Food Is Medicine is a growing movement that recognizes how nutritious food can be used as a tool to improve health outcomes at the individual, community, and systemic levels. Free From Market, founded by Emily Brown, champions this movement by working with partners to increase access to diet and culture-appropriate food as well as provide education and support to achieve health goals.
According to Brown, one in three Americans have a chronic condition where food is part of the standard of care, making access to appropriate foods a necessity for a significant portion of the population. These conditions include diabetes, heart disease, food allergies, and gastrointestinal conditions, among others.
“The Food Is Medicine movement is rooted in this notion that food and nutrition are key foundational aspects of good health,” Brown said. “Just as food and nutrition play a role in causing diet and poor health outcomes it can also play a role in curing poor health outcomes and improving health.”
Fueled by Free From Market and similar programs that equitably empower people to make sustainable dietary changes, the Food Is Medicine movement is positioned to make an enormous impact on the landscape of chronic disease.
Combating Chronic Disease
Half of individuals living with chronic conditions consistently lack access to the foods they need to be healthy. Additionally, food deserts – areas where there are no affordable, fresh, nutritious food options available – contribute to this problem. Chronic health conditions and food deserts are intertwined, and this overlap disproportionately affects the health of Black, Brown, and low-income communities.
Access alone is not a viable solution; it is simply the first step. Too often, providers tell patients with chronic conditions to make a dietary change but are not properly equipped to help beyond that. In addition to food access, which many patients lack, they also need to know how to prepare healthy meals. Clinical and community support help patients keep up with dietary changes long-term.
Unfortunately, according to Brown, medical providers traditionally do not have the education to support patients with nutrition needs. “What’s great about this movement is it’s not only addressing those gaps in access but it’s also addressing those gaps in education,” she said. “It’s not just for patients and consumers it’s also for clinicians and physicians who have not always had access to that training.”
Free From Market Marries Data with Lived Experience
To effectively impact chronic disease, Free From Market’s approach marries evidence-based data around the link between food and health outcomes with patient-led lived experiences that contextualize and ground the data. Brown’s own lived experience served as the inspiration for Free From Market and influenced how the nonprofit operates today.
She has two daughters who have a chronic condition where food is a significant part of their standard of care and how they manage their health. Like many Americans, her family was experiencing economic challenges and couldn’t access the foods they needed to keep her daughters healthy, even with SNAP benefits.
“I think that lived experience is at the root of what we do, how we build, how we grow, because I’ve been that mom with limited resources with sick children navigating both the health care system and the food system and often coming up short – even though there were existing programs,” she said.
She initially attempted to address this need by starting a nonprofit to get special dietary foods into local food banks and pantries. Through this work, she saw the rising issue of social determinants of health (SDOH) and how they influence community health outside of the clinic, as well as the potential promise of value-based care models that work to address SDOH.
“I saw an opportunity to take this approach and scale it,” Brown said. “That experience of living in the gap has really informed the way that we approach our work so that we can be thoughtful and really center the patient or consumer in the model in a way to drive adoption and drive outcomes.”
How It Works
Free From Market operates on a digital platform and brings together three pieces of the Food Is Medicine puzzle:
- Personalized food selection, allowing consumers the dignity to choose their own foods and ensure the food they receive is culturally appropriate.
- Support to make dietary changes, through the utilization of both nutritional coaching support and peer-to-peer support.
- Program management data, which demonstrates improvement in health outcomes and return on investment for users, partners, and stakeholders.
Free From Market partners with community-based organizations, health systems, hospitals, health plans, and other existing organizations and programs that subsidize patient access. Patients are referred to Free From Market who then provides a quick onboarding questionnaire to learn more about the patient’s dietary needs and allow them to start shopping right away.
Through Free From Market’s online store, patients can access more than 2,000 healthy, high-quality, nutrient-dense, curated foods and products available across grocery categories. Products include fresh produce boxes, pantry staples, baby and kid food products, some ready-to-eat meals, and more. Users can search for products through several filters, including ones that identify products with food allergens or that are certified gluten free or nonGMO, among other specifications.
The subsidy or credit provided by program partners lands in the patient’s cart, adding a balance that declines as patients shop. If they shop above their credit limit, they are able to use a debit or credit card to purchase the balance difference – a feature that 35% of current users are taking advantage of.
Everything is then shipped directly to the consumer’s door through either FedEx or UPS, which deliver in most communities, including many that are affected by food deserts where “last-mile” options like DoorDash are not viable.
Purchasing information is then stored in the user profile so patients can reorder products, save them to a favorites list, or simply refer back to previous orders.
