The University Health FoodFARMacy, developed in 2022, is a transformative initiative aimed at addressing food insecurity and its connection to chronic disease management in underserved communities across Missouri and Kansas. Led by the Community Health Strategies and Innovation team at University Health, the initiative targets food deserts—areas with limited access to nutritious food—through a “food as medicine” approach. This model emphasizes the role of healthy eating in managing and preventing chronic diseases such as diabetes, hypertension, and heart disease by improving access to fresh produce. 

One of the primary objectives is to increase access to nutritionally dense foods through the biweekly distribution of produce bags to underserved or food-insecure populations with a diagnosed chronic disease. The research project evolved from a successful 12-week pilot program after years of operating the Healthy Harvest Mobile Market. “We wanted to have more programming where we linked up fruits and vegetables with a lot of the programming,” explained Janet Rhone, University Health’s manager of community health and career outreach. “That’s kind of how the FoodFARMacy was birthed.”

During the pilot, University Health partnered with NurtureKC and University Health’s behavioral health staff, including community health workers, social workers, and case managers, who served as coaches and educators. Fresh produce, provided by University Health, was delivered biweekly to clients. The insights and benefits gained from this pilot helped shape the current 12-month program. 

FoodFARMacy’s launch was made possible through essential partnerships and funding from organizations like the Health Forward Foundation, which contributed more than $3.4 million in grants to local health initiatives, including the Truman Medical Center Charitable Foundation, in 2021. “We were over the moon with excitement for the funding, which allowed us to tailor this program to truly meet the needs of the clients we serve,” Rhone said. 

The collaboration has achieved strong participant retention rates, particularly at its original pilot sites, NurtureKC and University Health Behavioral Health. “Of the two sites, one had an 84% retention rate at the 6-month mark, and the other had 86% retention,” noted Kelsey Gardiner, Ph.D., an assistant professor of nursing and health studies at the University of Missouri-Kansas City. Since expanding to include KC Care Health Center and Guadalupe Center, the project has enrolled 64 participants, with an impressive 96% retention rate, though the goal remains to reach 150 participants across five partner sites. 

With the addition of Lexington, Missouri’s Altruism, Inc. as the fifth partner site, University Health’s FoodFARMacy has extended its reach into rural communities, where food insecurity intersects with broader health disparities. Altruism, Inc.’s mission to empower communities to thrive equitably by equipping them with information and resources that advance whole-person care aligns seamlessly with FoodFARMacy’s goals. This partnership will provide not only access to fresh, healthy food but also nutrition education and holistic support, addressing the root causes of preventable diseases. By equipping rural residents with the resources they need to thrive, this collaboration represents a significant step toward creating healthier, more resilient communities built on equity, dignity, and compassion.

“We are more than pleased to partner with University Health to offer this program in Lafayette County,” said Altruism CEO Tonia Wright. “Food insecurity exacerbates dietary-related chronic illnesses. This is especially true for those who live in rural food deserts and lack transportation to get to and from a grocery store with fresh, quality produce that’s affordable. Understandably, for many, it’s far more expedient to go to the neighborhood McDonald’s and order from the $5 menu. FoodFARMacy will allow us to equip as many as 25 families with produce bags twice monthly over a 12-month period. We couldn’t be more excited about the impact this partnership will have in helping these families gain consistent access to fresh fruits and vegetables, and nutrition education. As for the birthing people we serve, FoodFARMacy will play a crucial role in supporting those with gestational diabetes, and other chronic illnesses that can negatively impact maternal and infant health outcomes.”

The Problem of Food Insecurity

Food insecurity is a widespread problem that affects one in eight Americans, according to the U.S. Department of Agriculture (USDA) Economic Research Service. It is a critical social driver of health, with those in food-insecure households often suffering from poor health outcomes, including obesity and chronic diseases. In Missouri and Kansas, these food deserts exacerbate the problem of food insecurity. Approximately 7% of households in Kansas City rely on the Supplemental Nutrition Assistance Program (SNAP) for food support, according to the U.S. Census Bureau, highlighting the deep-rooted problem of food access in the region. A report from the University of Missouri’s Interdisciplinary Center for Food Security’s Missouri Hunger Atlas shows that rural areas face higher rates of food insecurity compared to urban regions, with some counties reporting over 20% of residents experiencing food scarcity. Similarly, rural counties in Kansas face similar challenges, with one in five residents in some areas reporting food insecurity.

The FoodFARMacy Solution

Unlike some community-based programs that focus on farmers’ markets or community gardens, University Health’s FoodFARMacy directly supplies patients with fresh fruits and vegetables through partnerships with local food vendors, “Our standards are much higher. We want to provide high quality to the people that we’re serving, “said Rhone, emphasizing the need for high-quality, fresh produce. To promote healthy food consumption among underserved populations, FoodFARMacy offers culturally appropriate nutrition education tailored to meet the target audience’s needs. 

