Ensuring Access in Food Is Medicine

The U.S. Department of Health and Human Services (HHS) is committed to improving health outcomes and advancing the health and well-being of all Americans by expanding access to high-quality care, strengthening prevention efforts, and supporting health care providers who serve individuals at increased risk for poor health outcomes.

The impact of diet on chronic conditions and other poor health outcomes is well documented. Despite this knowledge, health outcomes resulting from diet-related conditions and disease continue to move in a concerning direction.

Improving access to nutritious, whole foods and supporting individuals in making informed dietary choices are central to preventing and managing chronic disease. The toll of diet-related chronic conditions is not distributed equally and is a result of a complex web of factors that also contribute to differences in health outcomes.

Studies have highlighted the many barriers to healthy eating. For example:

• Lack of necessary cookware or knowledge on how to prepare certain foods.
• Poor-quality food at local stores that individuals do not feel safe consuming.
• Insufficient time or energy to regularly prepare healthy meals.
• Fear within communities with limited access to services or prior negative experiences with institutions.
• Rising cost of living and stagnating wages can perpetuate food insecurity and exacerbate other barriers (e.g., transportation difficulties).
• Potential barriers when redeeming vouchers for fruit and vegetable interventions (e.g., retailers not accepting vouchers) due to a lack of point-of-sale infrastructure.

These challenges highlight the importance of community- and society-level solutions when addressing nutrition inadequacies and chronic health conditions and are important to consider in design of FIM interventions.

Incorporating input from individuals with direct experience during FIM program design and implementation is an essential component to better understand community needsand ensure successful program outcomes. FIM program administrators and physicians can also survey participants on challenges encountered when using FIM programs to identify barriers and personalize FIM interventions based on participant needs.

Best practices to collaborate with individuals with lived experience include:

1. Engage with trusted community leaders and organizations 
2. Facilitate open forums with community members, such as listening sessions, focus groups, and individual assessments throughout program design, implementation, and evaluation 
3. Evaluate the landscape of assets and barriers in the community 
4. Establish communication channels that foster ongoing feedback and adaption to support longevity of programs 
5. Compensate community members for their time and expertise

These practices should be applied when designing FIM interventions. It is important to establish a network of trusted community partners, especially those with lived experience and a deep understanding of the population served by the FIM intervention as well as the food landscape in which the program is implemented.   

As the health care system shifts toward identifying and addressing individuals’ social risk factors, creating opportunities for organizations from different sectors to come together with a shared vision and collaborative approach that align with the needs and preferences of the populations served will improve care coordination and outcomes.

Food is not merely a source of nutrients; it can be tied to cultural, religious, and personal identities. Many cultures and populations have linked food with medicine for centuries, and the distinction between food and medicine varies between cultures and time periods.

Ensuring cultural sensitivity in FIM and food assistance programs remains a major challenge that can limit the effectiveness of these programs. Multiple authors have highlighted approaches for ensuring cultural sensitivity in FIM interventions, including the following:

• Partnering with community-based organizations and participants during the design and implementation of FIM programs   
• Providing greater flexibility in FIM offerings and ways to access resources, including the option for vouchers rather than preset boxes or offerings at food pantries 
• Providing opportunities for communication and collaboration between program participants (e.g., trading recipes, tips, and other support) 
• Partnering with community champions to identify potential barriers and encourage FIM program use 

HHS resources have described qualities and actions that partners in different sectors contribute to help build a stronger, more integrated health and social care system that supports Food Is Medicine interventions. 

Methods and Emerging Strategies to Engage People with Lived Experience 

This brief identifies methods and emerging strategies [PDF - 1,489 KB] to engage people with lived experience in federal research, programming, and policymaking. It draws on lessons learned from federal initiatives across a range of human services areas to identify ways that federal staff can meaningfully and effectively engage people with lived experience. 

Supporting Food and Nutrition Security through Healthcare 

This resource summarizes the ways [PDF - 12.2 MB] in which health care systems, public health practitioners, and public health allies can partner to support food and nutrition security in their communities through programs, policies, and practices. 

It is written through the lens of supporting actors to work together to address diet-related health outcomes, including health care systems and payors, state health agencies, local health departments, and other public health allies such as universities, community-based organizations, and Centers for Disease Control and Prevention (CDC) grantees.