By LISA EISENHAUER
When St. Peter's Health Partners set up community farmers markets on its campuses last year, the health system also established a means to ensure that some of the fresh produce went to people with limited means.
Shoppers at the farmers market at St. Peter's Hospital in Albany, New York, were asked two questions by survey takers last summer and those whom the screen identified as being food insecure received a $10 voucher for fresh produce.
The community health and well-being division of the system, based in Albany, New York, budgeted funding for $10 vouchers to be handed out at the markets. Volunteers roamed the markets and did a two-question screening of anyone who was willing. They gave a voucher to people identified through the screenings as food insecure.
"The way that we did it at the market is that we were there, and the food was 10 or 20 steps away, so people could just go right to it," said Angel Surdin, manager of community engagement for the division.
Over the course of six events, the volunteers handed out 217 vouchers; of those, 215 were redeemed. At the last five markets, the farmers weighed the purchases and found that, in total, people had used the vouchers to get 1,092 pounds of potatoes, tomatoes, apples, cabbage and other seasonal offerings.
St. Peter's Health Partners teamed up with the Regional Food Bank of Northeastern New York on the farmers markets and the voucher program. Much of the produce came from the food bank's own farm, which follows sustainable agriculture practices. Money from the vouchers went to the farm.
St. Peter's is part of the Trinity Health system and its farmers market vouchers are one example of food insecurity programs operated by at least 13 ministries within the larger system. The programs' goal is to address a social issue that the U.S. Department of Agriculture estimated plagued 11% of households in 2018.
Screening for hunger
Trinity Health expects that its ministries will be able to identify and help even more people as the system rolls out its integrated Epic medical record system. The rollout started in January at all Trinity Health sites in Michigan, home of its headquarters in Livonia, and will continue in waves across the 22-state system. The rollout is projected to take up to two years. The health system customized its Epic records to include 12 screening questions for all patients on "social influencers of health."
Workers clean crates that are used to distribute unopened food packages from schools, restaurants and businesses to those in need through Fresno Metro Ministry's Food to Share program. The program gets some of its support from Saint Agnes Medical Center in Fresno, California.
The medical records system is matching the answers to those questions with a community resource directory curated by Aunt Bertha, an organization that indexes social services by ZIP code. When a screening identifies a social need, Aunt Bertha points out the top three resources to address that need in the patient's ZIP code.
"Through this process, our expectation is that every individual who comes into a Trinity Health facility will be screened at least once a year and those screenings will be reviewed when they return to see if their needs have been met or if additional needs have arisen," said Jaime Dircksen, the health system's vice president for community health and well-being.
Three of the screening questions focus on food insecurity.
Ivonne Der Torosian, vice president of community health and well-being at Saint Agnes Medical Center in Fresno, California, said countering hunger and other nutritional issues is a way for Trinity Health to pursue its mission of improving health outcomes for people who are poor and vulnerable. She noted that poor nutrition can worsen conditions such as diabetes and heart disease.
In Fresno, Der Torosian said, almost 30% of adults self-report a body mass index — a measure of body fat — that exceeds the healthy range. "What we find is despite there being a high obesity rate, many of our residents are malnourished," she said. "They don't have access to nutritious foods."
Another bit of irony for the Fresno region is that it grows much of the fresh produce sold across the nation, yet the 2019 community health needs assessment done by Saint Agnes cited food insecurity rates there that are higher than the averages for California and the United States.
One of the ways Saint Agnes is addressing the nutritional needs of the community is to partner with the Fresno Metro Ministry to support its Food to Share program. The program recovers unopened packaged food from grocery stores, restaurants and schools to redistribute to low-income neighborhoods where grocery stores and other food outlets are scarce. Starting last July, Saint Agnes committed to providing financial support to the program for three years.
From July 1 through the end of January, the operators of the program collected 158,000 pounds of food and distributed it among 49 partner agencies, such as churches and food pantries. Der Torosian said recipients will be surveyed once a year to see if Food to Share has reduced their households' food insecurity.
Healthy meals on a budget
On the other side of the country in Hartford, Connecticut, Saint Francis Hospital & Medical Center has contracted with the nonprofit Cooking Matters to teach courses on preparing nutritious, low-cost meals. The courses run six to eight weeks and are offered five to six times a year at community sites, including senior centers and libraries. As part of the contract, Cooking Matters staff do cooking demonstrations at a weekly farmers market in a low-income neighborhood.
"We're providing the funding and then we do some data collection collaboratively," said Mary Stuart, regional director for program integrity and community benefit compliance for Trinity Health of New England. Saint Francis Hospital & Medical Center is within that regional Trinity Health group.
Stuart said the data collection is meant to ensure that the classes reach the target audience of people who endure food insecurity and that those who get the lessons find them useful. So far, the courses and demonstrations have reached more than a thousand people and the feedback has been positive, she said.
"It's a big part of our mission to address inequities in communities and there's a huge inequity in people's knowledge and experience and understanding about food," Stuart said. "In our community health needs assessment we saw huge issues around food insecurity and the research shows that changes in people's behavior and understanding around food can have major impacts on their health."
In Springfield, Massachusetts, Mercy Medical Center has taken a different approach to reach a similar end. The hospital helped facilitate a $200,000 low-interest loan from Trinity Health's Transforming Communities Initiative to the Wellspring Collaborative's greenhouse project. The worker-owned for-profit business uses hydroponic techniques to grow produce for hospitals, schools, businesses and individual customers. The Transforming Communities Initiative supports strategies that address social influencers of health.
Doreen Fadus, executive director of community health and well-being at Trinity Health of New England, said the greenhouse is in an economically challenged neighborhood. The project will serve the dual purpose of providing jobs and producing healthy food options for locals.
Mercy Medical Center also is giving advisory support to the Springfield Public Schools Culinary and Nutrition Center. The center, which opened a $21 million site last year, provides daily preparation, cooking and baking of fresh foods for 50 schools, training for students and jobs for the community.
Fadus said the commitment to addressing hunger and nourishment issues goes back to the founders of Trinity Health. "Previously they might have looked at growing food or providing groceries to people or providing meals through a soup kitchen or resource center," she said. "We might be calling things differently and we might be delivering in a different way, but we're still doing the same work."
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