Food is Medicine: Transforming Healthcare Through Nutritious Food in Texas 

By Wes Gibson

Food is Medicine (FIM) is a transformative concept that emphasizes the provision of healthy food as a means to prevent, manage, or treat specific clinical conditions and is integrated within the healthcare system.¹ The Center for Health Equity (CHE) has a portfolio of efforts spanning coalition building, research, and policy to accelerate FIM in Texas.   

Our activities include: 

Coalition building 

Center for Health Law and Policy Innovation at Harvard Law School, which advocates for legal and policy reforms in health and food systems, the CHE hosted two webinars: one exploring potential reimbursement structures for FIM and another explaining community-clinical partnerships. Additionally, the Center serves as the backbone organization of the Health Equity Collective systems coalition in the Greater Houston region and is actively facilitating regional scaling of FIM programs and related knowledge base, and FIM policy conversations using a collective impact approach. These activities have brought together stakeholders from diverse sectors, equipping them to inform legislative action around healthy food being a covered medical benefit. 

Center for Health Equity is also partnering with the Texas Consortium for Non-Medical Drivers of Health, a statewide effort, to create a collaborative platform for learning and knowledge sharing among researchers, policymakers, and practitioners. This initiative includes a comprehensive Program Index that catalogs statewide FIM partnerships. Using these data, CHE faculty have developed an interactive map to visualize rates of food security and availability of related FIM programs across Texas. Faculty are currently implementing a FIM landscape scan to identify and document FIM programs across Texas, enhancing the understanding of these initiatives and fostering the sharing of best practices. These efforts will strengthen the evidence base and drive meaningful change in the integration of FIM interventions into the healthcare system. 

Evaluating FIM Studies 

As a dedicated research center, the CHE is committed to building a robust evidence base for FIM studies, demonstrating their potential impact on health outcomes and dietary behaviors.  Currently, the CHE is conducting FIM research across two populations: 

1. Pediatric populations – In partnership with health systems and school-based health clinics, we are evaluating the impact of a home-delivery based produce prescription program on diet quality, food security and weight outcomes across school-aged children at risk for obesity and are Medicaid-eligible. 

1. High-risk pregnant mothers – In partnership a county safety net health system and a managed care organization, we are implementing and evaluating two different types of produce prescription approaches in high-risk pregnant mothers on Medicaid.  

As FIM research progresses, plans are in place to understand factors informing implementation success of these FIM programs, assess impact on social, behavioral and health outcomes to advance evidence-based results, and incorporate economic analyses to bolster the case for reimbursement, particularly from payers like Medicaid, ensuring long-term sustainability. Most importantly, the center is using a human-centered design approach to ensure that patient lived experience is driving its efforts. In 2023, CHE launched a Community Advisory Group of mothers previously participating in regional FIM interventions to help inform our efforts. The advisory group meets bi-monthly to share lived experience with these interventions, including barriers and facilitators 

New funding from the Cigna Foundation for persons with diabetes – We are excited to share that Center for Health Equity and UT Physicians has received new funding from the Cigna Foundation to implement and evaluate a multi-component produce prescription approach among persons with diabetes receiving care at UT Physicians clinics in Houston.   

National Collaboration and Commitment 

These collaborative efforts and research initiatives align with the CHE’s ultimate goal: to increase access to nutritious food, a critical component of sustainable health. The federal government also shares this goal indicating FIM is a crucial component of a national strategy aimed at eradicating hunger. In March 2024, this commitment was further solidified through participation in the White House Challenge to End Hunger. CHE Director, Shreela Sharma, PhD, RDN, LD, represented the CHE, showcasing the organization’s dedication to leveraging collaboration and research to thoroughly evaluate FIM studies and their potential to combat food insecurity and enhance health outcomes. Additionally, Sharma serves on the American Heart Association Healthcare x Food initiative’s research planning group to inform national research efforts to advance FIM policy and practice.  

The integration of food as a vital component of healthcare through the Food is Medicine initiative represents a promising pathway toward improving public health and addressing food insecurity. Through strategic partnerships, research, and advocacy, the CHE is at the forefront of this movement, working tirelessly to ensure that nutritious food is accessible to all. 

1. Volpp, K. G., Berkowitz, S. A., Sharma, S. V., Anderson, C. A. M., Brewer, L. C., Elkind, M. S. V., Gardner, C. D., Gervis, J. E., Harrington, R. A., Herrero, M., Lichtenstein, A. H., McClellan, M., Muse, J., Roberto, C. A., Zachariah, J. P. V. (2023). Food Is Medicine: A Presidential Advisory From the American Heart Association. Circulation, 10.1161/CIR.0000000000001182.