Food insecurity is a critical social determinant of health, yet healthcare is uncertain how to address it. Food organizations want to collaborate with healthcare but struggle to navigate healthcare’s complex systems.

Approach

Bolstered by the San Francisco Department of Public Health, the Food as Medicine Collaborative (FAMC) is a multi-sector collaboration involving food and health systems that 1) tackles food insecurity in healthcare through a race equity lens and 2) builds capacity within both sectors to create policy and systems changes that support food security. FAMC implemented Food Pharmacies in eleven primarily safety-net clinics across four health systems where patients access healthy food, nutrition education, cooking demonstrations, hypertension and diabetes counseling, and referrals to the food safety net.

Results

In 2019, 1,271 patients were served at Food Pharmacies, approximately 60% of whom were Black/African American. Among patients who attended three or more sessions for whom we have clinical data (n=144), there was a 4.4 mmHg decline in systolic blood pressure (CI 0.71-8.69, p=.021) and 2.7 mmHg decline in diastolic blood pressure (CI 0.92-5.37, p=.005). 92% of patients indicated adopting healthier eating practices (n=151). The momentum and stakeholders cultivated through establishing food interventions in healthcare spaces led to state-wide efforts to have food be a covered medical benefit under Medicaid.

Discussion

Public health can play a critical role in bridging healthcare and food systems, enabling the transformation of healthcare environments and systems to address food insecurity. These partnerships can then be leveraged for collective policy change.