Community-based Produce Prescription Programs Encourage Healthy Eating
New community-based programs integrate produce prescriptions into healthcare practice to encourage healthier lifestyles.
There are many barriers to healthy eating, including food insecurity stemming from lack of access to healthy foods, financial costs, and other socioeconomic forces, that contribute to diet-related diseases.
In an effort to drive systemic change in the fight against food insecurity, the federal government has invested $59.4 million to support the Gus Schumacher Nutrition Incentive Program’s (GusNIP) Produce Prescription and Nutrition Incentive programs to encourage healthy eating at a national level by increasing access to fresh fruits and vegetables. A Produce Prescription (PRx) Program is a medical treatment or preventative service for eligible patients due to diet-related health risks or conditions, food insecurity, or other documented challenges in access to nutritious foods, and are referred by a healthcare provider or health insurance plan.
“Food insecurity is persistent in low-income communities, and presents a major barrier to the health and well-being of families and individuals in Western Massachusetts,” notes Lorraine Cordeiro, professor of nutrition and director for the Center for Research on Families (CRF) at UMass Amherst. “Produce Prescription Programs are a really innovative way to engage hospitals, clinics, and health centers with local farmers and other entities in the food supply chain to improve food access and promote healthy eating.”
Cordeiro serves as the principal investigator for the Springfield Prescription Produce Collaborative, an academic-community research team that recently received a three-year, $500,000 United States Department of Agriculture (USDA) grant to improve access to fruits and vegetables among Springfield residents. The Wellspring Cooperative Corporation, a Springfield-based organization that runs the Go Fresh Mobile Market, serves as the lead agency for the project. Supporting partners include Baystate Health and its three community health centers– Brightwood Health Center, Mason Square Health Center, High Street Adult Medical Center– and the UMass Center for Research on Families. Nutrition alumna Bi-sek Hsiao ’22PhD, a CRF research fellow, serves as the project coordinator, with Dr. Elizabeth Eagleson of the UMass Chan Medical School serving in the instrumental role as the project’s clinical lead.
“As a primary care physician, I spend most of my time helping patients manage chronic illnesses,” says Eagleson, a practicing physician at Brightwood Health Center. "I call myself a healthcare provider, but most of the time I am a sick care provider. Health care happens when our neighbors have the resources to lead active and healthy lives. Addressing food insecurity with projects like the Springfield Prescription Produce Collaborative has the power to improve health outcomes, and help people meet their goals for physical and mental health.”
In nearby Holyoke, MA, Nuestras Raíces (Our Roots, in English), an urban agriculture organization that has a five-acre farm in Holyoke, MA, received a similar $500,000 USDA Produce Prescription Program grant to implement Nuestros Productos ("Our Produce"). The program aims to improve food and nutrition security, vegetable consumption, and cardiometabolic health among Latinx pre-diabetic and diabetic MassHealth and Medicare accountable care organization (ACO) patients, primarily living in Holyoke.
“Diabetes disproportionately harms Latinx, low-income, and food insecure communities - Holyoke is all three,” notes Airín D. Martínez, an assistant professor in the Department of Health Promotion and Policy.
Martínez and Nutrition faculty member Megan Patton-López lead the Nuestros Productos research and evaluation team. Additional project partners include the Holyoke Health Center and the Community Care Cooperative (C3). The researchers are charged with establishing evaluation metrics and assessing the impact of produce prescriptions on vegetable consumption, individual and household food security, subjective and objective (from patient EHR) health, and healthcare use and costs from C3.
The produce prescriptions will be provided biweekly for four months, across two years. The produce prescription boxes will include many culturally relevant vegetables from Nuestras Raíces and other local farms, such as diverse squashes, ajíes dulces, recao, and cilantro.
“Our expectation is that by improving access to produce and food security that we can improve cardiometabolic health (e.g., BMI, blood pressure, fasting glucose, hemoglobin A1C, and lipids) and reduce healthcare utilization and costs by improving weight and diabetes management,” notes Martinez. “If this intervention proves to be successful in improving these community and/or individual-level health outcomes, the state may sustain the intervention by using ACO Flexible Spending dollars to subsidize produce prescriptions in the future.”
In Springfield, the academic-community research team aims to improve metabolic disease health outcomes, food insecurity, and lifestyle choices for low-income patients through an integrated produce prescription intervention that engages patients with a mobile produce market, nutrition counseling, and cooking classes. Participants will receive “prescriptions” to receive fresh fruits and vegetables from primary care providers at collaborating health centers. They will then pick up $40-$80 worth of produce/month from the Go Fresh Mobile Market operating sites around Springfield and receive recipes and other nutritional information.
Cordeiro notes that the Springfield Collaborative believes that better nutrition and reduced food insecurity will result in measurable health improvements over time, and a long-term investment in prevention will reduce health costs and improve the quality of life of participants.
“Produce Prescription Programs such as this are part of the ‘food as medicine’ movement,” says Cordeiro. “These initiatives recognize the health benefits of fruits and vegetables and the potential for people to better manage diet-related chronic diseases with greater access to healthful foods and the support of the healthcare system.”