At-risk Michiganders can now get healthy food with fruit and vegetable prescriptions

Like most Americans, Alma resident Helen Beebe, 77, struggled in the past to eat the daily amount of fruits and vegetables recommended by health experts.

Beebe says she’s a widow and living on Social Security, “so there would be a lot of things I wouldn’t get because of the cost.”

But since she got connected with Live Well Gratiot Prescription for Health program, a local program in Gratiot and Isabella counties that provides vouchers that can be used in exchange for produce, not only has her daily intake improved, but she also said she’s lowered her blood sugar levels.

Live Well Gratiot is one of around 20 produce prescription programs operating through local health partners in Michigan. A produce prescription program is a preventive health service that helps those without access to quality food or who are at risk of chronic health issues obtain healthier food options. 

A partnering health clinic refers patients to the program; the patient then gets credit vouchers and can use them as payment for fruits and vegetables at partnering farmers markets or grocery stores. 

The Centers for Disease Control and Prevention says only one in 10 U.S. adults eats enough fruits and vegetables every day, and those disparities are worse among marginalized racial and economic groups.

The goal of produce prescription programs is to improve beneficiaries’ health by filling that gap while helping to stimulate the local economy by boosting business for farmers and grocery stores in the area.

“Persons of color are disproportionately affected by food access,” Bella Pagogna, a produce prescription program manager with the Michigan Farmers Market Association, told the Michigan Independent. “Produce prescription programs being so community-driven, this is something where they really thrive, is that they can have this population that they’re trying to support, and they can use the community resources around it.”

Since 2014, the Michigan Farmers Market Association has acted as a support arm of the local community programs, offering technical assistance, helping connect programs with resources, and helping one program learn from another through quarterly meetings of their statewide learning network.

Another aspect of produce prescription programs is nutrition education classes that teach participants about different fruits and vegetables. In some cases, the classes are a requirement for receiving the produce credits.

Mickey Johnson, 74 of Alma, said her favorite part about the Live Well Gratiot Prescription for Health program is that she’s learned how to “tweak traditional recipes and make them healthier” by incorporating various types of produce.

The program offers one class a week for six weeks every year. When Beebe first joined in 2019, she was getting a $20 credit per class. Now, she only gets a $10 credit per class.

Because the produce prescription programs are individually operated, they’re also individually funded, through either private donations or federal or state grants. Funding sources can change from year to year, putting a strain on program resources and making the long-term financial stability of the program uncertain.

A 2017-2021 analysis by the Michigan Farmers Market Association shows that produce prescription programs cost $759 per participant on average.

“We have had about eight to nine programs cease operation due to a lack of sustainable funding sources, which can be very debilitating for those populations that that program previously did serve,” Pagogna said.

There are successful programs that have built sustainable relationships with funding partners, Pagogna said. Washtenaw County’s Prescription for Health program is one example.

Washtenaw County started Michigan’s first produce prescription program in 2008. The program has been able to adapt and grow over the years, said program coordinator Ariane Donnelly, who joined the county health department in 2014. The changes include increasing the number of tokens — a currency used to pay farmers which they then exchange for payment from market staff — given to participants to 100 and incorporating community health workers as support staff. Donnelly said the program also started providing bus tokens and expanding farm stand locations to help residents who were having issues with transportation that prevented them from participating in the program.

“We really like to think, you know, that we all worked together to make sure this program happens and it’s successful. And our program really connects the medical sector to the food sector,” Donnelly said.

This year’s program was funded by the federal American Rescue Plan Act. It aided in the enrollment of 459 participants, although Donnelly said that’s likely an overestimate to compensate for individuals who don’t follow through with the program. In 2022, she added, participants contributed about $26,800 to the local economy through the program.

The Michigan Farmers Market Association is looking to garner more state support for the produce prescription programs and recently held a legislative education day at the state Capitol in Lansing. During the day, program implementers, partners, and participants spoke with legislators and their staff about produce prescriptions in order to get an understanding of what legislative needs the lawmakers can help with.

The produce prescription space is still very new, both in Michigan and throughout the country, but it has shown meaningful growth. The Gus Schumacher Nutrition Incentive Program, a national initiative started in 2018, provides grants to local programs. The National Prescription Produce Collaborative, started in 2019, created a work group for programs in a number of states.

Pagogna said there needs to be more widespread education and substantial data collection about the programs, but she sees Michigan at a turning point on this issue..“It’s a very evolving space. It’s having its moment right now, for sure,” she said.