The initiative aligns with guidelines from Harvard Medical School, which recommend that individuals consume at least five servings of fruits and vegetables per day to reduce the risk of chronic diseases. By following these recommendations, the FoodFARMacy helps patients incorporate more nutrient-dense foods into their diets, with the goal of improving health outcomes. 

A unique feature of FoodFARMacy is its use of the Veggie Meter, a noninvasive tool that measures carotenoid levels in the skin. Carotenoids are a type of antioxidant found in fruits and vegetables, and their presence is a reliable indicator of a person’s fruit and vegetable consumption. The Veggie Meter provides real-time feedback on participants’ intake of fruits and vegetables, allowing both health care providers and patients to track dietary improvement over time. The tool not only provides useful data for health care professionals but also motivates participants. “A large percentage asked, ‘What was my score last time? I’ve been trying to eat more fruits and vegetables, and I want to see if I’ve improved,” Rhone noted. 

This evidence-based approach encourages participants to increase their consumption of healthy, plant-based foods. By using the Veggie Meter to provide immediate feedback, the initiative fosters accountability and motivation for participants to maintain a nutritious diet. 

Another key objective is to increase participants’ understanding of the impact of nutrition on health through culturally appropriate education, further aligned with their literacy needs. Studies have consistently shown that low-resourced individuals are more likely to experience food insecurity and suffer from related chronic diseases. The FoodFARMacy project seeks to alleviate these disparities by offering a lifeline to those in need. 

Developing a Community-Focused Program to Empower Healthy Living

Gardiner emphasized the focus on the community. “We developed the program with the community in mind,” she said. “It took about six months for all the planning, including curriculum development, which incorporated feedback from the pilot initiatives and input from dietitians.” 

Gardiner also highlighted the barriers faced in the early stages of the project, particularly around data collection and research protocols. “One of the key hurdles we faced was with the CITI training for the coaches due to the nature of the data being collected,” Gardiner said. “It added extra expense and time, but was crucial from a research perspective for quality assurance.”

Beyond food provision, FoodFARMacy also provides education on healthy eating and lifestyle changes, equipping patients with the tools they need to make informed choices about their health. Community health workers play a key role in delivering this education and support, ensuring that patients not only receive healthy foods but also the knowledge to sustain a nutritious diet over the long term.  

Sustainability and Future Directions

University Health’s FoodFARMacy is committed to sustainability and long-term success. In future phases, it plans to expand its partnerships with local organizations and increase its reach within the community. By working with local food banks, health care providers, and community leaders, FoodFARMacy aims to create a scalable model that can be replicated in other areas with similar food access challenges. 

FoodFARMacy is also producing tangible results in improving food security. Roughly 40% of participants reported marginal or high food security at the midpoint of data collection. meaning they are now no longer considered food insecure,” Gardiner said. This progress shows that the project is making strides in reducing the severity of food insecurity for enrolled patients. 

The project’s ongoing research will focus on evaluating the long-term health benefits. By gathering data on participants’ health outcomes, the research team will be able to demonstrate the effectiveness of the “food as medicine” model in reducing the prevalence of chronic diseases and improving overall community health. 

In addition to food security improvements, health outcomes have also shown positive trends. “We’ve seen improvements in hypertension and A1C for participants managing prediabetes or diabetes,” Gardiner added. “Fruit and vegetable intake has increased from one to two servings per day to three to four servings, as confirmed by both self-reporting and Veggie Meter data.”

These self-reported measures mirror what was found by using the Veggie Meter device to confirm increased consumption of fruits and vegetables based on skin carotenoids as a biomarker.

  • The number of participants reporting they eat one to two servings of fruit per day increased by 50% compared to baseline. 
  • Participants reporting they eat one to two servings of fruit per day rose by 21% from baseline.
  • Participants eating one to two servings of vegetables per day increased by 60% compared to baseline.
  • At baseline, 74% of participants had stage 1 hypertension, compared to 37% at six months. 
  • At the midevaluation, only 11% of participants had a blood glucose level in the diabetic range, down from 38% baseline. 

FoodFARMacy’s ongoing research will focus on evaluating the long-term health benefits. By gathering data on participants’ health outcomes, the research will demonstrate the effectiveness of the “food as medicine” model in reducing the prevalence of chronic diseases and improving overall community health. 

Rhone also emphasized the program’s long-term goals. “We want to advocate for Medicaid and insurance companies to cover fresh produce subscriptions,” she said, underscoring the FoodFARMacy’s vision to make food a central part of preventive health care. 

To learn more about the University Health FoodFARMacy program, email chsi@uhkc.org or call 816.404.3320. You can also visit University Health’s Nutrition and Nourishment page for additional details on how FoodFARMacy is making a difference in communities.