The Food Is Medicine Initiative in Texas: A Landscape Scan of Programs, Priorities, and Opportunities

By Naomi Tice

Introduction to Food Is Medicine Initiative

In Texas, nearly half of the state’s budget (around $43 billion) is spent on healthcare yet 23% of adults have at least one major chronic disease, clearly demonstrating the need for different approaches to addressing health. Integrating nutrition within health care offers a powerful opportunity to address this challenge. (1-2)

Food is Medicine (FIM)  is defined as the provision of healthy food to prevent, manage, or treat specific health conditions, with a focus on integration within the health care system. (3) It differs from standard food distribution in that FIM programs provide nutritious food and aim to improve an individual’s health, rather than focusing more on the provision of additional calories for those who are food insecure.

FIM aligns well with current state and federal level priorities, including the recent passage of Texas House Bill 26, which allows for Medically Tailored Meals, a type of FIM intervention, to be provided by Managed Care Organizations, organizations providing Medicaid services, to qualifying pregnant women. The timeliness, and potential effectiveness of FIM programs to improve health outcomes of Texans, provides an imperative to better understand the work underway across the state.

The research team at the Center for Health Equity (CHE), led by Naomi Tice, MPH, project manager at UTHealth Houston School of Public Health developed and implemented a comprehensive statewide landscape scan survey of FIM programs, priorities, and opportunities. The scan determined which Texas organizations were implementing FIM programs, what types of FIM interventions are currently being implemented across the state and to address what types of health conditions across which populations, and if these programs were being formally evaluated.  

This survey was developed in collaboration with the Food Security Workgroup of the Health Equity Collective systems coalition,  the Texas Consortium for Non-Medical Drivers of Health,  and FIM researchers and implementers across the state.

Findings of the Landscape Scan

The scan identified 24 health systems across the state that are implementing 48 unique FIM programs. The most common type of program is medically tailored groceries, which provides healthy groceries and food options, mainly fresh fruits and vegetables, to help participants improve their diet quality and manage their health conditions. The top-reported chronic diseases that these programs address included obesity, hypertension, and diabetes, with some programs focused on prevention and pre-diabetes . The majority of programs serve the Greater Houston Region, with 27 programs serving Harris County alone. To see more detailed results can be viewed through the FIM Landscape Scan , which includes  here breakdowns by intervention type, disease conditions addressed, areas served, and more. Viewers can also  explore an interactive map here to see FIM programs by county and distribution of chronic health conditions.

results reveal that FIM is not a new concept in Texas, with the oldest program launching in 1988. The bulk of programs were launched in 2022 or later. Despite this history within the state, the future funding for programs remains uncertain. Almost half of all programs are funded through private grants and 60% of programs were unsure if they will continue after their current funding period, highlighting the need for innovative funding mechanisms and sustained support.

Conclusion and Next Steps

The FIM landscape scan demonstrates that Texas is well-positioned to harness the current momentum around healthy eating and behavior change, with strong alignment to state and federal priorities. Next steps include expanding FIM programming into high-need geographical areas that remain underserved, especially a large number of rural communities, which currently have no programming; using FIM programs to treat a broader range of health conditions, fostering stronger, sustained partnerships across healthcare, community, and policy sectors to increase program sustainability.  

Organizations looking to implement FIM programs can reach out to the CHE, which provides consultative services to design, implement, and evaluate FIM programs. Through our Data Visualization Studio, we also map and visualize program data to help organizations understand impact and opportunities.

The landscape scan is open and will be administered annually to capture changes and include new interventions. If you are already implementing a FIM program, but were not included in the Landscape Scan, reach out to Naomi Tice, MPH, program manager, to have your program included in the FIM Landscape Scan Dashboard.

Additional collaborators on the research team from UTHealth Houston include Wes Gibson, MPH; Angelina Johnson, MPH; Christopher Reyes, MPA, MPH, Deepali Ernest, PhD, MPH;  Oguchukwu (Ruth) Abasilim, MPH; Milan Jaiswal, MD; Niharika Sawant; Ruth Emmon Tyson, MPH; and Mengxi Wang, PhD, MS and Jing Xie, MPH from The Coordinating Center for Clinical Trials.

1. Minton L, Vela L, Wright B. Counting the Cost of Texas Health Care: Comptroller Report Examines Vital State Spending. Texas Comptroller of Public Accounts. Fiscal Notes. March 2017. https://comptroller.texas.gov/economy/fiscal-notes/archive/2017/march/health-care.php. Accessed September 18, 2025.
2. Prevalence of Diabetes, CVD and Asthma in Adults by Total (2011-2023). State Health Compare. University of Minnesota. https://statehealthcompare.shadac.org/map/51/prevalence-of-diabetes-cvd-and-asthma-in-adults-by-total-2011-to-2023. Accessed September 18, 2025.
3. Volpp KG, Berkowitz SA, Sharma SV, et al. Food Is Medicine: A Presidential Advisory From the American Heart Association. Circulation. 2023;148(18):1417-1439. doi:10.1161/CIR.0000000000001182
4. National WIC Association. WIC Program overview and history. National WIC Association. Accessed October 14, 2025. https://www.nwica.org/overview-and-history