Investing in Food as Medicine

In the United States, chronic diseases are the most common and costly, yet the most preventable, health problems. Before COVID-19, cardiovascular disease was the leading cause of death, resulting in about 31% of deaths each year. Low-quality diets drive cardiovascular disease and disproportionately affect low-income and racial-ethnic minority communities. How can investing in food as medicine help, and what does that mean?

These underserved communities are often labeled as food deserts. Food deserts are geographic areas where residents experience severely limited access to affordable and healthy food–– often resulting from systemic inequities. To achieve good health and reduce wasteful healthcare spending, impact investors must advance produce prescriptions for a better future.

The United States Healthcare System

Even before the pandemic, the U.S. led other industrialized nations in healthcare spending, with health spending accounting for 17.7% of the GDP, roughly $3.8 trillion, in 2019. However, the U.S. has reportedly worse health outcomes in comparison to other wealthy nations. For example, an influential study in 2018 showed that life expectancy in the U.S. is 78.8 years, while ten other high-income countries demonstrated a life expectancy range of 80.7 to 83.9. High healthcare costs impact all people, as increased insurance costs have depressed individual spending power in the past decades. 

Nutrition, and the innovative ways that it can be promoted, is slowly gaining traction in the U.S. healthcare system. This approach is multifaceted and can be crucial in both preventing and treating diet-related health ailments. The rise of produce prescription programs is proof that successful models promoting healthy eating are growing in power and number.

Produce Prescriptions

 Produce prescription programs (PPPs) use monetary incentives to promote fruit and vegetable consumption among at-risk patients through identification and referral. These prescriptions provide accessibility to subsidized produce through multiple community partners, including local farmers’ markets, grocery stores, and community-supported agriculture initiatives. These prescriptions serve two critical functions:

• Physicians convey a message that eating produce plays a crucial role in the patient’s short and long term health
• Serves as an initial step to securing insurance coverage and financial support for the prescribed therapy 

Investing in the expansion of PPPs not only increases the financial ability of patients to access healthy food, but the professional recommendation also elevates the value of preventive healthcare. In other words, an authority figure, or the referring physician, can have a role in positively reinforcing healthy habits.

 However, it is imperative to note the power dynamics and ethics of improving diets, especially within historically marginalized communities. Because diet quality often lies at an intersection of culture, education, and economics, physicians and PPPs must collaborate with patients and community leaders to successfully improve the availability and intake of nutritious foods. 

Case Study: VeggieRx, Chicago 

In the North Lawndale neighborhood of Chicago, the diabetes mortality rate is 62% higher than the national average. Since 2019, the VeggieRx PPP has offered residents experiencing diet-related ailments and food insecurity the opportunity to pick up a weekly selection of fresh fruit and vegetables, as well as complimentary cooking classes. 

While VeggieRx, like many PPPs, is too young to show data reflecting community health, the program demonstrated rapidly increasing demand during COVID-19. Before the pandemic hit, this organization was providing roughly 35 to 70 boxes a week. After, demand surged up to 130 to 160 boxes weekly. While the pandemic has placed a financial strain on families, requiring them to stretch food dollars, VeggieRx also attributes the increased demand to clients interested in strengthening their immune system. Many have pre-existing diet-related health conditions and now are at a greater risk for COVID-19. 

Food For Thought

Addressing the challenges of food insecurity and problems in the U.S. healthcare system have been priorities for impact investing even before the pandemic. According to a 2019 simulation study of Medicare and Medicaid recipients, providing just a 30% subsidy on fruits and vegetables could prevent nearly 2 million cardiovascular events and save almost $40 million in annual healthcare costs. With COVID-19, as inequities have run deeper, there is increased opportunity to focus on long-term and systemic solutions.  

Ultimately, impact investors who fund preventative healthcare solutions like PPPs can affect the social, economic, and physical barriers to healthy food choices while also shaping and reforming a limited healthcare system.