Eat healthy foods. This simple, straightforward advice is typically near the top of any doctor’s set of parting instructions. Today, Americans are more informed than ever about the likely pitfalls of a diet high in cholesterol, sodium and sugar. And for people living with diabetes, being ever mindful of diet guidelines is critical.
Yet for many residents of Chicago’s South Side, where diabetes rates are among the city’s highest, following seemingly clear-cut nutrition guidance is often a monumental task. For some putting a healthy meal on the table could mean getting on a bus with kids in tow and traveling miles to a supermarket to hunt for nutritious choices within budget. Then it’s back to the bus lugging cumbersome bags for the trek home. There’s no mystery why some opt for the convenience and low-prices of nearby fast food restaurants and corner stores.
The Improving Diabetes Care and Outcomes on the South Side of Chicago project based at the University of Chicago Medicine has set its sights on helping more South Siders take better control of their eating habits by lowering two major hurdles: access and affordability.
Diabetes patients who visit one of six South Side clinics can receive a prescription-like checklist of their doctor’s food recommendations and a coupon for $5 off $20 worth of healthy food at participating Walgreens locations. Patients also can get a $3 voucher for the weekly 61st Street Farmers Market in the Woodlawn neighborhood.
Monica Peek, MD, assistant professor of medicine and associate director of the Chicago Center for Diabetes Translation Research, said the initiative puts the power of a prescription behind a doctor’s counsel on diet.
“The factors driving the diabetes prevalence rate on the South Side are multifaceted, and addressing them requires a comprehensive, nuanced approach,” said Peek, lead on the Food Rx initiative. “Many of the patients we see have challenges accessing and preparing healthy food. Through continued education and initiatives like this one, we’re working to chip away at the obstacles and alter behaviors.”
Simple advice, complex solutions
The Food Rx initiative builds on the Improving Diabetes Care and Outcomes on the South Side of Chicago interventions already under way, including patient education, grocery store tours, tools for health care providers, improvements to clinic systems and relationships with community organizations such as food pantries.
Food Rx organizers say the participating clinics are natural collaborators in this effort because they already serve the target population. In addition, Walgreens’ prominence in urban communities and its commitment to provide greater access to fresh fruits and vegetables, low-fat dairy products and whole grains in many locations, make the retail giant another ideal ally.
Marshall Chin, MD, professor of medicine, director of the Chicago Center for Diabetes Translation Research and co-principal investigator of Improving Diabetes Care and Outcomes on the South Side of Chicago, points out that while the impact of food access is significant, particularly when it comes to diabetes, there are many other dynamics at play with health disparities.
“These include cultural issues, health system issues, unconscious bias, residential segregation, fewer treatment options and limited community resources,” Chin said. “Our overall project tries to address many of these elements. With the Food Rx program, we’re helping people with some of the elements they can control. Diabetes management is largely lifestyle — what you eat and what you do.”
The Food Rx organizers will continue to look for other accessible destinations for healthy foods. Researchers will review feedback, redemption rates and other data from each site to evaluate program effectiveness and make any necessary tweaks.
Peek is proud of the Food Rx collaboration, and she acknowledges that transforming cultural norms that are generations in the making will not be easy.
“We didn’t get here overnight,” she said. “But there is proven effectiveness in empowering people to make better choices, overcome social determinants and play a stronger role in their own health outcomes.”
Improving Diabetes Care and Outcomes on the South Side of Chicago is funded by the Merck Company Foundation and National Institutes of Health. For more information on the project visit http://southsidediabetes.org.