District’s needy get fruit and vegetable Rx

“We talk a lot about health in a holistic sense, but we haven’t been empowered to endorse it in any way,” says Shikha Anand, a doctor in Boston who helped develop the prescription program. “I could write prescriptions all day long for amoxicillin. But I couldn’t prescribe a tomato.”

When it comes to health care, American society likes its medicine to come with a guarantee: “clinically tested,” “doctor-approved,” and so on. The focus on treatment, rather than prevention, stems from the fact that it’s not easy to pinpoint good nutrition’s impact on health. But Anand was keen on the fruit-and-vegetable prescription program collecting data to prove its worth. Patients report their consumption of fruits and vegetables. Doctors regularly record the subjects’ weight and blood pressure. The program tracks patient visits to health-care clinics (71 percent of patients return more often to clinical obesity programs) and farmers markets (51 percent of patients visited the farmers market eight or more times).

The results are winning over physicians. Michael Lambke implemented the program in the poor, rural community of Skowhegan, Maine. In 2011, 76 percent of patient families attended sessions at the clinic at least three times and made 10 trips to the farmers market, spending more than $5,000 on fresh produce.

Anecdotally, the program is inspiring families to embrace other aspects of a healthful lifestyle, Lambke says. One family got friends to join the program. Another tried out a new walking trail. “The best quote was a kid who came back to me and said that the thing he liked about the program was that his parents played with him more,” Lambke says. “Oh, man. That was awesome.”

In the District, three groups are working together to implement the fruit-and-vegetable prescription program: Unity Health Care is distributing the prescriptions. The Columbia Heights Community Marketplace and DC Greens, a nonprofit organization that runs incentive programs at area farmers markets, are handling tracking and redemption. On the first Saturday of the program, 26 patient families filled their prescriptions, spending $708 at the Columbia Heights market.

The program is starting small; it will distribute just $26,000 in vouchers during the 24-week farmers-market season. But it hopes to expand to new clinics and new markets in 2013. New funding could come from Wholesome Wave or the D.C. City Council, which is supporting farmers market incentive programs for those who receive food stamps and WIC. In 2013, the District’s Department of Health will allocate $50,000 for these programs.

But it might not take a lot of money, at least in relative terms, to make fruit-and-vegetable prescriptions work.

“They come back once a month. It’s not a huge amount of money,” says Skowhegan’s Lambke. “In the broad spectrum, when we think about how much we spend on Lipitor every year, it is a cheap, cheap intervention. And arguably more effective.”

Black, a former Food section staffer now based in Brooklyn, writes Smarter Food monthly. Follow her on Twitter: @jane_black.