5 Questions for Rose Gowen, M.D.

Rose Gowen is a woman with a purpose. After learning that one in three residents of her Brownsville, Texas, hometown is diabetic, the physician made it her mission to get the small city with a big obesity problem walking more, bicycling more and eating better food.

As a result, Gowen — who is an obstetrician/gynecologist and, since 2009, a Brownsville city commissioner — has been at the forefront of transforming the poor border city (population: 181,860) by developing a network of bike trails, and establishing regular farmers’ markets and a monthly “CycloBia” during which more than 10,000 people of all ages take to the streets on bicycles.

A tireless advocate for smart growth, quality of life projects and public health, Gowen, was instrumental in Brownsville’s decision to become a member of the AARP Network of Age-Friendly Communities this past January. The city's efforts have resulted in recognition this year by the National Civil League and the Robert Wood Johnson Foundation. (See the boxes below.)

1. How have you and other Brownsville leaders been able to pursue the community to pursue a healthier lifestyle?

At the time, I was a private practitioner who did not regularly vote, so I can’t really say I was in the trenches with policy makers at all. But I got involved in an initiative at the University of Texas School of Public Health here in Brownsville to create a farmers market that would be accessible and affordable to people of all incomes and ages.

For that initiative I was usually the person who spoke to the city government about permits and that type of thing, so I learned a bit about how policy is made and how funds are allotted. That led me to become interested in getting involved in a political sense because I realized that if designing and opening a farmers market, which should be a simple, very good thing for the community, was so hard and had so much red tape around it, that I needed to have a stronger voice. Otherwise, the voice of wellness was not going to be heard.

Back then the relationship between wellness or age-friendly communities and the economy was not not understood by policy makers. Translating the health data into its economic implications is what began to get folks listening.

2. Do you remember there being a light bulb moment when you were talking to people and you realized they had got it, at last?

Well, I remember very clearly that as we went from initiative to initiative — we started with farmers’ markets, then we went on to the Challenge, which is a five-month springtime event for engaging the community in healthy living, and then the CycloBia — there were fewer and fewer people who stood up and said “No.”

The rewarding a-ha moment was when that scale tipped and instead of having to make a case and argue for a particular initiative, we received a more enthusiastic welcome. “Oh, you have another initiative. OK, what’s it about? How can we get involved?”

We hope and expect to see economic vibrancy and prosperity grow as we create the changes that make the community more livable. We’re already seeing that many of our downtown restaurateurs and retail owners love when we host these events because they see increased revenue during those times. We’ve had several restaurateurs say they’ve been able to pay two months of taxes after only one event that brought people in on foot or by bike.

3. What is and isn't age-friendly about Brownsville?

Brownsville is a community that is very rich in its culture. The tapestry of Mexican and American cultures merging is vibrant, and families often take care of and house their older relatives. Brownsville is a very nurturing environment, and I think that’s at the very essence of being an age-friendly community.

We’ve made a lot of progress in the last few years in integrating seamless transportation between mass transit and our Brownsville Metro system, our bike lanes and our sidewalks. We now have sidewalk ordinances for retail, commercial and neighborhood development, which was not the case a few years back. We have a master bike-and-hike plan so folks can get around the city without having to depend on cars. Since the master bike plan integrates or intersects with our B-metro routes, an older person in Brownsville doesn’t have to always drive a car, doesn’t have to afford a car, and can go from point A to point B across town in a comfortable, safe environment.

I do think we still need to work on our parks system and integrate our parks with the master bike-and-hike trail program. We still have neighborhoods that don’t have green space in them. We tend to have larger parks in different parts of the city but not the smaller, more intimate neighborhood parks that, perhaps, a grandparent or a senior citizen would be able to walk to in the afternoon. We need help in those areas. We also need to continue revitalizing our downtown space. There are many neighborhoods that are within walking distance of downtown, and the downtown itself needs help improving its walkability.

