Model and Strategy
One in seven East Bay families are “food insecure,” meaning they rely on cheap and unhealthy food. Food insecurity is associated with poor health and life outcomes. Low-income neighborhoods have ample fast food sites, but often lack options for purchasing healthier food. Most children in these so-called food deserts develop a lifetime preference for cheap, processed, high-calorie foods, and are often paradoxically overweight despite being hungry.
Food as Medicine is a novel initiative in which pediatric providers have teamed up with urban farmers. The providers “prescribe” weekly deliveries of food boxes from the farmers, directly to family’s homes. The boxes have a variety of fresh, locally-grown produce and whole grains-- enough to last a family a week. The program covers the cost of food for the initial three months. Families also receive cooking videos and recipes that use the food they receive. For families that want to continue on their own after the initial three months, the food costs about a third of what it would from a mainstream retail grocery store, and the farmers accept EBT.
Impact
The theory of change is that exposure to doorstep delivery of healthy food (and recipe support for the cook in the family) ultimately increases children’s consumption of fruits, vegetables, and whole grains. First, it increases household availability of foods that are already familiar (e.g. carrots), and addresses barriers of access, such as having limited transportation or being in a food desert with no nearby supermarkets. However, it also impacts acceptance for specific, previously-unfamiliar foods (e.g. kale). Sometimes the children in the house are early adopters. But parents are important role models, and influencing how much a parent eats vegetables affects how much they are willing to purchase them. In other words, it sparks, ‘I now know that leafy greens will not go to waste if it comes into in my house.’
At a larger systems level, the exposure is not only to specific foods, but to home-delivered food as a phenomenon. Most of our participating families, have not ever heard about the concept of local produce from community farms, and few are aware that increasingly, farmers markets and urban farms accept EBT (‘food stamp’) benefits and offer produce at 50% reduced prices. Exposure to the phenomenon (and increased understanding about the price point) helps connect low-income families who need affordable food to sustain them with the local food systems, which in turn need customers to sustain them.
Leadership
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Barbara Staggers, MD, MPH
Executive Director, Center for Community Health and Engagement
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June Tester, MD, MPH
Program Director