The US Department of Agriculture (USDA) Gus Schumacher Nutrition Incentive Program’s (GusNIP) Produce Prescription and Nutrition Incentive program has awarded $500,000 over three years to support the Produce for Health in Hampshire County’s Food Desert Communities project.
Healthy Hampshire focuses on building communities that support nourished, active, and joyful residents who are empowered to shape the places they live and the lives they lead; and will be part of this work.
Caitlin Marquis is a member of the Healthy Hampshire team. She’s passionate about working to solve food insecurity issues. Caitlin views this as the next step in the ongoing journey toward ensuring that low-income residents and those with health issues have access to the food that they need to eat for better health. This means increasing the availability of healthy food close by, by working to provide food sources within “food deserts”; and improving local residents’ ability to afford the foods locally that support better health.
A lot has been accomplished. In 2019, the Collaborative for Educational Services (CES) and 10 other partner organizations, including the Hilltown Community Health Center, received a 2 year state grant from the Social Determinants Partnership Program to address inequities in the food system and to design and implement a distribution system for healthy food that would connect the underserved members of the community to healthier affordable produce. Because Hilltown Community Health Center is a federally funded health center, they work in particular with many low income patients or those who are medically underserved.
A year later, CES was one of the partners along with Hilltown Community Health Center and Cooley Dickinson Health Care in a significant grant from the Massachusetts Health Policy Commision’s Moving Massachusetts Upstream investment program to improve access to healthier food via development of a Hampshire County Food Policy Council. The funding would “provide opportunities for residents experiencing food insecurity to assume leadership positions as part of this new council,” according to Marquis.
The Hampshire County Food Policy Council, was first discussed in 2017 after a food access assessment from Healthy Hampshire, and culminated in the launch of the council in 2020. The food policy council focused on giving a voice to those in the area who struggled with food insecurity – to have a seat at the table and help to make change. “The fact that we have spent so much time thinking about how to make the council an inclusive space makes me confident that anyone who feels passionate about food justice will be able to find a home there,” said Marquis at the time.
“It’s been five years since Healthy Hampshire first partnered with the Hilltown Community Health Center to try to figure out different ways to refer their patients to healthy food resources,” says Marquis. The goal in recent years is connecting the patients at Hilltown Community Health Center not only to healthy food, but to the resources within the community. An example was the creation of the Amherst Mobile Market as an accessible, local food resource. Hilltown Community Health Center has referred patients to the market via the John P. Musante Health Center in Amherst. The Amherst Mobile Market Planning Committee’s goals for the Market included the design and implementation of a mobile market model that was affordable, provided economic opportunity for community members, sourced food from local farms, and included a culinary education component.
The Amherst Mobile Market offers the ability to purchase fresh seasonal, locally grown vegetables and fruits at multiple locations each week. After two years of planning, the Amherst Mobile Market completed its first active year, a 12 week season in 2020. According to the organizers, “71% of customers had annual household incomes of less than $50,000 and 33% had annual household incomes of less than $15,000. Customers were able to purchase 6-item farm shares for $5 a week, and were able to pay with SNAP, HIP, P-EBT, WIC, or Senior Farmers Market Nutrition Program coupons.” In 2022, there were five sites for the market each week.
Now the work begins that will be supported by the USDA GusNIP grant. Hilltown Community Health Center will first look at their internal data to identify a population of patients to call and recruit. Initially, there will be a cohort of 50 patients meeting the eligibility criteria – low income, eligible for SNAP, medicare or medicaid, with specific pre-existing medical conditions – perhaps an elevated A1C, elevated blood pressure, or BMI at a certain level with a followup plan.
These participants will receive $40 a month on a payment card for fruit and vegetable purchases. Purchases will be similar to those made using programs such as the “Healthy Incentives program (HIP) and SNAP,” says Marquis. Making these fruit and vegetable purchases “will be a little bit easier for the participants” as the cards may be used at places such as Stop and Shop and Walmart Supercenters – places people are already shopping.” The cards will also be taken at the Hilltown Mobile Market permanent farm stand in Worthington and by vendors at the Florence Farmers Market.
The USDA looks at this as a research study in many ways, and data will be shared as part of this grant. The University of Massachusetts School of Nursing is a key partner on the project, to ensure that the research elements are managed appropriately
Memnun Seven, an oncology nurse and scientist at the University of Massachusetts, will be part of the grant team. Seven does research relating to improving health behaviors among people affected by cancer, with a focus on underserved and minority populations. “Although health behaviors are considered as personal choice in many contexts, social and structural inequities can be barriers or facilitators for these behaviors,” noted Seven, explaining that “unhealthy eating associated with food insecurity plays an important role in chronic disease management including cancer. To promote healthy eating, we need to address the economic and social condition of limited or uncertain access to adequate food.”
Seven explained that, as a researcher, she would be “working with other researchers and research assistants at UMass to evaluate the effect of the Produce Prescription Program through data on consumption of fresh fruits and vegetables, self-efficacy for developing a healthy diet, and healthcare use and associated costs among low-income individuals and households in Hampshire County. Our ultimate goal is to provide recommendations for policy and practice change to mitigate food insecurity among low-income people with or at risk for chronic disease.”
To Marquis, the work ahead signifies that “the health care system is moving towards working on prevention”. The research obtained through the GusNIP work will help drive the discussions about what the next steps are. “This idea of food as medicine and essentially just using food very intentionally as a chronic disease prevention tool – this is an affirmation. It means the time is right to test out the impact of this model and its possible long-term sustainability.”
To learn more about the work of Healthy Hampshire, visit our website.