Increasing meals available to children and their families by integrating nutrition assistance and food access into healthcare’s services and investments in social determinants of health.
Like education, health care is a system that touches nearly all families, and as such, presents a compelling opportunity to broaden our reach beyond schools and community organizations. Our vision is to significantly increase meals available to children and their families by integrating nutrition assistance and food access into healthcare’s services and investments in social determinants of health.
For children living in households experiencing low income, higher rates of food insecurity, diet related disease and the lack of access to affordable healthy food can cause immediate and long term health challenges:
- Children and adolescents experiencing food insecurity are more likely to have overall worse general health. ( Thomas, M. M. C., Miller, D. P., & Morrissey, T. W. (2019). Food Insecurity and Child Health. Available at: https://publications.aap.org/pediatrics/article/144/4/e20190397/38475/Food-Insecurity-and-Child-Health ; Hartline-Grafton, H., Hassink, S.G. (2020). Food Insecurity and Health: Practices and Policies to Address Food Insecurity among Children. Available at: https://doi.org/10.1016/j.acap.2020.07.006 )
- Food insecurity in early childhood is associated with behavioral problems, anemia, and asthma at rates higher than those found among children who are food secure. Craig Gundersen & James P. Ziliak, Food Insecurity and Health Outcomes, 34 HEALTH AFFAIRS 1830 (2015), https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2015.0645
- Food insecurity and malnutrition in childhood impacts health outcomes and presents an increased risk for disease in adulthood. (Victora, C. G. V., Adair, L., Fall, C., Hallal, P. C., Martorell, R., Richter, L., & Sachdev, H. S. (2008). Maternal and child undernutrition: consequences for adult health and human capital. Available at: https://www.thelancet.com/article/S0140-6736(07)61692-4/fulltext)
Informed by a comprehensive landscape analysis and learning from pilot projects, No Kid Hungry’s current and future health strategies work centers on reaching kids and families at risk of hunger by focusing on three Medicaid health systems: (1) Managed Care Organizations; (2) Networks of School-Based Health Centers; and (3) State-Level Medicaid Managed Care Contract Procurement and Clinical Quality Improvement Strategies.
Challenges in meeting social and economic needs can lead to poor health outcomes, driving up healthcare costs and contributing to disparities. Given this impact, Medicaid programs are increasingly focused on addressing social determinants of health and health equity across the Medicaid population.
- The Medicaid system is instrumental in providing health coverage for millions of children from low income households. It presents a tremendous opportunity for integrating food access in healthcare delivery.
Share Our Strength's Health Systems team is working with HealthBegins to develop strategies that address family food insecurity by impacting and leveraging state Medicaid policy. This work is currently in development.
Innovative partnerships with Medicaid Managed Care Organizations - insurance providers - to increase access to meals and federal nutrition programs for families.
Healthy Families Produce Rx
Healthy Families Produce Rx is an innovative food access program for Medicaid enrollees, developed in partnership with Aetna Better Health of Louisiana, Share Our Strength’s No Kid Hungry campaign, Vouchers for Veggies, and LSU Ag Center. With funding from the USDA’s Gus Schumacher Nutrition Incentive Grant Program (GusNIP) the program will provide eligible families in six rural Louisiana parishes with $40 per month to purchase fresh fruits and vegetables at select local farmers markets and grocery retailers. The goal of the program is to improve dietary health and food security for families in these communities who are disproportionately impacted by poor nutrition and related health outcomes.
Nutrition in Housing
In partnership with UnitedHealthcare, we are integrating nutrition access and education programs within the existing services and culture of affordable housing communities that serve families. The vision for this project is healthier, food-secure communities where residents can access affordable quality nutrition with choice, confidence and dignity.
We currently have partnerships with two affordable housing developers:
By embracing and building on families’ trust in school-based health centers, we are promoting federal nutrition programs and nutritious food consumption in support of positive health outcomes and improved food security
In partnership with the School-Based Health Alliance (SBHA), we are addressing access to healthy food as a social determinant of health with a learning network of school-based health centers. The School-Based Health Center Learning Network (SBHCLN) is a food security initiative at the intersection of school environments and healthcare systems.
SBHCLN seeks to achieve three goals:
- Create or expand a local health center model that will identify food insecure students and connect them and their families to healthy food resource(s) and nutrition education;
- Evaluate the model to understand the impact on (1) Student health outcomes, (2) Student food security, and (3) Student fruit and vegetable consumption; and
- Develop promising practices for integration of food security models in school-based health center workflows.
