Hippocrates made a good point in 470 BC. Maybe it’s time we dusted it off and put it to work.
When I talk about a preventative health care model, I mean that our interventions in the lives of our clients and our agency’s clients should be demonstrably beneficial to promoting their longer-term nutritional health and food security.
The evidence is there that food patterns over time lead to health disparities. The easiest way to wreck or improve people’s health is with food and exercise. That means that we have the opportunity to move from being that band aid on the unsolvable problem to a situation where we can provide the widely accepted cure for it.
Preventative medicine always makes sense, but the value proposition we are offering is way more attractive and cost effective than most healthcare strategies. Consider the below choice:
The double-blind trials are in on broccoli and lentils and poor misunderstood Mr. Kale. We know this stuff works as good as medicine, and without even the need for a gentle voice at the end of the drug commercial explaining about the possibility of nausea, sudden death and our bits dropping off if we consume it.
If we are talking to someone who says we should be focusing our attention on providing any kind of emergency food, and not waste time and money on being picky, then we would point out how those empty calories are being destructive to the health of the person we are trying to help.
All our supporters care about kids, well how about bringing these facts to their attention:
How can food banks not jump fully into the healthcare arena? We have so much opportunity to make such an incredible impact. It’s time we wrote a prescription for the health of our communities and our organizations.
Many food banks are doing amazing things to promote health by emphasizing the provision of fresh produce and providing various types of nutrition education programs. But what would happen if we got more serious and more precise about what we were doing?
What if our new health-based destination could also usefully embrace the destinations of other organizations – like the Department of Health and Human Services for example. They’re not exactly a fringe organization of tofu munching ginseng swillers. Check out their goals for 2020.
We could totally help them do that stuff! Give us the money and we’ll get it done no problem. But we can also look to our local state and county health initiatives: how can we utilize our programs to meet their goals? Nutritious food security and education are key to stop diseases of undernutrition like anemia and rickets (vit D deficiency) Nutritious food security and education are also key to stop diseases of overnutrition like obesity and diabetes
The point is food HUGELY influences both of these diseases. So why not simultaneously prevent the immediate sensation of hunger and move towards reducing these devastating diseases by providing appropriate types of food?
Funders will be motivated to work with Foodbanks who are on the frontline of prevention. Prevention is key when it comes to chronic disease because that is the only way to STOP chronic diseases from happening. Once you are obese or have diabetes it is almost impossible to completely get rid of it.
The only catch to this rosy scenario is that we have to prove we can do what we say we are going to.
If we are talking to the epidemiologists and the healthcare funders they might think that we are being a little vague when we are talking about what we do. How can we have a single ‘disease prevention and amelioration’ strategy that seems to be dealing with a range of problems. They are also going to want to know whether we are offering a long-term cure or a short-term suppression of symptoms? So it’s all down to evaluation.
Up to now, we’ve had pounds and meals and numbers served. Those are not outcomes, those are outputs. And that is not going to cut it in the healthcare world.
If we are going to be preventative healthcare organizations, we are going to have to play like the grownups play when it comes to talking about the impact of what we do. Talking only about the number of pounds we shifted is like saying we gave out a lot of Prozac, so in theory it should have made a bunch of people much happier.
Food banks can & should measure attitudes and behaviors towards healthy eating with simple questionnaires developed with local higher education establishments.
The data Food Banks won’t so easily be able to collect themselves:
- Anthropometrics – Height, weight, waste circumference, body fat %
- Biochemical measures -Hematocrit, hemoglobin, cholesterol, blood sugar, others
That is why collaborations are key – with clinics, hospitals and WIC.
There is a lot that Feeding America can do nationally and that State associations can do at the State level to help develop and disseminate accurate and data aligned with comparable evaluation strategies.
Each programs we undertake at our foodbank has to have its own special evaluation approach, which we believe in cooperation with the data provided by local healthcare sources will show clear anti-obesity and anti-diabetes results. Here is an example questionnaire for our award-winning Kid’s Farmers Market program.
And if we want healthcare funders to have confidence in the quality of our ‘medicine’ we need to implement programs that let us nutritionally rank the food that comes into our warehouses so that we develop a baseline to work from. We currently use a system called CHOP (Choose Healthy Options Program) which is actually too focused on nutrients, so we are looking to simplify, always simplify…
HOW ARE WE GOING TO PAY FOR ALL OF THIS MEDICINE?
Sometimes when I speak to health or multi-region foundations, I get those four dreaded words: We don’t fund foodbanks. Usually it is based on some conception of what Foodbanks were doing in 1983.
We have to prove to both the community and funders that we are different than the food bank they remember. We are not a place that the government sends processed cheese to slowly die. We are not a set of shelves to store a blue fizzy drink that did not capture the imagination of the American public. Our warehouses can be the engines of a huge leap forward in the health of millions of people.
To go after the big bucks, we can’t fall back on tending our neat little geographic fiefdoms. Healthcare funders want to see big populations – multi-county at the very least. There is a clear role for State associations and Feeding America at the national level to put together coalitions prepared to run the type of measurable programs required to meet the stringent criteria of these funders. We bitch and whine about the paperwork and voodoo activities required to get state reimbursement funds, so you can only begin to imagine the hoops for healthcare reimbursement funding. By pooling our human capital in this area, we can we succeed on a large scale.
Of course there are risks of adopting a preventative health care model – misperception of our mission, risk to existing ‘hunger’ charitable donations, and that given that our demonstrated excellence is primarily in the areas of sourcing, storage and distribution of food. So some people might consider this other stuff as being out of our wheelhouse. The upside is huge, however – a recognition that we are educating and empowering people to take responsibility for their own health and that we helping people build true food security for their families and for our country.
The end result, besides a healthy populace, could be that food bankers would one day have the same respect as doctor’s for their heroic work in preventative medicine. Don’t count on it, though! The Airforce still haven’t had a bake sale to pay for that bomber. Still, we can dream that we are George Clooneys bursting through the doors of the ER with our stethoscopes around our necks ready to administer the 100cc’s of cauliflower which are going to save little Jimmy’s life!
3 thoughts on “The Preventative Healthcare Model”
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