Cultural, Clinical, and Community Support
What sets Free From Market apart from traditional food pantries and food banks is the personalized aspect. This grants consumers the power to choose foods that are appropriate for them, which is critical for making long-term dietary changes. Because of this, the online store offers a wide range of culturally diverse foods.
“Food is very personal,” Brown said. “It’s tied to our identity; it’s tied to our culture. In order to have that adherence, it’s really important to be able to then continue to have some of those cultural foods that are important to you and your identity so you’re not losing yourself.”
The program also includes an educational component that provides content and resources that support the utilization of healthy foods, including healthy recipes and tips to use the foods offered through the store to optimize health, which is then personalized with the support of a coach.
Patients who are referred to the nutrition program, which is offered in English and Spanish, are matched with certified nutrition coaches and offered one-on-one tele-coaching sessions as well as unlimited text support. If they have a question while shopping for, preparing, or cooking a meal, for example, they can send a quick text and receive advice on the spot to help keep them on track with their diet.
Free From Market works with a large group of diverse coaches who represent a variety of identities as well as lived experiences. As a result, patients receive support from someone who looks like them and has overcome the same health challenges, making it more likely that dietary changes will be appropriate and adhered to. Utilizing certified coaches rather than registered dieticians (RDs) is an intentional one, as the RD profession is known to lack diversity.
Some program partners also pull together group sessions to offer peer-to-peer support, providing patients with a community of people with shared racial and cultural backgrounds, health afflictions, and lived experiences. Advice offered in these sessions is less clinical and more cultural. For example, patients can ask peers for advice on how to talk to their family about their food needs around the holidays and adapt traditions.
To Brown, there’s something “magical” about peer-to-peer learning. Managing chronic disease and adhering to dietary changes can be difficult, but receiving advice from a peer who understands your situation and is living it just like you can be more powerful than strictly hearing it in a clinical setting.
Building a Sustainable Movement
One consistent problem across food access movements is passing off patients between providers throughout their care journey, leaving them alone to navigate multiple systems, leading to gaps in their care. To address this, Free From Market manages its own supply chain and network of supply-chain partners, operating in a closed-loop environment that manages the patient experience from end to end.
Free From Market partners with community-based organizations (CBOs), hospitals, health systems, and health plans, especially those which are focused on addressing a specific disease state. Health systems and hospitals are key because they are frontline for patients. Free From Market works with them in two main ways:
- Helping them in their efforts to address community benefit dollars, for which access to food is typically a priority, and helping stock food pantries through high-volume orders.
- Supporting their patients after they leave the clinic through direct-to-door food service and nutrition education.
“Free From Market is really well-positioned to be a partner in this work with health systems and health plans and I think that’s transformative because then there’s this sustainable solution to provide access to consumers that quite frankly have always wanted and needed and deserved access to healthy foods, but it’s simply been not accessible either because of disinvestment in their communities and also just a lack of buying power,” Brown said.
She said a large part of the food access problem is consumers not having the purchasing power to get the foods they need. Although there are a wealth of options on the market to support individuals with the means to get healthy food, many fall through the gaps. Through this program, Free From Market and its partners give power back to these individuals.
“Free From Market is built targeting specifically those who have been locked out of that market,” Brown said. “I look at our work as transformative, transforming both the food system and the health care system, by creating this new market opportunity for consumers to have access to a healthy food economy that they have not been able to participate in because they haven’t had the dollars.”
It is undeniably clear that health happens outside of the clinical setting, and more attention needs to be put toward investing in programs with sustainable, scalable models like Free From Market. The Food Is Medicine movement is continuing to grow, and with the Biden administration opening Medicaid and Medicare for states to leverage dollars for nontraditional services, like access to food, there is an opportunity to bring this conversation to a national and federal level.
“The Food Is Medicine movement is growing and we’re at an inflection point,” Brown said. “This is really an opportunity to bring health equity to the forefront.”
Join the Food Is Medicine Movement
In addition to community and clinical partnerships, individuals are also encouraged to join this movement. People can get engaged by raising awareness in their sphere of influence and making an impact locally. “Chances are this movement impacts either you personally or somebody that you know,” Brown said.
She encourages individuals to be thoughtful about their interactions with food, whether by joining a local food policy council and identifying opportunities to improve foods in schools, or by simply providing healthy, diet-appropriate options at community events, such as PTA meetings or faith-based gatherings.
According to Brown, Free From Market believes in the mantra “better, not perfect,” recognizing that small changes over time add up to a significant transformation. Free From Market began as a solution to her own family’s needs and has since grown to help communities nationwide impact chronic health issues through the power of healthy food, education, and support.
“I was just a mom on a mission,” Brown said. “It really does take everyday people who see problems and challenges in their community to take action.”