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Delivering Healthy Meals to Food Deserts

A self-described gourmet cook, Joan Owens used to prepare meals such as butternut squash and eggplant parmesan for herself almost every day. 

But these days, at 83, she needs help grocery shopping because her diminished eyesight prevents her from driving and reading. Plus, meal preparation can be tedious. 

“I’m tired of cooking,” she says. “I don’t want to do it every day.” 

Healthy food access 
Whether a mile or 20 miles away, supermarkets filled with healthy foods are out of reach for millions of people in the U.S. 

A pilot meal delivery service introduced by Blue Cross and Blue Shield of Illinois (BCBSIL) and the Blue Cross Blue Shield InstituteSM was created to help people like Owens get easy access to more nutritious food.

Long-term benefits, especially for those diagnosed as having diabetes, heart disease and stroke, could include improved health, as well as fewer emergency room visits and hospital admissions. 

The service, called foodQSM, delivers nutritious and affordable meals in targeted Chicago ZIP codes. Everyone living in these ZIP codes can participate, even if they’re not BCBSIL members. 

Meal delivery is among efforts to boost access to healthier options for people in food deserts — areas where high percentages of low-income residents live at least a mile from a grocery store, or more than 10 miles in rural areas. The U.S. Department of Health and Human Services estimates 23 million Americans have limited supermarket access. 

"foodQ is a pilot, so we will be examining the results and determining how we want to move forward,” says Manika Turnbull, vice president of community health and economic impact for Blue Cross and Blue Shield Plans in Illinois, Montana, New Mexico, Oklahoma and Texas. 

“foodQ is a great springboard to what other projects we want to take on that really go bold and deeper into how we’re addressing social determinants of health,” Turnbull says. 

The future of health care 
U.S. health care costs for chronic diseases, including heart disease, cancer and diabetes totaled $1.1 trillion in 2016, according to a 2018 report for the Milken Institute, a nonprofit, independent think tank.

Policy experts, health care providers and insurers are exploring how social, economic and environmental factors — or social determinants — influence people’s health, and how to address them while reducing health care costs. 

“The goal is to not wait until someone gets into the hospital setting to suddenly care about how someone is managing their health.” 

Eighty percent of a person’s health is affected by socioeconomic status, education, neighborhood and employment, as well as exercise or smoking, research for the Robert Wood Johnson Foundation found. Only 20% is linked to actual care, including access and quality. 

“The future of health care is less about the four walls within the doctor’s office or the four walls of the hospital setting and much more about what’s happening in the community,” says Dr. Trent Haywood, president of the Blue Cross and Blue Shield Institute of the Blue Cross and Blue Shield Association. “Blue Cross and Blue Shield plans are definitely taking leadership on this.”  

Target areas include finding ways to connect people with housing, transportation, utilities and nutrition programs.  

 “The goal is to not wait until someone gets into the hospital setting to suddenly care about how someone is managing their health,” Haywood says. 

Solutions require collaboration 
Cities, organizations and businesses across the country have tried to increase availability of healthy foods. Many states offer supermarkets grants and loans to encourage development in neglected neighborhoods and help smaller stores expand fresh food supplies. 

Despite good intentions, programs like these may not spark change because they don’t involve their intended beneficiaries, says Lauren Ornales, executive director of the Food Empowerment Project, a food education organization in Cotati, Calif. 

“It’s important to survey communities to understand the issues and barriers,” she says. “People need to be part of the process to feel like they’ve been respected.” 

Besides affordability, is the food good? Is it culturally appropriate? That information, Ornales says, must be gathered before initiating a program.  

Haywood agrees. foodQ’s development relied on focus group participants, who taste-tested meals and made recommendations that helped shape the service’s menu.  

“Let’s be honest,” Haywood says. “Nobody wants to eat healthy, nasty food.” 

foodQ may be just the first of many steps in leading people to better health.  

“foodQ is one way for us to do our part,” Turnbull says. “We want to be at the table, and we want to be a convener and bring other people in who also have an interest in addressing social determinants of health. We’re focused on tackling social determinants of health for the long haul.” 

Delicious, nutritious and convenient 
Owens attributes her good health and on-the-go lifestyle to a nutritious diet. She’s active in her southside Chicago church, traveling the country and participating in several community groups. 

foodQ, which Owens discovered while listening to a Chicago radio program, offers tasty, healthy and affordable meals like those she used to make. Preparation is as simple as reheating a meal in a microwave. 

“When you can get that meal, and you can put it in the microwave, we’re ready for that,” Owens says. “If I could, I would eat the rice with mushrooms every day. And I love that sauce. It’s just right for seniors who want to be healthy.” 



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