In June 2018, I had the opportunity to be a part of the Our Table discussion on food law and policy. My own research focuses on healthcare policy and the role that the social determinants of health – such as food security – play in shaping federal and state entitlement programs such as Medicaid.
Currently, there is not a close relationship between healthcare policy and food security. This needs to change. Right now, healthcare practice is driven by the resources available to patients and providers under insurance or government assistance. Many providers make diagnoses that assume patients will have access to healthy food, such as "take these pills with food." They may tell a patient with a chronic condition to work on diet or lifestyle. But, other than perhaps a referral to a nutritionist, insurance and governmental policies on the whole do not allow for food and nutrition as a part of prescription for health. This is a cultural shift that we'll need to make to involve health professionals into a more holistic approach to health.
The Medi-Cal Medically Tailored Meals Pilot Program is an exciting example of this shift. Part of the California Food is Medicine Coalition, the Medi-Cal Medically Tailored Meals is a $6 million pilot program funded by the California state legislature. While the California program is the first large-scale policy, research in smaller studies has indicated that prescribing and providing three meals a day for patients with certain chronic conditions, such as heart disease, reduced these patients' healthcare costs and reliance on the healthcare system dramatically. This makes total sense. For example, a low-sodium diet may be impossible to follow in areas where inexpensive, processed foods are more readily available. The hope is that California will also see dramatic decreases in Medicaid spending with this new program. I argued during the Our Table discussion that Michigan should be taking a similar approach. Providing healthy meals for healthier people is a far more advantageous policy than having more people in the hospital or in the healthcare system.
The exciting takeaway from Our Table was to hear how attendees from different disciplines and professions saw how this could happen in Michigan. For example, several faculty and graduate students from the School of Packaging discussed ways they might collaborate to ensure food safety for meal shipments in a “food is medicine” prescription plan. Nonprofit leaders discussed how food might be brought to free clinics in community centers. I left with multiple avenues to begin putting a theory such as “food is medicine” into action.
Dawn Opel is an assistant professor in the Department of Writing, Rhetoric and American Cultures within Michigan State University’s College of Arts and Letters. She is part of one of two MSU–based research teams to be awarded Food@MSU seed grants, which seek to aid researchers across disciplines to find new approaches to solving complex real-world issues related to food and community. You can reach her at email@example.com.