Why Focus on Communities?

Community-based organizations (CBOs) have been responsible for implementing Food is Medicine interventions for decades. As far back as the 1980s, community-based organizations across the U.S. led the way in implementing the home delivery of meals and groceries to people living with HIV/AIDS. Community-based organizations soon began to provide food services to people living with cancer, heart disease, and other conditions. Community-based organizations -particularly faith-based organizations-have also taken on much of the challenge of distributing food to people experiencing food insecurity. Local and regional food banks, medically tailored meal providers, and community-engaged health care champions have been vital partners in groundbreaking Food is Medicine research, showing its potential to support improved health and food security outcomes among people living with a wide range of health conditions.

The success of community-engaged Food is Medicine initiatives can be attributed to community-based organizations' enduring presence, trust, and know-how. When their Food is Medicine initiatives succeed, it is often because these organizations have developed strong relationships with the people health care systems serve. Successful community-engaged Food is Medicine initiatives often rely on leaders, staff, and volunteers from the communities served by the initiatives. These community-based organizations have taken time to build formal and informal connections needed to serve as intermediaries among community members, health care systems, and food systems. To survive, community-based organizations and community leaders also evolved the ability to provide Food is Medicine services in environments where funding is inconsistent or comes from multiple sources that must be braided into a sustainable organizational budget.

In the U.S., there is a growing conversation about how best to incorporate food in our health care as a potent healing or preventative intervention. The phrase “Food Is Medicine” has become shorthand for a set of practices that intentionally apply food to prevent, manage, treat, or reverse disease.

The most effective community-based organizations consistently treat the communities they serve as more than a collection of consumers, health care patients, app users, or statistics. They understand that communities' food preferences reflect culture, place, and shared memories. Effective community-based organizations have invested the time necessary to understand the emotions and histories behind communities' choice of foods for a Fourth of July meal. Effective community-based organizations embrace communities' lived experiences and understand that food is much more than medicine.

Increased intake of healthy foods is an essential component of most Food is Medicine interventions. However, simply making healthy foods available at no cost or reduced cost to Food is Medicine participants is not sufficient to achieve desired impact. Effective community-based organizations use their knowledge, experience, and trust to engage communities as active ongoing participants in Food is Medicine initiatives. These community-based organizations need adequate reimbursement for the effort required to get nutritious, culturally relevant food to those who need and want it.

Adequate reimbursement enables Food is Medicine growth and reach that is otherwise unattainable. The next section of this guide describes what we heard from community-based organizations, health care payers, and others about important opportunities and challenges confronting community-based organizations' reimbursement for Food is Medicine. The guide will conclude with a series of compelling stories in case studies from the Food is Medicine field demonstrating how community-based organizations and community leaders promote increased engagement, duration, and dosage necessary to support community members' health journeys.