Produce-prescription programs offer healthy food to those in need — and a valuable wholesale outlet for farms
A new and lucrative wholesale market is taking root for regenerative farmers who produce fruits and vegetables.
There are 112 active “produce-prescription” — and nearly 40 “food-is-medicine” — medically tailored meal programs throughout the United States. Many of these programs allow doctors to prescribe fruits and vegetables as medicine. Patients are enrolled in six- to 12-month programs where they receive nutritious food and coordinated education on cooking.
These programs measure health data and assess healthcare cost savings, and the results show that the programs are lucrative for both the patient and the health system in a multitude of ways. As our health system moves away from a “fee-for-service” to a “value- and outcome-based” model, we will see the mass adoption of purchasing and prescribing fruits and vegetables through both the non-profit and for-profit sectors.
As studies by both the agricultural and healthcare industries accumulate and connect, we will also see a more refined look at nutrient density and the correlating soil health practices utilized by farmers. When soil health declines, human health follows suit. Ten-thousand baby boomers turn 65 every single day in the Unites States, and each has an average of 15 or more prescription drugs per year, with skyrocketing chronic conditions. But nutrient-dense food will become increasingly valuable as it is proven to directly correlate to healthcare outcomes and savings.
After completing a master’s degree in gerontology at the University of Southern California and studying soil science through the soil advocacy program at Kiss the Ground, I have come to understand the connection between longevity and soil health. I moved back home to Tulsa, Oklahoma, after completing these programs and began implementing a community program to try to battle both rapidly deteriorating soil and human health.
Our program, FreshRx Oklahoma — a produce-prescription program — not only tackles both soil and human health; it also creates community by connecting patients and the public with local, regenerative farmers and their produce. Agriculture is public health.
Because of our knowledge around soil health and nutrient density, we chose to source only from local and regenerative farmers, many of whom have conducted the Haney Soil Test through Regen Ag Lab (regenaglab.com) and have been regeneratively certified through Soil Regen (agsoilregen.com). FreshRx Oklahoma provides a wholesale market alternative for local farmers willing to grow fruits and vegetables with no chemicals, crop diversity, cover crops, little-to-no tillage, and some livestock grazing. The participants claim they have never really eaten vegetables before trying this food, because it tastes so good! And the health outcomes are even more extraordinary.
Like medically tailored meal programs and some produce-prescription programs, FreshRx Oklahoma partners with primary care physicians and clinics and helps connect their patients to produce. The program is prescribed by physicians who are champions of food as medicine. FreshRx began with a focus in North Tulsa, a predominantly low-income area that for 14 years was without a grocery store; the lifespan difference compared to south Tulsans is nearly 11 years. Of the five zip codes in Tulsa County with the highest mortality rate for diabetes, three are in North Tulsa. The choices to eat are places like McDonald’s, Taco Bell and Dollar General.
The FreshRx “Food Is Medicine” North Tulsa program provides a combination of free local, nutrient-dense fruits and vegetables and educational classes for twelve months to those with uncontrolled Type 2 diabetes with an HbA1c level of 8.0 or higher in the north Tulsa area of Tulsa, Oklahoma. The program includes three efforts: fresh bi-weekly food boxes, nutrition cooking classes and clinic evaluation check points. The objectives of the program are to improve health metrics, increase consumption of fresh fruits and vegetables, improve participants’ knowledge of nutrition, and improve patients’ ability to self-manage chronic conditions.
The program partners with local clinics and primary care physicians, who prescribe the program, with a goal of reducing participants’ HbA1c levels by 1-2 percent in 12 months. FreshRx, with the help of the primary care physicians, tracks HbA1c levels, blood pressure and weight every three months and tracks mental health and nutrient intake. A comparable study conducted by Fresh Food Farmacy Geisinger estimated healthcare cost savings from $16,000 to $24,000 per year per participant who reduced their HbA1c by 1-2 percent.
In FreshRx’s first year, the program saved the state of Oklahoma an estimated nearly $750,000 in healthcare costs. Forty out of fifty-two participants graduated after 12 months, and 30 of the graduates had some type of reduction in their HbA1c level, with an average reduction of 2.2 percent; the largest HbA1c reduction was from 14.0 to 6.9. Collectively, the cohort lost 296 pounds. For many, this could be the difference between life and death.
Simultaneously, FreshRx has supported 20 local small- and medium-size farms by providing a consistent alternative wholesale market. Many farmers reported that they would not have survived the pandemic without the support of this program. FreshRx partners with the Oklahoma Conservation Commission and the Oklahoma Association of Conservation Districts to provide technical assistance to farmers. FreshRx also helped four farmers get funded for hoophouses through the Natural Resource Conservation Service.
As a result of creating a cohort of farmers, the program supplies food to the FreshRx participants and then opens up to the public to buy any food overages, serving as an aggregator and USDA retailer that also accepts SNAP/EBT benefits. The Food Bank of Eastern Oklahoma will then buy any overages, providing additonal relief to farmers and reducing concerns over overharvesting and waste.
I would like to see more produce-prescription and medically tailored meal programs support local agriculture and holisitic soil management. Such programs are available in 44 states; you can find a combined list of them at nutritionincentivehub.org/grantee-projects. Though the leaders of these programs desire to source with integrity, most just don’t know how. It certainly adds another layer of work to source locally, but the time spent is well worth it, with huge rewards for both the local economy and the patients they serve.
If you’re a farmer who is willing to grow healthy food, I encourage you to reach out to these programs, negotiate, and partner to serve your local community. My farmers love selling wholesale to our program. They have a reliable wholesale market to sell to without having to sit at a farmers market, and they know their food is going toward a good cause.
Connecting farmers and patients is magic. It creates community in a way I have never seen before. I am grateful to be a light and bridge in this process. If anyone needs some convincing, or wants more information on how Fresh Rx and other such programs work, please connect with me via email at erin@consciousagingsolutions.com or visit us at freshrxok.org.