4. What changes and benefits will Brownsville residents notice as the community becomes more age-friendly?

I think Brownsville citizens will be happy about the inclusiveness. We’re trying to create a community that’s accommodating and safe for everyone from the age of 8 to 80 years old.

I think residents will listen more clearly as we go forward with the rest of the initiatives we need to begin, and I hope they’ll understand that if they get on board they can be a part of sustaining the changes that we create. Perhaps the first thing they’ll notice is increased opportunities for public transportation and walking and that they can enjoy moving about the city without restrictions and without fear of being harmed or injured.

5. You began all this work because of your concern about Brownsville’s diabetes rate. Please explain the link between livable communities and public health?

Livable communities are communities that people want to be in. I challenge anyone to tell me what city in the U.S. — or the world — is vibrant and livable yet filled with a lot of sick people.

One in 10 people in the U.S. are diabetic. In Brownsville, one in three people are diabetic and 50 percent of them don't yet know they're diabetic. Our numbers are of epidemic proportion.

An estimated 80 percent of our people are either obese or overweight, and that breaks down to about 52 percent obese with the rest being overweight, which basically means we are the heaviest Hispanic population in the nation. These findings are very frightening when you think of children and grandparents living and growing in a community with these health risks.

On top of that, 70 percent of our people don’t have access to health care, or they don’t have health insurance of any kind. So when you couple those things together with the fact that we’re also the poorest community in the nation, you really have a perfect storm.

The research that was done, and is still going on at the University of Texas School of Public Health, has given us data and statistics that are very sad, but they’re also a driving force for us to continue to make these changes.

Our diabetes and obesity numbers aren’t going to go down unless we engage our population, unless we provide an atmosphere for the people to make healthy choices the easy choices as they grow older. Unless we’re able to provide families with the tools they need to raise their children and be positive role models for healthy eating and active living, a community will not be a livable community in the richest sense of the word.

What has been very rewarding, and that we’re very proud of, is what we’ve achieved despite the naysayers saying, “We don’t have any money.” It’s very easy to sit and say, “We’re the poorest community in the country so, oh my gosh, we can’t do anything.”

But the reality is you can do a lot with very little if you get the right partners together, and the right partners are not always the obvious partners. It’s those not obvious partners that can be very powerful because they bring pieces that you don’t normally think of. [See the box below.] We hope we’ve provided a road map to other poor communities.”

Natalie Turner is a senior policy advisor for AARP International. Additional reporting was provided by Veronica de Lafuente, AARP Texas, Rio Grande Valley, associate state director for advocacy and outreach.

^{Article published 2014}

Brownsville's Partners

Among the organizations helping in Brownsville’s improvement efforts:

• AARP Texas
• The Brownsville business community
• Brownsville Independent School District
• Brownsville Public Utilities Board
• Brownsville Community Improvement Corporation
• Greater Brownsville Improvement Corp.
• Port of Brownsville
• Walkable and Livable Communities Institute
• University of Texas Brownsville Department of Health and Human Services
• University of Texas School of Public Health (Brownsville Regional Campus) 

Here's how:

“Our public utilities board came onboard and produced a whole weekend of healthy food choices at one of our large grocery stores,” explains physician and city commissioner Rose Gowen. “The Port of Brownsville hosted a Fun Run 5K walk at the port. AARP brought in Dan Burden, a world-renowned walkability expert. We were able to have him interact one-on-one with our departments and city leaders, and then talk to the community. It was a whole weekend of education with insight into best practices, which is not something we’d have been able to do on our own. With partners it’s not just about collecting dollars, although that’s great, but it’s also about collecting the resources that others have available.”

Adds Art Rodriguez, Brownsville's director of public health: "It's an exciting time to be working with community partners to promote more active lifestyles and create a healthier Brownsville. We're thrilled to be a partner with AARP as we set out to make our city more accessible, livable and age-friendly for people of all needs and ages — from 8 to 80."