Produce Prescriptions: An Innovative Method to Address Food Insecurity in Uninsured Populations

Evan Gies1, Anne Klapheke2, and Kyla Maddox2

1 University of Cincinnati College of Medicine

2 Good Samaritan Free Health Center

As the rates of chronic conditions like hypertension and diabetes rise in the United States, healthy eating habits have become an increasingly important lifestyle change that has a large impact of the management of chronic disease 1. The ability of patients to successfully implement these diet changes is critically dependent on their access to fresh produce and high-quality foods. Unfortunately, food insecurity rates in Hamilton County are around 14% and disproportionately affect low-income individuals 2. With the socioeconomic strains of the COVID-19 pandemic, this number is likely to increase 3. Produce Prescriptions are an innovative and integrative approach to address food insecurity by connecting an individual’s healthcare with their food access. At the Good Samaritan Free Health Center, we partnered with Freestore Foodbank to implement a Produce Prescription program that gives patients monthly vouchers to be redeemed at a mobile produce market. The program lasts one year and tracks health statistics and participation with the goals of 1) assessing the state of food security of patients at the clinic amidst the COVID-19 pandemic and 2) improving health outcomes with improved patient access to fresh fruits and vegetables.

The program involves a daily food insecurity screening of every patient with an appointment at the clinic using two validated questions on food scarcity and worry about food scarcity. The first 45 patients to screen positive are offered to join the program, consisting of one $15 voucher per month for nine months. These vouchers can be redeemed at the Healthy Harvest Mobile Market, a traveling market run by Freestore Foodbank. Enrollees are asked six questions about their weekly fruit and vegetable intake, which is used to calculate the Estimated Daily Consumption (EDC). Also collected are the patient’s age, language, BMI, Blood Pressure, and A1C. Each month, the amount of produce prescriptions redeemed are reported to assess participation. At the end of June 2021, the patient’s health statistics and produce consumption will be recorded again to assess the impact of the program on patient health.

The final patient cohort consisted of a representative sample of the clinic’s demographics. This included a range of ages (23-68), a range of BMI’s (23.5-56.3), and 44% non-English-speaking (compared to the 50% of clinic patients that speak a language other than English). After the cohort was recruited, all patients in the clinic continued to be screened for food insecurity. On average, 30.4% of all patients with appointments at the clinic screened positive for some form of food insecurity. In the first two months of the program, 12 vouchers of the 75 distributed have been redeemed at the mobile market. The most common reasons for not redeeming the vouchers include lack of transportation and restrictive hours of the market. Further results will be analyzed as the program continues through June 2021.

The early results of the produce prescription program show a high prevalence of food insecurity in patients at the clinic and a large need for access to fresh produce. Through continued outreach and adjustments to the program, the Produce Prescription Program can be an impactful method to addressing food insecurity in uninsured patients in Hamilton County.

Contact: giesep@mail.uc.edu | 614-602-7944

Key Words: Food Insecurity, Produce Prescription, COVID-19, Uninsured, Diet

Citations

1.      Song Y, Liu X, Zhu X et al. Increasing trend of diabetes combined with hypertension or hypercholesterolemia: NHANES data analysis 1999–2012. Sci Rep. 2016;6(1). doi:10.1038/srep36093

2.      Map the Meal Gap. Feeding America. https://map.feedingamerica.org/county/2018/overall/ohio/county/hamilton. Published 2020. Accessed September 23, 2020.

3.      Ahn S, Norwood F. Measuring Food Insecurity during the COVID-19 Pandemic of Spring 2020. Appl Econ Perspect Policy. 2020. doi:10.1002/aepp.13069