STORIES FROM THE FIELD
Food-is-Medicine Program for Patients Experiencing Food Insecurity

Food-is-Medicine Program for Patients Experiencing Food Insecurity

Food bank serving urban and rural communities partners with local health systems to provide Food is Medicine interventions to patients with diet-related chronic conditions experiencing food insecurity.

Food Bank of the Rockies
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STORIES FROM THE FIELD
Food-is-Medicine Program for Patients Experiencing Food Insecurity

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The Problem

Food insecurity and diet-related chronic diseases, such as type II diabetes and heart disease, are inextricably linked, with individuals experiencing food insecurity facing higher rates of chronic disease.

In 2022, Intermountain Health and Lutheran Hospital, two health systems in Colorado, sought to increase access to healthy foods for patients experiencing food insecurity and managing chronic disease. To address this need, the health systems tapped into Colorado's existing food infrastructure, and partnered with Food Bank of the Rockies to co-design Food for Health, a Food is Medicine program aimed at supporting patients’ chronic disease management through the provision of healthy foods. With an extensive network of more than 700 Hunger Relief Partners across Colorado and Wyoming, Food Bank of the Rockies’ made for a natural partner to support both urban and rural patients’ healthcare through food.

The Intervention

Food Bank of the Rockies started Food for Health in October 2022 to support patients’ access to healthy foods. Patients are referred to Food for Health by their healthcare provider, inclusive of hospital systems, outpatient clinics and Federally Qualified Health Centers, if they screen positive for food insecurity and have a diet-related chronic condition such as prediabetes, type II diabetes, hypertension, or cardiovascular disease. Initially, Food for Health operated as a one-year produce delivery program supported by grant funding from partner healthcare agencies and Feeding America. Participant feedback heavily shaped the program’s evolution, with patients noting a desire for more fruits and vegetables and flexibility in selecting produce offerings.

In response, Food Bank of the Rockies has transitioned the program into a dual intervention, year-long program:

  • Six months of medically tailored groceries (MTG): Participants receive weekly food boxes with shelf-stable goods and fresh produce that are designed by a registered dietitian nutritionist (RDN). MTG deliveries are facilitated by partners in Food Bank of the Rockies’ network and third-party couriers.
  • Six months of produce prescription: Participants receive a card with $40 per month to use on fruits and vegetables at participating retailers. Food Bank of the Rockies currently provides produce prescription benefits on a digital card, and plans to offer a physical card in the future.

The Food for Health program aims to supplement participants' existing food resources with healthful items that support chronic disease management. Participants also receive nutrition education to support healthy behavior changes though educational fliers, recipes featuring ingredients included in their MTG items, and interactive text messages.

Food Bank of the Rockies works closely with referring healthcare partners to ensure smooth operations and timely execution of referrals. Clinical providers refer eligible patients to the Food Bank of the Rockies through a shared SmartSheet referral form.

Costs And Funding Structure

Total Costs

$1.2 million total annual costs

  • $450,000 for MTG
  • $90,000 for produce prescription
  • $230,000 for delivery and transportation
  • Staffing
  • Supplies

$1,200 per participant for one year of services, including food or prescription funds and transportation costs.

Funding

Food Bank of the Rockies received a four-year grant from the Colorado Department of Public Health and Environment to support the rural expansion of the Food for Health program into the Western Slope and Eastern Plains regions. Additional funding for the urban areas (Denver metro) was provided by Feeding America, referring and non-referring hospital systems, and community foundations. Organizations including Project Angel Heart and Denver Health have also provided funding for specific projects.

This program is funded by the Health Disparities and Community Grant Program (HDCGP). The views expressed do not necessarily reflect the official policies of the Colorado Department of Public Health and Environment (CDPHE), nor does mention of CDPHE imply its endorsement.

Value
Financial
  • No financial value outcomes were identified for this intervention.
Economic
  • 74% of respondents reported zero days of hospitalization or emergency department usage.
  • 49% of respondents reported good or excellent health in the past 30 days.
  • 42% of respondents reported zero days of poor mental health, inclusive of feelings of stress and anxiety.
Social
  • 95% of respondents reported improved food insecurity status
  • 69% of respondents consumed at least two servings of fruits and vegetables daily
  • 81% of respondents prepared a meal at home most days
  • 81% of respondents felt confident in their ability to follow doctors recommendations
  • 90% of respondents increased nutrition education and understanding of how food affects health

Food Bank of the Rockies captured outcomes using a self-reported participant survey. Food for Health participants noted the immediate impact of the program on their health. Seventy-four percent of participants did not utilize emergency or in-patient hospital services in the past 30 days. Additionally, although self reported blood pressure and blood sugar metrics mainly stayed the same, almost half of participants reported better physical and mental health.

Overwhelmingly, participants reported healthy behavior changes as a result of Food for Health. The majority of participants noted consuming at least two servings for fruit and vegetables per day as well as increasing the number of meals they cook at home. Participants also felt more confident following their doctors recommendations and noted an increased understanding of how food choices affect health. Almost all participants stated that Food for Health improved their food security status by increasing their access to health supporting foods.

Lessons Learned
  • Establish a framework to track the nutritional content of food across your food inventory early on in your implementation. Historically, food banks have focused on pounds of food rather than the nutrients in foods. Incorporating nutrition-based metrics as well as getting buy-in from staff across operations and food sourcing departments are instrumental in offering MTG through a food bank setting. Food banks partnering with Feeding America can reference Feeding America’s Health Eating Research Guidelines to inform nutrition standards.
  • Survey your participants and adapt your programming to best fit their needs. Participants receiving MTG for one year noted that they would like more flexibility in choosing fresh produce. In response to this feedback, Food Bank of the Rockies restructured their FIM program to offer six months of produce prescriptions that could be redeemed at local grocers. Additionally, Food Bank of the Rockies will be launching a physical produce prescription card to mitigate technology barriers experienced with the digital card.
  • Utilize third-party couriers to provide weekly deliveries to rural patients. Utilizing local couriers has enabled Food Bank of the Rockies to expand their operations to reach more rural patients without overextending existing staff capacity or compromising patient experience.
Resources and Continued Learning

Food Bank of the Rockies