What Is Food as Medicine?

Feeding America® is the largest hunger-relief organization in the United States. The organization is a network of 200 food banks, 21 statewide food bank associations and more than 60,000 partner agencies, food pantries, and meal programs across the country. Chances are if you’ve been to a food bank or food pantry, it’s affiliated with Feeding America, which provides meals to tens of millions of people in need each year.

In addition to reducing hunger, the organization is committed to improving health and addressing health inequities for people in the U.S. Those are the drivers behind the “Food as Medicine” program, created in partnership with the Elevance Health Foundation. Building on its previous support, the Foundation recently announced new grants of $14 million for the program — and another $8.7 million for the food as medicine efforts of 19 other organizations.

Since its start in 2019, Feeding America has grown from seven member food banks to more than 20. Mark Stephens, Feeding America executive vice president of innovation, shared more about the program.

Can you define the broader concept of “food as medicine”?

Food as medicine refers to the spectrum of programs aimed at addressing that critical link between nutrition and health. Highly nutritious foods are an important part of bolstering the whole health of a community, which includes the treatment and prevention of diet-related diseases such as diabetes and high blood pressure. Half of the adults in our country have one or more preventable diseases. This is a huge problem. Many of those diseases are related to poor nutrition.

The data also shows that the prevalence of diet-related diseases is even higher among people who are experiencing hunger and food insecurity.  Many studies have demonstrated this. For people who are at the intersection of a diet-related disease and food insecurity, they are making some unimaginable trade-offs between their health and their nutrition. Food as medicine is about removing those barriers because people shouldn't have to choose between their health and the food they need.

What are some of the barriers and disparities that lead to food insecurity?

People experiencing food insecurity are often affected by multiple, overlapping issues that can make it difficult to access and afford nutritious food. Rising food costs, financial struggles, unemployment or underemployment, lack of transportation and affordable housing, among other challenges, can all contribute to food insecurity. This can create high levels of stress that affects the entire household. For people who are also coping with diet-related chronic conditions, the combination of stress and poor nutrition from food insecurity can make it difficult to manage their condition. It can also lead to poor health even for individuals who do not already have a diet-related health condition.

We also know that not all households experience food insecurity in the same way. Our research has shown that extensive racial and geographic disparities exist, with households of color and rural communities likely to experience higher rates of food insecurity. Programs like those under the Food as Medicine initiative can help identify and close the gaps in these disparities.

How does the Food as Medicine program work?
It’s really aimed at forming strong partnerships between food banks and health partners. These are two sectors that have not traditionally partnered, but that’s been changing. That's the first step: Forming those partnerships at the local level, so when someone enters their doctor's office, they’re screened for food insecurity. It’s reaching people where they are. For the folks who screen positive for food insecurity, it's connecting them to the resources that they need, which might include referring them to food pantries and agencies that are local to the individual, an onsite food pantry at the health facility, a mobile pantry or, depending on the individuals, like older adults, even delivering food to their home using OrderAhead, Feeding America’s online grocery ordering system.

One of the big things that we do as part of these programs is connect people to other services that will help them become more resilient, such as SNAP (Supplemental Nutrition Assistance Program), which provides families with necessary funds for food.

There’s a lot of innovation happening throughout our network of food banks. For example, Gleaners Food Bank of Indiana has been one of our pioneers in the Food as Medicine program. To date, they’ve screened more than 440,000 patients through a partnership with Eskenazi Health and have provided medically tailored food boxes as well as personalized home delivery. Another example is the Food Bank of Northern Nevada, which was able to expand their prescription programs to food pantries in three rural cities through a partnership with a rural healthcare clinic that is part of the University of Nevada. They were also able to expand to a food pantry on the Walker River Paiute Tribe Reservation.

How has the program changed over the past three years?

We've been trying out different models in different communities, figuring out how to make these partnerships effective, and how to more effectively screen patients. How do we get people, once they’re screened, to connect with services?  What we heard from a lot of physicians is they were grateful for the program because before, when physicians encountered food insecure patients, they didn't know what to do. It’s raising the level of awareness among the medical community about how to address food insecurity. So that's huge.

We’re also hearing that participation in these programs really helps patients adhere to their treatment plans. You think about diabetes or high blood pressure: It's one thing to say, OK, eat lower-sodium foods and so on, but it's another thing to have a partnership where you can help make that happen, and in some cases having professionals at the food banks who are involved in this conversation among the doctor, the patient, and the food banks. It’s wonderful for healthcare staff.

What’s the next step for the Food as Medicine program?

Feeding America and the Elevance Health Foundation are having a conversation with health partners: How do we ensure that the people we’re reaching with this program are getting better? So one of the big things that we're doing with the third phase of the Food as Medicine program is leaning in on measurement, using an objective third party to evaluate whether or not people are experiencing better health. It's really an evolving program for us, and we are very proud of the partnership. Healthcare partners screened 91,000 patients in 2019 and today they have screened more than 700,000 people.