Program provides free food, encourages better nutrition
By BETSY TAYLOR
Brenda Beard knows she should eat better as a step toward improving her health. The rural Nunnelly, Tenn., resident weighs more than 400 pounds and has type 2 diabetes, sciatica, difficulties walking and dental problems, she says.
But it's a challenge to move away from eating the foods she has always enjoyed. "I was raised up on chicken and dumplings and corn bread," she says, describing a weakness for fried chicken and catfish. And it's difficult to get access to fresh foods. Beard is physically unable to walk to the store, and her 1985 Chevrolet Caprice Classic broke down, so she relies on family members or friends for a trip to the grocery store.
Finances are a concern, so Beard can't always spend a lot on fresh fruits and vegetables. She brings in some money doing sewing and clothing alterations from home, though she acknowledges there are days where she doesn't feel well enough for the work.
But Beard recently has been eating more foods suitable to her medical conditions through a new program at Saint Thomas Hickman Hospital, an Ascension Health member in Centerville, Tenn. It is about 60 miles southwest of Nashville and just a few miles from Beard's home. A food pantry at the Catholic hospital opened this year to give away boxes of food with the contents tailored to meet the needs of patients who require special diets. One box offering is for patients following a low-sodium diet, one for patients who are diabetic and one for patients with renal conditions (see sidebar).
Each box contains about 16 to 18 nonperishable and canned items, including vegetables, fruit, whole wheat pasta, brown rice, cereal, beans and canned chicken. Box contents are modified based on the recipients' dietary restrictions. For example, a box going to a diabetic patient would not include jelly. A box for a person following a low-sodium diet would contain canned products with reduced levels of salt.
Strained budgets
Kevin Campbell is director of mission integration for Saint Thomas Health of Nashville, Tenn., the hospital's parent health care system. He says the idea for a hospital-based food pantry providing diet-specific food boxes originated from conversations between leadership at Saint Thomas Hickman, Saint Thomas Health, the Saint Thomas Health Foundation, Second Harvest Food Bank of Middle Tennessee and the Centerville Church of Christ. Leaders of these organizations knew many residents in Hickman County were struggling financially. In Hickman County, the median household income is about $20,000 annually, less than half of the median household income in the state. Food insecurity and sound nutrition are issues for many households.
The organizations' leaders decided to take some of the food cost burden off a subset of low-income people: those who have the added burden of a chronic medical condition. "We didn't want it to be where we were just giving away free food. We really wanted to make sure the educational component was there," Campbell says.
He explains that to accomplish this, the hospital coordinates its food box program with clinical staff. Doctors, nurses and therapists at Saint Thomas Hickman or at its adjacent medical clinic can refer a patient to receive a food box. The patient doesn't need to fill out any paperwork, or prove need. Campbell says of the hospital staff: "They know the folks that they see; it's a small community. Lots of the folks are repeat customers."
Teaching moments
Saint Thomas Hickman is ensuring food box recipients also get information about healthy eating. On paperwork used for discharge discussions, the hospital is adding a question for nurses: "Did you offer a food box?" If a patient accepts the food box, "that opens the door to education," Campbell says. The nurse offers some guidance on nutrition related to the patient's medical condition and explains how the items in the box meet his or her nutritional requirements and dietary restrictions.
When patients try the food, they have the cans and labels for ready reference. This may prompt them to buy the diet-appropriate products when they're shopping themselves. Patients can get additional food boxes as needed, too.
Beard says she has learned to use the box contents imaginatively. She "doctors up" meals with items from the food box, for instance by combining brown rice with canned mixed vegetables, canned chicken and an onion. And the staples help her stretch her own limited resources. "Sometimes you have to be creative; you eat what you have here. And when you don't have anything in the house, that whole wheat pasta comes in handy," she says.
A philanthropic effort
The hospital and medical clinic together distribute about 35 boxes a month, on average. An anonymous donor to the Saint Thomas foundation provided $25,000 to buy food, Campbell says. Food box program organizers expect the initial donation to keep the program going for quite some time and expect that other donations will sustain it.
Volunteers at the Centerville Church of Christ, including area teenagers, help to pack and label food boxes, which are stored at the church and delivered to the hospital in small batches.
Tracey Alderdice, director of agency and program services for Second Harvest Food Bank of Middle Tennessee, says there is another effort in the region to provide those in need with fresh produce once a month. But, Alderdice says, the products in the food boxes have a longer shelf life, and that gives patients, some of whom might otherwise go home to bare cupboards, a supply of food. "We do see people making choices, when they have to pay for medical bills, rent and food. Sometimes, the food gets cut,"
she says.
She adds of the hospital's work, "Distributing food is not their frontline mission, but access to healthy food does play into medical costs, and the numbers of times someone is hospitalized."