time will impact life expectancy going forward?

  • A: Phone calls and virtual meetings and events have some of the same health benefits as meeting in person since they connect people and combat loneliness. But outside this pandemic, we do believe face-to-face gatherings and regular in-person meetings are optimal for health, or a mix of both digital and live.


Q: How does Blue Zones work when there are different cultures living in the same community?

  • A: We work in many regions and cities with great diversity. We have a statewide project in Hawaii, which is a majority-minority state, are working in Monterey County where the Hispanic population is the largest demographic group, and have been working in Fort Worth since 2014, which is a diverse metropolitan area.


Q: Crime is an issue in many of our neighborhoods, which keeps people in their homes and away from their neighbors. How does the Blue Zones approach overcome this?

  • A: We always take a multidisciplinary and community-led approach and we create conversational spaces with, and intently listen to, communities to ensure we understand the full picture before presenting a suite of tools. For our approach: Blue Zones applies the principles of traditional town form, helping retrofit communities of all size and scale, putting “eyes on the street” for natural surveillance, helping populate the streets with more walking, bicycling, a better mix of diverse housing, homes and buildings built to the street, and street designs that slow traffic and help create place. Our Blue Zones people and place first approach is proving to measurably reduce crime, while bringing back health and community pride and vitality. We also help people by making it safe and easy to take solo walks or with others, helping individuals get to know more people, relate to streets, parks and open space, have more friends, and to “own” their neighborhood.
    Stop Six Neighborhood Improvement Strategy | City of Fort Worth, Texas


Q: Some families are privileged to always have fresh fruits & vegetables on their table to eat. How can families in Jacksonville do that when they live in food deserts?


Q: What’s the ideal population size and geography to be the most effective? What was the geographic footprint and population size of the Blue Zones communities? Is it possible to work in one neighborhood vs a whole city?

  • A: Our population sizes vary from small rural communities to large metropolitan areas. Sometimes we do start in a smaller central region and expand to a wider region.


Q: Many of us strive for an alcohol free life, believing that it is healthier and will aid us in a longer life. Is there something special about the wine that they drink?

  • A: There is evidence that the red wine they drank in blue zones regions had a higher amount of antioxidants. “Wine at 5” is part of the Power 9, the lifestyle characteristics of blue zones centenarians. However, part of this practice is related to people leaving work at a reasonable hour and socializing and sharing quality time together over food and drink. If Wine at 5 does not align with your personal beliefs and principles or family history, then we don’t recommend it.


Q: Is this project only for Jacksonville? What if I live in Nassau County?

  • A: The assessment will be focused on Duval County because it is the population center for Northeast Florida and because it has the worst health indicators of all the Northeast Florida counties. We do expect that lessons/recommendations in Duval will have applicability in Nassau and other Northeast Florida counties. Happy to discuss further.


Q: I’m curious about feasibility. What barriers have you discovered that need to be removed in order for Blue Zones to be effective?

  • A: One of the most important aspects of measurement is how engaged the local community is — including elected officials, residents, community organizations, sponsors, and participating organizations. Blue Zones doesn’t swoop into a community and change it; the work is community-led and in partnership with us, so we need strong and motivated champions in the community that can get other people and organizations to convene and break down silos to unite around this common purpose.


Q: Have you gone back to those communities 5 years after your last study to see where they are? Are they able to sustain improvements?


Q: Do the hospitals see a reduction in emergency use and a decline in in-patient procedures/stays?

  • A: Communities define their own priorities, and improving overall well-being is usually one of the most important. Fort Worth has had a dramatic increase in overall well-being, which has a direct impact on hospital utilization: “Since the launch of Blue Zones Project in Fort Worth, the health and well-being of residents has surged while the U.S. overall health score has dropped. According to the annual Gallup-Sharecare Well-Being Index®, Fort Worth’s overall 2018 Well-Being Index score rose to 62.5, a gain of nearly four points since 2014, when the city began working with Blue Zones Project®.
    Each point increase in well-being for a population leads to approximately a two percent reduction in ER visits and hospital utilization, and to approximately a one percent reduction in total health care costs.


Q: How have these cities wrestled with the underlying structures of oppression that have contributed to inequitable outcomes among communities of color?

  • A: Addressing health at a systems level means acknowledging and identifying the legacy of systems and structures of racism and poverty that may have been created decades ago but still segregate entire neighborhoods and communities, limiting access to resources and opportunities to live healthy, happier lives. We believe that communities can address these glaring gaps through informed and directed policy reform coupled with community-led engagement practices. In Fort Worth, neighborhoods and sectors of the city whose citizens showed the highest well-being disparities, in 2014, now show the greatest gains in well-being. This significant community achievement comes at a time when many cities in the U.S. are experiencing widening gaps in health.


Q: What are some of the ways the program addresses implementing engagement with faith communities?

  • A: We will meet with faith leaders in your community – individually and in groups as appropriate. Our experts will glean insights from these leaders as the best way to get engagement from the various faith communities in your area.


Q: What is the target age and/or demographic?

  • A: Blue Zones strives to improve the places and spaces we spend the most time so healthy choices are easiest for all people, all ages, all communities.


Q: In Fort Worth, were the interventions focused in certain areas of the city or the entire city—it’s very large and just wanting to understand how you prioritize what happens where?

  • A: There were about seven implementation strategies in Fort Worth, one for each distinct community. All communities experienced improvement in health and wellbeing.
    Blue Zones Project — Fort Worth


Q: What is the diversity of the Blue Zones team?

  • A: We’re committed to and working on building greater diversity on the Blue Zones team. When we launch a full Blue Zones Project, we hire full-time employees all from the local community, anywhere from 5 to 50 people depending on the size of the city.


