When a 10-year-old at risk of diabetes goes to the Eisner Pediatric and Family Center in Los Angeles this summer, the doctor might hand them a "prescription" for fruit and vegetables, known as an FVRx. It's more than just a suggestion for better nutrition; the prescription can be redeemed at local farmers markets and the area's 20 Target stores for free produce.
It's one of several FVRx programs across the country, all based on a simple idea. In the past, patients at risk from diet-related diseases who went to the doctor would get advice to change what they ate, but often wouldn't take that advice. The extra incentive of free food—and, perhaps, the officialness of a "prescription"—changes the outcome.
The prescription is a way to give incentives for prevention and potentially avoid years of medical bills for insulin, or treating organ failure or nerve damage, either for the patient or for the public. The top three diet-related diseases, alone, cost taxpayers and the economy almost half a trillion dollars a year.
"Instead of paying for expensive treatment on the back end, [this] puts the doctor or the prescriber in the position of being able to come up with the same diagnosis, tell the patient they need to significantly increase their intake of fruits and vegetables...and then can give them a prescription that actually allows them to afford to purchase the foods they need," says Michel Nischan, founder and CEO of Wholesome Wave, the organization that pioneered FVRx programs.
In Los Angeles, the new program (funded by two grants from Target) is focused on pediatric patients because kids there suffer from particularly bad health; toddlers have the highest obesity rate in the country, at 17%. With the prescription program, low-income kids who qualify will get fruit and vegetable vouchers for their family, so the whole family can change eating habits.
In other cities, such as New York, where the program already exists, the organization has seen nearly half of patients lower their Body Mass Index over a 20-week intervention. Forty five percent also said the program helped increase their food security.
The key is making food affordable. "We found that the single largest barrier that prevents people from being able to make healthier food choice is lack of affordability," he says. "Lack of education is a challenge, but not a barrier. Location—food deserts—is a challenge, not a barrier. What we found is that if we address affordability, and make fresh food affordable, markets will show up in underserved communities, corner stores will carry produce, and people will buy the produce."
Wholesome Wave also works on other programs to make healthy food affordable. One program, launched in 2007, doubled food stamps at farmers markets; in 2014, the federal farm bill put $100 million toward the idea. The organization hopes to do more.
"We also hope to influence the Affordable Care Act, and other kind of big money policy targets, to steer Medicare/Medicaid dollars toward investing in healthy food at the front end—as a much less expensive alternative to paying for treatment at the back end," says Nischan.
They also hope to help doctors hand out more fruit prescriptions. "We believe that there are powerful implications for the program, and it's our intent to scale it significantly," he says.
Correction: This article formerly stated that the toddler obesity rate was 70%. It's 17% percent. We regret the error.
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