Refugees in Utah face poor nutrition; doctors and farmers prescribe collaborative response

Story and photo by DANNY O’MALLEY

A national program that provides fresh produce to refugee patients in need of nutrition has arrived in Salt Lake City. VeggieRx, also known as the Fruits and Vegetables Prescription project (FVRx), empowers doctors to prescribe wholesome nutrition in the form of fresh farmers market produce to refugees at risk of malnutrition or other health concerns like diabetes.

At St. Mark’s Family Medicine, in the Millcreek area of Salt Lake City, patients receive prescriptions for $10 toward fresh produce. They take the prescriptions just down the street to the Sunnyvale Farmers Market, to be used up to four times. The market also accepts SNAP, Supplemental Nutrition Assistance Program, which can double the amount of vegetables carried home by refugee patients. The Sunnyvale Farmers Market, an endeavor of the International Rescue Committee through its New Roots farming initiative, is open on Saturday afternoons from July to October every year.

Refugees who are newly resettled face a myriad of challenges, but nutrition and diet are often the most pressing.

Ze Min Xiao, director of the mayor’s Office of New Americans in Salt Lake County, said even the idea of a supermarket can be a challenge to newcomers. Often when a refugee arrives, “suddenly they’re buying processed food, and it’s more expensive and not as good for you. Obesity and lack of vitamins are a problem,” she said.

The transition to the American diet and food culture can be jarring for some. Many refugees struggle to find food they recognize. Familiar ingredients may grow plentifully in other regions around the world, but varieties here in Utah may be nonexistent or prohibitively expensive.

For example, according to cost of living data collected by Numbeo.com, fruit and vegetable prices are anywhere between two and 10 times greater in the United States than in Syria and Somalia. And that’s just for ubiquitous produce like apples, oranges and potatoes — anything remotely exotic is exponentially less likely to be carried by local grocers.

Because of programs like VeggieRx, farming initiatives like New Roots and medical outreach through St. Marks, the avenues to help alleviate issues of nutrition and unfamiliar culture are opening wider. The innovative practice of prescribing access to vegetables packed with nutrients is a direct result of addressing the needs of the refugee community, Xiao said. “We can identify some answers they bring as New Americans,” she added.

Similar programs are already coming to fruition all over the country. VeggieRx was started by Wholesome Wave, an organization centered on increasing accessibility to nutrition and health resources. First piloted in Maine and Massachusetts in 2010, the success on the East Coast has allowed Wholesome Wave to partner with organizations in 48 states as of this writing, as well as Washington, D.C., and the Navajo Nation in the Four Corners area.

Fiona McBride, senior communications associate for Wholesome Wave, has been with the organization since 2014. “We’re really proud of our growth and impact,” she said in a phone interview. “In 2015, we helped about 150,000 people. In 2016, we reached over 550,000.” She expects that growth trend to continue.

The benefit doesn’t stop at the limit of the prescription value either. Refugees and other low-income families are more likely to buy lots of veggies once they get a little, giving an economic boost to the farmers at the market. “We’ve seen that for every $5 in vouchers, they spend an additional $15 on fresh produce,” McBride said. “Our case workers have said that the families can’t believe what they’re getting.”

Patients in greatest need of nutrition are often children. “It’s really powerful to tackle and prevent problems with diet and health starting young,” McBride said.

St. Mark’s Family Medicine is a program with the Utah Healthcare Institute. Diane Chapman, a nurse practitioner involved with the program, said the link between diet and chronic disease can’t be emphasized enough. The majority of patients she sees are refugees. “It’s my primary professional focus and passion,” she said in a phone interview. Often, she said, clinicians have “little context” for a diet that refugee patients might be familiar with. “Dietary change can be difficult for anyone.”

The VeggieRx pilot provided the opportunity for refugee families to align their diet with food similar to that of their countries of origin, at little to no cost. The pilot ran from September to October 2017, through the end of the farmers market season. Chapman said the program goal was to enroll at least 50 patients, which was met, and now the data can be assessed by the Utah Department of Health.

According to a report from the Center for Science in the Public Interest, healthcare costs related to diet are over $950 billion a year. This is especially dangerous for low-income families including refugees.

Fiona McBride said that’s what the VeggieRx program is all about — spending less on healthcare by treating preventable diseases through nutrition. “We’re really trying to show the power of produce to improve personal and environmental health. The money we save in avoiding extremely expensive health problems could transform the country,” she said.

Utah’s pilot of the program is in its infancy, so the exact impact is yet to be seen at the local level. But it has a huge pool of organizers invested in seeing it thrive. The International Rescue Committee, the Utah Department of Health, Salt Lake County and St. Mark’s Family Medicine have made good headway together. Thanks to everyone involved, refugees can eat healthy and avoid burdensome long-term healthcare costs.

Keep your eyes peeled for updates from the Utah Department of Health in early 2018.