Food as Medicine - Improving People's Wellbeing through Healthy, Sustainable Food
Improving patients’ health by linking the clinic to their tables, their kitchens, stores, and the food supply system.
Lead Applicant Organization Name
Fair Oaks Health Center (contact person: Dr Rakhi Singh)
Lead Applicant Organization Type
Government (City, State, National, etc.)
If part of a multi-stakeholder entity (i.e. team), provide the names of other organizations and types of stakeholders collaborating with you.
The Nueva School (contact person: Tanja Srebotnjak)
Website of Legally Registered Entity
How long have you / your team been working on this Vision?
Lead Applicant: In what city or town are you located?
Lead Applicant: In what country are you located?
United States of America
Your Selected Place: what’s the name of the Place you’re developing a Vision for?
The San Francisco Bay Area
What country is your selected Place located in?
United States of America
Describe your relationship to the place you’ve selected.
The San Francisco Bay Area (SF Bay Area) is home to more than 7 million people in seven counties. It encompasses the major cities and metropolitan areas of San Jose, San Francisco, and Oakland, along with smaller urban and rural areas. The SF Bay Area's nine counties are Alameda, Contra Costa, Marin, Napa, San Francisco, San Mateo, Santa Clara, Solano, and Sonoma. The region is well known for Silicon Valley and a dense ecosystem of technology, bio-pharmaceutical, and Internet companies. But is also afflicted by chronically high living costs and a shortage of housing, which makes other daily items, such as healthy food, less affordable for many people. We, the applicants, live and work in the SF Bay Area and are attached to our communities. As healthcare professionals, educators, and students we care about the wellbeing of the people who make the Bay Area the beautiful, dynamic, and diverse region that it is, but who often cannot afford to take care of themselves, especially when it comes to healthy nutrition. Although we have high-end grocery stores offering a rich variety of produce, fruit, grains, and other delicious items, although we have farmers markets in many towns and cities, we also have food deserts and a lack of affordable food options. We want to help change this by connecting our most vulnerable community members: low-income, food insecure residents with nutrition-related health problems such as high blood pressure and cardio-vascular illnesses by connecting them with healthy, easily accessible food options. This benefits not only their health and wellbeing, but the wellbeing of the whole community through greater community connectedness (people helping people) and reduced healthcare costs. By treating food as medicine - something considered crucial to health and worth examining in a precise, calculated manner, we anticipate making real improvements in people's lives and in improving the overall prosperity of our beautiful region.
Describe the People and Place: Provide information that would be helpful for an outsider who has never been there and may have no context about this Place to better understand the area.
Many people in the United States and abroad will have heard about the SF Bay Area. It is an incredibly dynamic, entrepreneurial, generally affluent, and diverse hub for startups, venture capital, biotech, ICT, and large Internet companies. International brand names like Facebook, Google, Apple, YouTube, Genentech, Gilead, Uber, Lyft, and many more are headquartered here and employ a high educated workforce of hundreds of thousands. Thus, there is no shortage of disruptive innovation and the region has a powerful, progressive "can do" mindset that spurs new ideas and improvements for life and people in rapid succession. Diversity is present in the arts, cuisine, family sizes and compositions, religions and all aspects of daily life. Yet, the region is also plagued by high levels of inequality. Much of the region's buzz is sustained by low-paid jobs in the service sector such as food, retail, janitorial, childcare, and domestic help. Even solidly middle-class professions such as teachers, nurses and firefighters are having a hard time making ends meet in this high cost of living region. Nutritious food is plentiful in the many affluent ZIP codes in the Bay, but not accessible or affordable for everyone. Thus, healthcare clinics serving disadvantaged population groups see a disproportionate share of illnesses related to socio-economic factors, including many attributable to or worsened by diet and nutrition. Hypertension, high blood lipids, obesity, cardio-vascular and other symptoms have well-established scientific links to the lack of well-balanced, nutritious diets. It is these healthy diets that many of the residents with low-paid jobs cannot afford, do not have the time to prepare because they are holding multiple jobs, or cannot access for lack of local vendors. These dynamics: well-paid, educated tech workers and executives (many millionaires and even billionaires among them) who can afford to order their groceries online and get them delivered to their doorsteps stand in contrast with those, who provide these services but cannot enjoy an equally well-nourished life. But the SF Bay Area is also a place where partnerships and innovations can flourish for the good of the people and the greater good of the community. Technology and human ingenuity can be combined to address inequities and find smart, cost-efficient solutions. Our proposed "Food as Medicine" project is one such venture, that was started at Fair Oaks Health Clinic but that we believe can be scaled up and transferred to other clinics in the region and beyond. Fair Oaks Clinic serves a lot of low-income, food-insecure patients and knows the diet-related impacts on people's health all too well. Two of our partners, Dr. Singh and Dr. Burkham, have thus developed the plan of linking food to the medical treatment catalog and providing patients with options to access healthier food options at no cost.
