There is a program in western Massachusetts that provides a special kind of medical treatment for food-insecure residents who have health risks or conditions. It does that with fresh fruit and vegetable prescriptions.
For NEPM's Hunger Awareness week, we spoke with Lorraine Cordeiro, professor of nutrition at UMass Amherst, and lead investigator for the Springfield Prescription Produce Collaborative. It's a partnership with Baystate Health and Wellspring Cooperative, which runs Springfield's Go-Fresh mobile market.
Lorraine Cordeiro, UMass Amherst: We know that there's been rising food insecurity in the western Mass. region, differentially from what we're seeing in both Worcester and kind of central Massachusetts and eastern Mass. around the Boston area. We're experiencing much higher rates of food insecurity. And Hampden County has some of the poorest — both health, social service and human service, and public health — outcomes in the state.
So we were concentrating on areas that are high-poverty zones where there's a high number of food insecurity, but also this environment of food deserts, where there aren't enough fresh produce that's locally available in the grocery stores or in bodegas.
Carrie Healy, NEPM: So, clinics and hospitals, local farms and others are all, I guess, actively involved in these produce prescriptions. What do you find that the healthy vegetables or fruits replace in somebody's diet?
Right. So we're not looking to replace anything in an individual's diet. Our approach is that fruits and vegetables are value added. So we're adding them to your diet. And we're asking you to increase your consumption of fruits and vegetables.
The patients that are enrolled in our program are individuals who have already been diagnosed with hypertension, obesity or diabetes. So these are high-risk patients to begin with. And we're very well aware that behavior change for individuals is particularly difficult when they're experiencing food insecurity.
So we have the produce market, which has availability, where people can go to and purchase their fruits and vegetables, particularly if they're SNAP [EBT] beneficiaries, because in Massachusetts, we have a great program called HIP [Healthy Incentives Program], which allows you to get an additional $40 to $80 added to your SNAP card if you purchase fruits and vegetables. That'll be cut down to $20 per household starting December 1.
So, this produce prescription is an additional benefit on top of any government benefits that participants already get?
Yes. So we're providing them with an additional voucher just as an incentive to continue to eat fruits and vegetables. Our goal is to actually write another grant for a continuation of the project that we have right now.
Now, it takes a long time to make a lifestyle change. How do the preliminary results of this program look?
We're really excited to report that when we've done focus groups with patients, they are extremely excited about eating fruits and vegetables and adding it to their diet.
They're reporting, in focus group discussions that we have with them, that they have not only lost weight, but they're eating higher volumes of fruits and vegetables. They're feeling better.
So, this kind of information directly from patients is, for us, invigorating. We didn't expect to see such a change in such a short period of time.
We have incredible individuals on the team. Our research coordinator, Bi-sek Hsiao, has done a lot of community building with individuals so that they have a network where they can come together and have conversations about how to meet their food needs.
And she's been a huge advocate for additional vouchers to supplement individuals that are losing some of their HIP benefits. So, for example, we've shifted our budget so that we can provide more dollars to kind of bridge individuals that are losing benefits as of December 1 due to the cuts in the HIP program.
