Recognizing that 80% of a person’s health happens outside of the healthcare system, Harris Health’s Food Rx program is designed to address health-related social needs, like food insecurity, poor nutritional knowledge, and lack of access to culinary education, that are prevalent in vulnerable populations and tied to poor health outcomes. The literature is rich in evidence demonstrating how food insecurity is linked to chronic diseases including obesity, heart disease and diabetes. This program proactively embeds a population health approach as part of our standard of care for chronic disease management, strategically intervening with patients with expressed social needs and known health risks in order to improve their health outcomes.
Harris Health’s Food Farmacies are currently located at Strawberry and Acres Home Health Centers and recently opened at the LBJ Hospital campus. The Food Farmacies serve adult patients (and their families) expressing food insecurity while providing a more intensive intervention for those with chronic diseases, such as Type 2 diabetes. Patients screening positive for food insecurity at these locations are referred to the Food Farmacy, enroll with a community health worker, select a variety of healthy foods with a dietitian, are connected to a Houston Food Bank navigator for benefits enrollment, and are linked to community food resources. Patients with uncontrolled chronic conditions are invited to participate in a 9 month program. They “walk and learn” with a diabetes educator during their biweekly redemption of 30 pounds of fresh foods from the Farmacy, and also enroll in UTSPH’s co-located culinary medicine curriculum, which teaches patients the skills to make delicious, healthy, low-cost and culturally relevant meals. Graduation from Food Rx now includes curated linkages to community supports, such as H-E-B’s network of grocery stores and nutritionists, to support patients’ positive behavioral change at accessible locations within their home communities.
In the first year, more than 650 patients enrolled in the Food Rx program. At the end of their nine-month enrollment, patients with uncontrolled diabetes saw A1c levels drop an average of 0.72 percentage points. They also reported improved nutrition knowledge and increased daily fruit and vegetable consumption—with a 38% increase in patients reporting continued lifestyle changes like high confidence in day-to-day use of cooking techniques to prepare fresh meals. The COVID-19 pandemic has only highlighted how essential this work is. Due to the economic and health consequences of the pandemic, food insecurity is projected to rise by 33% in Harris County alone. Given the known nexus between food insecurity and poor health outcomes, it is critical to proactively identify food insecurity and provide meaningful assistance to our patients, particularly those already struggling with a nutrition-related chronic disease.