Grady Health System, a premier level I trauma center in downtown Atlanta, is located in a fast-growing community where a large portion of the population faces food insecurity. To address this need, UnitedHealthcare Community & State came alongside Grady Health System, Atlanta Community Food Bank, and local nonprofit Open Hand to create the Food as Medicine partnership, which focuses on making sure patients and their families have access to healthy food that aligns with their specific dietary needs. Through the partnership’s innovative, on-site Food as Medicine Center (known as the Jesse Hill Market), patients have access to a food pharmacy, farmer’s market, café and teaching kitchen. This puts food directly in the hands of those who need it during their care visit at Grady Hospital.
Assessing food insecurity through patient screenings
Half of Grady Health System’s patient population are food insecure, and 63% of their patients diagnosed with diabetes face food insecurity. And since the onset of COVID-19, they have seen a 50% increase in food insecurity in the Atlanta metro region. Knowing the impact that food can have on health outcomes, especially for those with diabetes, Grady set out to ensure that all patients that entered their doors — whether through the emergency department, clinic or for surgery — were screened for food insecurity and provided food, as needed.
Half of Grady Health System’s patient population are food insecure, and 63% of their patients diagnosed with diabetes face food insecurity.
At the beginning of the initiative, all patients at Grady were asked four questions as part of a formalized food screening. If the patient’s answers rated them as living in a food insecure household, a dietician referred them to food pantries near their home. However, this referral system only resulted in a 20% adherence rate, as many patients faced social barriers, such as lack of transportation or childcare, that prevented them from getting to a food pantry during open hours.
To adjust the program to accommodate these barriers, Grady partnered with the Atlanta Community Food Bank, which focuses on building meals for medically fragile populations in the community, to open an on-site food pharmacy. Now, when patients screen positive for food insecurity, they receive a prescription to the food pharmacy located at the on-campus Jesse Hill Market. This prescription includes a full set of meals for all individuals in a person’s household and accommodates dietary needs and restrictions based on a patient’s condition and medications.
Because most Atlanta-area individuals facing food insecurity utilize food pantry services on average of 8 – 12 months, all food prescriptions are renewable. When patients return for follow-up appointments, they can receive another prescription to the food pharmacy for additional meal boxes. And to serve these individuals outside of their clinical care appointments, the pharmacy still helps connect individuals with their closest community food pantry to meet ongoing needs.
On-campus café and market contributes to sustainable model
Jesse Hill Market was built on the health system’s campus, which houses the food pharmacy, as well as a teaching kitchen, a farmer’s market and a café run by Open Hand. Through the café and farmer’s market, Grady’s 6000 employees and any visitors can purchase healthy foods and meals, with all profits running back into the program.
Through the café and farmer’s market, Grady’s 600 employees and any visitors can purchase healthy foods and meals, with all profits running back into the program.
Because healthy foods are not always easily accessible to patients, the teaching kitchen offers free classes that shows patients how to prepare the foods included in their pharmacy boxes. This helps reduce food waste, provides a fun and interactive experience to encourage healthy eating and ensures that individuals will not only have food, but will also enjoy eating it.
While the Jesse Hill Market is projected to self-sustain its own funding in the next several years, funding is currently provided by UnitedHealthcare Community & State and the other Food as Medicine partners.
Measuring food pharmacy success
Construction delays while building the Jesse Hill Market and the onset of COVID-19 postponed the market’s grand opening, which was originally scheduled for November 2019. Since its true opening in August 2020, Grady has been collecting data and anticipates that screening results will begin to stabilize as individuals regularly connect with the food pharmacy. During these initial months, Grady will also be working to ensure that the initiative is getting the right produce to the right patients, in addition to gauging the program’s ease of use and effectiveness among patients, providers and nutritionists. They will also continue to assess health outcomes on a 6-month basis as the program becomes more established.
Within the first three years of operation, Grady anticipates that more than one million pounds of food will be distributed to 8,000 patients and 16,000 household members through the food pharmacy.
Within the first three years of operation, Grady anticipates that more than one million pounds of food will be distributed to 8,000 patients and 16,000 household members through the food pharmacy. In the long-term, the team hopes this model will be picked up across the Atlanta region.
While the Food As Medicine model is starting to gain momentum across the country, the Atlanta Community Food Bank stands out as one of the first free-standing centers to provide these services. By showing how partnerships with nonprofits can contribute to a successful model, other health systems can more easily adopt a similar approach to addressing food insecurity.
Providing ongoing support for food programs
Through this innovative approach, our partnership has created an opportunity for individuals in the Atlanta community to receive food and education on healthy eating practices. This will not only empower patients to take advantage of healthy choices outside of a health care setting, but will allow them to take better control of their health long term.