For all the talk about how important food is to health, it can be surprisingly difficult to get healthcare providers to refer patients to sources of healthy food. Island Harvest Food Bank has found a way around that issue by embedding its own dieticians in area hospitals and clinics.
The food bank’s six dieticians work on site at the clinics of four different healthcare systems, a set-up that lets them develop relationships with the healthcare staff and regularly meet with patients. “They’re embedded at the clinic all day, every day,” said Randi Shubin Dresner, President and CEO of the Long Island, NY-based food bank. “The idea was we want to get as close to where the patients are as possible.”
Referring patients to places where they can get healthy food should be a simple matter, but in reality it often falls short. A survey of nearly 150 healthcare providers conducted by Food Research and Action Center in 2023 found that virtually all (99%) agreed that screening for food insecurity is important, but less than half actually execute any type of referral once food insecurity is discovered (see chart). At the same time, food banks or pantries are hardly top of mind in the referral process; only 25% of healthcare providers made referrals to hunger relief agencies.
By placing its dieticians on site, Island Harvest is addressing that problem head on. “It’s not like we’re a visitor on site, we’re an equal partner to [the healthcare centers],” Dresner said. Gaining that status took some time. When Island Harvest first pitched its idea of co-locating to one of the largest health systems, “it literally took two years for them to get comfortable with this whole concept,” Dresner said. “It was a big deal.”
The pandemic, combined with an ever-growing understanding of the value of nutrition to health, has helped to smooth over the resistance. “The hospital system seemed to realize that they need us as much as we need them,” Dresner said. “They recognize the importance of this kind of relationship and how it supports their community.”
When patients get referred to an on-site Island Harvest dietician, they enter into a 12-week “Nutrition Pathways” program that includes regular pick-ups of healthy food from the food bank’s “Healthy Harvest Markets” set up at each partner site. At the regularly scheduled meetings, dieticians help patients understand the connection between the foods they’re eating and their health, medicines and chronic illnesses. They also pass along recipes and sign people up for SNAP.
Being able to receive healthy food at every doctor’s appointment is an important aspect of the program. “It brings patients back to see their doctors more,” Dresner pointed out. “So there are a whole lot of ways that we’re supporting each other.”
The healthcare systems are benefitting from the program by seeing emergency room visits go down and patient outcomes, like blood-sugar levels and weight, improve. Often, an entire household benefits when the head of the household gains some nutrition education. “We get letters all the time from patients in that program telling us how it’s changed their lives and it’s impacting their whole family,” Dresner said.
The co-location program is not the only way Island Harvest is embracing Food is Medicine. Now that New York State has been approved to conduct demonstrations of nutrition’s impact on health via an 1115 waiver, Island Harvest has recently started getting reimbursed for delivering boxes of healthy food to people who are homebound and at risk. Dresner noted that the home delivery service represents the first time the food bank has ever been reimbursed for services provided. “We’re not being fully reimbursed for all of the expenses we have, of course, but it’s the first time that we’ve gotten recognized that way,” she said. – Chris Costanzo
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