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Center for a Livable Future


October 2010

Manuel Franco

Department of Epidemiology

Manuel FrancoManuel Franco, MD, PhD, an adjunct faculty member in the department of epidemiology at the Johns Hopkins Bloomberg School of Public Health, studies cardiovascular disease risk factors and collaborates with Center for a Livable future on its assessments of Baltimore's food environment.

Although Franco is still actively engaged in work with JHSPH colleagues, he is now based in Madrid, Spain at the National Cardiovascular Research Center, where he is involved in heart disease prevention efforts and a school-based nutrition intervention.

"In the last two years in Spain, there has been a lot of research on childhood obesity-and now there are national recommendations for school lunch menus," he said.  "What we will develop now is a whole curriculum for children aged three to five to try to intervene on cardiovascular risk."

The program, which will eventually be expanded to students up to age 16, will also include education on physical activity, alcohol and tobacco abuse as well as consumerism and social responsibility.

"From the point of view of cardiologists, we want to intervene very early to try to build healthy habits," Franco said. "The interesting part is that this project takes a holistic point of view, not just controlling hypertension, but addressing addictions and social factors."

Back in Baltimore, Franco and the center staff is completing an expansion of a local food environment assessment that was the basis of Franco's doctoral thesis.

Franco's thesis rated healthy food availability in census tracts in Baltimore, and compared that to health outcomes from the Multiethnic Study of Atherosclerosis (MESA study) a NIH-funded cardiovascular cohort study.

"I thought this was very interesting because it addresses how social determinants relate to individual health," he said.  "We were able to focus on the food environment, and how it relates to the quality of the diet of people living in those neighborhoods. It's quite complex and fascinating-and we were able to prove quantitatively that health and cardiovascular risk depends on where you live and the availability of healthy foods."

The Baltimore City Health Department and Center for a Livable Future, as well as local urban planners and community organizations, have been engaged in assessing the entire city's food environment.  A report is expected to be published in Fall 2010.

"The policy makers in the city health department were very eager for us to explain what we did and do something about it," he said. "This is very interesting from the point of view of health policy because it presents an option to intervene in a neighborhood characteristic that has been shown to directly affect the quality of diet of the residents.   It points out one policy change that is pretty amenable for health policy makers."