The next generation of Fresh Rx: Home delivery of food prescriptions

By Dennis Archambault

Dr. Robert Graham, a physician and chef, noted in a recent Detroit News commentary that “over the last 50 years, food has become more accessible than ever. Yet Americans are experiencing the worst health outcomes of any high-income nation.” Many community health advocates know that and have worked in various professional capacities to do something to improve this sad statistic. “The pervasiveness of food deserts, the prevalence of junk food, and a lack of nutritional education have led to obesity,” which contributes to the death of 1.7 million people annually. Dr. Graham not only advocates the “Fresh Prescription” idea – which Authority Health has been involved with for several years, she wants physicians to integrate “food as medicine” concepts into their practice.

In his commentary, he raised the potential of legislation co-sponsored by Sen. Debbie Stabenow, known as the “Medically Tailored Home-Delivered Meals Demonstration Act,” which would amend the Social Security Act to appropriate federal funds to pay for the delivery of nutritious food to certain clinically-appropriate discharged hospital patients. As with the Fresh Prescription program, patients would need to have a “diet-impacted disease, such as kidney disease, congestive heart failure, diabetes or chronic obstructive pulmonary disease.”

Dr. Graham is not idealistic enough to think that even though health begins with nutrition, “changing someone’s lifestyle isn’t as simple as telling them what to eat. It is not enough to give someone a healthy, bland salad and ask them to eat it daily to lose weight. A doctor has to meet the patient where they are and understand that their cultures, preferences, budgets, and zip codes shape what they eat … People are more likely to stick to a diet plan if they have access to food that’s convenient, affordable and tasty – and medically tailored meals can check each of these boxes.”

The natural evolution of this thinking is to move upstream to people who are healthy, but their lifestyles are not. Physicians and nurse clinicians are in a position to plant the idea that health begins with nutrition and active living – before they reach a point where they need a prescription to eat well.

At this point, the holiday that often celebrates the grand food day of the year – or at least the day that we anticipate eating food that tastes good and a lot of it – has launched the time in which eating comfort food will be an almost constant activity. This is the best and worst time to discuss food as medicine.

But we should key in on the first phrase in Dr. Graham’s essay, “Food threatens Americans’ health…” In a land of plenty, where there are increasingly food insecure people and those compromising their health by consuming bad food products, we can change policy, market incentives, and personal behavior – but not without a lot of work.

The second half of the title leads to Dr. Graham’s point: “… it’s also the cure.” We have choices this holiday season — food that provides comfort and joy, as well as food that provides nutrition and vitality. And as chefs provide creative spins on traditional (not-so-healthy) comfort foods — some featured at programs held at our Ruby Cole Community Kitchen — we can celebrate “Food as Medicine.”

This may be a great time to try new healthy recipes and substitute healthy ways of preparing the old ones. And, of course, when it comes time for resolutions, what better one than to take baby steps toward a more nutritious diet.

It would also be nice to have the “Medically Tailored Home Delivery Meal Program” passed in Congress.

Happy healthy holidays ahead…

Dennis Archambault is vice president of Public Affairs for Authority Health.