Food is Medicine
North Carolina is fertile ground for an approach that bolsters health care’s role in addressing food security and opens doors to healthy food, all while leveraging the expertise and leadership of two of the state’s great resources - its people and the work of our community-based organizations.
This promising approach features partnerships between community-based organizations and the health care sector that leverage the inextricable links between food, nutrition, and health. In these programs, health care providers assess patients for diet-related conditions and/or food insecurity. They then prescribe a food-based intervention, delivered by local organizations with long-standing ties within their community.
Like many medications, Food is Medicine programs are not a cure all. However, they are many great things, including most significantly a pathway to food security, nutrition, and health. They are community driven and customized rather than a one size fits all approach. They meet people where they are. And they leverage, and marry, the expertise and trust of health care providers with the capabilities and wrap-around services of community organizations to serve the unique needs of residents.
In an era of deepening focus on shifts to value-based care and increased attention on non-medical drivers of health, growing community-based Food is Medicine could not be timelier, both in North Carolina and throughout the country. With them, the health care sector and others have an emerging opportunity to meaningfully move the dial on addressing food security and reducing diet-related conditions.
Understanding this potential, our foundation funded a statewide scan of Healthy Food Prescription interventions to learn more. From this, we saw the opportunity to strengthen the work happening in our state, which has resulted in a $4.5 million investment to support, and learn from, 10 community-based Food is Medicine programs throughout North Carolina. They range from small operations serving historically under-resourced neighborhoods to the largest produce prescription program in the country, whose footprint spans the entire state.
Collectively, these programs showcase the gambit of possibilities within community-based Food is Medicine, including:
- Solutions for urban, rural, and Tribal communities.
- An array of interventions ranging from vouchers and medically tailored meals to fresh food from local farms.
- Diverse health care partnerships including health plans, health systems, community health centers, and more.
Each organization – detailed below – is receiving three years of funding and technical assistance 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.
