In Washington DC’s Ward 8, adults who are diagnosed with hypertension, pre-diabetes, or diabetes are now being prescribed a visit to their local Giant supermarket. Instead of picking up antihypertensive medications or insulin from a pharmacist, some patients fulfill a $20 produce prescription using their grocery loyalty card and consult with an on-site nutritionist. The program is making produce affordable and accessible to program participants, enabling them to meet their health needs by changing their eating habits.
Ingredients of Success
DC Greens, a local food justice organization, is the leader and coordinator of the produce prescription program. The organization is, perhaps, an unlikely convener of a such a vast citywide health project. “We have to speak to the DC Greens team’s abilities to think about how many different stakeholders had to be engaged in this process, from clinics and Medicaid providers to a retail supermarket and even city government,” says Trenor Williams, MD, Co-Founder and CEO of Socially Determined, the company that provides the data analytics platform for the produce prescriptions administered by DC Greens.
The successful integration and application of their core values—collaboration, integrity, creativity, sustainability, and equity—into every aspect of DC Greens’ work has proved to be the most important ingredient of the program’s success. In fact, within its first six months, the produce prescription program has already been granted a 2019 Milan Pact Award for the “life-changing impact” it is having on DC residents.
Yet, proving the program’s success is no easy feat. Co-Founder and Executive Director of DC Greens, Lauren Biel explains: “As somebody who’s trying to address food security through the produce prescription model, we know it’s necessary for us to prove out a clear return on investment to the healthcare system.” The ability to do so rests, in part, on being able to collect, aggregate, and analyze multiple types, sources, and layers of data, ranging from individual healthcare metrics to grocery sales.
Data-Driven Proof Points
While patient behavior changes often take time to measure, one early indicator of success comes from retail data. When their supermarket partner, Giant, first opened its Ward 8 store in 2007, it was the first major grocery store in the area. As such, the store filled a critical gap in supplying fresh fruits and vegetables to the community. And since the produce prescription program started there in early 2019, the average program participants’ spending on produce more than doubled, increasing from 8 percent to 20 percent.
Placing this kind of discrete data point into broader context, aggregating increased produce sales to make it meaningful for understanding the overall picture of community health, and keeping that data safe and secure can be huge challenges. That’s where Trenor and his team at Socially Determined come in.
Trenor was a family doctor who co-created Socially Determined three years ago out of a deep understanding of the need to focus on the social conditions that shape health outcomes, such as birthplace, residence, employment, etc. Like DC Greens, Socially Determined takes a holistic approach to health justice. Its innovative SocialScape™ platform is built upon a taxonomy of factors dubbed the “Significant Seven”: 1) Economic Wellbeing; 2) Food Insecurity; 3) Housing; 4) Transportation; 5) Crime & Violence; 6) Health Literacy; and 7) Social Support.
Data security is a top priority at Socially Determined and their partnership is critical to DC Greens. Socially Determined rigorously follows industry standards in data security practices, enabling the organization to establish the kind of secure data sharing agreements and partnerships that build trust among partners and ensure the long-term health of the program. By serving as an intermediary among the different produce prescription partners, Socially Determined can safely and securely aggregate qualitative and quantitative data from myriad sources and translate that information to help monitor, evaluate, and advance the program’s impact.
Growing the Food As Medicine Movement
Through their partnership in the produce prescription program, DC Greens and Socially Determined—along with their many other partners—are developing a replicable model based primarily on patient self-assessments, clinical outcomes, and financial analysis of healthcare costs and utilization.
It’s hard to overstate the potential of enabling communities to track these multiple levels of data and overlay them with one another to better understand individual and collective benchmarks. This nexus of information is critical for understanding how these factors relate to one another and to the overall well-being of participants. Finally, this incredible program is helping to provide an important missing link in the Food As Medicine movement by providing the data and evidence needed to advance behavior changes and policy innovations in support of sustainable food systems and healthier communities.