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Eating our Way to Wellness

Tuesday, February 12, 2019   (0 Comments)
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Sarah Sullivan, Executive Director, Gorge Grown



Let’s say you just spent the last of your month’s budget on rent and are unsure how you will feed you children. While visiting the clinic, you share this concern and your doctor writes you a “Veggie Prescription”. Your doctor says that you and your family deserve fresh food, and that it is a cornerstone of your health. You are able to purchase whole fruits and vegetables and something shifts for you and your healthcare provider.


Gorge Grown Food Network and partners launched a unique Veggie Prescription (Veggie Rx) Pilot Program in August of 2015. The primary goal was to provide more access to fresh produce for the 1 in 3 Gorge residents that suffer from hunger. This initiative is just one of several programs to advance Gorge Grown’s mission to create a resilient and inclusive food system that improves the health and well-being of our community.


This is how Veggie Rx works:


First, healthcare and social service providers screen patients for hunger using Oregon Food Bank’s “screen and intervene” questions:


1. In the last 12 months, did you and the people you live with worry that you would run out of food before you were able to get more? 


2. In the last 12 months, did you and the people you live with run out of food before you were able to get more?


Providers then write a ‘prescription’ for those in need. Patients or clients ‘fill’ the $30 prescription at farmers’ markets in the summer months and grocery stores during the remainder of the year for fresh, whole fruits or vegetables.


In just 4 months, the program grew to include over 35 distribution partners and 19 grocery stores/farm stands and all 10 regional farmers markets. Distribution was widespread throughout the Gorge in both Oregon and Washington, making this the most robust program of its kind in the country.


Over 1,000 people enrolled. Healthcare providers reported that they felt more empowered to screen patients for hunger because they could offer them a tangible remedy for their suffering.


Providence Memorial Hospital generously provided funding for an innovative PhotoVoice Evaluation. PhotoVoice puts cameras into the hands of participants to shape a program from the inside based on their questions, experience and feedback. What did those people say?


Veggie Rx participants experienced an improvement in diet, nutrition, physical health, mental health, and financial health.


Participants in the focus groups shared that family members of all ages were consuming more fruits and vegetables. They told us that they were losing weight, felt better, and were experiencing less stress and anxiety. Their children were now comfortable inviting friends over, knowing they had fresh fruit to share.


Participants in the Veggie Rx program do not view the vouchers as a hand out, but as an acceptable alternative medicine that treats the cause of an ailment (hunger).


“My kids came with me to the farmers market. I feel like for the first time they are learning that food doesn’t come from the refrigerator. People work so hard to grow this food for us, and we live in a special place. The food is just better. It’s in season. My son got to try a fresh peach for the first time. His eyes got so big. It’s such a privilege to be there with a person when they try something for the first time.” – Veggie Rx participant


Participants especially enjoyed shopping at the Farmers Markets, often for the first time. Some of them said they never felt like it was “their market” before and cherished their new sense of connection with their community.


A Veggie Rx recipient cooking with her Veggie Rx produce



Hunger is complex, and we know that ultimately it is rooted in poverty. The deeper question we’ve been grappling with is, why is there such economic disparity here?


Hood River was deemed the 22nd richest small town in America in the Bloomberg Index. Yet Hood River Valley Schools indicate some of the highest rates of poverty in the state: over 83% of the children at Mid-Valley Elementary are eligible for free/reduced price lunch. We can assume those children’s families are living below the poverty line, and that school lunches may be where those children get most of their calories.


In 2014, 40 organizations worked together to identify the top health needs in the region through a Community Health Needs Assessment. Information was gathered from more than 1,100 community members in English and Spanish. Through this work, the top two needs identified by community members in the Social Determinants of Health category were food insecurity and affordable housing.


Income for those living in poverty goes to rent and utilities first, so unfortunately the lack of affordable housing and hunger are closely linked.


Veggie Rx participants said that if they had access to more financial resources, they would be able to eat well enough to achieve good physical and mental health. “Fresh food is expensive and you can’t find coupons for it.”


They said they limit themselves to the cheapest food they can buy, often opting for canned, frozen, and processed foods. They worry about the health consequences of eating this way. While many participants suffer from health problems such as diabetes, they told us that they were not able to afford to eat as the doctor recommended. “Now I’m eating fresh, not processed. I crave the nutrition”.


