California has been testing out a new approach to combating chronic conditions by subverting the concept of a “prescription.” Called the “food prescription” experiment, according to the Long Beach Post, it’s a new program that prescribes healthy food in place of pills. For example, those that live with diabetes can sign up to have a free box full of fruits, veggies, chicken breast, quinoa, and other nutritious items delivered to their doorstep every two weeks.
Advocates believe the program has the potential to not only improve chronic conditions, but lower health care costs and reduce hunger as well. It’s mostly aimed at elderly people like Shane Bailey, who at 72-years-old has three heart conditions, diabetes, kidney disease, high blood pressure, and cholesterol. Since receiving free produce prescriptions, she says her life has improved considerably. Speaking to the Long Beach Post, Bailey shared, “My primary doctor is impressed with my cholesterol because they say it’s better than theirs! My dream is to live until I’m 95.”
The “food is medicine” movement is what inspired produce prescriptions. They believe that nutritious food helps prevent, manage, and reverse chronic disease. One study shared to the National Library Of Medicine estimates that up to $100 billion in national health care costs over the projected lifetimes of current Medicare and Medicaid patients can be saved if healthy eating is incentivized. Similar state programs have already proven to lower obesity, blood pressure and average blood sugar.
Convincing counties and health plans to start using the food prescription program does present some challenges though. Brent Ling, director of external affairs at the nonprofit Wholesome Wave says, “The vast majority of them don’t even know how produce prescriptions work. So it’s a lot of education and information sharing.” The federal Farm Bill is currently funding 14 food prescription tests in California. In Alameda County, there’s Recipe4Health, which started as a food pharmacy program in 2019 before growing to become one of the state’s top medically supportive food programs that’s also integrated into the county’s health care system.
According to Steven Chen, its chief medical officer, with 11 sites across Alameda County, the program is able to serve almost 4,000 people. He believes that testing is an important step towards making the services permanent under Medi-Cal. “Any innovation starts with fragmentation, because it’s a 1,000 flowers bloom approach… You want to create enough openness because otherwise, it’s just a top down approach, which never works.”
Assembly Bill 1644 was recently introduced. If passed, it will require that medically supportive food and nutrition be covered by Medi-Cal for at least 12 weeks for eligible Californians. “I remember opening the fridge and seeing only celery and peanut butter and my mother telling me we were on a ‘special diet.’ I did not realize at the time we were food insecure,” said Assemblymember Mia Bonta, an Oakland Democrat that proposed the bill. “Too many Californians, particularly Californians of color, are living with largely preventable chronic conditions.”
Positive intentions aside, the bill is estimated to cost in the tens of millions, and as a result, was held in the Assembly appropriations committee. Bonita and her bill co-sponsor at the San Francisco Bay Area Planning and Urban Research Association (SPUR) plan to reintroduce the bill next year.