Prescribing change: Using healthy food to break the cycle of poverty and chronic disease

As a child, Brian Frank, sat down at the beginning of every week with his father and brother to plan each of the family’s meals for the next seven days. Every morning, he knew he would wake up to a delicious breakfast, that he would have something in his lunchbox and that he would return home from school to a nutritious meal on the table.

“What I didn’t realize at the time,” he said “was the incredible sense of security that gave me.”

Now, as a physician at OHSU Family Medicine at Richmond, Dr. Frank understands all too well that food security is a luxury that many of our community members do not enjoy. In fact, an astounding 75 percent of Oregon’s Medicaid patients lack reliable access to affordable, nutritious food.

So what does this mean for our community? Lack of consistent access to nutritious foods, especially in childhood, can have devastating and long-lasting health effects. In particular, food insecurity leads to patterns of overconsumption of calorie dense, but nutrient poor, foods. This “high calorie malnutrition” can cause or worsen chronic diseases such as diabetes, leading to poor health outcomes. Once people develop chronic diseases, food insecurity prevents them from making changes that would improve their health. In turn, people suffer worse outcomes, driving up the cost of medical care as a whole and leading to financial devastation for patients and their families due to hospitalizations, illness and lost time at work. These catastrophic events send families further into poverty and worsen food insecurity. What we end up with is a cycle that continues until patients are dying at an earlier age than their counterparts who have better access to food. “Hunger is more than nutritional or physiological deficit,” Dr. Frank explains. “It’s a dangerous medical condition that requires urgent treatment.”

This year, OHSU Family Medicine at Richmond, the Oregon Food Bank, Multnomah County, Zenger Farms, and researchers at Portland State University have partnered to launch a research project with the aim of changing how we think of, and provide, food. The project, collectively called CSA Partnerships for Health (CSAP4H) provides weekly, subsidized boxes of fresh, locally-grown fruits and vegetables.

Building on the work of a pilot program at Multnomah County’s Mid-County Medical Center, and supported by grants from Kaiser Permanente and the OHSU Knight Cancer Institute, CSAP4H hopes to show that this simple intervention can change eating habits of its participants.

Over the course of the 20-week growing season, patients will also have access to free cooking classes hosted by the Oregon Food Bank, and food education by Zenger Farms.
At the end of the 20-week period, the team will conduct an in-depth evaluation, with the hope of proving the medical benefit of “prescribing” healthy foods to patients in need.

OHSU Family Medicine’s mission to address food insecurity and malnutrition extends beyond this summer’s project. Other efforts will include additions to OHSU’s curriculum across all healthcare professions, which will arm providers with the ability to better understand, treat and manage food insecurity. Final steps will also include coming up with best practices for evaluating and addressing food needs across the country, so there is a standardized, evidence-based method that can be easily used by all healthcare organizations.

Want to learn more? Visit OHSU Family Medicine at Richmond to see Dr. Frank in action, learn more about healthy eating, and enjoy delicious giveaways.

OHSU Family Medicine at Richmond

Friday, August 12

1 – 5 p.m.


Dr. Brian Frank is a Family Medicine physician at OHSU Family Medicine at Richmond, a Federally Qualified Health Center. OHSU Family Medicine at Richmond treats infants, children, adults, and seniors in the Southeast community, regardless of their insurance status or ability to pay.

One response to “Prescribing change: Using healthy food to break the cycle of poverty and chronic disease

  1. that is wonderful, and enlightening that there is a shift in the thinking of food vs meds. I applaud you for this. I also believe it is part of Maslow’s theory of basic needs>? bravo, with slow clap,

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