This is the most inspiring, collaborative project I have ever been a part of in all of my 19 years in food systems work, so I’m reticent to end on a less-then-celebratory note.


I wish I could say that we’ve developed the solution to hunger, but the reality is that the demand for fresh food from those that need is most is so enormous that we just could not keep up. We are working hard on figuring out long-term funding and designing the next iteration of the program but in the meantime Veggie Prescriptions are only being distributed through several visionary providers. For example, One Community Health, the regional federally qualified health clinic, is allocating funding from their general operating budget to provide over $35,000 per year in Veggie Rx to their most vulnerable patients. Providence Memorial Hospital in Hood River funds Veggie Rx for their food insecure Oncology patients. A new pilot through Hood River Health Department provides Veggie Rx for 50 pregnant women and their families, with support from the regional Coordinated Care Organization (PacificSource). These families receive a Veggie Rx box, delivered directly to their door, which helps alleviate barriers to accessing fresh food like transportation and childcare.


This is truly revolutionary and now we are field calls from around the county about how we’ve been able to get this far. Still, it’s heartbreaking to field the inquiries about when the program might start back up in full from those suffering from hunger, and from passionate health care workers who now feel helpless again.


How much food can we provide? Other Veggie Rx programs throughout the country have set the minimum ‘dosage’ at $1/day per person. So a family of 4 could receive $28/week.


If we believe the research that says 1 in 3 people in the Gorge are suffering from food insecurity, that means about 25,000 people could benefit from this program. What if we gave them all the recommended Food Rx dosage? That would require $750,000 in funding a month, $9 million per year. Those figures are daunting, but not when compared to health care costs related to poor nutrition. Consider the economic impact of 1 in 3 children unable to focus hungry bellies and minds in school, or the babies born to malnourished mothers. What are the chances of those children being as successful as their well-fed peers?


Let’s imagine the 25,000 hungry people in the Gorge are enrolled in a 12 week Veggie Rx program over time. Not only would they receive $1/day in fresh produce, but they could enroll in cooking classes, garden in a community plot, engage in farmers market tours, participate in produce gleaning events, and get connected to other services. That assumes they have time, are able-bodied, are not elderly or house-bound. Many of our participants are truly unable to access other services and opportunities. Providing a healthy supplement to those suffering from food security is clearly impactful, but hunger is chronic and people need more then just one extra serving of fruits/veggies a day.


Students at cooking class



We need to take a longer term, multi-pronged approach to providing better access to high quality food for all and Gorge Grown Food Network cannot do this alone. Would you believe that only 1% of the food grown in the Gorge is sold directly to consumers? Or that we are importing over 95% of the food we eat? We have an opportunity to support local farmers and improve the health and quality of life for those living in the Gorge. To rebuild a broken food system that supports community health and the local economy, we need a holistic and collaborative approach.


The Columbia Gorge Food Security Coalition is a newly formed collaborative group of 30+ food related organizations including nonprofits, farmers, government agencies, medical providers, grocers, gleaners, Oregon Food Bank, Oregon State University Extension Office, tribal leaders, local business owners and yes, some suffering from food insecurity.


The Coalition is in the early stages of its work, and will work collaboratively in re-evaluating the entire food system landscape. This will include mapping the current food access services, identifying gaps in the system, and supporting innovative strategies to fill those gaps and serve the entire food system, from producers to consumers.


The primary goal of the coalition is to reduce hunger and strengthen the local food system. The outcomes of this initiative will include a comprehensive response to local food access, farm, and nutrition issues.


In the meantime, we will continue to work on raising funds for Veggie Rx. We will improve the program based on participant feedback and design deeper evaluation to measure health impacts. We will work with our health care funders to consider how we might fund nutrition incentive programs through our Coordinated Care Organization, insurance or federal funding like others do around the country. We will also continue to support our farmers to grow more local produce, and help our groceries prioritize and showcase more local food. We must increase both supply and demand.


I believe that together we can create a healthy, self-sufficient Columbia River Gorge where our food is produced with integrity and is valued, abundant, and accessible to all.




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