UTH

Center for Health Equity

Project Details

Food is Medicine at the Center for Health Equity.

Project Overview

The Center for Health Equity has a robust portfolio of Food Is Medicine research and policy activities to inform the evidence base across diverse populations in Texas. In partnership with health systems (e.g., Harris Health, UT Physicians, Legacy Community Health), managed care organizations (e.g., Community Health Choice), and community organizations (e.g., Houston Food Bank, Brighter Bites), the Center is designing and testing different models of FIM programs across different populations, including high-risk pregnant mothers, pediatric populations and adults with diabetes.  

Food Is Medicine State-Wide Learning Collaborative

Food is medicine (FIM) can be defined as a set of interventions that include the provision of healthy food as a means to prevent, manage, or treat specific clinical conditions integrated with the healthcare system. Largely, these include Medically Tailored Meals, Medically Tailored Groceries, and Produce Prescription programs. Access to healthy food is critical for the management of chronic medical conditions, and the opportunity nationally is to have healthy food be a covered medical benefit under our insurance plans. Many states, using approaches such as 1115 waiver funds or in lieu of services, are paying for these programs through Center for Medicare and Medicaid Services funds. However, consistent and widespread coverage will require the establishment of an evidence base to inform this work.  

The Center for Health Equity has a robust portfolio of Food Is Medicine research and policy activities to inform the evidence base across diverse populations in Texas. In partnership with health systems (e.g., Harris Health, UT Physicians, Legacy Community Health), managed care organizations (e.g., Community Health Choice), and community organizations (e.g., Houston Food Bank, Brighter Bites), the Center is designing and testing different models of FIM programs across different populations, including high-risk pregnant mothers, pediatric populations and adults with diabetes.  

Project Details:

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. 

Additionally, the Center for Health Equity has collaborated with Center for Health Law and Policy Innovation at Harvard Law School, which advocates for legal and policy reforms in health and food systems, to host two webinars: one exploring potential reimbursement structures for FIM and another explaining community-clinical partnerships.

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: 

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. 

High-risk pregnant mothers – In partnership with 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 the implementation success of these FIM programs, assess the 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 experiences with these interventions, including barriers and facilitators.

We are excited to share that the 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 that 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,  showcased 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 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. 

Get involved by reaching out to Naomi Tice at [email protected].

Food Is Medicine: A Presidential Advisory From the American Heart Association

Project Contact: Naomi Tice, MPH

 

 

UTHealth Houston School of Public Health Team 

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Shreela Sharma, PhD, RDN, LD

Director, Center for Health Equity

Professor and Vice Chair, Department of Epidemiology

[email protected]

 

 

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Ryan Ramphul, PhD

Assistant Professor, Department of Epidemiology

[email protected]

 

 

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Naomi Tice, MPH

Project Manager, Center for Health Equity

[email protected]

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Wesley Gibson

Research Coordinator, Center for Health Equity

[email protected]

 

 

Project Partners

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Elena Marks, JD, MPH

Co-Founder, Texas Consortium for NMDOH

  

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Jacquie Klotz, MA 

Program Manager, Texas Consortium for NMDOH

 

 

Collaborators 

Texas Consortium for Non-Medical Drivers of Health 

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