The food is medicine movement needs a lesson in equity, say researchers

A new editorial, led by faculty members at UC Irvine Joe C. Wen School of Population & Public Health appears in the American Journal of Public Health and urges the “Food is Medicine” (FIM) movement to course-correct—warning that without broader access strategies, it risks leaving behind the very people it aims to help.

The FIM movement encompasses health care and community-based interventions that use food and nutrition to prevent, manage, and treat diet-related health conditions. However, with more than 27 million people uninsured and millions more underinsured in the United States, the authors argue that efforts to integrate food into health care must be paired with accessible, community-based approaches to truly promote the beneficial outcomes of the FIM movement.

Poor nutrition is a leading risk factor for chronic diseases, including diabetes, cardiovascular disease, and certain cancers. Research shows that FIM interventions can significantly improve health outcomes, with studies demonstrating reduced hospitalizations and better disease management.

“Without intentional design and execution, even the most well-meaning movements can widen disparities,” says corresponding author, Matthew Landry, Ph.D., RDN, assistant professor of population health & disease prevention at Wen Public Health. “It’s time to expand the reach.”

The authors, Matthew Landry and Kelseanna Hollis-Hansen, Ph.D., MPH, assistant professor at UT Southwestern Medical Center’s O’Donnell School of Public Health and the Harold C. Simmons Comprehensive Cancer Center, call for a dual approach: continue building FIM programs within health care while also investing in existing community-based models that directly serve uninsured and underserved populations.

“The Food is Medicine strategy is a powerful tool, but its potential is limited if we fail to account for the realities of those outside the health care system and ultimately perpetuate a cycle of poor health outcomes,” says Landry.

The authors argue that, given the reality of our current health care system, policymakers must consider ways to expand health insurance coverage that specifically includes FIM programs.

These efforts could involve subsidies for FIM-inclusive plans or federal mandates to include FIM coverage in basic insurance packages (e.g., Medicaid, Medicare, Indian Health Service, and Veterans Affairs coverage, and inclusion in state-defined essential health benefits). Bolstering nutrition programs can generate both health improvements and health care cost savings.

Complementary to policy and system-level solutions is investing in community-based implementation strategies. By supporting local food programs, such as federally qualified health centers and food banks, they can address the specific needs of people experiencing food insecurity without health insurance.

In addition, funding for community organizations should also support their capacity-building and infrastructure development to ensure long-term program sustainability.

When these approaches work in synergy, with health care reimbursements allowing community organizations to strategically redirect other resources to serve the uninsured and underinsured—FIM can achieve broader reach with potential insurance expansion and ultimately better care for uninsured and underinsured populations.