Health impacts of health system implementation of a food-as-medicine strategy.

Abstract

Objectives: To describe a regional health system's experience with medically tailored groceries (MTG), focusing on program reach and effectiveness as determined by observed within-person changes in cardiometabolic measures.

Study design: Case study including individuals aged 18 to 79 years referred by an ambulatory health care provider to a single regional health system's MTG program from April 2020 through September 2023.

Methods: Demographics, clinical characteristics, and cardiometabolic measures (blood pressure [BP], weight, body mass index [BMI], and hemoglobin A1c [HbA1c]) were abstracted from electronic health records. Descriptive and bivariate analyses evaluated differences in demographics and comorbid conditions among those who ever vs never used the Food for Life Market. Weighted linear mixed-effect models evaluated the expected change in outcomes from baseline to recent measure, accounting for demographics, time between measures, and attributed market location.

Results: A total of 2259 adults received referrals to the MTG program (median, 1 referral; range, 1-7; 3184 total referrals). Of those referred, 1397 (61.8%) ever attended; MTG users were significantly older than nonusers (median age, 52.9 vs 38.3 years; P < .001). MTG program attendance was associated with favorable changes in market attendees vs nonusers in diastolic BP (-0.54 vs -0.51 mm Hg; P = .04) and BMI (0.20 vs 0.23; P = .02) after 3 years from baseline, after accounting for confounders. No significant differences were observed in systolic BP, HbA1c, or weight.

Conclusions: An unincentivized MTG intervention demonstrated modest impacts on key cardiometabolic measures. Future efforts to colocate MTG sites with clinical settings may enhance program uptake and impact on cardiometabolic measures.