Health Systems Innovating to Address Food Insecurity: Analysis of Program Implementation, Evaluation, and the Future

Abstract

While individuals have always been able to recognize the influence of social factors on their health, and ability to attain healthcare, the healthcare industry has only recently shifted their attentiveness to the impacts of social determinants of health. One prevalent social determinant of health is food insecurity, impacting approximately 1 in 10 people in the United States (United States Department of Agriculture, 2019). As healthcare organizations conduct community needs assessments and ascertain social needs, they may find even greater prevalence of food insecurity, and other social risk factors in their communities, and develop something to meet these recognized needs. There are a few such organizations that are leading the field with programs to address food insecurity. This thesis aims to understand why these organizations initiated their programs, how the programs are set up and financed, what some of their outcomes have been, lessons learned in the implementation process, and what they perceive to be the key characteristics contributing to their success. In-depth interviews with individuals at six different programs seek to investigate beyond the information accessible to the public what makes these programs work. Community engagement, active collaborations and partnerships, leadership and organization support, and communication were consistently identified as factors for success. More nuanced, however, were the mentioning of payer-involvement and buy-in, the role of grants, different budgeting schemes and the costs of running a program. While the health systems are still collecting patient outcomes data, and continuously developing rationale for renewal and expansion, this study seeks to lay out extrapolatable factors for other health systems that might consider developing or initiating food is medicine programs. The largest takeaway for the health systems getting to the point they are now, and where they still plan to go was the role of teamwork with different stakeholders and expanding cross-sector buy-in and participation.