Achieving health equity through food as medicine and medically tailored meals: local economic opportunity

Diet-related disparities are attributed to factors experienced by historically disadvantaged communities, such as inadequate access to healthy food and socio-economic stressors. Poor quality diets have contributed to high rates of chronic disease, with nearly 50% of adults suffering from diet-related chronic diseases such as cardiovascular disease, type 2 diabetes, and obesity. Racial and ethnic minorities carry a disproportionate burden of nutrition-related illness, leading to significant health disparities. Health care systems and public health professionals are embracing Food is Medicine (FIM), including medically tailored meals (MTM) as an evidence-based approach to reducing chronic disease risk and health care costs. Recent studies have demonstrated improvements in dietary quality, food security, and the management of diet-sensitive health conditions among high-risk patients who have been provided with MTMs. However, little research has been done on understanding the most effective approaches to reducing health disparities through these programs. Equiti Foods developed Good Bowls as healthy, affordable, good-tasting frozen meals that are convenient, locally sourced / produced, and culturally conscious. Our mission is to decrease health disparities by increasing the availability and consumption of nutritious food in high-need communities while providing economic opportunities for local farms and small businesses. Expanding on our existing Good Bowls approach, we propose to implement a “Food is Medicine” (FIM) program that will tap into existing reimbursement initiatives to bring medically tailored meals to underserved groups at low or no cost in an effort to reduce health disparities. Proposed Specific Aims are to: Aim 1: Form two advisory committees composed of 1) Leaders in Food is Medicine (FIM) Programs, Medicaid waiver programs, and private payer entities who are exploring or promoting FIM interventions including medically tailored meals (MTM) designed to address health disparities; 2) service providers and clients of FIM and MTM programs with relevant lived experience. Aim 2: Expand Equiti Foods’ capacity to produce culturally and medically tailored Good Bowls and family meals through 1) developing new family/child friendly recipes and testing acceptability among current and potential recipients; 2) creating and testing new production models including caterers and rural communitybased commercial kitchens; and 3) building out Equiti Foods’ web platform to link individuals and organizations with a means to acquire healthy, affordable food and while also providing recipes/educational resources; and Aim 3: Use implementation science methods to test feasibility and acceptability of these approaches, and the business case for implementing a FIM program and MTM approach through these programs. This will inform future scale up and revenue generation.