Upstream def: in the opposite direction from that in which a stream or river flows; nearer to the source.
The Food RX program is an initiative focused on addressing a person’s health issues at one of the sources. Food insecurity and, more specifically, healthy food insecurity is one of the main upstream causes or exacerbators of health issues that develop downstream, including obesity, diabetes, and cardiovascular disease. Healthy food insecurity can even cascade into other indirect health issues such as stress, anxiety, or any number of other mental health issues. In Region 10 (San Miguel, Ouray, Montrose, Delta, Gunnison, & Hinsdale counties) 13.5% of the residents are food insecure. This is higher than the state’s food insecure rate of 12%. These figures do not include those who are healthy food insecurity, which means an individual or family only has access to processed and prepared meals.
Housed in a primary care doctor’s office, the Food RX program reaches patients that want to make a change to their eating habits but may not have the money or cooking knowledge to do so. The program addresses a number of upstream issues:
Why is this an upstream issue? Educational attainment is already a factor in determining a person’s household income and therefore their overall health. Nutritional education is often a luxury. However, if the education is offered at no cost and requires little effort except for showing up at your doctor’s office, it can be a tool of empowerment.
Food RX participants gain the knowledge of how vital food is to their whole health. They learn the nutritional value of fruits and vegetables and how fresh produce affects their overall health and their acute health issues that the participant might have. For example: a participant with diabetes might learn to reduce the amount of red meat they eat by cooking with white meat or vegetarian instead.
2. Household income
Why is this an upstream issue? An individual or family’s income determines the trajectory of their life and consequently their health. A household with a higher income can access better schools, which typically leads to better jobs and better access to healthcare services, healthy foods, transportation, and the different services that impact health. On the other hand, impoverished households have to make tough choices on what to purchase and when. For example, some may have to choose between buying healthy foods versus paying for healthcare services, rent, and keeping the lights on. Healthy food often gets pushed to the backburner.
Food RX participants are prescribed $15 vouchers each week for 6 weeks to be used at a local grocery store or farmer’s market. They also receive a $30 voucher bonus upon graduation from the 6-week program. Not only does the program assist individuals and families with extra money to make healthier food decisions, but also keeps that money in the community.
3. Food insecurity
Why is this an upstream issue? As mentioned before, lack of food can lead to mental health issues, physical health issues, and even issues with employment and in school. How can a person focus at work or at school if they haven’t had enough food to eat or don’t know where their next meal is going to come from?
Food RX participants are offered prescriptions and one-on-one assistance from a medical professional who sticks by their side the entire program, creates a care plan, offers participants easy recipes, and anything else the participant may need to be successful in the program. Participants are also exposed to other resources or referrals to help them continue on their journey of eating and purchasing healthy food. For example, Food RX participants are presented with the opportunity to enroll in a 6-week evidence-based cooking class, Cooking Matters, where participants learn how to cook healthy meals on a limited budget.
The Food RX program focuses on upstream issues and the unequivocal relation they have to health. Upstream and downstream efforts working together to combat individual health issues and larger health inequities are necessary and long overdue in the health world. The Food RX program is one step towards a more equitable and healthy community.
-Alexis Klein, Regional Health Connector