There are times when medicine simply isn’t enough to combat a chronic health condition or a serious illness. For some people with certain conditions, from diabetes to kidney failure to cancer, what’s needed is—food. Healthy food, adequate food, appropriate food, accessible food.
It may seem self-evident that people without adequate nutrition will have difficulty recovering from a health crisis or managing a chronic ailment. But it’s only recently that the concept of food as medicine has gained converts among health care providers. The advent of managed care, which stresses outcomes and cost-containment, has forced medical practitioners, hospital systems, and health insurers to take the social determinants of health as serious challenges to health outcomes.
A diabetic may be receiving the correct amount of insulin. But if he’s eating sugary foods, his health is at risk. A cancer patient may be receiving chemotherapy, but if she’s too exhausted to make nutritious meals, then she can’t regain her strength.
As a researcher at Einstein Healthcare Network, I recently conducted a study that revealed that many patients who are frequently hospitalized have “food insecurity”; they’re often worried about having enough food and, at times, go without eating or reduce portions because they can’t afford to buy more.
We interviewed 40 adults who’d been hospitalized at Einstein Medical Center Philadelphia three or more times in the previous 12 months. Most of them were hospitalized five times in the previous year. The study was published in Population Health Management, a peer-reviewed journal about health care management and quality. It is part of a growing body of research that is being conducted by researchers across the country examining what happens when patients do not have access to healthful food on a consistent basis.
Providing healthy meals for patients has benefits beyond the individual; it has the potential to save the health care system money. A lot of money.
As one 66-year-old patient explained to me: “At the end of the month, I don’t have money really. By the time you buy personal, household ... you’ve got to have coffee, you’ve got to pay your copay for doctors ... I go to doctors a lot, transportation, gas.” The patient said when she’s out of money, she relies on her daughter for food “I go the first of the month and buy what I can and when it goes, it goes,” she said.
Providing healthy meals for patients has benefits beyond the individual; it has the potential to save the health care system money. A lot of money. An analysis of healthcare costs of clients receiving home delivered meals and nutritional support from MANNA—an exemplary volunteer-driven organization serving patients at nutritional risk-- reported an average monthly decrease in overall healthcare costs of $10,000.
Einstein recognizes the importance of access to healthful foods and the challenges faced by the communities we serve. We are working with community partners, such as the Food Trust, Common Market and the City of Philadelphia Department of Public Health, MANNA, and Philabundance, among others. We encourage our employees, patients, and neighbors to use the farmers’ market located on our campus (pictured above). We are part of a citywide project, Healthy Foods, Healthy Hospitals, working to improve the quality of food provided to employees, patients, and visitors. We are working with MANNA on a number of initiatives to provide targeted, time-limited home-delivered meals to our patients with diabetes and heart failure. We’re exploring the creation of a hospital-based food pantry. We’re providing grocery gift cards as stipends to research participants. We have a staff member who volunteers at a local farm who brings in boxes of fresh fruit and vegetables directly from the farm for patients in our HIV-AIDS clinic.
The failure to consider food as a critical part of health will someday seem as misguided as the dated notion that our brains and bodies are separate and have no impact on each other. This is a challenging problem for sure. Health insurers such as Health Partners Plan here in Philadelphia are one of very few insurers that are testing out time-limited coverage of home delivered meals for low-income patients with diabetes. In fact, Health Partners Plan and MANNA have distributed over 250,000 meals since their partnership started.We need more innovative programs, testing out strategies to improve health outcomes, reduce readmissions, and promote wellbeing. We need policy changes to include coverage of food as a key component of medical treatment. Because clearly what’s in a patient’s refrigerator is just as important as what’s in the medicine cabinet.