Food as Medicine
by Madeleine Richter-Atkinson, Jamie Dudensing
Experts estimate that direct medical care affects only 15-20% of a person’s overall wellness, whereas the conditions in which people are born, grow, live, and work — social determinants of health (SDOH) — play a much greater role. To encourage better outcomes, health plans are working in communities to help address SDOH, including the need for healthy food.
Food security is the most commonly unmet social need, but health insurance providers are looking to fix that. In fact, every Texas Medicaid managed care plan is helping to address food insecurity and many health insurance providers have initiatives to bring healthy foods to specific populations of patients who are chronically ill or face barriers to accessing nutritious foods.
Whether due to living in a food desert, lacking the income to afford food, or lacking the mobility to make a trip to the grocery store, 1 in 7 Texans experiences food insecurity. Malnutrition and poor diets lead to chronic illnesses — such as heart disease, hypertension, type 2 diabetes, and obesity — that account for 70% of deaths in the U.S. every year and result in more frequent ER visits. Compared to people who have food security, those who don’t are 2.4 times more likely to have multiple ER visits, resulting in higher health care costs for everyone.
14% of Texans experienced food insecurity before the COVID-19 crisis — but as a result of the pandemic, that number grew to 16.5%, increasing the food-related burdens on our health care system. In response to the sudden surge of food insecurity, health plans got to work to get good food to those who needed it, expanding upon their existing food access programs.
UnitedHealthcare supported 1,995 members and distributed over 28,000 meals in the first two months of the pandemic alone, and Molina Healthcare of Texas continues to donate to food banks and run food drives to benefit their members most impacted by the pandemic. Anthem Blue Cross and its Foundation have donated $200,000 to Feeding America and the United Way — representing a portion of the nearly $4 million they have committed to COVID-19 relief.
Superior Health Plan partners with more than a dozen food banks across Texas, helping to support those in need. This includes the Salvation Army food pantry trailer, which serves tens of thousands of individuals from low-income communities across Dallas. Another recent initiativewill open a food pantry in Laredo to serve 250 Prospera residents and about 50 other members in Laredo.
Access to food on its own is not enough to improve health outcomes and reduce the cost of care across the board. A point of serious concern for positive health outcomes is accessibility to food with nutritional value. Though food banks significantly reduce food insecurity, oftentimes food donated to the banks is “hand-me-down” food high in sugar, fats, and salts. And in grocery stores, the cost of food has been rising significantly.
Even when affordable, fresh, nutritious food is often still too far away for many to access and is impractical for many to purchase when it is not shelf-stable and requires more time to prepare and cook — a complementary solution is needed to ensure a balanced diet.
From food delivery services to mobile food pantries, health insurance providers are investing in innovative models to increase access to nutritious foods and ultimately improve health care outcomes for their members.
In addition to its support of local food banks, Superior also supports the San Antonio Food Bank’s Mobile Mercado, a mobile food pantry it is now bringing to Prospera properties. Furthermore, Superior is providing members with vouchers to expand access to fresh produce and healthier foods for the whole family.
Meanwhile, Blue Cross Blue Shield of Texas provides in-home meal delivery services for STAR Kids members returning home after surgery. Several plans, such as UnitedHealthcare, Bright Health, and Humana provide meal delivery services for Medicare members who may be limited in mobility and access to food post-discharge. Molina Healthcare additionally offers home meal delivery services for its elderly and disabled members.
Studies show these programs work. In one study, researchers found seniors who participated in a medically tailored meal delivery program had fewer emergency department visits, hospital admissions, and emergency transportation trips, compared to those who did not participate. Further, medical spending for those in the medically tailored meal delivery program decreased about $570 per month per person.
Successful, sustainable interventions to food insecurity and improved nutrition include community-based support with programs that focus on increasing access and promoting behavior changes related to food preparation. Implementation of these services don’t just serve the individuals who directly need them — it serves communities by lowering the cost of care for conditions associated with malnutrition.
This article is part of a series on five categories of social determinants of health. Learn more about SDOH and read our articles on transportation, education, employment, and food to learn more about how each category affects overall health.
Make sure to check out our Texas Covered conference this November, where our panels on SDOH and health equity will feature experts discussing current issues and solutions to improve health outcomes and reduce the cost of care.