When it comes to positive
Ashley Tyrner lived in a food desert 12 years ago, and has been fighting for equitable food access ever since. After working alongside President Barack Obama's senior adviser for nutrition policy, Sam Kass, to create nutrition-forward public programs within the administration, Tyrner went on to launch FarmboxRx in 2020, which now works to deliver nutritious foods to Medicaid and Medicare members with chronic conditions.
"I was on food stamps, pregnant with my now 11-year-old daughter and I happened to live in a rural food desert," says Tyrner. "Although I did not know what a rural food desert was. It was just a way of life."
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Approximately 53.6 million people live in food deserts, which are urban communities more than one-half mile from a supermarket, and rural communities more than 10 miles away. In other words, access to fresh produce is not guaranteed in the U.S. As a social determinant of health, access to nutritious food can influence the severity of chronic conditions — or whether or not people develop those conditions to begin with.
"In America, diet-related disease is massive, whether that's type two diabetes, hypertension or cardiovascular disease," says Tyrner. "Where you live, down to your zip code, can tell you better than anything what your health is going to be."
In fact, it's possible to reverse type 2 diabetes through one's diet, but not without accessibility and education, Tyrner further explains. It's why FarmboxRx delivers food to their members' doors rather than simply offering a financial stipend. Tyner also notes that those on Medicaid and Medicare plans may not have the money for transportation or may suffer from limited physical mobility. Additionally, every farmbox comes with easy recipes and tips on what foods members should avoid depending on their specific chronic condition.
"One [member] remembers the magazine in her farmbox said she shouldn't fry her zucchini because of her hypertension," says Tyrner. "Now she knows to bake her zucchini, which she never knew she could do."
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To qualify for FarmboxRx, Medicaid and Medicaid Advantage plan members must fall under "Special Supplemental Benefits for the Chronically Ill," meaning they have one or more complex chronic conditions with a risk for hospitalization or adverse health outcomes and require intensive care coordination.
"These are the most vulnerable populations: low-income Americans and our elderly," says Tyrner. "For us, it was important to move into a market that served the most underserved."
Given that half of the U.S. population receives their health plan directly from their employer, Tyrner also encourages companies to evaluate if their workforce can afford and access healthy foods. This should be a top concern for any employer bridging their DEI and healthcare efforts.
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"There is no equitable health system unless you have food equity," she says. "In this country, just because you have a job doesn't mean you can afford to make ends meet."
However, Tyrner is hopeful as she has seen increasing recognition of this issue among employers and policymakers, with funds directed toward the expansion of Medicare Advantage and the inclusion of social determinants of health surviving two presidential administrations. Notably, Seema Verma, who served as the Centers for Medicare & Medicaid Services administrator during the Trump administration, spearheaded movement on this. Tyrner predicts the CMS will come out with a budget focused specifically on food equity in the next few years.
"We are going to see the pendulum swing further toward health equity," she says. "And that begins with the social determinants of health, and food is top of that pyramid."
