I visited the Delridge neighborhood, one of Seattle food deserts, to investigate the extent of food access difficulties, and had the pleasure of interviewing several locals. The personal experiences of Malcom (not his real name) as a community pharmacist struck a chord with me.
“I’ve been helping my neighbors understand medical prescriptions for years, but I’ve now realized the actual value is teaching them about food as the ultimate remedy,” he says. We have a nutrition literacy barrier, and clients don’t know what meals can assist them manage their condition or keep them from getting sick. He goes on to say how his new commitment to his community includes educating and promoting nutritious foods to clients, as well as selling pharmaceutical drugs at a neighboring pharmacy store.
As Malcom describes his experience, I reflect and become more conscious of the shifts made by a few pharmaceuticals that are not only selling drugs, but devising new strategies to support healthy eating behaviors. I am excited to imagine private health institutions as a critical pillar, but not a panacea for improving access to healthier and affordable foods to those most in need.
I am optimistic in part because I see them as catalysts that can possibly reinvigorate the efforts by the federal and state governments to address the persistent issues of food access. Whilst this engagement offers enormous gains, tackling individual and social barriers rampant in low income and racially marginalized communities involves many and diverse players.
Do we need food prescriptions?
As more research emerges, humans are discovering the possibilities of adapting nutrition interventions as medical therapies. According to recent groundbreaking investigations, it’s now evident that individual responses to identical meals are highly variable and that universal dietary guidelines, such as those supported under women, infants, and children (WIC) and Supplemental Nutrition Assistance Programs (SNAP), may be of limited use. To keep abreast with new discoveries, several states are innovating on how clinical care is delivered, by combining drugs with medically tailored meals, food prescriptions, and/or food vouchers to meet their patients’ needs.
Emerging evidence on the use of food, as a medical prescription is certainly overwhelming. According to a Massachusetts research, people who received medically adjusted meals had 50% fewer inpatient hospital admissions than those who did not. Medically adjusted meals were also linked to a 13% reduction in hospital readmissions and a 24% reduction in medical costs.
According to the study by Project Angel Heart. Such projects and many other successful trials are a reason to celebrate, as we welcome knowledge on how to manage individuals living with chronic diseases, and get an opportunity to cut health care costs. Besides, this is only possible if medical care providers embrace diets to fulfill customized patient needs.
A spotlight on food prescriptions in United States
To say the least, Malcom’s perspective on improving health through prescription is not a novel one, as similar technologies have already been successfully explored in Michigan, Pennsylvania, California and many other states. Pharmaceutical companies and health-care providers in California and Pennsylvania have developed new techniques to unlock solutions that integrate medicines and dietary prescriptions in the management of their patients’ health. Some of their food pharmacies carry food supplies and fresh produce, as well as drugs to treat chronic ailments including diabetes, cardiovascular disease, and obesity, as prescribed by their doctors. Patients meet one-on-one with licensed dietitians who teach them how to cook healthy meals and provide recipes.
The solution in Pennsylvania is unique and admirable. It is a multi-sectoral and collaborative endeavor involving physicians, public health professionals, and the local food economy. Physicians in participating community clinics prescribe fresh produce to patients with chronic illnesses as part of the program.Farmers who fill these prescriptions are compensated through grants provided by hospitals, healthcare providers, and the local government.
In other situations, the search for holistic health solutions have necessitated a shift away from community-based providers towards larger health-care institutions. Kaiser Permanente, for example, has developed a new platform, dubbed as the food for life initiative whereby patients in several places, including Seattle, can receive medically designed meal delivery services for those with allergies or chronic diseases like cancer and diabetes.
Payers have also created insurance coverage plans that cover the cost of food for specific patient groups. Medicaid-waiver programs have been piloted in several states, including North Carolina and California. Some insurance companies and partnerships with organizations have covered food for people eligible for both Medicare and Medicaid, and Medicare Advantage. More recently, Jim McGovern, a congressman in Washington D.C., announced the introduction of a new bill that would create a pilot program to provide medically vulnerable seniors with nutritious meals and address links between diet and chronic illness.
What lessons can be replicated for Seattle?
Malcolm’s initiative is changing lives, one at a time. Jane, one of the beneficiaries, considers herself a lucky survivor after successfully completing the pharmacy’s prescription and training on managing celiac disease. For almost five years, she had also had to deal with pain in her bones and the crippling effects caused by the lack of Vitamin D and fiber in her diets. Malcolm’s advice has restored her warm smile, and her joyful strides are her biggest testimony as she makes a way to show us the wide range of nutrient-dense vegetable and gluten-free meals that is now her remedy. So, what happens to those who cannot reach or afford Malcolms service ?
A review from Gensworth Financial, Inc, helps us understand the urgency to act. In Seattle, assisted living costs ($6,700 per month) are twice as high as the national average ($4,500 per month) while in-home care costs are 30% higher than average national costs ($5,148/month). The high number of seniors living in Washington calls for judicious management of funds allocated to the states Medicaid programme,
Seattle’s administration could examine some of these alternatives. Partnerships with Seattle community colleges could look into ways to expand existing programs – such as fresh bucks and P-Patch community garden – through exploring options for connecting healthcare organizations to business opportunities, while maintaining patient health. Policy initiatives that ride on partnerships with health institutions, can help tailor curriculums for training the next generation of physicians, who in turn combine food and therapeutic prescription in patient care. Under the stewardship of the Human Services Department, these expansive opportunities offer Seattle residents a chance to reap from wider collaborations within traditional and non-traditional health actors!
Diana M. is a staff writer at the Seattle Collegian, where she focuses on writing simple articles and tricks that can help students or Seattle residents optimize their health. In the future, she hopes to serve on the frontlines of clinical care, innovating and inspiring others to improve the health and lives of marginalized populations across nations.
During her free time, she loves to engage veterans and survivors of war with art and music sessions that support healing, health, and mental wellbeing. She lives by the quote that “ There’s likely a place in paradise for people who tried hard, but what really matters is succeeding. If that requires you to change, then that’s your mission" -General Stanley McChrystal, U.S. Army Retired