By Danielle Pierce

As a result of COVID-19, approximately 1 in 9 people, or more than 165,000, are facing hunger in Central Virginia right now. People living in food-insecure households without reliable access to affordable, nutritious food are more likely to experience poor health across their lifespan.

The “Food is Medicine” program, sponsored by Feed More and VCU Health, seeks to reduce hunger among patients screening positive for food insecurity during health care visits.

Originally established in 2019, a new grant from the Anthem Blue Cross and Blue Shield Foundation more than doubles the number of clinics the program serves, adding three adult outpatient clinics and expanding its screening program to four pediatric clinics. This will bring the total number of Food is Medicine screening sites to 10 VCU Health clinics across Richmond.

“Do you need food today?”

This simple yes/no question is one of the three screening questions social workers and nurses ask patients and families to find out if they are experiencing food insecurity. If the answer is yes, they give the patient and the family of pediatric patients a box of heart-healthy, shelf-stable food to take home and use immediately.

“Being able to provide food to patients and families right away has been a game changer,” said Kimberly Lewis, director of community outreach and administration in the division of community health at VCU Health. “Our patients and families know that we are listening and that we are here to help them. It’s more than just pointing them in the right direction. It’s saying ‘I hear you and I can help you right now.’”

In addition to the box of food, families are directed to programs that can help with long-term solutions, such as the Feed More Hunger Hotline. Feed More volunteers connect families with the food pantries closest to their homes and encourage callers to apply for Supplemental Nutrition Assistance Program (SNAP) benefits, among other assistance programs.

“Overall this program is a great way to reach more people who need help and who might not know how to navigate the food assistance system,” said Sydney Orgel, client resource coordinator at Feed More. “We are excited to pursue ways to invest in the health of our community and be one of the connectors between food insecurity and health.”

More than just a food box

The Food is Medicine program fulfills an immediate need for patients and families who do not have reliable access to nutritious food, but there are additional bonuses as well. One example is patient engagement.

“Anecdotally, we have found that families are more receptive and trusting when they know we are truly here to help them,” said Shirley Alexander-Das, LCSW, a clinical social worker for the pediatric nephrology team. “If they tell one of our clinicians that their family needs food and they are immediately given a box of food to take home, it means so much more than just giving them a card with a number to call.”

“They know that when they talk to our doctors and nurses, they are listening. They are then more than likely to schedule that follow-up appointment or to bring their child back for their next well visit. This goes a long way in terms of patient care and engagement. It’s building trust and relationships with our patients.”

Addressing social determinants of health

Individuals and families dealing with food insecurity don’t usually experience just one need in isolation. They are likely battling other major issues as well, such as lack of transportation and housing. These issues, among others, are referred to as social determinants of health.

According to the Center for Disease Control and Prevention, social determinants of health are conditions in the places where people live, learn, work and play that affect a wide range of health and quality of life risks and outcomes.

At VCU Health, the Food is Medicine program is coordinated by the Office of Health Equity, which strives to remove systemic barriers affecting social determinants of health. It works with the Division of Community Health to address the social and economic factors that affect an individual patient’s health.

“We have great doctors, specialists and teams to take care of the clinical issues, but we want to make sure all of those other social issues that make up the whole person and contribute to their overall quality of life are addressed,” said Anne Massey, director of patient and community services for VCU’s office of health equity. “Food is Medicine is one of the projects that allows us to do this.”

Connecting with families

During the pilot year of the Food is Medicine project, from April 2019 through September 2020, patients at four VCU Health adult outpatient clinics in downtown Richmond were screened. Of those, 41% were found to be food insecure, and over 400 boxes of food were distributed. With the recent grant, Food is Medicine began serving three pediatric clinics and one inpatient unit at Children’s Hospital of Richmond at VCU (CHoR).

Even before it became part of the Food is Medicine program, CHoR recognized the need to provide food-insecure families with groceries. Small pilots were tested that highlighted the need to explore this idea further. With the support of this grant, CHoR expanded these services.

“During the height of COVID, there was concern about some of our patients having access to food. So, we put together some donations,” said Megan Lo, assistant professor of pediatric nephrology at CHoR. “We received a grant from the Children’s Hospital Foundation and were able to secure funds to buy groceries. But we wanted to create a long-lasting system —something that we could sustain even after the pandemic — and we were excited to connect with Food is Medicine and VCU Health on this initiative.”

“COVID has been hard for everybody,” Lo said. “To be able to fill this need has been like a little bit of hope for us as well. To know that we are doing something that is not just directly related to the clinical care we provide, but hopefully providing a little bit of relief to families — it means so much to all of us.”

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