To make bread or give love, to dig in the earth, to feed an animal or cook for a stranger—these activities require no extensive commentary, no lucid theology. All they require is someone willing to bend, reach, chop, stir. Most of these tasks are so full of pleasure that there is no need to complicate things by calling them holy. And yet these are the same activities that change lives, sometimes all at once and sometimes more slowly, the way dripping water changes stone. In a world where faith is often construed as a way of thinking, bodily practices remind the willing that faith is a way of life.
Barbara Brown Taylor ~ (An Altar in the World: A Geography of Faith)
On a cloudy and dreary Saturday morning in October, I headed into Albany to catch up with the ever busy Veggie Mobile to see if I could get a glimpse of the Veggie Rx Program in action. It is not that I had never seen it before—I have. However, I wanted to observe it with full attention. It had been almost two years since I began overseeing this fruit and vegetable prescription incentive program that I had helped to create, and as a concerned mom, needed to check in on it and see how it was doing.
Prescription incentive programs, similar to Veggie Rx, wherein fruits and vegetables are “prescribed” by health care providers to encourage consumption, have begun to emerge in the past few years. They are being considered as a model of a viable public health intervention for disenfranchised communities. Until just recently, I administered this program at the Health Center.
Though each program is designed and funded through different means, this particular one was established to serve a fifty person caseload of patients diagnosed with diabetes and/or hypertension. Once recruited and enrolled through the medical providers at the Health Center, the participants receive prescription coupons valued at $7 each, to be redeemed weekly on Capital District Community Gardens’ (CDCG) Veggie Mobile. This physician-based approach offers powerful messaging regarding healthy eating from an institution that traditionally proffers mainly pharmaceutical solutions and well-meaning but often weak recommendations for health behavior change.
I met up with the Veggie Mobile that day in the city’s Arbor Hill neighborhood. Parked at the corner of a side street, it was a burst of color in a rather gray landscape. That brightly painted truck always shows up representing the rainbow, but it is the activity that it fosters that is the pot of gold.
Among the customers were two Veggie Rx participants. One was a woman whom I had recently enrolled in the program. There with her two young granddaughters, ‘patient with diabetes’ transformed into ‘loving grandma’ as she solicited the girls’ advice for what to choose that week. The other was a gentleman whom had been enrolled in the program early on but who had not participated much initially. I had called him months before to discuss removing him from the program—he asked me not to. He explained that he had experienced a host of health problems but was feeling better and had really wanted to have this opportunity to improve his diet. Sure enough, there he was, purchasing a sophisticated assortment of produce. He was like a kid in a candy shop.
After an hour there, the dedicated Veggie Mobile staff women closed up shop to head over to the next scheduled stop. I hopped in my car and followed them as they got back on and off the highway and made their way over to a low-income housing complex—not too far from the Governor’s Mansion. Arriving there, I saw about twelve people waiting. More came along later. Two other Veggie Rx participants whom I knew were there They were surprised to see me and greeted me with smiles and hugs.
This was a busy site, so I assisted with bagging while anchoring myself at a good vantage point. Shopping on the Veggie Mobile begs some patience—but perhaps not any more than waiting in a fast food drive-thru line. Here though, there was connection, community and lots of conversation about good food. Men, women and children were present. There was squeezing back and forth as people reached to add another sweet potato, banana or onion to their order. All forms of monetary equivalent “green” — money, SNAP EBT cards, New York State Fresh Connect and Farmer’s Market Coupons along with the cute Veggie Rx coupons were exchanged for the real green—collards, kale, green beans, green peppers and broccoli.
This collaborative Veggie Rx Program was born out of CDCG’s insatiable quest to bring any and all options for healthy food to places and people who have long been deprived; coupled with the imperative that drives my own nutritional work—that healthy food must be provided as medicine to address the scourge of our chronic diseases. Teaching about healthy eating when the local landscape is devoid of the ingredients necessary to attain it is an exercise in futility.
Despite having given substantial thought, time and care to Veggie Rx, I am still not exactly sure what this and other similar programs are about. There are a few possibilities. It could be a token, feel-good, short-term experiment or the template for a new health and food revolution. As I have researched the findings of other incentive based programs, I can see that there are still many questions to be answered. It may be difficult to decide if the program is worth all the effort for the few that it serves. Can this little grass-roots project put even the tiniest dent in the massive problem it is trying to solve? Can a few fruits and vegetables a week really affect change?
What I do know is that I have seen it change the behaviors and well-being of a number of the patients I managed in the program. Let me strengthen that. I have witnessed some profound changes in individuals due to this program. There has been some powerful “medicine” going down. Some participants have started juicing or making smoothies, and some have taken to more plant-based diets. Many have noticeably become more enlivened. I have also seen improvements in individuals’ health markers–though to see those markers shift in a significant way for this highly challenged population will take time. I caution not to base the success of these types of programs solely on those indicators–it is too myopic a lens.
The Veggie Rx Program offers more than just food and is about something greater than the consumption of produce. Relationship building, the true foundation of this program, is what distinguishes it from others that mainly enhance food access. This power of relationship–that between the participants and the Health Center and Veggie Mobile staff is not to be underestimated. Having personally undertaken an evaluation of some aspects of this program and through my direct contact with the participants, I know that they feel better valued as both patients and customers which increases their engagement in both roles. And, that they consider this program to be a blessing in their lives.
My visit to the Veggie Mobile on that fall morning highlighted some particular aspects of the program that I had not fully appreciated. Assuming patients’ engagement in these types of programs is not a given. Enrollment comes with some requirements which asks something deeper of its recipients. The coupons are not purely a handout. Though not all who are enrolled take advantage of the program, the majority do and some to quite a large extent. Witnessing the participants actually shopping on the Veggie Mobile provided evidence that the mere act of showing up and filling one’s bag with beautiful produce reflects a powerful commitment to one’s health. It also sheds light on what a new paradigm of health care could look like–particularly in response to the problems associated with health disparities–but in the larger context as well. I returned home with a reassurance that my little program was behaving appropriately.
As always, greetings, thoughts, and inspiration welcomed.
In health, Elyn
My Plate Haiku
Food is medicine
Farmers are doctors, Cooks priests
Eat, pray, eat, pray, love. By Gordon