Building Capacity for Healthy Food Prescriptions
Background
In 2022, the Blue Cross NC Foundation conducted a statewide scan of food is medicine interventions taking place across the state. Out of that effort, the Foundation saw an opportunity to strengthen community-based approaches to food is medicine, which resulted in a three-year $4.5 million investment to support, and learn from, 10 healthy food prescription programs throughout North Carolina. Support is provided in the form of grant-funding and technical assistance.
While the Foundation appreciates the need for all approaches to Food is Medicine – including large, scalable, and private sector ventures – its focus and investments are directed toward community-based approaches, specifically. This aligns with the organization’s commitment to strengthen the capacity of nonprofits to address the needs of their communities, to leverage the unique value community-based organizations bring to food is medicine given their deep connections to the people they serve, and to support the integration of local food, which strengthens local economies, in addition to supporting the health of program participants.
Food is medicine is gaining momentum across the country, and North Carolina is seen as a leader.
As a result of these investments, and the work happening on the ground, both the Foundation and many of the funded organizations have, and continue to garner, attention for this work, as North Carolina has become a hub of sorts for food is medicine, particularly those approaches that feature community-based organizations. This includes being recognized as part of the White House’s commitment to combat hunger and diet related disease, and opportunities to be part of – or lead – conversations at leading food is medicine gatherings across the country. Attention on North Carolina has also been elevated as a result of the Medicaid 1115 waiver which is supporting food is medicine interventions through the Healthy Opportunities Pilots. Four Foundation-funded organizations supported through this work are participating as vendors in the program.
Collectively, this has presented the platform for the Foundation, and its partners, to play a role in elevating the value of community-based organizations in food is medicine interventions, especially as more stakeholders – both private and public – are investing in this space overall. To support this, the Foundation has recently increased programmatic investment to explore and/or build a regional food is medicine hub that centers nonprofit organizations and the local food system, as well as an increased focus on identifying or leveraging opportunities to elevate the value of community-based approaches.
Coordination/Connection with Blue Cross NC
Foundation staff is in regular communication with the company’s Drivers of Health team, as it relates to food is medicine initiatives. Examples of coordination include sharing of ideas and perspectives and fostering of connections, as appropriate. A current Foundation grantee is a company food is medicine vendor and others are in discussions with NourishdRx to become food delivery partners for Blue Cross NC’s Feed Your Health. Additionally, representatives from the Foundation and the company’s corporate social responsibility function have started to meet regularly on areas of shared interest.
Each organization – detailed below – is receiving $300,000 of funding over two years and are participating as part of a learning community to engage with, and learn from, one another.
Appalachian Sustainable Agriculture Project (ASAP) seeks to help local farms thrive, link farmers to markets and supporters, and build healthy communities through connections to local food. ASAP has a myriad of food and farming programs that support strong communities. Through their Farm Fresh Produce Prescription program, participating health care providers write a prescription for fresh produce for patients identified as food insecure and/or are at risk of diet related disease. ASAP offers a farmers market model for more urban/suburban communities and a produce box model for rural communities. The farmers market model provides patients with wraparound support and weekly financial incentives to purchase fresh, local fruits and vegetables from farmers markets. The rural community model provides patients with weekly food boxes (offered through pickup or delivery) along with monthly community gatherings. The organization is located in Asheville (Buncombe County) and currently serves seven western North Carolina counties.
Conetoe Family Life Center, Inc. has a mission to improve the health of the youth and community by increasing access to healthy foods, increasing physical activities, and providing access to health services. The organization operates a farm and beekeeping operation, youth development programs, and food security efforts in rural Eastern North Carolina. Through their Food is Medicine program, which is centered on a partnership with a large university health system, they supply customized food boxes from their farm with wraparound health and wellness information. This includes distribution from the farm, at health care sites, and direct to patients’ homes. Located in Conetoe (Edgecombe County), the organization serves both Edgecombe and Nash counties.
Feast Down East (FDE) strengthens the farming communities in and around the Wilmington area by providing resources, education, and distribution opportunities to farmers while addressing equitable food access in communities with the greatest need. For its Food is Medicine program, Feast Down East works in partnership with medical providers from the local health system to fulfill food prescriptions for individuals identified as food insecure with fresh food that comes from (often small) local, traditionally disadvantaged farmers seeking new outlets for their products. Food is distributed at mobile farmer’s markets which visit public housing communities, after school programs, community centers, and community-based health care locations. The organization has locations in Burgaw (Pender County) and Wilmington (New Hanover County) and serves Brunswick, New Hanover, and Pender counties.
