The Healthy FoodRx pilot at the Outpatient Community Pharmacy

Integrated into the hospital’s existing pharmacy space and building off the Abundance FoodRx virtual food pharmacy platform, the Healthy Food Pharmacy pilot is illustrating healthy food can be medicine just as importantly as picking up prescription medications at the same pharmacy counter. Dr. Kelly Garrett, Director of Pharmacy Services, is championing the Healthy Food Pharmacy concept, recognizing its ability to impact health improvement, disease prevention, health disparity reduction, and resource access, all by improving access to healthy foods, that are aligned to an individual’s diet-related health-state needs, right from the pharmacy. 

Working in parallel, the online side of the Healthy Food Pharmacy pilot serves as a healthy food navigator (abundancefoodrx.com) and is coupled with Instacart technology, enabling local residents to use all of the benefits available to them through innovative tools like the Instacart Health Wallet.  

Back at the hospital, our outpatient pharmacy is the only walk-in public pharmacy in the county, enabling a trusted resource to pilot a Food is Medicine concept for many local residents. With nearly 90% of Americans living within five miles of a pharmacy, and both high-risk Medicaid and Medicare beneficiaries visiting their local pharmacy more often than their primary care provider, it is being quickly recognized the vital role of the pharmacy within a Food is Medicine approach. 

The Healthy Food Pharmacy pilot at Allendale County Hospital outpatient pharmacy provided locally-grown whole fruits and vegetables alongside compassion-driven flexible formats like purees made from locally-grown fruits. These purees, designed for individuals with conditions like stroke, dysphagia and difficulty eating while in cancer therapy, offered several benefits that positively impacted patient dignity:

• Improved Swallowing: The smooth, pudding-like texture of purees helped make it easier for patients with difficulty swallowing to consume meals safely and effectively. ​
• Reduced Risk of Aspiration: By eliminating the need for chewing, purees helped minimize the risk of food entering the airway, reducing complications like aspiration pneumonia. ​
• Nutritional Support: Made from locally-grown whole fruit, these purees included essential nutrients, and all the benefits of its whole counterpart, supporting nutrition despite limited appetite or dietary restrictions. ​
• Enhanced Mealtime Experience: Visually appealing and flavorful purees can help promote engagement and enjoyment during meals, fostering a sense of normalcy and dignity. ​
• Empowerment and Independence: Safe and palatable food options can help empower patients to maintain independence and improve their quality of life during recovery. ​

By addressing the unique dietary needs of stroke patients with compassion and flexibility, the healthy food pharmacy program is loving with food that supports patient dignity and autonomy, improved health, and contributes to overall well-being of both patients and their families. ​

The Healthy Food Pharmacy pilot based out of the Allendale County Hospital Pharmacy, initially launched on a small scale to the regional community by utilizing the Local Food Purchasing Assistance Program (LFPA), a federally-funded program administered by state departments of agriculture, that enabled distribution of locally-grown fruits and vegetables to underserved communities at no cost to the distributor (the hospital) or its underserved recipients, while at the same time supporting the local producers through a third party reimbursement of local food by LFPA aggregators. ​

Through barrier-free healthy food access, this initiative aimed to address food insecurity and improve health outcomes for clients, many of whom are Medicaid or Medicare beneficiaries managing chronic conditions such as type 2 diabetes, hypertension, and cardiovascular disease out of a nonprofit, Critical Access Hospital and two Rural Health Clinics. ​​ The program leveraged the accessibility of the health system's outpatient pharmacy team to screen patients for food & nutrition insecurity,share opportunities in  educate about healthy eating, and distribute produce prescriptions and medically tailored groceries. ​ Every other week, eligible pharmacy clients received an opportunity to take home a bag  of locally-grown fruits and vegetables, approximately 5 to 8 servings, with each receipt recorded in SC Thrive's ThriveHub as a referral. ​

The program served a diverse population, with more than 700 unique clients making a total of 2,001 visits across a seven month period. The service scope included:

• Race: Black or African American clients accounted for 83.99% of visits, followed by White (15.61%), Asian (0.30%), and Native Hawaiian (0.10%).
• Age: Older adults aged 56–75 years had the highest engagement, with frequent visits reflecting their need for chronic disease management and support. ​
• Gender: Both male and female clients participated, with Black or African American males aged 56–75 showing the highest percentage of multiple visits.
• Geographic Distribution: Clients came from various towns and counties across the region, with Allendale County having the highest number of visits (790 client visits across Allendale, Fairfax, and Ulmer). Hampton County followed, with significant participation from towns like Brunson, Hampton, and Varnville. ​

The program demonstrated the potential for measurable health benefits, particularly for racial minorities and older adults disproportionately affected by diet-related chronic diseases. ​ Existing studies show that increased fruit and vegetable consumption can improve glycemic control. ​ For example, a 1% reduction in HbA1c levels is associated with annual healthcare savings of $736 for diabetes-related costs and $545 for all-cause healthcare expenses per individual. ​ Even a modest 0.5% reduction yields savings of $368 and $272.50, respectively. ​ These savings highlight the program's economic impact, reducing the financial burden of chronic disease management. ​​

Beyond diabetes management, increased fruit and vegetable intake is linked to reduced risks of cardiovascular disease, hypertension, and stroke. ​ An NIH study estimated that even a 0.4-serving daily increase in fruit and vegetable consumption could prevent 1.93 million cardiovascular disease events and save $39.7 billion in healthcare costs over a lifetime. ​ The program’s provision of 5 to 8 servings per visit far exceeded this threshold, underscoring its transformative potential for improving health outcomes and reducing healthcare costs. ​

Despite its success, the LFPA program’s cancellation at the federal level has left our vulnerable populations without essential dietary support, exacerbating food and nutrition insecurity and chronic disease management challenges. ​ Reinstating the program would restore proven health and economic benefits while supporting local farmers and promoting equity. The program was so deeply valued locally that one minority-based local church has stepped forward asking what they can do and is working with the The Good Fruit Foundation exploring how to possibly replicate LFPA through private donations so that services could re-open at the pharmacy. All of this emphasizes the critical need for sustainable reimbursement pathways for scaling a healthy food pharmacy model effectively and how deeply it was valued by the local community. ​ 

The Healthy Food Pharmacy pilot actively demonstrated the potential for transformative impact of integrating "Food is Medicine" interventions into healthcare systems. ​​ By addressing food insecurity and chronic disease management, the program hold the potential to measurably  improve health outcomes, reduce healthcare costs, and support local agriculture all at the same time. ​ The demographic data highlights the program’s reach, with Black or African American clients and older adults being the most consistent beneficiaries. ​ The initiative aligns with the "Food is Medicine" approach, emphasizing the integration of nutrition into healthcare strategies as a vital investment in public health, economic sustainability, and equity. ​​ Policymakers should prioritize reinstating and scaling such programs to ensure sustainable health improvements for underserved communities while addressing both immediate dietary needs and long-term health challenges. ​​We also know we can figure this out. This was so loved by our community. If you agree this is too good to see go, we've opened up an ability to now donate directly to the sustainability of this program, outside of the present volatility of federal funding sources, so that it can be supported by the community itself and mission-focused private investors wanting to contribute toward measurable, resilient opportunities in health at the Allendale County Hospital.