Q: How can the average citizen advocate for the implementations of Blue Zones here in Jax? I am hearing the vital buy ins are legislators, policy creators, and the health community, but how can everyone else help?

  • A: There are opportunities for all to learn more about the assessment on the Blue Zones Jacksonville website. If we move to implementation, there will be opportunities for all Jacksonville citizens to participate.


Q: Duval County/Jacksonville is a geographically large area with 4 district areas of north, south, east and west-sides. What experience, insight, and strategies can you share with the size of our county? 

  • A: We do have experience in large widespread metropolitan areas. Fort Worth is a great example. While we learn from each community, we’re also aware that each community is unique – with unique strengths and opportunities.


Q: Are plant-based meat substitutes ok for Blue Zones? Are they a suitable and effective substitute for real meat?

  • A: We recommend that you don’t eat a lot of processed foods, and sometimes meat substitutes are highly processed. However, tofu is a staple Blue Zones food. Beans and legumes are the cornerstone of the Blue Zones diet.


Q: In the “post-COVID” society with so much fragility in terms of economic stability and a focus on the bare necessities, will you all have to adjust your approach?

  • A: Yes. We’ve made adjustments and we’ll leverage what we learn through our assessment process to make the appropriate adjustments in our approach in a post-COVID world. In addition, we know the systems and policy changes that are foundational to the Blue Zones approach will make communities more resilient and equitable in the long run. Although this has always been our approach, now more people understand that their health and well-being is dependent on the health of their neighborhoods and greater community.


Q: What is the next step to start the process? Is there a timeline to follow?

  • A: Blue Zones experts will be talking with Jacksonville citizens and leaders about food systems, alcohol, tobacco, health equity, built environment, neighborhoods, workplaces, schools, and civic and faith organizations. They will report their assessment and recommendations during a community event like this one on May 11. All attendees will be invited to join the community report.


Q: When it comes to policy change, will the assessment include examining challenges to the Blue Zones process that our consolidated form of government may present?

  • A: Yes, part of the assessment is understanding any political complexities and realities that may be a barrier to improving public policies.


Q: How can an individual participate in the assessment, focus groups, and perhaps become an advocate for this program?


Q: Greater Jacksonville has many “communities” that are distinct and different from each other—Fernandina, Riverside, Southside, Mayport, etc. Would the implementation tie to mini-communities near Baptist Hospital facilities, or other sites?

  • A: The Blue Zones assessment is for the totality of Duval County. We selected Duval County because it is the population center for Northeast Florida and has the worst health outcomes including life expectancy. We do anticipate that some recommendations will apply to other Northeast Florida counties. The assessment will review the unique needs of each distinct Jacksonville community. Ft. Worth is similar, and the project implemented actually included distinct strategies for each different neighborhood.


Q: To add to the 4 sections of Duval, we have our Duval County Beaches. We are comparable to 5 cities closer to 200,000 each in population!

  • A: Beaches communities in Jacksonville are included in the assessment.


Q: Making the healthy choice, the easy choice comes with aggressive advocacy & policy efforts (i.e., vending machine, kids meal/restaurant menus, school breakfast & lunch, school wellness policy, active transportation, decreasing sugary drink consumption, etc.), pushing county and state government, school districts, and more. Will the feasibility study include readiness of our community to push policy efforts along with recommendations on where we start?

  • A: Yes, the assessment looks at readiness and feasibility. Blue Zones success is dependent on the whole community coming together around a common initiative to break down the silos that currently exist so that everyone is working together to improve health and well-being. We look for strong committed leadership across all geographic areas and sectors (including the school district), existing communications infrastructure, community alignment, and demonstration of coalition and collaboration.


Q: Jacksonville is far from a pedestrian-friendly city, with the sixth highest rate of death for pedestrians nationally. How does suburban sprawl with limited “walkability” affect the feasibility of this program?

  • A: Our Built Environment team has worked in hundreds of sprawling and auto-centric American communities for exactly these reasons. Depending on the opportunities, landscape, and existing infrastructure, they can work with local partners to update zoning and building codes to encourage mixed-use development and adopt form-based codes for neighborhoods. They have also worked with communities with downtown and main street revitalization, improving bicycle and trail infrastructure, expanding public transit, increasing density along transit corridors, and retrofitting strip malls and malls as walkable, mixed-use destinations.


Q: Have you done preliminary health assessments of Jacksonville and are any of those assessments available?

  • A: Every three years the local health systems conduct a Community Health Needs Assessment. The next one begins this month. You can find previous reports on any health system website.


Q: We really think of Jacksonville as including some of other counties as people live and work in different counties. Is there any consideration of looking at some other NEFL counties?

  • A: We do anticipate that several of the recommendations for schools and workplaces will translate to other Northeast Florida counties.


Q: Working directly with the homeless community on a clinic basis and in a food service capacity and strictly donation based, how do you see Blue Zones being effective for this uninsured, poverty level population?

  • A: Both our food systems and health equity experts have experience expanding SNAP and WIC programs and acceptance, as well as working with homeless populations and expanding food bank and meal delivery to seniors and other high-risk populations.


Q: I know about the Naples, FL success. What’s the status of other Florida communities where you’ve completed assessments like Pensacola and Orlando? Are any other Florida cities in flight?

  • A: We are still in discussion with these communities but haven’t launched projects in either Orlando or Pensacola at this time.


Q: What/who are the roadblocks we should be considering now?

  • A: We’ll gain a better understanding of the potential barriers to success as we complete our assessment. All of this will be factored into our Blueprint that will be provided to the community at the end of our process.


Q: Can the Blue Zones work help our community’s response to future health pandemics?