By Dr. David Feinberg, President and CEO of Geisinger.
Not long ago, complications from type 2 diabetes caused Tom Shicowich to lose a toe, a month of his life in the hospital and rehab, and his savings.
But today, Tom is doing much better. He’s lost 45 pounds, and his blood pressure and blood sugar have dropped so much he may soon be able to get off his medications. He’s able to enjoy a walk with his girlfriend and climb stairs more easily.
Tom’s improvement didn’t come from a new surgical intervention or wonder drug. He credits his turnaround to the help he received as part of Geisinger’s Fresh Food Pharmacy program.
The Fresh Food Pharmacy gives free groceries and meal plans to low-income patients with type 2 diabetes in Shamokin, Pa. Those enrolled in the program, like Tom, get five days’ worth of healthy food per week that’s recommended by the American Diabetes Association to control blood sugar. The food prescription includes vegetables, fruit, lean proteins and whole grains. Patients also receive education and support.
So far, the results have been mind-blowing. All patients in the program are seeing similar results to Tom. They have significant declines in their hemoglobin A1C levels, the blood test that shows how well blood sugar levels are controlled. That drop in A1C gives them a much better chance to avoid the complications of type 2 diabetes. They won’t go blind; they won’t have kidney disease; they won’t lose a toe or a foot.
Shamokin was the perfect place to pilot this concept. About one in three Shamokin residents is considered food insecure, and nearly 50 percent are predisposed to diabetes, mostly due to obesity. Those are among the worst stats in the nation.
By removing the barriers to getting fresh food, which can be more expensive and hard to find, we not only improved the diets of the patients with diabetes, we helped entire families. Participants are provided with food for themselves and their entire families in an effort to break the chain of unhealthy eating. This can prevent diabetes and lifestyle-related conditions in future generations.
The knowledge that a better diet can improve the outcome for those with type 2 diabetes is not new. But a health system giving food to folks outside the walls of the hospital may be revolutionary and long overdue.
Our goal as healthcare providers must move from dealing only with the medical crises that come to our doors. We need to disrupt the forces in our communities that trigger preventable illness and early death. These social determinants of health; income, education, employment and environment, guide our holistic understanding of our patients and reveal how we can make a difference in their long-term health outlook.
Our investment in the Fresh Food Pharmacy is the right thing to do for patients. We’re also looking at how it affects the cost of their care. Our early results show that it’s a really good value. For every one-point decrease in hemoglobin A1C, we save about $8,000 in cost-of-care because of the complications that are prevented by the Fresh Food Pharmacy. That’s a great return on the $1,000 per year we spend on the program participants.
We’re expanding this pilot program in Shamokin to other Geisinger locations. We’ll follow the results to make sure the diet changes are sustained for lasting health benefits, and we’ll share what happens. Clearly, as healthcare leaders we can’t afford to protect the status quo. Innovation around the social determinants of health is not optional.
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