We see this searing truth, declared by Dr. Camara Phyllis Jones, epidemiologist and former president of the American Public Health Association, play out every day. While the coronavirus pandemic has ignited an increased awareness of racial health inequity throughout the country, it is incumbent on each of us to understand why this inequity exists and, more importantly, how we can combat it. At God’s Love We Deliver, we use food and nutrition education to address serious illness. We refer to this practice as “food is medicine,” and we know that a good portion of healthcare inequities – both racial and socioeconomic – have to do with lack of access to good nutrition. Food is not only a root cause of racial disparity in health, but also a key factor in the solution.
We, like many other service organizations, have witnessed a huge increase in food insecurity and malnutrition during the coronavirus pandemic. The fault lines in our food and care systems are now craters, and since March 2020, they have exposed how many people have long been one emergency away from hunger. But let’s not forget that the people who are having the hardest time obtaining nutritious foods – people with serious illnesses, disabilities, and those who live in food deserts – are the same people who faced this challenge before the pandemic began.
It has long been known that people of color face higher rates of chronic disease such as diabetes, stroke, heart disease, and cancer than white people and overall worse healthcare outcomes from those diseases. The CDC reports that people of color are across the board more likely to be diagnosed with diabetes than white people. African Americans are 3 times more likely than white people to develop end-stage renal disease, which is often caused by diabetes. Furthermore, a report based on data from the Centers for Disease Control and Prevention and the National Center for Health Statistics reported that diabetes-related mortality per 100,000 was 37.6 for Black Americans and was 19.5 for white Americans. Disparities at each stage of this disease progression, from diabetes to mortality, are in part due to unequal access to nutrition. While nutrition alone will not solve racism, we can use the food is medicine approach as a tool to ameliorate entrenched health inequities.
The good news is that we know nutrition works. It is vital to good health and compared to other clinical interventions, is much less expensive and produces great results. Every day, we witness how medically tailored meals drastically improve our clients’ health. In the early days of HIV/AIDS, nutritious food made it possible for our clients to absorb and adhere to their multiple medications. Today, consumption of medically tailored meals can help people wean off daily medications for various illnesses and drastically transform their lives.
Our client, Nettie, with Brena
For example, our client Nettie is in her 90’s and lives in Queens. She came onto our program at the height of the Covid-19 pandemic because her niece/caretaker was struggling to safely obtain the right food to manage her aunt’s diabetes, hypertension, and COPD. Since she started our program, Nettie’s doctors say that her glucose, hemoglobin A1c and cholesterol numbers have improved, and as a result, she is no longer on insulin. We have countless stories like this, and the peer reviewed research also demonstrates the efficacy of medically tailored meals. Studies show a 50% reduction in hospitalization and a net cost saving of 16% when medically tailored meals are added to a care plan. Our work at God’s Love We Deliver, and the work of other Food is Medicine Coalition organizations across the country, addresses the systemic inequality that already exists and seeks to rebalance health in favor of our clients by providing access to life-saving nutrition.
There is no singular action that will create health equity in America because racism is systemic. However, there are steps that can be made to start to create greater health in communities that have been disproportionately affected by racism and unequal access to care. By providing the right food, tailored to a person’s serious illness, we can have a significant impact on someone’s nutrition and health status. Right now, whether or not a person has access to medically tailored meals depends on where they live and if their insurance provider offers this service. To serve thousands of New Yorkers each year, we raise most of our funding through philanthropic donations. The remainder is from limited government funding and partnerships with health insurance providers who offer medically tailored meals to their members. Our experience is typical of the patchwork system of access and provision across the country which will remain insufficient to meet the growing need for medically tailored meals. A simple change in policy could dramatically increase access to this life-saving intervention. Since so many of those that need our services qualify for public insurance programs, the Centers for Medicare and Medicaid Services must ensure that medically tailored meals become a benefit for people living with severe and chronic illness who are too sick to shop or cook for themselves.
As this pandemic continues to compound and intensify racial and health inequity, we must find meaningful solutions to help those in need. Medically tailored meals are one of the least expensive and most effective ways to improve our healthcare system in an equitable way. This week is National Public Health Week . Let’s finally implement this transformative food is medicine intervention as key to our approach to improving public health, achieving health equity and dismantling systemic racism.