Some state agricultural leaders and farm groups are beginning to rethink 'food as medicine' programs to better connect local agricultural systems with nutrition.
Food as medicine encapsulates several federal nutrition programs, starting with school meals, the Supplemental Nutrition Assistance Program (SNAP) and the Women, Infants and Children (WIC) nutrition aid . The idea of produce prescriptions and medically tailored groceries is also gaining momentum, according to some advocates.
“We think of food as medicine intervention for policy as ... something that ultimately we want to be embedded into healthcare and therefore paid for by the healthcare system, and then has positive healthcare outcomes that can be measured,” said Mollie Van Lieu, vice president of nutrition and health at the International Fresh Produce Association.
Produce prescriptions specifically can be implemented as companion to traditional drugs for diet-related diseases. Individuals who have problems with food affordability could have produce delivered or a monthly allotment specifically for fruits and vegetables.
The Centers for Medicare and Medicaid Services (CMS) permits some states to allow Medicaid to cover nutrition interventions like produce prescriptions. Other federal initiatives like Gus Schumacher Nutrition Incentive Program or GusNIP, which was authorized by the 2018 farm bill, support some produce prescription pilot projects.
Such initiatives have centered around health benefits and potential financial savings in health care costs. However, as they gain momentum, some are showing economic potential for local agriculture as an additional benefit to addressing diet-related illness.
Mollie Van Lieu The year four GusNIP impact findings, published by the Nutrition Incentive Hub, found that participation in produce prescription projects not only improved food security but also had a $107.4 million local economic impact. This included $43.3 million for farm direct, which covers farmers markets, farm stands, community supported agriculture and mobile markets.
Now as food as medicine hopes to grow, it would be helpful for policymakers particularly at the state level to see the positive economic impact of produce prescriptions for farmers and local supply chains, Van Lieu said.
At the recent annual meeting of the National Association of State Departments of Agriculture, state agriculture leaders appeared interested in the opportunities to better connect nutrition and agricultural production at the local level.
“Anywhere that we can connect consumption and production is important, and so that's a topic area that we have to, I think, be engaged in,” said Russell Redding, Pennsylvania’s secretary of agriculture.
Redding suggested there are opportunities to improve coordination between food assistance and charitable programs and to have a more holistic strategy to supporting food consumption and production.
This is difficult in Pennsylvania and even at the federal level where different departments oversee different nutrition programs. Redding said greater coordination is needed.
It’s easy to be “in the know” about what’s happening in Washington, D.C. Sign up for a FREE month of Agri-Pulse news! Simply click here
Still, farmers increasingly see themselves as contributors to nutrition programs, particularly since the COVID-19 pandemic, and that "gives you power to both build interesting coalitions and help local markets," Redding said.
During a presentation to NASDA, Kendall Singleton, vice president of partnerships and compliance at Nourished Rx, a digital health and nutrition company that partners with healthcare groups and food networks to increase access to healthy foods, said procurement contracts are beginning to require local sourcing. More health plans are starting to draw connections between their members and local supply chains, she said.
“This is an exciting opportunity, again, thinking about better health outcomes and backing it all the way to the farm,” said Karen Ross, secretary of California’s Department of Food and Agriculture.
Karen RossBecky Garrison Warfel, director of public policy at NASDA, encouraged state agriculture departments to consider how they could engage with food as medicine and incorporate it into their agricultural agendas. She said representatives should look at what is being grown in their state and consider how not just produce but other foods that can be incorporated.
“Yes, produce is a part of that conversation, but it's also really a spectrum of foods,” Warfel said.
The concept of better connecting food consumption with production is not limited to produce prescriptions. Groups like the Urban School Food Alliance shared ideas with NASDA about improving procurement practices for school districts, in part to include more local foods.
“One of the main things, I think, behind this desire is to be creating these sustainable opportunities for producers to enter into a marketplace that hopefully will make it easier for them to sustain their own economy within their community and within their own operation,” said Dottie Arnold, cooperative agreement administrator for the alliance.
Michigan has hosted listening sessions to understand challenges of incorporating more local food into school meals. Michigan Agriculture Director Tim Boring said they found persistent struggles in processing, distribution and having access to the system.
Lack of time and adequate funds are another key barrier, as well as access to fresh fruits and vegetables in many urban or rural communities, Boring said.
“It is an awful lot easier to call up an amalgamated distributor and the truck shows up rather than trying to call around to 50 different farms and source product on a daily basis,” he said.
Paul Brierley, director of the Arizona Department of Agriculture, expressed interest in incorporating the state’s farm sector into food as medicine, but said money is limited.
“I don’t really have the funds for new initiatives,” he said.
For more news, go to Agri-Pulse.com.
