Dear friends,

It’s my pleasure to hand over this month’s newsletter greeting to three of my colleague, HealthBegins’ Consulting Director Kathryn Jantz, Program Manager Eva Batalla-Mann, and Senior Program Manager Madeline Moritsch. Enjoy!

Best,

Rishi Manchanda, MD, MPH.

The cost of eggs is predicted to rise 24% in 2025. Even fast food is becoming too expensive for many households. And just when more and more households cannot afford the nutritious food they need, federal policy changes are gutting public food assistance and threatening to make hunger invisible.

These pressures expose and widen decades-old gaps in America’s fragmented, underfunded food safety net. People with chronic conditions who can’t afford or find nutritious food appropriate for their clinical needs will get much sicker, quickly.

One intervention—Food Is Medicine (FIM)—has a chance to help address these acute needs and mitigate the impact of poor diet on health. But only if we confront the ways in which our current Food Is Medicine strategy is compounding systemic and structural barriers to health instead of mitigating them.

Food is Medicine, or the delivery of nutritious food designed to meet specific clinical needs, is one of the rare tools today with broad political support. Yet to make it effective—for all, not only for some—we need to sharpen its strategy by debunking these increasingly pervasive myths.

Myth #1: Food organizations and health care are separate sectors with separate interests. 

Many healthcare organizations, including self-insured employers, payers, and providers, see Food is Medicine organizations as referral recipients or friendly neighbors but not integral partners. Yet in reality both share overlapping goals and work through interconnected systems—which means health care, if it works across all its levels of influence to support FIM, could be a force multiplier for healthy, productive workforces and communities.

For example, at the level of patient care, health care can go beyond writing FIM referrals to deepen collaboration, integrate workflows, and share resources. That partnership could be informed by key insights into community health that only health care can provide. Healthcare institutions, as employers with many employees experiencing food insecurity, can partner with FIM and food systems in innovative ways to support a healthy workforce. At the societal level, healthcare and FIM organizations should work together to drive policy changes to improve health and reduce chronic disease, first and foremost to protect and meaningfully improve SNAP and WIC.

Myth #2: Only “certain” food counts as therapeutic. 

In healthcare circles we talk about the cost of unhealthy food but rarely consider the cost of forcing diverse communities to adopt a Western clinical standard of a healthy diet. FIM interventions that require adherence to a particular diet risk inflicting more harm than benefit. For example, researchers note that in indigenous communities food security might mean having “ceremonial foods, origin story foods, and foods that are harvested, processed and prepared using knowledge passed down generationally…” Adequately fed is healthier than alienated, shamed, and still inadequately fed.

Food is more than calorie counts and grams of protein, and it matters far beyond clinical outcomes and healthcare costs. Food is qualitative as well as quantitative, cultural as well as biological. It is a primary channel for human culture, community, joy, connection, love, and pleasure. Which means that FIM interventions can only promote full physical, mental, and social well-being if they reflect the complex roles that food plays in our lives.

To support health and do no harm, FIM strategies must integrate the principles of food sovereignty, centering community preferences and empowerment alongside clinically desired nutrients. The FED Principle (Fidelity, Equity, and Dignity) offers a model for how to respect community expertise in FIM design.

Myth #3: People at all income levels need Food Is Medicine equally.

Even within health care, conversations often frame diet and weight as matters of personal choice. Yet research shows that pressures such as chronic stress, racism, poverty, and scarce access and time are the primary drivers of diet and resulting health conditions. Poor diet affects every income bracket, but poverty makes keeping a healthful diet much harder.

If we want to make sure Food is Medicine is available to those who need it most, we must prioritize people who have a clinical need AND a social need, for whom lack of access to healthy food is a primary barrier. This means building social needs into eligibility criteria and designing interventions to serve a low-income population. FIM programs that do not aim to address food insecurity and poverty may worsen disparities and drive up costs by forcing a higher investment than needed in some populations and failing to adequately invest in others.

A wise Food Is Medicine leader once told us that feeding our community is the root of democracy. By breaking bread together, we have the potential to build new relationships, heal communities, and support our future. But to do that we must guard against the political, social, and financial narratives that distract and detract from our ultimate goal.

Best,

Kathryn Jantz, Eva Batalla-Mann, Madeline Moritsch