WASHINGTON (THE WASHINGTON POST) – Ms. Adrienne Dove stopped on the line of the Giant grocery store in Washington, DC with carts filled with cabbage, bananas and beans in sacks.
The registry was $ 20.60 ($ 28.37). Instead of cash or card, Mrs. Dove paid with the product Rx voucher from the pharmacy store.
The giant in the poorest part of the District of Columbia is the latest frontier in the "Food as Medicine" movement.
Hospitals and local authorities throughout the country are writing and filling healthy food recipes in an effort to address the root causes of diabetes, hypertension and other expensive diseases.
The Federal Law on Agriculture passed late last year included more than $ 4 million in grants for the US Department of Agriculture (USDA) for distribution to governments that run recipe-making programs, but money has not yet been distributed.
The goal, supported by some research, is to improve health and reduce costs by subsidizing fresh products such as broccoli and grapefruit, next to insulin and beta blockers.
"We hope to find returns to the healthcare system: reducing emergency visits, respecting drug regulations," said Lauren Shweder Biel, executive director of DC Greens, a nonprofit group operating the District Rx pilot product.
"It is a holy grail for such systems."
Improved diet is also a target.
"I was trying to manage diabetes and high blood pressure, but when they told me they were eating Top Ramen, donuts and donuts because it kept them full, everything I could say was:" That's bad, here are more drugs, "" she said. Dr. Rita Nguyen of the San Francisco Public Health Department, who now oversees a wider program of recipe for production in six clinics.
In the country's headquarters, the Produce Rx program started last month and provides 500 Medicaid patients for $ 20 weekly vouchers for Giant's products in section 8 by the end of the year.
Section 8 is the poorest part of the city and has the highest rates of mortality from diabetes and heart disease. It is also desert food, and Giant is the only store with a complete service.
The Produce Rx program, which includes voucher costs and patient outcomes, received $ 500,000 from the District Government and $ 150,000 from AmeriHealth Caritas, a Medicaid-managed care organization.
AmeriHealth Caritas patients are the only ones who now have the right to produce Rx pilots. DC Greens seeks additional funding from USDA to expand the program.
Council member Mary Czech calls on lawmakers to increase sales tax on sweetened drinks by 1% in order to create a steady source of revenue for the Produce Rx initiative, among other programs.
Ms. Dove, 43, learned about the program while she was in the clinic to check her condition of hypertension and anemia.
Medical experts often urge Ms. Dove to eat better, but she was surprised when a clinic official called for a pharmacy to buy vouchers for her in the same way that doctors would seek a prescription for medication.
"I just mostly ate baked chicken wings and French fries. I grew up in McDonald's and got high blood pressure," said Ms. Dove, who lives with her mother and two children near the store.
"Now I tell my son," Do not be like a mom, "and he seeks broccoli and spinach."
Boston Medical Center launched in 2001 one of the earliest pharmacies in the food industry with its preventive dunk in the basement of the hospital for the safety net, which treats patients irrespective of their ability to pay.
In San Francisco, health officials have found that patients are more likely to take food from weekly events in clinics in the surrounding area than in a public hospital. In clinics, patients can choose their own meat, whole grains and vegetables, as well as demonstrations for cooking by nutritionists – sometimes provided with cutting and knives.
Dr Nguyen, a San Francisco healthcare worker, said food supporter drugs as yet are trying to discover the best way to establish such programs.
"We do not know what a dose of food is enough to make a difference," said Dr. Nguyen.
"Is the food itself sufficient, or do you need a nutritionist, do you need food for cooking, recipes?"
In Pennsylvania, the Fresh Food Farmacy Initiative, a regional health insurer and Geisinger, offers products, cooking demonstrations and diabetes lessons for 700 patients in the northeast and central parts of the country.
In the first two years of the program, officials found that diabetics who received foods recorded a drop in blood sugar levels, unlike those who were not given.
Ms. Allison Hess, Geisinger's executive director, said that a fresh food farm annually costs around $ 3,500 per family, and a drop in blood sugar will result in higher costs of less medication.
"It's kinda insignificant," said Mrs. Hess. "We will either pay this medical expense or pay for this food and education that will be more lifelong."
District access continues to differ. Instead of a new pantry or food offer in the clinic, the city encourages residents to buy fruits and vegetables in a food store that is already part of their weekly routine.
City health officials said earlier efforts to connect residents in food deserts to produce in stores in the corner came to problems as salesmen could not always find enough customers. The Rx production program is based on a limited subsidy program that already exists in farmers' markets.
"Most people will come to a grocery store, while agricultural markets and pop-ups in certain places at a certain time of the year," says Dr. Lavdena Adams Orr, Chief Medical Officer of AmeriHealth Caritas.
Ms. Ciera Price from Washington was disturbed when hypertension, diabetes and high cholesterol were diagnosed during the winter. She left the doctor's office with a warning to eat healthier and has a recipe for the program.
Ms. Price was in the store, on her first shopping trip with her production vouchers, watching melons and strawberries when she met the nutritionist at the supermarket, Jillian Griffith, and scheduled the appointment for free consultation.
The Produce Rx program does not require consultation, but patients who harvest their vouchers for production are encouraged to meet Giant's nutritionist.
The Giant has them in the Washington region, and usually travel between stores and offer consultations of $ 25, and the fee is reduced by $ 25 in product vouchers. The Ward 8 Giant does not charge consultations with nutritionists and is the only store in the supermarket chain with a wellness center in the store. It offers hours of diabetes management and one-to-one training.
"When they tell you to eat healthy, what does that mean to you?" Ms. Griffith asked Miss Price behind her desk recently in the store's wellness center.
Ms. Price got crazy.
"Leaving everything I love and keeping green," she replied.
Ms. Griffith offered a more optimistic answer.
"Maybe you can learn to love new things," she said. "We want to be in the middle and look at the things we eat and how to eat the food that makes us happy."
Over the next hour, they talked about what Ms. Price likes to eat (pasta, mac and cheese) and what she does not like (chicken and apples). They finished with two specific goals: larger vegetable and smaller parts of pasta during dinner, and the addition of fresh strawberries and bananas to breakfast.
Before she left, Ms. Price asked to pose for a self-portrait with Ms. Griffith as photographic evidence to meet with a nutritionist.
One of the biggest challenges for recipe programs is that access to healthier foods changes what a person chooses to eat.
Ms. Griffith said it was not unusual to hear from patients who, like Mrs. Price, were overwhelmed with thoughts that they had to change everything regarding their meal. Instead, he tries to direct them to new possibilities, rather than limiting their diet.
"They have been fighting diabetes for a long time or have never received information outside of" healthy food, "said Griffith." Especially on this side of the city, there are not many opportunities for people to get the one-to-one route they need. "