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7 Possible Solutions to Food Insecurity from PA Hospitals

August 02, 2018 | By: Robert Shipp, III

7 Possible Solutions to Food Insecurity from PA Hospitals

How can you be healthy if you sometimes don’t get enough nutritious food to eat?

That’s a question hospitals and health systems are taking to heart. One in 12 Pennsylvanians experienced food insecurity last year. At some point, they lacked consistent access to enough nutritious food to lead healthy lives.

Pennsylvania hospitals and health systems witness the consequences of this problem every day, in the health of their patients, families, and communities. In response, hospitals are experimenting and innovating, seeking sustainable ways to address this issue.

Here are seven possible solutions to food insecurity—and these are only a sampling of the many related initiatives underway.

  1. Food insecurity screening and referral

Asking patients about hunger is the foundation of many hospital initiatives. To help fix a problem, you first have to identify it.

In the Philadelphia area, seven health systems worked together on a Healthy Food Access Pilot. Each health system selected one or more patient areas or clinical settings in which to try out a “screen-and-intervene” framework. Trained hospital staff:

  • Asked patients about food insecurity
  • Connected patients who need help with resources (such as the Supplemental Nutrition Assistance Program, or SNAP), including these programs offered through hospitals and health systems participating in the pilot

As of February 2018, about one in four (24.4%) of the nearly 7,000 patients screened were found to be food insecure. This short, two-minute video tells the story of Temple University Health System’s Healthy Food Access Pilot.

With its summertime Complete Eats program, Children’s Hospital of Philadelphia connects patients and their families with free lunches when schools are closed.

Through a survey process in the emergency department, the hospital found that many families (63%) were unaware that free lunches were available in their neighborhoods, at 1,000 or more Philadelphia locations participating in the USDA Summer Food Service Program. After learning more about the USDA program, most (73%) of these families felt confident that they would be able to find a place in their community where their children could get lunch.

The program began in the emergency department, but this summer has expanded to primary care and specialty settings. To get patients and families off to a good start, the hospital provides USDA lunches during emergency department and doctor’s visits.

  1. Food pharmacy, or “farmacy”

On selected hospital campuses in Geisinger and Allegheny Health Network, patients who are food insecure and diabetic receive prescriptions for the food “farmacy”—an onsite market where food is healthy, nutritious, and free.

Geisinger pioneered this approach several years ago at the health system’s Shamokin Area Community Hospital in Coal Township. Patients who have diabetes of a specified severity (HbA1C levels greater than 8) are referred to the Fresh Food Farmacy and have access to:

  • Enough food to prepare healthy and nutritious meals for the whole family, twice a day for five days each week
  • More than 20 hours of diabetes education with health coaches
  • A weekly diabetes self-management support group and online wellness information
  • Free, interactive cooking and nutrition classes

Geisinger says patients are achieving remarkable results:  on average, a two-point reduction in HbA1c, plus less need for medications and other health care services.

Allegheny Health Network has opened a similar Healthy Food Center on its West Penn Hospital campus.

  1. Food bucks and other healthy food incentives

Several Pennsylvania hospitals are experimenting with the use of coupons to encourage healthy eating habits.

Main Line Health’s Lankenau Medical Center used The Food Trust’s Philly Food Bucks as a way to begin talking with patients about meeting basic food and nutritional needs. Diabetic patients who had body mass indices greater than 30 received $6.00 worth of food bucks. These coupons could then be used for the purchase of fruits and vegetables at a network of farmers’ markets and other food stores.

Patients who took the first step, and spent their food bucks, had begun the journey toward healthier eating. What’s more, patients who used their food bucks and were receiving SNAP benefits had the opportunity to connect with a steady stream of additional food bucks. For every $5 in SNAP purchases, patients received another $2 Philly Food Bucks coupon, increasing their buying power to bring home 40 percent more fruits and vegetables.

Einstein Medical Center in Philadelphia distributes Philly Food Bucks at its weekly Farmers’ Market. Affordable fruits and vegetable are available to all shoppers. Those who pay with their Pennsylvania EBT (electronic benefits transfer) Access cards for SNAP, Medicaid, and other benefits receive an additional $2 of food bucks for every $5 of produce purchased.

Along these same lines, Mercy Health System is working on a program to provide food-insecure patients with coupons they can use at an onsite farmers’ market.

  1. “Food as medicine” healthy meal deliveries

In Greater Philadelphia, a Medicaid health plan owned by several health systems is using food as medicine. In partnership with the Metropolitan Area Neighborhood Alliance (MANNA), Health Partners Plans provides up to three six-week cycles of “clinically tailored” meals for patients with chronic disease.

