James Letts remembers a time when patients would tell him that they’re struggling to pay for food – and there was nothing he could do about it.
“We knew a lot of our families struggled with food insecurity and we literally had nothing to offer. I mean we could try to find a food shelf… but nothing concrete, ” Letts, a family physician with the M Health Fairview Clinic – Roselawn in St. Paul said.
In 2015, the health system started the “food is medicine” approach in hopes of addressing food insecurity that can lead to poor health outcomes for patients. That location was the first one to have a Veggie Rx program, and had around 10 patients.
M Health Fairview works with various farms in the state to supply food for the enrolled patients. The Fairview Foundation covers the cost of purchasing the food from the farmers, and then the boxes are delivered to the office or to a patient’s house.
There are now 20 clinics in the program and 296 participants.
Enrollment for the program begins each April, and clinics have two months to identify patients who may be a good fit. Food boxes are then available weekly from June to December, said Terese Hill, the supervisor of Community Advancement Food System Strategy at M Health Fairview.
Clinics like Roselawn and M Health Fairview Clinic – Rice Street, quickly fill up spots, which Hill said has much to do with the relationship between the providers and their patients.
“We’ve never had a problem of ‘I can’t find enough patients for this program,’” Hill said.
Patients who are experiencing food insecurity and some type of diet related chronic condition are eligible for the program.
“In reality, we know it’s just much more complicated than that. Diet related conditions could be mental health … there could be many underlying (issues),” Hill said.
M Health Fairview recently started using a social determinants of health screening for its patients, which will provide a more accurate measure of patients who are food insecure and what the resulting health impacts are – and plans to use that more formally to determine eligibility.
In the first three weeks of that screening the program looks at housing safety, utilities and food each day. There have been anywhere from 10-20 patients have screened positive for being food insecure, Hill said.
In a survey from 39 participants before and after the program, M Health Fairview found there was a 26% increase in vegetables being consumed two times a day or more. It also found a reduction in people who were eating packaged meals five to seven days a week.
Culturally relevant foods
The food from the program comes from farms like the Hmong American Farmers Association (HAFA), Sin Fronteras Farm and Food and the Women’s Environmental Institute, among others.
HAFA has 155 acres in Hastings, split between roughly 20 families. They produce things like fruits, vegetables and flowers, and try to offer culturally relevant foods, such as lemongrass for example, which is an ingredient used for many Southeast Asian dishes.
In 2022, the HAFA farm supplied food to 117 people. Of those, around 59% were Asian, 18% were Black, 17% were white and 5% were Hispanic. This year, 130 patients across six clinics receive food from the HAFA farm.