Is Food as Medicine Setting a Price on Health?
Increasing investment and selective attention
I’ve been thinking a lot about the role of capital investment in the rise of food as medicine. The field has grown in lockstep with an influx of funding from the White House as well as private institutions such as the Rockefeller Foundation and Elevate Foundation. Hospitals will soon be able to request reimbursement by Medicare and Medicaid for offering patients food as medicine support through interventions like medically tailored meals, produce prescriptions, and nutrition counseling. More recently, a new tech platform made headlines for raising over $2M in seed funding for its affordable patient-led solution addressing chronic diet-related disease and food insecurity. And while this investment is an incredibly positive indicator for the growing public acceptance of the role food plays in our health, I wonder how the distribution of these resources might impact the future landscape of food as medicine.
We can’t talk about food (or health) in this country without also talking about money. Greater wealth is often a predictor of better health, shielding families from chronic stress and providing them with better access to greener environments, schools, and healthcare. Communities with fewer funds more often experience injustices such as food insecurity; one in five United States residents reported household food insecurity in 2022. Food insecurity is, at its heart, an economic inequality issue, and as the result of economic and racial discrimination in critical needs like housing, education, and employment, is also experienced most often by low-income households of color.
I think further investment in ensuring nutritious food access is necessary, and investment in programs connecting people to healthy food is critical. But I do worry how this new abundance of investment might create a larger divide between those programs that have the administrative and financial resources to pursue funding, and those that don’t. The distribution of wealth through philanthropic avenues often leaves out smaller grassroots efforts doing essential work in the spaces and communities that stand to gain the most from even small investment. Having worked in nonprofit development for almost ten years, I know how tedious the process of securing and reporting on a grant can be. Many funders require demonstration of effective use of their dollars through the tracking of specific data, something that a small nonprofit or grassroots organization rarely has the power and resources to do. For many smaller organizations, these requirements create significant barriers keeping them from resources that are intended to support them.
My intent is not to criticize those programs that are successful in securing these new funding streams. I think ultimately that growing collective interest in food as medicine as an intervention will lay important groundwork, ideally leading to more equitable and food-focused policies. But I also think it’s worth considering what happens when the narrative of who gets funding, who succeeds, who has the greatest impact, and therefore, who is an example of a successful food as medicine intervention becomes restricted only to those who can secure the largest grants. These stories perpetuate a narrative that continues to keep power away from smaller organizations that might be doing very powerful work but struggle to survive.
The other primary funding stream supporting food as medicine is through Medicaid and Medicare reimbursements for hospitals administering plans and delivering meals that address food as medicine needs. While this is an important step in the right direction, it’s often the case that the communities who suffer the most from diet-related disease and poor health in the United States are distrustful of doctors, and thus less likely to find themselves in the presence of one to access these supportive programs. If hospitals are truly to invest in food as medicine interventions, they should also be willing to distribute some of those resources back into the communities they serve or work to build trust and repair relationships as a key component of their programming.
The growth of startups and platforms like Season and Free From Market offer an interesting approach that allows for innovation and pilot testing without the use of federal dollars. In some ways, the startup model is better equipped to “build fast and break things” than a nonprofit or a hospital. I’m cautiously optimistic about these and other emerging solutions that blend private investment with social impact and responsibility, and I look forward to seeing what new models they might bring into the space. If private investment can find a way to make money and support people in accessing better food for healthier lives, we have the potential to drastically change our food system for the better (though I am, as always, a bit wary to the idea of somehow monetizing food as medicine in this way).
I’m not sure what the best solution is, and I recognize that change won’t happen without the resources to test new ideas. Still, many of these solutions feel to me like a repackaging of the same problems of access, unchecked capitalism, and institutionalized discrimination. I’m eager to see truly transformative and widespread change, and while this current round of investment might begin to open up the conversation to what food as medicine can be, I think it is a step on the road to success, not the end goal.