In 2022, through an investment of nearly $400,000, 16 school-based health centers implemented community-driven food security solutions in their health center over an 11-month period (February – December 2022). SBHCN members participated in monthly sessions to learn from each other and other experts in this work. As a continuation of the pilot learning network in 2022, eleven SBHCs received funds to build on their projects and learning. The SBHCs have been funded for this capacity building and program expansion opportunity from February 2023-June 2024.
A list of awardees can be found here.
- 2023 Grantees
- 2022 Grantees
Synergy Health Tech
NKH supported the launch of Synergy Health Technologies' mobile grocery app in a family affordable housing community to enable residents to receive healthy food delivery and Cooking Matters nutrition education. In the next phase of this project, we hope to gain more understanding of how the grocery delivery program, alongside using SNAP benefits online, impacts food security, diet quality and health-related quality of life for participants.
Learn more Attached report
Feed to Heal
Cambridge Health Alliance’s “Feed to Heal” project is an initiative initially created during the height of the Covid-19 pandemic to connect quarantining food insecure patients with free, contactless food delivery. Seeing the potential for this referral model beyond quarantine, Feed to Heal got to work building out a technology-based system that deepens collaborations between healthcare systems and community food organizations with the goal of connecting patients, providers, health care systems, and food pantries.
Learn more about Feed to Heal’s successes connecting families with meals and other food supports in this case study.
Rural Produce Rx Toolkit and Learning Cohort
Providing access to healthy foods, especially produce, is increasingly becoming a priority for community organizations and health care entities seeking to address social determinants of health.
The Share Our Strength’s No Kid Hungry campaign (NKH) is addressing access to healthy food as a social determinant of health by providing support to rural produce prescription programs. Produce prescription interventions have been popular as a means for addressing nutrition insecurity. Unfortunately, most of these interventions have been piloted in urban areas, thus the collective learning captured in resources meant to help communities adopt and scale these practices largely leave out key considerations that make the application of such models useful in rural areas.
NKH grantees will integrate lessons learned from established produce prescription programs to build capacity and sustainability for rural communities. Grounded in the belief that produce prescription programs should be uniquely tailored to meet the specific needs of each community, NKH partnered with Vouchers 4 Veggies to research and develop a toolkit focused on implementing programs in rural areas. By sharing strategies and lessons learned from produce prescription programs operating in rural areas across the country, this toolkit identifies specific ways to utilize community strengths and assets to address the unique challenges often faced by produce prescription program operators in rural communities.
Through this investment of nearly $500,000, 10 rural produce prescription operators will implement programs utilizing the toolkit and access to a learning cohort over an 18-month period. Goals of the learning cohort include:
- Addressing the key challenges that established rural produce Rx programs report facing in community-based capacity and funding
- Strengthening and scaling rural clinical-community partnerships’ capacity to connect families with food and nutrition programs
- Helping rural produce Rx programs increase food resources available to families
- Expanding the reach of established rural produce Rx programs via effective practices
- Helping rural produce Rx programs to develop local strategies for project sustainability
A list of the grantee organizations is included below:
Rural Clinic and Community Food Access Innovations Cohort
This learning cohort is part of a pilot effort to test emerging strategies that leverage the potential of health care settings and systems to expand access to food and to nutrition programs for families. The ultimate goal of this learning community is to provide tested clinical-community food access interventions that are locally sustainable and that can be leveraged in other rural areas to address food needs of families before hunger becomes a crisis. These partnerships are being supported with a two-year grant (Jan 2021-December 2022) from NKH, and are each engaged in a community-centered approach to increasing access to food through produce RX and voucher programs in cooperation with local health clinics.
Learn more cohort projects here.
Existing models and external resources available to connect children and their families with healthy food access through integration with healthcare services
Healthcare settings have increasingly become venues where food insecurity and other social determinants of health needs are identified. However, addressing patients’ social needs in a consistent and sustainable way has proved challenging. Patients experiencing food insecurity may be referred to federal nutrition programs or other local food access programs (such as a local food pantry). A variety of referral systems, food resources and funding mechanisms have emerged to meet patient food needs. Some existing models include:
American Academy of Pediatrics and The Food Research & Action Center. (2021). Screen and Intervene: A Toolkit for Pediatricians to Address Food Insecurity. Available at: https://frac.org/aaptoolkit