Since 2015, Health Partners has paid the full cost for 560,000 meals to be home delivered to more than 2,100 enrollees who have conditions such as diabetes, heart disease, and kidney failure. The insurer says the investment is paying off in healthier patients who:

  • Can better manage their diseases
  • Need fewer hospital and health care services
  • Cost less for the insurer to cover

Research published in the Journal of Primary Care & Community Health shows that MANNA meals significantly reduced patients’ health care spending. Patients’ average monthly costs for hospitalization dropped 30 percent during the six months after receiving MANNA services, with an average monthly savings of about $50,000.

Aetna and two other insurers in the Philadelphia area have also begun providing MANNA meals to their Medicaid enrollees.

  1. Farmers’ Markets and “Farm to Families” produce deliveries

Many hospitals host farmers’ markets to connect patients, employees, families, and neighborhoods with healthy, affordable produce. Einstein Medical Center’s “Fresh for All” pop-up farm stand is an example.

In partnership with Philabundance, the medical center distributes free, fresh produce every Thursday morning. Since March, the 200-plus volunteers involved in the program have distributed more than 61,000 pounds of produce to 3,400 families.

Temple University Hospital System and St. Christopher’s Hospital for Children, also in Philadelphia, have “Farm to Family” programs to bring low-cost, fresh produce to families struggling with food insecurity.

  1. Hospital-based farms and gardens

Hospitals with the necessary space and other resources are taking things a step further and growing their own healthy food. The Children’s Hospital of Philadelphia, Lankenau Medical Center, Holy Redeemer Health System, and St. Luke’s University Health Network all have gardens or farms.

Produce grown at Lankenau Medical Center’s Deaver Wellness Farm makes its way to a farmers’ market for patients, visitors, and employees. Food from the farm also is used to address the food insecurity and chronic disease management needs of Lankenau’s most vulnerable patients.

The medical center even hosts pop-up cooking classes in patient waiting areas. Health educators show easy ways to prepare the farm’s produce—and patients and families get healthy treats.

Each year, St. Luke’s Rodale Institute Organic Farm harvests around 50,000 pounds of produce grown on the farm’s 11.5 acres. Fresh produce is distributed every week in season to all hospital cafeterias in the network.

Children’s Hospital of Philadelphia has a garden and orchard at the Nicholas and Athena Karabots Pediatric Care Center. The garden’s harvest is shared with families that are part of CHOP’s Healthy Weight Program and Early Head Start, a comprehensive early childhood development and family support program based at Karabots.

Supported by the Sisters of the Redeemer, the Redeemer Valley Garden at Holy Redeemer Health System is a large community garden providing produce for local food cupboards as well as the community. Holy Redeemer also supports a School Garden, a year-round collaborative that includes a local elementary school, the Master Gardener Program of the Penn State Extension, and the Sisters of the Redeemer. The program combines nutrition education, physical exercise, gardening skills, and fun, and contributes to food cupboards.

  1. Gleaning and hospital-supported food pantries

Summit Health’s Summit Endowment foundation supports a gleaning project to bring fresh, locally grown produce to vulnerable communities in Franklin County. By collecting and distributing donated produce, the project helps:

  • Reduce hunger
  • Improve nutrition
  • Prevent waste

During 2016, approximately 300,000 pounds of produce was donated from 80 farms, orchards, and personal gardens. With assistance from 70 community partners, the fresh fruits and vegetables were then distributed for free to more than 23,000 people in need.

Hospitals across the state also work with food pantries. Holy Redeemer Health System in southeast Pennsylvania is one example. In partnership with the Greater Philadelphia Coalition Against Hunger, the health system’s Drueding Center Green Light Pantry helps families choose healthy food and offers nutrition classes. In addition, Holy Redeemer has multiple food pantries including a choice pantry in northeast Philadelphia, which serves about 5,000 families and over 10,000 people every year.

Hospitals and health systems are expanding their missions, to keep people healthy and out of the hospital as well as taking excellent care of them when they are sick or injured. Helping patients and communities fight food insecurity and improve their eating habits is one way to forge ahead to better health.

It’s almost impossible to keep up with all the great work going on at Pennsylvania hospitals and health systems. If you know of another way that hospitals are working to reduce food insecurity, please share!

Robert Shipp
Written by Robert Shipp III

Robert Shipp, III, is HAP's vice president, population health strategies, and is responsible for overseeing initiatives related to quality and population health.




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