“This is the single best thing that’s ever improved my health – it was a life changer.”
Those were the words of a participant in the UVM Medical Center’s first-ever Community Supported Agriculture (CSA) share. Known as a “Health Share,” this program offered a weekly share of produce to 26 patients at Colchester Family Practice free of charge. This program was a partnership with Vermont Youth Conservation Corps (VYCC) and was made possible, in part, by a grant from TD Bank.
The Community Supported Agriculture (CSA) model allows a farmer to sell a set amount of “shares” to the public at the beginning of the growing season. This allows the farmer to focus on growing, rather than marketing, when the busy harvest season comes. The consumer benefits by getting a share of fresh, local produce each week. As well, they often save money, and are able to develop a relationship with the farmer who grows their food. Incorporating farmers into the team of health care providers in a patient centered approach leverages one of our region’s most valuable resources – our farms.
The health benefits from taking charge of our diet are well documented, and can be profound; however, incorporating seasonal, local food comes with its own challenges. For example, what the heck do you do with kohlrabi? Or radish? Or patty-pan squash? The beauty of the health share is that we were not only able to send participants home with a weekly share of produce, interspersed with free range chicken, dried beans, cooking oil, and helpful kitchen tools, but were also able to provide cooking demonstration, recipes, and advice for incorporating each week’s produce.
For a participant working to make healthy dietary changes, being bombarded with dietary information, unfamiliar food, and complicated recipes can be enough to make them want to throw in the towel. Meeting patients where they are means using simple, delicious, easily prepared recipes from the UVM Medical Center dietitian Maryann Ludlow, RD, prepared and served by the UVM Medical Center chef William Cosman. The result was the eye-opening realization that taking our diet into our hands is within our reach.
Anecdotally, a survey of 13 participants suggests a decrease in fast food consumption, a decrease in prepared food consumption, and an increase in fruit and vegetable intake over the twelve-week period. As important to us was that participants came week after week, eager to share what worked for them, what they found challenging, and willing to try our next round of samples and recipes. One participant said, “It has been great for me and my kids. We all love it.”
Because we were set up outside the front door of Colchester Family Practice each Thursday afternoon, patients outside the program, providers, and even the custodial staff were included in the weekly happenings. Having a community of people gathered in front of a doctor’s office sharing recipe ideas and talking shop about healthy food struck me in a profound way. Could incorporating local food into primary care really bend the curve on health care spending and improve patient outcomes?
The systemic cycle of our diet’s effects on our health does not have to define our approach moving forward. While this program was conducted over only twelve short weeks, a tipping point seemed to be reached in a handful of participants. Anecdotally, participant exercise increased slightly, energy levels increased, and general feelings of health increased. As well, blood pressure and resting heart rate were down slightly over the twelve-week period. One participant even reported to have quit smoking. The goal of gathering biometrics in this first pilot year is to build a model that may lead to actual clinical measurements for the benefits of healthy nutrition. While incorporating local food into primary care may not be a panacea, what it has done is brought thoughtfulness to the dietary choices of everyone involved.
For me, one of the most exciting aspects is that incorporating CSAs into primary care is a tangible goal. This program was a success because we had a committed group of participants, a farm that was able to provide amazing produce each week, providers willing to encourage the program, and a dedicated group of volunteers.
Moving forward, it all comes down to participant engagement. If participants are willing to take their health into their hands by making positive dietary changes then the whole program is possible. If we are able to make a positive change in even five participants’ lives, says Dr. Alicia Jacobs (medical director at Colchester Family Practice), then it is all worth it.
Conner Soderquist is in the Post-Baccalaureate Premedical Program at the University of Vermont. He is a volunteer with the Health Share program and works at the intersection of healthcare and agriculture.