Green Rural Redevelopment Organization (GRRO) was founded to address poverty, food insecurity, and chronic diseases in rural North Carolina. What began as a grassroots effort to revitalize rural communities through micro-market farming and food-based entrepreneurship has grown to addressing acute and upstream causes of hunger and poverty. GRRO’s Food is Medicine operations include a food prescription program in which the organization connects patients of local health care providers to produce and other food items. They also provide nutrition and lifestyle support and connection to wrap-around services including for the Haliwa-Saponi tribal region, working in partnership with a local rural health center. GRRO is a food vendor for North Carolina’s Medicaid Healthy Opportunities Pilot program. The organization is located in Henderson (Vance County) and serves Franklin, Granville, Person, Vance, and Warren counties.
Highland Neighborhood Associationis a grassroots organization located in a historically Black community in Gastonia, not far from the city of Charlotte. Their goal is to support the health and well-being of all the people of their community. Originally started to address acute hunger needs, they have expanded services and programs to serve the community more holistically. This includes a Food is Medicine program where local health providers prescribe food certificates to patients which can be redeemed for prepared meals at the organization’s community-based food operation RAMS (Really Amazing Meals with Soul) Kitchen, or the meals can be delivered. Options include healthy adaptations of culturally relevant foods, prepared by community members familiar with the needs and preferences of their neighbors. The organization is located in Gastonia (Gaston County) and serves Gaston County.
Hunger and Health Coalition is dedicated to empowering neighbors in need through healthy, nutritious food and life-saving medications. They provide Food is Medicine programming in partnership with all local health care providers in the county. Medical professionals screen patients for food insecurity and diet-related disease and use a prescription pad to refer patients to Hunger and Health which provides nutrition education for the whole family, fresh food, medically tailored food boxes, and delivery services for individuals with transportation challenges. The organization is located on Boone (Watauga County) and serves Ashe, Avery, and Watauga counties.
Nourish Up works to help support the 200,000 people in Mecklenburg County facing food insecurity, providing choices in groceries and meals that are nourishing and delicious. Their Food is Medicine program provides healthy food boxes to individuals with a chronic illness and are identified as food insecure. Current partnerships with health care providers, such as hospitals and community clinics, are the main referral systems to help connect their services to individuals who receive nutritionally balanced and healthy non-perishable and perishable items. Patients have the option to pick up food at mobile food pharmacies or receive no-cost home delivery. Based in Charlotte (Mecklenburg County), the organization serves Mecklenburg County.
Reinvestment Partners: is a nonprofit that addresses the problems of poverty and social injustice. Eat Well is the organization’s produce prescription program which provides participants with a pre-paid debit card each month to purchase fruits and vegetables when and where they want, integrating produce prescriptions into the health care sector to meet individuals’ food and health needs. Eat Well leverages best-in-class technology to distribute healthy food funds at scale and make the enrollment and shopping experience as easy as possible. The program – which partners with payers, health systems, care management companies, and community clinics – is largest of its kind in the country. It has served more than 120,000 people, and participants spend as much as $1 million per month in fruits and vegetables at their local retailers The organization is located in Durham (Durham County) and serves all 100 North Carolina counties.
SHARE Winston-Salem, Inc. is a faith-based, food-focused organization, formed to serve the diverse citizens of Winston-Salem, North Carolina. Their mission centers on providing wholesome and nutritional food to families in and around areas designated as food deserts. SHARE Winston-Salem’s Food Pharmacy Project involves a health care provider writing a food prescription for a patient, and then typically that patient brings the prescription to SHARE’s Harvest Market, where a staff nutritionist helps the patient select food items that will support their health and wellness goals. In some cases, patients can order items for delivery. The organization is located in Winston-Salem (Forsyth County) and serves Forsyth County.
TRACTOR Food & Farms is a food hub focused on increasing access to local food by empowering producers and consumers alike, reconnecting people with agriculture for a healthier community, environment, and economy. TRACTOR's Clinical Referral Program procures and delivers locally sourced food to individuals and families experiencing food insecurity or diet-related illnesses. Individuals are referred by local health care providers, and offered CSA-style shares which are available for pick-up or delivery. Local farm products are aggregated to offer a wide selection of seasonal fruits, vegetables, dairy, grain, and meats. Customers may customize weekly shares by setting preferences and/or making direct product selections. Located in Spruce Pine (Mitchell County), the organization serves Avery, Buncombe, Madison, Mitchell, and Yancey Counties.