What is the estimated population (current 2020) in your Place?
Challenges: Describe the current (2020) and the future (2050) challenges that your food system faces.
The SF Bay area's population is expected to grow another 10% by 2025. This will put further strain on the local housing stock, transportation infrastructure, and land dedicated to the environment and to growing food. Since the region already imports a significant amount of its food from agricultural regions in California, the U.S. and other countries, the biggest challenges will be the pressures of high cost-of-living on people's ability to afford rent and food. More lower-paid people will face food-insecurity without measures to address the systematic housing shortage, lack of living-wage jobs, and in same cases, access to food vendors offering healthy foods. The diets of those making less than $15/hour will be squeezed and likely emphasize calories over nutritional value. Culture and technology will likely make healthy foods even more preferable and easier to access for those who can afford it, leaving lower income residents behind. Although there are local efforts at schools, cities, and counties to increase local neighborhood and school gardens and to teach people how to prepare healthy meals quickly and without much extra cost, but these efforts need to be stepped up and be partnered with efforts to address the already significant diet-related disease burden. It will require a multipronged effort to reach those underserved and most vulnerable to food insecurity and income-related malnutrition.
Address the Challenges: Describe how your Vision will address the challenges described in the previous question.
Community-wide health (our end goal) would be better if our communities ate healthier diets. We propose to improve the factors in our food systems that affect those diets. Our vision aims to improve health by improving diets, and we propose to do so from our patients’ dinner table back to the producers of the food. For many people in our communities, there is insufficient access to healthy foods. This stems from the lack of healthy food for sale in their neighborhoods (food deserts), lack of affordable, healthy food (food insecurity), and lack of knowledge and comfort with healthy food choices (systemic cultural influences). We will approach the problem starting from our patients’ health, and then move to their table, to their kitchen, to their stores, and to the food supplies upstream. By treating food as medicine we anticipate making real improvements. We will achieve this by focusing on improving access to and “compliance” of eating healthy. By thinking of food as medicine we can investigate the food systems under the medical framework of compliance with treatment plans. Many people lack simple access to healthy food. Our vision thus houses the food pantry inside the medical clinic or within a short walk from it. Since cost is another factor, our vision will offer a no-cost option for healthy foods for patients. Another challenge is time: many people in our target population hold several jobs and juggle family obligations. Additionally, needing to take public transit to get to the grocery store takes takes time away from other activities. Culture-based compliance means that healthy eating habits can be culturally incongruent (portions too small, too little sugar/salt/fat, unfamiliar foods). We will address this by increasing familiarity, presenting healthy options in a culturally acceptable form, and education about what is healthy in order to reset cultural norms. We will address these issues directly, starting from contact with the community in their health care facilities. We propose to identify patients who are 1) food insecure (definition needed), and 2) affected by a health condition that can be treated by healthy food (food as medicine). Then, when our target population has been identified, we will start our intervention at the one-on-one level of the provider/patient relationship. The provider will write a prescription for a healthy diet on a prescription pad (give data for how this increases compliance). The prescription will be to visit the Food Pharmacy. Our Food Pharmacy will function as a local (or in-house, no-cost teaching facility for patients to receive and learn to prepare healthy food that has been designed to be fast and culturally appropriate (including redirecting/re-educating around cultural norms).
High Level Vision: With these challenges addressed, now provide a high level description of how the Place and the lives of its People will be different than they are now.
With several "Food as Medicine" food pharmacies set up in the areas where most of our target population is concentrated, we will see a shift in how patients perceive food as part of their treatment plan. We will help a large share of our residents access healthy food options and live healthier and more productive lives as a result.
Full Vision: How do you describe your Vision for a regenerative and nourishing food future for your Place and People for 2050?
Our Vision is that no resident will suffer health consequences due to lack of access or affordability of healthy food options.
How did you hear about the Food System Vision Prize?