Optimal health care outcomes can be difficult to achieve if patients don’t have food on the table at home. Essential hospitals face this challenge daily; nationwide, they serve more than 10 million patients who lack access to healthy food.

Food insecurity, a key social determinant of health, occurs when individuals have limited or unreliable access to nutritious, substantial foods. Restricted availability of healthy meals often drives individuals to seek other measures to avoid starvation, including eating low-cost foods that lack nutritional value, skipping meals, and overeating during concentrated periods of time.

Food-insecure individuals not only struggle with hunger but also can experience weight gain and obesity, caused by overconsumption of inexpensive food that has high levels of sugar and fat. Lack of access to healthy food and the subsequent adoption of coping habits can lead to chronic conditions , including hypertension, diabetes, cardiovascular disease, anemia, decreased nutrient intake, asthma, tooth decay, infection, and birth defects.

The vulnerable populations that essential hospitals serve experience disproportionately high rates of food insecurity and related chronic conditions. Low-income patients with chronic conditions also are more likely to use emergency rooms for treatment, driving up hospital operating costs. Decreasing the prevalence of food insecurity can lead to long-term cost savings for a hospital while also serving the community at-large.

Essential Hospitals Taking On Food Insecurity

At a July 31 briefing on Capitol Hill, representatives from association members UMass Memorial Health Care (UMMHC), in Worcester, Mass., and Hurley Medical Center, in Flint, Mich., shared initiatives to improve access to affordable, healthy food in their communities. Attendees from various congressional offices joined a discussion on how this issue affects the communities they serve.

Alisa Craig and Melany Gavulic (left), from Hurley Medical Center, join Monica Lowell and Douglas Brown (right), from UMass Memorial Health Care, to share their food insecurity initiatives with congressional staff on Capitol Hill.

Alisa Craig and Melany Gavulic (left), from Hurley Medical Center, join Monica Lowell and Douglas Brown (right), from UMass Memorial Health Care, to share their food insecurity initiatives with congressional staff on Capitol Hill. Photo by Madeline White.

Community Gardens and the Veggie Mobile

UMMHC serves a community with a large Hispanic population, which faces disproportionate rates of food insecurity, as well as diabetes, heart disease, obesity, and cancer. Douglas Brown, president of UMass Memorial Community Hospitals and chief administrative officer of UMMHC, and Monica Lowell, vice president of community relations at UMMHC, explained how this complex patient population inspired them to take a preventive approach to fighting food insecurity.

UMMHC identified community health priorities through a community health assessment, which validated that access to healthy food and hunger were primary issues challenging the individuals of Worcester. With assistance from local partners, the health system developed three community gardens in underserved areas that lack access to fresh, affordable produce. A single garden produces 500 to 800 pounds of produce annually, which is transported around the neighborhood by the Veggie Mobile. Supported by the Regional Environmental Council, a program partner, this delivery truck doubles as a pop-up farmers market. The success of this initiative has expanded demand for fresh produce, so UMMHC leaders established 26 backyard gardens to provide healthy food to even more residents.

Map of Veggie Mobile route and community gardens

This map depicts stops on the Veggie Mobile route (pink) and the backyard and community gardens that have been established (green). Courtesy of UMass Memorial Health Care.

In addition, UMMHC now hosts a “Cooking Matters” course using curriculum developed by the anti-hunger advocacy organization Share Our Strength. The class offers a guided grocery store trip to teach healthy shopping habits and provides hands-on cooking instructions.

Food FARMacy

Targeting food insecurity also has proved to be an effective recruitment tool at essential hospitals. Hurley Medical Center prioritizes community outreach and partnerships, and the hospital’s efforts to fight food insecurity help attract new physicians and employees who seek to work for an organization that cares for the community.

Melany Gavulic, president and CEO, and Alisa Craig, administrator of population health, explained how the community need and the desire to attract mission-driven professionals motivated them to create the Food FARMacy.

This onsite food supply center ensures that patients who screen positive for food insecurity can access immediate assistance. The hospital implemented a routine screening process through the EPIC electronic medical record, asking two questions that allow patients to express any difficulty they have had accessing food in the past 12 months. Patients and family members can go to the Food FARMacy and select from a wide variety of foods that align with the U.S. Department of Agriculture’s MyPlate nutritional guidelines, as well as receive advice on how to create complete meals.

Food FARMacy referral slip

A referral slip from Hurley Medical Center displays hours, directions, and transportation assistance for patients to access the Food FARMacy.

Through partnerships with local food banks and foundations, Hurley’s Food FARMacy has provided nutritional food and resources to more than 2,200 household members. The hospital recently received a new grant to fill this growing demand by expanding the Food FARMacy at other local, non-Hurley clinics, and preparing emergency take-home food bags for individuals.

The initiatives implemented by these and other essential hospitals provide needed nutritional resources to communities, but food insecurity still threatens thousands of individuals and families in the United States. Essential hospitals are in a unique position to continue creating population health initiatives that can address the social determinants of health that affect their patient population and the larger community.

Essential Hospitals Institute’s Essential Communities website highlights population health initiatives across the country and additional resources on the social determinants of health.

To learn more about food insecurity as a health care issue, read our research brief on Food Insecurity, Health Equity, and Essential Hospitals.