food as medicine - california wic association
TRANSCRIPT
Food as MedicineMoving Upstream to Improve Our Community’s Health
Steven Chen, MDChief Medical Officer ALL IN Alameda [email protected]
“People are fed by the food industry, which pays no attention to health, and are treated by the health industry, which pays no attention to food.”
– Wendell Berry
“And both the food and health industry pay no attention to the agricultural industry.”
– Steven Chen, MD
ALL INFood as Medicine
Community
Public Safety
Food Farmacy
● Regeneratively grown food● Food as Medicine training● Food prescriptions
Policy Change
Health Plans cover Medically
Supportive Foods coupled with
nutritional and behavioral support
services
1) Screen for food insecurity
2) Treat, prevent, and reverse chronic disease
● GMVs integrate Food Rx● Transdiagnostic● Experiential
Behavioral PharmacyGroup Medical Visits
Move | Nourish | Connect | Be
Clinic X = Native American Health CenterSDOH training on Food Insecurity, Social Isolation
Behavioral Pharmacy
community site
1) Improve health outcomes
2) Improve healthcare utilization
3) Improve food security
ALL IN’s Food as Medicine Initiative supports clinics to move midstream & upstream to make change
The Problem: Clinics are stuck downstream
Food insecurity
Inadequate housing
Legal issues
Safety concerns
Diabetes HypertensionObesity DepressionAnxiety
Social Determinants
of Health (SDOH)
Upstream
Midstream
Clinical Condition
Downstream
Social Isolation
So what? What is the intervention?
Building Food Farmacies at the Clinic
Food Farmacy
● Regeneratively grown food● Food as Medicine training● Food Prescriptions
Clinic X = Native American Health CenterSDOH Training on Food Insecurity
Food Farmacy: Co-located in clinic waiting room
Where does the food for the Food Farmacies come from? Dig Deep Farms
Dig Deep Farms
Permaculture &
Regenerative Ag
Polyculture Composting
VermicultureSheet Mulching
• Carbon sequestration• Pesticide – FREE• Higher nutrient density• Improved soil health
Food Farmacy: Dig Deep Farms & a Green Economy
Building Behavioral Pharmacies at the Clinic
Behavioral PharmacyGroup Medical Visits
Move | Nourish | Connect | Be
Clinic X = Native American Health CenterSDOH Training on Social Isolation
● GMVs integrate Food Rx● Transdiagnostic● Experiential
Behavioral Pharmacy Group Medical Visits - Open Source Wellness
GOOD LUCK
WITH THAT,
I’LL SEE YOU
IN 3
MONTHS!
Behavioral Pharmacy Group Medical Visits: Open Source Wellness
Behavioral Pharmacy Group Medical Visits: Open Source Wellness
1. Experiential
2. Trans-diagnostic: Diabetes, Hypertension, Obesity, Depression, Social Isolation, Food Insecurity, etc.
3. Increased access, productivity without Provider Burnout:
16-25 patients in a group medical visit
What’s Different?
Behavioral Pharmacy Group Medical Visit
Food Farmacy
Food as Medicine: Meeting the COVID Moment
Outcomes: Behavioral Pharmacy Group Medical Visits & Food Rx
4.9
6.3
0
1
2
3
4
5
6
7
Fruits and VegetablesDaily Servings
Pre Post
81.3
145.8
0
20
40
60
80
100
120
140
160
ExerciseWeekly Minutes
Pre Post
All p’s < .001, full sample, n = 97
29%⇑ 80%⇑
Depression p < .001, Anxiety and Loneliness p = .01, depressed subsample, n = 23
12.8
10.8
5.76.5
6.0
3.9
0
2
4
6
8
10
12
14
Depression Anxiety Loneliness
Pre Post
PHQ-9 GAD-7 UCLA 3-item Loneliness Scale
Outcomes: Behavioral Pharmacy Group Medical Visits & Food Rx49%⇓
44% ⇓
32% ⇓
Outcomes: Behavioral Pharmacy Group Medical Visits & Food Rx
d= -1.04, p < 0.01, n=24
Outcomes: Behavioral Pharmacy Group Medical Visits & Food Rx
d = -0.53, p = – 0.14, n = 49
Health & Food & Soil, Connected: Improves Human health, Soil health, & Planetary health