Boston Medical Center makes healthy food part of patients' medical care

AHA News

Boston Medical Center (BMC) has taken to heart Hippocrates 2,500-year-old dictum: “Let food be thy medicine and medicine be thy food.”

BMC’s preventive food pantry makes access to nutritious food part of the medical care for low-income patients and families who don’t always get enough to eat.

Deborah Frank, M.D., a pediatrician and director of BMC’s Grow Clinic for seriously underweight children, started the program for her patients in 2001. 

“A nutritionist came to me and said, ‘I’m tired of having mothers come to me and burst into tears when I tell them what their children need to eat,’” she recalls. “My colleagues were upset. They said, ‘Why do you have to wait until a kid is malnourished before you feed them?’”   

What began as a service for children and pregnant moms quickly expanded into a hospital-wide program that today serves more than 7,000 people each month – 40% of whom are children.

Patients in the hospital’s emergency department and in more than 20 clinics are screened for food security, and, if they are found eligible, receive a prescription to the pantry. They can be referred by a BMC primary care physician, clinician, nurse or social worker as part of their medical care regimen, meaning they receive foods specially tailored to their medical needs, such as diabetes or hypertension. Most of the pantry’s clients suffer from a chronic illness.

Each family can visit the pantry twice a month, with each visit providing three or four days’ worth of food.

It makes picking up food as routine as picking up a prescription, says pantry manager Latchman Hiralall. “We are more of a food pharmacy” than a food pantry, he says.

When patients visit, Hiralall makes a note in their medical file so their physician knows they are using the pantry. He also is able to see if patients are keeping their doctor’s appointment and reminds them to schedule one if he sees they are overdue. 

The pantry relies entirely on philanthropy, with the bulk of its donations coming from the Greater Boston Food Bank. What sets the preventive food pantry apart is its high standards for food nutrition, says Hiralall. Carts are routinely filled with fresh carrots, pears, apples, cauliflower, onions, potatoes and rutabaga – produce often hard to find in poorer neighborhoods. 

Making nutritious food part of a patient’s medical plan also eliminates the stigma associated with people going to a neighborhood food pantry, Frank and Hiralall say.

“People are very embarrassed, and that is one of the nice things about having [the food pharmacy] in the hospital,” Frank says. “Coming here is part of your health care. You are doing what your doctor has suggested.”

Hiralall adds, “Families are comfortable, and it is like one big happy family. No one is being judged.”  

The preventive food pantry last year expanded storage space – it’s now about 1,500 square feet – to accept more donations and offer more than 20 monthly cooking classes. It distributes about 12,000 pounds of food a week.

Another key part of BMC’s food pharmacy is its demonstration kitchen, which is located in the cafeteria across from the pantry. A registered dietitian and chef runs classes loaded with useful, thrifty and healthful dishes using food from the Preventive Food Pantry and from the medical center’s rooftop garden, which opened in June.

BMC transformed the top of its power plant building into a 7,000-square-foot farm that has produced about 10,000 pounds of fresh produce for the pantry, demonstration kitchen and patients’ meals.

Frank’s work in tackling food insecurity has taught her “hunger is invisible. It is not an eyeball diagnosis.”

She says hospitals and health systems, like BMC, are doing their part to tackle the issue of food insecurity in their communities. But she says emergency food distribution isn’t the solution to ending hunger.

“It’s a political problem and I wish it was getting more attention from federal, state and local government,” Frank says.

Of the preventive food pantry’s accomplishments, Frank says “we don’t have to sit and listen to people cry anymore because they don’t have enough to feed their kids. We can help in the moment and that is wonderful. But we have to step back and say, this is necessary; it is not sufficient.” 

Topic: Community Health
Tags: population health, Community health, Community Connections, Redefining the H, chronic conditions

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