At one of the oldest community health centers in the country – that’s Delta Health Center in Mississippi – there’s a story about a famous doctor who used to write prescriptions for food.
Dr. Jack Geiger, the founding father of the community health center movement, would send his patients to the grocery store to get healthy food. The grocer would fill the order and send the bill to the health center.
Someone told Geiger that food couldn’t be prescribed. Geiger retorted that the best cure he knew for malnutrition was food.
Robin Boyles, who’s now the chief program planning and development officer at Delta, said that treating food insecurity “really does go back to our very, very early days…You can treat someone for an illness or infection, but if you’re sending them home and they don’t have food to eat and they don’t have clean drinking water and they don’t have sanitation, they’re not going to get well.”
Food insecurity is on the rise across the United States. In Mississippi in particular, food insecurity rates are higher than the national average. A 2019 study from the USDA’s Economic Research Service found that the state had the highest rate of food insecurity in the country – 15.7% of the population experienced it.
And the state’s community health centers are coming together to do something about it – together with the Community Health Center Association of Mississippi and Direct Relief. Direct Relief provided the health center association with a $250,000 grant designed to fight hunger among Mississippi’s most vulnerable.
The result is the Cornbread Cooking Series, a program that’s designed to both increase access to food and teach people how to buy and prepare food that’s healthy and good to eat. Six Mississippi health centers will introduce or build on existing programs around food access and education.
“It’s Southern and everybody loves cornbread…it’s winter and it’s comfort,” said Janice Sherman, the association’s CEO.
But despite the homey name, Sherman is focused on new cooking techniques as well as food access. “I thought it would be an opportunity to really introduce some new areas of spices and things that will really be better for our diets,” she said.
Patients are screened for food insecurity. If they qualify, they’re referred to the program, which provides a combination of education, activities, and food vouchers or other access to healthy, nutritious food.
Sherman explained that health centers, as trusted community resources, are in an especially good position to deliver help and education. “For a provider who’s your doctor to address the fact that you need food is pretty powerful,” she said.
Three health centers participating in the program sat down with Direct Relief to talk about hunger, healthy cooking, and how they’ll use the funding.
For Patients with HIV, Closing the Cracks
At G.A. Carmichael Family Health Center, dietician Kyskie Bolton explained that there are a number of patients who are “dramatically food insecure, but don’t fall into any category where they would get significant assistance.”
In participating in the Cornbread Cooking Series, G.A. Carmichael wanted to focus on the patients who most needed intervention – in this case, by focusing on patients dealing with both food insecurity and HIV/AIDS.
Some of those patients have comorbidities such as hypertension or diabetes as well.
Bolton explained that HIV-positive patients often don’t want anyone to know their diagnosis. “They will protect it at all costs, even at the cost of their hunger or nutritional health,” she said. “These are the type of patients who are going to fall through the cracks.”
G.A. Carmichael is preparing videos of healthy cooking techniques – how to prepare vegetables, for example – and a supermarket tour, to show patients who qualify for the program how to shop around the edges of the grocery store for the healthiest food.
The goal, Bolton said, is “increasing their literacy and empowering them to make better decisions so they can utilize what they have.”
The health center is also working with nearby farmers to acquire and distribute produce to patients with chronic diseases – a long-term enterprise that the funding will help them continue. Active participants in the program will also receive vouchers and gift cards to nearby grocery stores.
For Bolton, part of the challenge is reaching a diverse patient population – one that’s both rural and relatively urban, and that includes a range of ethnicities and backgrounds – and produce materials and messaging that will appeal to everyone.
However, the population does have one thing in common: “Most people here are extremely technologically advanced and don’t have much to do with cornbread,” Bolton said.
Reducing Childhood Obesity
For Dr. Wendy Williams, a pediatrician at Coastal Family Health Center, an interest in increasing food access came about when she noticed a correlation between food insecurity and obesity in the children in her practice.
“Until we started asking the questions, I had no idea how pervasive [food insecurity] is down here,” she said. “You can’t get to the bottom of pediatric obesity until you conquer that, or at least make some dents.”
The health center started by planting a vegetable garden to teach kids about healthy food. It met an enthusiastic reception: Williams said that one child described a radish as the most beautiful thing he had ever seen before putting it in his pocket to preserve it. Another was anxious to learn to grow food – his uncle, he told Williams, didn’t have enough to eat.
The Cornbread Cooking Series grant will help Coastal Family Health Center expand its program, reaching out to local farmers to acquire excess produce for patients, and launching a cooking education series.
“Down in the South we like to do things with a lot of fat and salt, so really being cognizant of that and teaching them to use other things to make food taste good,” such as herbs, will be a priority, Williams said. “It’s definitely a mindset. You have to change how people view it.”
The health center also plans to develop food boxes, working with a local food bank to get protein sources for patients and with a produce distributor to get fruits and vegetables.
But throughout it all, the community garden remains a fixture.
“You don’t even think you’re making that big a difference in the community,” Williams said. But feedback from patients – and enthusiasm for what the garden produces – have changed her mind.
“We’re teaching kids that, from the very beginning, they can be self-reliant,” she said.
Going back to the beginning
Between the pandemic and the winter storms that blanketed large swathes of the U.S. in February, need is especially high among Delta Health Center’s patients, said Neuaviska Stidhum, the health center’s chief operating officer and chief nursing officer.
“Right now, we’re in crisis,” she said. “We really want to be able to just get the hunger out, to provide for them so they won’t have that hunger.”
Since the 1960s, Delta Health Center has played a role in alleviating hunger among its patients. The health center currently has six acres of land – cultivated by a local university – that it uses to provide a range of fresh produce, from greens and sweet potatoes to fresh fruits.
Stidhum explained that, while many of their patients qualify for public assistance, it’s often not enough, or too far away to be accessible for people who don’t have transportation.
“It’s really difficult for some of our more rural patients…especially if they don’t have transportation and have to depend on someone else,” Boyles said.
The grant will be used to provide much-needed food vouchers to patients, and health providers will give patients supplemental information about how to choose and eat healthy food that won’t break the bank.
Stidhum has hopes for a kitchen in the health center someday. For the time being, providers will refer patients to cooking videos, health services, and other resources.
“We’re just going back to the beginning, to help the people any way we can,” she said.