Local Food Bank Expands Innovative Program to Help Expecting Mothers
When Nausha Russ was about 20 weeks pregnant, she visited SSM Health DePaul Hospital in Bridgeton, where a health care provider took her “hunger vital signs.”
That meant the provider presented her with two statements: “Within the past 12 months we worried whether our food would run out before we got money to buy more.” And “within the past 12 months the food we bought just didn’t last and we didn’t have money to get more.”
Were these statements always true, sometimes true or never true? When Russ confirmed that she had experienced such situations, the provider made a referral to Operation Food Search, a hunger relief organization based in Overland.
Russ was the first participant in the food bank’s year-old pilot program aimed at improving birth outcomes among low-income women in St. Louis. Fresh Rx: Nourishing Healthy Starts has provided 60 expecting mothers with weekly meal supplies in an effort to eliminate food insecurity. According to OFS, 98 percent of the participants experienced healthy births, with only one baby spending a single night in the neonatal intensive care unit.
The program is part of a larger trend in medicine of examining and trying to address the “social determinants of health,” according to Trina Ragain, director of policy and innovation at OFS. That means looking at what role factors like housing and access to nutritious food play in people’s health and using social service programs to prevent diseases such as diabetes rather than relying on doctors to treat issues once they emerge.
For example, in 2012, the Los Angeles County Department of Health Services launched a program to provide people experiencing homelessness with supportive housing and found that it reduced the need for medical and mental health services and provided a cost savings to the county of 20 percent, according to a 2017 study from the RAND Corporation, a nonprofit think tank.
Ragain modeled the OFS initiative in St. Louis on a central Pennsylvania health care system program called Fresh Food Farmacy in which patients with Type 2 diabetes receive prescriptions of free food and regularly meet with a registered dietician with the goals of getting them to lose weight and reducing health care costs. Geisinger Healthy System started the program because its staff noticed an increase in the prevalence of diabetes and wanted to see if they “could positively impact those individuals by providing healthy, nutritious food that they otherwise wouldn’t have access to,” says Allison Hess, Geisinger vice president of health.
Before joining OFS in 2017, Ragain worked at March of Dimes, a nonprofit that aims to improve the health of mothers and babies. “[I] knew from my work there that nutrition is incredibly important during a pregnancy; it’s important to a mom and how she does during a pregnancy and also to the development of that baby,” Ragain says.
In September 2018, OFS started enrolling participants in the program, which received an $850,000 grant from a fund affiliated with Bayer, the multinational corporation with a large agricultural science campus in Creve Coeur.
Russ, then a mother of three who lived near the Central West End, was “having a hard time putting meals together for my family.” As a participant in the OFS program, she not only received free food, she also met with a social worker and nutritionist and took cooking classes in which she learned how to prepare the sorts of healthy meals that she would not previously have made.
In addition to the food, she received another bonus: “It helped me build my family; we spend more time together in the kitchen,” Russ says.
The nonprofit provides food to participants from the 24th week of their pregnancy through 60 days after the delivery. And it provides enough food for the entire household because “we know from working in the field of food insecurity that if you give a food insecure household food for one person, they are going to share it with the other people in their household,” Ragain says.
The cost is about $3,000 per participating family, with each person receiving about three dinners per week and much of the food sourced from Illinois and Missouri farms.
By asking the women for feedback during the pilot, OFS staff learned that “while they love the local food—and it’s something they don’t always have access to—when you get a bounty every week of whatever is in season, sometimes they were unfamiliar with the ingredients” or not able to use it all, Ragain says.
One participant had never seen a spaghetti squash. OFS staff sent recipes on how to use such produce—but some dishes included ingredients that would have required a trip to the grocery store, and participants often didn’t have cars. As a result, in December 2019 the organization shifted to a meal kit system in which participants receive recipes and all the required ingredients, sometimes via home delivery.
In 2020, the nonprofit will launch a three-year randomized control trial with 765 participants. The aim is to establish the program as a reimbursable health care service.
“Whether you are publicly insured through Medicaid or uninsured, someone is picking up the cost of that health care, so we believe either way that an intervention is going to potentially save money. If food improves your overall health and your health outcomes, it stands to reason, you are going to have lower health care costs,” Ragain says.
The planned increase in the number of participants comes as the Trump administration tightens its rules for the federal food stamp program. Brandon Lipps, deputy undersecretary for the U.S. Department of Agriculture’s Food Nutrition and Consumer Services, told the Associated Press in December 2019 that tightening a work requirement rule would save roughly $5.5 billion over five years. Opponents of the change argue that it targets the program’s most vulnerable recipients.
Meanwhile, Russ’ daughter Aliza recently celebrated her first birthday. “She’s growing really well; she’s busy and very smart and she loves the vegetables that we get every week,” says Russ.
And Russ is now working part-time for OFS, delivering meals to moms who don’t have easy access to transportation. “I get to explain to them some of the stuff that I have been going through,” she says. “And some get a package for a week, and they’ll look in the bag, like, ‘I don’t know what to do with none of these things.’” Russ explains how she would cook it—combining ingredients in a slow cooker, for example—drawing on her own positive experiences and, in the process, generating more. “It’s been really nice working with the ladies.”
Images of Fresh Rx: Nourishing Healthy Starts participants, their families and staff celebrating the program’s one-year anniversary and taste-testing the new meal kits were provided by Operation Food Search.