Empowering Patients and Fighting Food Insecurity: The AHN Healthy Food Centers Initiative

The Allegheny Health Network's "Food as Medicine" program addresses food insecurity through comprehensive services including direct food provision, nutrition education, and social support, significantly benefiting patients' health and well-being. The program has expanded and adapted through community partnerships, demonstrating resilience and impact, especially during the COVID-19 pandemic.

The Allegheny Health Network (AHN) Healthy Food Centers (HFC) have implemented a transformative "Food as Medicine" program designed to address food insecurity and empower patients. This program, developed by researchers from the AHN and supported by the USDA and Healthy People 2020 initiatives, aims to mitigate the adverse effects of food insecurity, which affects 10.2% of US households. Food insecurity, defined as limited or uncertain access to nutritionally adequate and safe foods, is increasingly recognized as a critical social determinant of health, contributing significantly to poor health outcomes and higher healthcare costs. The AHN initiative, embedded within a 14-hospital non-profit academic medical system, seeks to combat these issues through a multi-faceted approach involving direct food provision, nutrition education, and connections to essential social services.

Expanding and Sustaining a Vital Initiative

The program began in 2018 with a single site and has since expanded to five locations, demonstrating a model that is both scalable and sustainable. Funding for the Healthy Food Centers comes from a combination of grants, health system backing, and community partnerships, allowing the program to grow and maintain its comprehensive services. Patients are referred to the HFC by their healthcare providers based on their responses to food insecurity screening questions. Once referred, patients receive a variety of services, including access to healthy foods tailored to their medical needs, one-on-one nutrition counseling, and support for other social determinants of health such as SNAP applications and behavioral health referrals.

Comprehensive Nutritional Support

The HFCs are stocked with fresh fruits and vegetables, whole grains, plant-based proteins, lean meats, and low-fat dairy products. Patients receive enough food to last four to five days based on household size. In addition to providing healthy food, the centers offer nutrition resources such as shopping on a budget, healthy cooking tips, cooking classes, weight management, and recipes correlating with the foods provided. The centers also provide personalized nutrition plans tailored to individual medical conditions, helping patients set goals and answer questions. Staff members are trained to connect patients with wraparound services as needed, addressing a broad range of social determinants of health.

Growing Impact and Patient Benefits

Since the inception of the program, a total of 10,778 visits have been recorded across all five HFC sites, with 2,330 being initial visits and 8,458 return visits. Data shows a progressive increase in the number of visits each year, highlighting the growing need for such services. Patients have reported significant benefits from participating in the program. Surveys conducted in 2022 and 2023 revealed that more than 50% of respondents experienced decreased stress, improved access to healthy foods, learned healthier recipes, increased fruit and vegetable intake, and saved money on food. These qualitative outcomes are supported by patient comments emphasizing empowerment, better disease management, and overall improved well-being.

Adapting to the Pandemic Challenge

The program has proven particularly resilient during the COVID-19 pandemic. To address the rising food insecurity and restrictions on patient interactions, the HFC began offering home deliveries and curbside pickups, ensuring that patients continued to receive food despite the challenges posed by the pandemic. Although these modifications temporarily limited some educational aspects of the program, the HFC adapted by providing handouts and recipes in the food bags. Once the immediate threat of the pandemic eased, the centers resumed in-person services, reinstating the comprehensive educational components.

Building Strong Community Partnerships

The Healthy Food Centers have established strong community partnerships to enhance their services. Collaborations with organizations like the Greater Pittsburgh Community Food Bank and 412 Food Rescue have enabled the centers to provide a variety of fresh and shelf-stable food options while preventing food waste. Partnerships with the Food Trust and local farmers markets have allowed for the distribution of prescription produce coupons, further promoting healthy eating habits among patients. Additionally, Travelers Aid supports patients with transportation to and from the centers, facilitating regular visits.

Looking Ahead: Future Goals and Challenges

One of the key challenges facing food as medicine programs is sustainability. The HFC has addressed this issue by leveraging a combination of grant funding, health system support, and community partnerships. Tracking outcomes and utilization data has demonstrated the program's effectiveness and created traction for expanding the number of sites. Despite limitations such as insufficient clinical data, the program's impact is evident through the growth in patient volume, positive survey results, and strong community support.

Moving forward, the HFC aims to expand its reach to more high-need areas within the AHN footprint. The program continues to seek additional funding and support, with the ultimate goal of being recognized as a reimbursable service through insurance providers. By addressing food insecurity and its related health impacts, the AHN Healthy Food Centers represent an innovative and effective model for integrating food security measures within healthcare systems. The comprehensive approach of the HFCs, combining direct food provision, educational resources, and connections to social services, highlights the potential for significant improvements in health outcomes among vulnerable populations.