Doctors as Farmers: How Food 'Prescriptions' Can Save Our Cities

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Joe Erario


I was recently asked to talk about Wholesome Wave's new Fruit and Vegetable Prescription Program (FVRx) at the Roots of Change Conference in Los Angeles. We partner with Roots of Change and they throw amazing conferences, so the answer was YES!

FVRx relies health practitioners in underserved communities to serve as "dispensers" of "prescriptions" that can be redeemed for fresh fruits and vegetables at local farmers' markets. The concept is receiving tremendous excitement, but especially from the practitioners who are charged with providing health services to people who have no access to healthful food and, in most cases, no health insurance. Quite a charge—steward the health of folks who can't afford the stewarding.

As always, I wanted to be provocative and somewhat entertaining, so I looked for an angle to help everyone draw a connection between community health practitioners and farmers. The more I chewed on this, the more I realized that these two groups have a bit in common. For instance:

    • Farmers passionately steward the health of the soil. Practitioners passionately steward the heath of the community. Neither group is "in it for the money."

    • Both work long hours in conditions most workers would never accept.

    • Both feel a tremendous sense of accomplishment when they succeed.

They face the same challenges:

    • Both are seriously underfunded,

    • Both know what they need to do to provide maximum health to their charges, but lack even the non-financial resources to do so.

    • Both feel that good food is key to a vibrant and healthful life.

I have no idea how it came to me, but I came up with a one-word-notion approach to make the connection obvious, and dubbed the physicians in underserved communities the new American "PHarmers." I thought, "Man, this is kitschy." But the team said, "Works for us!" Therefore, I introduced the notion that because we are giving these noble folks the ability to provide the food their patients so desperately need to make the lifestyle change that can prevent expensive diseases, "PHarmers" seems appropriate.

NEWSFLASH! The choice for an underserved community member isn't between a chicken and vegetable dinner and a Happy Meal.

After all, it's all about the food when it comes to diet-related, preventable health conditions that cost American taxpayers over $800 billion annually.

Seems like common sense: Shift money from expensive treatments toward the food that the folks who suffer from obesity-related disease need in order to become, well, un-obese. The money also creates economic stimulus and jobs instead of record profits and dividends for very few people on the treatment side.

At this point in preparing, I realized that I had to deal with the serious misinformation and misperception that exists in the minds of many Americans, because their votes drive policy and, frankly, hatred. Many Americans believe they know why obesity is so rampant, but they truly don't.

Lots of people in the sustainable food movement know why underserved community members are in the condition they are in—because we work there. Besides, some of the folks I'm addressing happen to be relatives and friends of mine.

What Many Think

Underserved community members (often referred to as "those people," or "they"):

    • Are lazy and should get a job

    • Don't know how to cook

    • Don't want good food; they want junk

Unfortunately, much of this misperception comes from widely published information created by folks who usually agree with the sustainable food movement. I looked hard at the following two popular statements and felt they need adjustment:

    • Rising rates of obesity in children and adults stems from poor food choices.

    • The vast majority of obese children and adults live in food deserts with no access to healthful food.

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Michel Nischan is the CEO and president of the Wholesome Wave Foundation, a pioneer of the sustainable food movement, and a James Beard award-winning chef and author. More

Chef Michel Nischan wears many hats, from dynamic restaurant owner, award-winning cookbook author, and media personality to food policy advocate and non-profit foundation CEO. A proponent of sustainable farming, local and regional food systems, and heritage recipes, Michel has long been a leader in the movement to honor local, pure, simple, and delicious cooking. He is owner and founder of Dressing Room, his homegrown restaurant in Westport, CT, and CEO and president of the Wholesome Wave Foundation, which is dedicated to nourishing neighborhoods by supporting increased production and access to healthy, fresh, and affordable locally grown food for the well-being of all.
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