Co-hosted by the Center for Health Law and Policy Innovation of HLS, Community Servings, and the Jewish Alliance for Law and Social Action, this year’s Food as Medicine Symposium brought together a number of professionals from all over the health and health policy scene. Corby Kummer, a prominent food journalist, led the dialogue held in the Harvard Law School’s Wasserstein Hall. At the heart of the discussion was, well, a literal application of food as medicine: the provision of nutritious food to yield both better health and cost outcomes for the critically and chronically ill, and at risk populations.
First tackling the issue was Robert Greenwald, Clinical Professor of Law and Director of the Center and Health Law and Policy Innovation. Giving a sort of state of the issue of insurance, he explained that, since just the last symposium a year ago, 8 million more citizens have enrolled in marketplace insurance health plans, however, 50 million more remain uninsured. Much of this is due, he maintained, to the lack of progress on insuring immigrant populations, as well as the prevalence of voluntary signup. Many of these people—disadvantaged, poor, and in many forms, invisible—are the target group for the program on food as medicine. Developing upon the previous Medicare and Medicaid program structure, the Center for Health Law and Policy Innovation hopes to weave in nutritional counseling and medically tailored, home-delivered meals to people in need, attacking their problems of health before the situation worsens.
Currently, Professor Greenwald finds that the most pressing issue in the food as medicine movement is the issue of scaling up, a derivative of the restrictions to discretionary funding these programs face. This was an accurate reflection of the problems often associated with sustainable, lasting initiatives. With limited funds as the “commons,” the food as medicine movement must devise creative ways to access funds and yield greater health outcomes for a larger pool of clients. Though this certainly was a looming problem, Professor Greenwald presented a “mixed bag” of perspectives, telling the audience that states are now having conversations with Medicare and Medicaid and have closed in on the “triple aim” of the food as medicine reform.
David Waters, CEO of Community Servings and next to speak, opened his talk with a sobering anecdote. Afflicted with heart disease, he recounted that after a double bypass surgery, his dietician gave him a list of technical nutritional suggestions, telling him that “this is what you need to do so you don’t die.” He told us then to imagine him without his financial and English-speaking privileges. Post-surgery, many of the underprivileged ill face these same nutritional issues, but under far greater stress. When they should be worrying about their potassium and glucose levels, they likely face stressors outside of just their physical health, making it unlikely that they could successfully follow a diet. Community Servings, the only organization of its kind in the New England area, also makes strides in catering to the mobility issues its clients may face, because, as Waters stated, “you can still go to work every day and have HIV.”
This is where Community Servings comes in. Providing service to the critically and chronically ill, the non-profit works to tailor free, home-delivered meals not only for their clients’ specific health needs, but also cultural and lifestyle preferences. Evoking the concept of “mindful eating,” this truly served to highlight the mental component of food, but now as medicine. Medicinal food should work not only to relieve the physical ailments of its consumer, but also to stir “food memories,” when he or she felt safe and at home.
Kim Prendergast, Consulting Project Manager for the Feeding America Diabetes Initiative, then took the attention, offering insight from the perspective of a dietician. Prendergast explained that issues in food security and nutrition are cyclic: Periods of food adequacy and inadequacy alternate due to the economic state of a patient, and only serve to worsen his or her condition and lead to more hospital visits. Knowing ends need to be met, a patient may choose less expensive and less nutritional food, and other stresses—needing to provide for children, for one—can worsen choices further. Feeding America, serving over 46 million, intercepts this cycle before a patient’s condition becomes more complicated by providing free “food boxes” for both patient and family. The organization also provides educational services to its clients, with recipes and classes on how to prepare those ingredients.
In sum, the event hit on many of the key points of the University’s yearlong campaign, Food Better, as the organizations and their representatives hope to better food to better health outcomes. As Prendergast concluded, “a lot of people have better access to health [services] than they do to food, and that’s a little backwards.”
A lot of people have better access to health [services] than they do to food, and that’s a little backwards.