In a study released this month by the Agency for Healthcare Research and Quality, a startling finding was reported: one in five hospitalizations involved patients with diabetes. As one way to tackle this ongoing epidemic, a new pilot was unveiled last week in Chicago that calls for adult diabetic patients to receive a different kind of prescription from their physicians—one for fresh, healthy foods sold through a local well-known retailer.
Several weeks ago, I wrote about the importance of communities—and addressing such difficulties as finding nutritious, wholesome foods for purchase within many communities—in regard to individual healthcare. While medical care was said to prevent only 10% to 15% of premature deaths, social and cultural factors and the quality of environment were found to play a critical role in determining our overall health.
Keeping in mind that an important, but easy, way to control diabetes is through healthy diet and exercise, three groups— Northwestern Medicine (which includes Northwestern Memorial Healthcare), Walgreens Corp., and Near North Health Service (a federally qualified health center with eight clinical locations in the Chicago area)—launched a new program called "Greenlight Select."
This new pilot will be focusing on the diabetic patients of one of Near North's clinics—who live in an area where grocery stores are not convenient: where it's easier to buy potato chips than a bag of potatoes. When they visit their physician, in addition to medical prescriptions for their diabetes, they also will receive a prescription that lists "foods for a balanced diet" such as a variety of fruits and vegetables, meats and proteins, dairy, and grains.
These prescriptions will be redeemable for discounts initially at a Walgreens found in a "food desert" location in the health center's neighborhood. Walgreens will be supplying a section of its store with these foods. The retailer, though, has also been s redesigning 10 of its stores on Chicago's South and West Sides, as well, to include an expanded variety of fresh foods and healthy meal components.
The pilot is an expansion of the Diabetes Collaborative—Northwestern's and Near North's 5-year old program that has been teaching diabetic patients how to control their condition through healthy lifestyles. As one part of that initiative, Northwestern Medicine researchers developed educational modules and worked with Near North to construct two, full-scale mock grocery stores at two of its community clinics.
"In the past, we used to help [Near North] by just writing a check. But now what we do besides that is sit down together and brainstorm about health issues—some of their most pressing health issues... and [see] what we can do to expedite care and in that manner [achieve] better care," says Daniel Derman, MD, who is president of the Northwestern Memorial Physicians Group and vice president of community services for Northwestern Medicine.
In addition, researchers from Northwestern will be reviewing those patients who will or won't take advantage of the prescription program and see if this intervention in diabetes control makes a difference, he says. "This is one of the most exciting things in community service work that we're doing."
"Oftentimes, people think they know what the good things are to eat, but they don't always. And even if they do know, it's amazing that the power of a prescription [will have]," says Carolyn Lopez, MD, the medical director of the Near North Service Corp.
She recalls that many years ago, she wrote patients a prescription for exercise. "That power of a prescription really sent a strong message to patients about what their job is. It's just as important as anything else."
Likewise, having a nutrition prescription not only is able to show people what they need to eat, but gives them addition tips and information. "I think it's a really neat part of all of this," she says.
To solve the problem of being in the food desert, you "first need to create the oasis, but the oasis has to be more than a mirage," she notes. This means having a handy source for patients to obtain the foods—and then making those products affordable—essentially competitive with the cheaper but high-calorie or fattier foods.
She doesn't rule out expanding the prescriptions in the near future to other conditions that would benefit from healthy eating—for instance, heart problems, hypertension, or kidney problems. "To start out, we thought we'd go with that population that really has a profound need so we're starting out with the adult diabetics," she says.
Eating healthy, though, could mean other changes—especially for the family of the diabetic patient. "The reality is that what happens to families tends not to be isolated with one individual," she notes.
"People probably wouldn't want to cook three different meals for those with families—so you can begin shaping and reshaping how people shop, as well as how people prepare foods," she says. "You have a positive impact not only on the individuals who have the need—because of a health problem—but even for those who are not currently struggling with that kind of a problem."
In other words, eating healthy could become a way of life.
Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at jsimmons@healthleadersmedia.com.