WASHINGTON (WASHINGTON POST) – Adrien Douv withdrew to the food line at a giant shop in Washington DC with a cart filled with cabbage, bananas and granular branches.
The registry rang $ 20.60 (S $ 28.37). Instead of cash or a card, Mrs. Dove paid with the Voucher Rice from the pharmacy store.
The giant in the poorest part of the county of Colombia is the latest frontier in the food-cure movement.
Hospitals and local authorities across the country write and fill recipes for healthy food in an effort to cope with the root causes of diabetes, hypertension, and other expensive diseases.
The Bill Farm, which was enacted at the end of last year, involved more than $ 4m in grants to the US Department of Agriculture (USDA) to be distributed to governments that work with recipes programs, but money has not yet been distributed .
The goal, supported by some research, is to improve health and reduce costs by subsidizing fresh products such as broccoli and grapefruit, in addition to insulin and beta blockers.
"What we hope to find is a return on investment for the healthcare system: reducing ER visits, drug compliance," said Lauren Schweeder Biel, executive director of the DK Green, a non-profit group that runs the Rex Production Pilot in the county .
"It's the holy grail for such systems."
Improved diet is also a goal.
"I was trying to manage the diabetes and high blood pressure of my patients, but when they told me they were eating Top Ramen, donuts and bagels because they kept them full, everything I could say was" It's bad, there are a few drugs "Says Dr Rita Nguyen from the San Francisco Public Health Department, who now oversees a recipe program that spreads in six clinics.
In the state capital, the Produce Rx program began last month and provides 500 patients with a Medicaid US $ 20 weekly vouchers for the production of the Dynasty at Ward 8 by the end of the year.
Section 8 is the poorest, richest part of the city and has the highest rates of death for diabetes and heart disease. It is also a food desert, and Giant is the only full-service grocery store.
The Produce Rx program, which includes the costs of vouchers and evaluation of the patient's results, received $ 500,000 from the District Government and $ 150,000 from AmeriHealth Caritas, a Medicaid-administered healthcare organization.
Patients of AmerHealth Caritas are the only ones who now meet the requirements for the Pilot Produce Rx. DC Greens seeks additional funds from USDA to extend the program.
Council member Mary Cech urges lawmakers to increase one-per cent spice tax on sweetened beverages to create a steady source of income for the Produce Rx initiative, among other programs.
Mrs. Dove, 43, learned about the program, while in the health clinic for checking the state of her hypertension and anemia.
Medical professionals often urge Ms Dow to eat better, but she was surprised when a clinic representative called her grocery store to provide vouchers for her in the same way as doctors would say about medication.
"I just ate fried chicken wings and fries, I grew up on McDonald's and got high blood pressure," said Ms. Dove, who lives with her mother and two children near the grocery store.
"Now I am telling my son:" Do not be like Mom "and asks for broccoli and spinach."
In 2001, the Boston Medical Center launched one of the first foodstuffs with preventive food in the basement of the hospital's hospital, which treats patients, regardless of their ability to pay.
In San Francisco, health workers found that patients are more likely to take food from weekly events in neighborhood clinics than in a public hospital. At clinics, patients can choose their own meat, whole grains and vegetables, as well as to follow cooking demonstrations by nutritionists – who sometimes produce cutting tiles and knives.
Dr Nguyen, a San Francisco health official, said food proponents as a cure are still trying to find the best way to set up such programs.
"We do not know which food intake is enough to make a difference," said Dr. Nguyen.
"Is the food itself sufficient? Or do you need a nutritionist, do you need the cooking stocks, the recipes?"
In Pennsylvania, the initiative for fresh food products by the regional health insurer and Geisinger provides production, cooking demonstrations, and diabetes management classes for 700 patients in the northeast and central parts of the country.
In the first two years of the program, officials found that diabetics who received food had noticed a drop in blood sugar levels, as opposed to those that had not been given to them.
Ms. Alison Hess, CEO of Gesinger, said that fresh-water pharmacy costs about $ 3,500 per family a year, and drops in blood sugar will result in greater savings than fewer drugs.
"It's kind of tapping," said Ms. Hess. "We will pay for this medical expense or we will pay for this food and education that will be more than a lifetime benefit."
The county's access differs. Instead of a new storage room or offering food at the doctor's office, the city encourages residents to buy fruits and vegetables at a grocery store that is already part of their weekly routines.
City health officials said earlier efforts to link residents to deserts for food production in angular stores were born in trouble because traders could not always find enough customers. The Produce Rx program is building a more limited subsidy program that already exists in farmers' markets.
"Most people will come to a grocery store, while farmers' markets and popup windows are at certain places at certain times of the year," said Dr. Lavdena Adams Orr, chief medical officer at AmeriHealth Caritas.
Mrs. Sierra Washington's price was upset when she was diagnosed this winter with hypertension, diabetes and high cholesterol. She left the doctor's office with a warning to eat healthier and a recipe for the production program.
Ms. Ceres was in a grocery store at her first shopping trip with vouchers for production, looking at melons and strawberries when she met an internal supermarket nutritionist, Ms. Gillian Griffith, and scheduled a free consultation meeting.
The Produce Rx program does not require consultation, but patients who take their vouchers for production are encouraged to meet the Giant dietician.
The giant is in the Washington region, and they usually move between stores and offer 25 US consultations, a fee of $ 25 in product vouchers. Ward 8 Giant does not charge for consultations with nutritionists and is the only store in the supermarket's supermarket chain in the store. He offers classes for managing diabetes and one-on-one training.
"When they tell you to eat healthy, what does that mean for you?" Mrs. Griffith asked Mrs. Price from behind the desk at the shop's wellness center on the last afternoon.
Mrs. Price won.
"Leaving everything I love and adhering to the green," she replied.
Ms. Griffith offered a more optimistic answer.
"Maybe you can learn to love new things," she said. "We want to be in the middle and watch out for the things we eat and how to eat food that makes us happy."
During the next hour, they discussed what Ms. Cesi wanted to eat (pasta and cats and cheese) and what she did not like (chicken and apples). They ended up with two specific goals: larger sides of vegetables and smaller pieces of pasta during dinner, and adding fresh strawberries and bananas to her oatmeal for breakfast.
Before leaving, Ms. Price called for suicide with Mrs. Griffith as a photographic evidence that she met with a nutritionist.
One of the biggest challenges for recipe-making programs is to ensure that access to healthier foods will make a difference in what a person chooses to eat.
Ms. Griffith said it was not unusual to hear from patients who, like Ms. Price, were overwhelmed by the thought that they should change everything around their meals. Instead, she is trying to focus on new options, rather than limiting her diet.
"For a long time, they have fought diabetes or never received information other than" eat healthier, "said Mrs. Griffith." Especially on this side of the city, there are not many opportunities for people to get a reusable time they need. "