People are fed by the food industry, which pays no attention to health, and are treated by the health industry, which pays no attention to food.

- Wendell Berry

The Food as Medicine Collaborative (FAMC) is a multi-sector coalition of over 20 organizations including community clinics, food nonprofits and businesses, and four health care systems.

Mission

Our mission is to bridge healthcare and food systems to advance nutrition security and health equity.

Vision

Our vision is of thriving communities supported by equitable, respectful healthcare and just, resilient food systems.

More about the Collaborative

Strategies

Programs

We coordinate on-site food programming within healthcare settings through robust clinical-community linkages. Food Pharmacies provide patients with fresh, healthy food and individualized nutritional counseling alongside their medical care.

Systems Change

We promote culture and systems change in healthcare to embrace food insecurity as a health issue.

Policy Change

We advocate for healthcare policy change, such as ensuring health insurance covers food as a medical benefit.

View Our Logic Model

Impact

Programs

In 2022, over 2000 patients attended Food Pharmacies, across 14 clinics, receiving over 13,000 bags of healthy food.

Currently, Food Pharmacies in San Francisco are serving 450-500 patients and their families per week.

Patients who utilize Food Pharmacies report:

92% have adopted healthier eating practices

93% feel more sense of community

83% are more likely to seek medical care at their clinics after attending Food Pharmacy

Preliminary evaluation has shown a statistically and clinically significant decline in blood pressure for Food Pharmacy participants. This blood pressure drop, 5 mm Hg, has health benefits equivalent to losing 11 pounds.

Between 2015 and 2019, the disparity between Black/African American patients with uncontrolled hypertension and all other patients with uncontrolled hypertension in the San Francisco Health Network (SFHN) dropped from an 8% disparity to a 3% disparity. FAMC’s Food Pharmacies were a key strategy of SFHN to reduce this disparity and improve health outcomes for low-income, Black/African American patients.

Systems

We have cultivated culture change within healthcare systems to integrate nutrition security interventions into day-to-day healthcare work. This systems change has seen healthcare embracing food as a critical health issue, allowing us to scale up on-site food programming from one pilot in 2015 to, currently, programs at 12 clinics, spanning four health systems. The systems change we sought proved to be resilient as the COVID-19 pandemic hit and our healthcare partners doubled down on their investment in food security interventions with seven more clinics expanding food security interventions since 2020.

Policy

2021 Medicaid Waiver Includes Medically Supportive Food and Nutrition Services.

After a year and a half of collective advocacy, our Collaborative successfully led efforts to persuade the California Department of Healthcare Services to include medically supportive food and nutrition (MSF&N) services in California’s Medicaid Waiver (CalAIM), enabling food to be a covered medical benefit under California’s Medicaid program, Medi-Cal, beginning in 2022.

For exciting opportunities to be a part of the CalAIM implementation, either as a food partner or a healthcare partner, visit our page offering technical assistance resources.

For more background information about CalAIM:

Integrating Food Into Health Care (Nov 2021)

Download Report

The Case for Medically-Supportive Food and Nutrition (2021)

Download Infographic

Integrating Medically-Supportive Food and Nutrition Services into CalAIM to Improve Health Outcomes and Reduce Health Care Costs (2020)

Download Position Paper

For further information about our policy efforts,
please visit our partner, SPUR.

young woman excitedly holding a bunch of very large golden beets

"By me eating healthier, my healthy outcomes have improved. My health has improved both physically and psychologically. When I come to [the Food Pharmacy at] Southeast Health Center, it has allowed me to feel like I am a part of the community, and not only a part of the community, but part of the health center in promoting good health and care and attitude dispositions in the community of the populations who live here."

-Patient at Southeast Health Center, interviewed spring 2021
“It [Food Pharmacy] showed me that the staff here really care about me. I appreciate going there unlike before. It was a little bit rough at first but now that I communicated with the staff here, I’m satisfied with the healthcare they provide for me… I feel a lot more comfortable going there now. I feel like I can trust the staff there. They’re out to help me, and that’s what it’s all about, isn’t it?”

-Patient at Curry Senior Center, interviewed spring 2021
“I think [the Food Pharmacy] is simply marvelous – they always have different types of fruits and vegetables and cookbooks for us to take home. I lost 7 pounds and my blood sugar is coming down, I’m now at 10; I’ve been taking my medicines like I’m supposed to – I feel good, I feel great. It’s really nice to meet everyone and get your blood pressure checked. I have no negatives or no complaints about the food pharmacy.”

-Patient at Southeast Health Center
“I feel more energetic. I’ve lost weight. Food Pharmacy is the type of environment that you want to walk into. I have a lot of people taking care of me.”

-Patient at Silver Ave Family Health Center
"Coming to Food Pharmacy has been very helpful for me...I was on four blood pressure pills, and now I am down to three."

-Patient at Southeast Health Center Food Pharmacy
"It never crossed my mind that doctors could be prescribing healthy food. That is really exciting and cutting edge medical care."

-Patient at Maxine Hall Health Center
"As a doctor, I prescribe pills for diabetes many times a day, and I can't tell you how exciting it is and how good it feels to prescribe green beans and carrots instead of medications."

-Anne Rosenthal, MD
“The patient pantry [Food Pharmacy] has literally been a life-line to some of my patients. I have used the patient pantry in times where my families literally have not had any food in the home and are under isolation orders due to COVID. I have been so impressed with this service and would support it anyway that I could!”

-Provider working with prenatal and postpartum families
“I know it doesn't solve more upstream problems, but when families are vulnerable and share they are food insecure or economically unstable as a result of unemployment, it's such a relief to them that we can do something, as small as it may seem, for them right there in the moment. We listened and responded.”

Provider who helped organize a Food Pharmacy program for prenatal and postpartum families in SF during the Pandemic
"As a doctor, it's alarming to me how often I hear from patients that they can't find or can't afford healthy foods, and how stressful it can be for them to make healthier choices. Food As Medicine is built on the understanding that not only can healthier food choices really aid in the management of chronic medical conditions and help patients see better outcomes, but that everyone – regardless of financial situation, location, or demographic – deserves access to healthy, nutritious, whole foods."

-Dr. Rita Nguyen, San Francisco Department of Public Health
“Food Pharmacy brings joy!”

– Healthcare provider at Curry Senior Center in the Tenderloin

History

The Food as Medicine Collaborative (FAMC) was founded in 2015 by Dr. Rita Nguyen, while she was caring for patients at Zuckerberg San Francisco General Hospital. FAMC grew out of the shared belief that healthcare and food systems can and should work together to address food security as a core social determinant of health and critical factor for health equity. Collaborative partners came together across disciplines to address the significant need and opportunity to more meaningfully engage healthcare systems to tackle food insecurity, thus leveraging healthcare resources against hunger, poor nutrition, and the health consequences of both. FAMC continues to work to transform health systems from disease-care systems to health-care systems by supporting them to tackle food security as a health issue that demands their attention and investment.

The Food as Medicine Collaborative is a fiscally sponsored project of the nonprofit San Francisco Public Health Foundation and is based within the San Francisco Department of Public Health.

map of San Francisco with dots showing the locations of the clinics FAM works with since 2017-2020 — Expansion of FAMC interventions in clinics

Timeline

2015

Therapeutic Food Pantry pilot at ZSFG Wellness Center

Funded by Stanford University d.school to apply human-centered design to our Food Pharmacy model

2016

Pilot Food Pharmacy at Maxine Hall Health Center

2017

Funded by Hellman Foundation Collaborative Change Initiative for backbone support

Expanded to 3 clinics in 1 health systems

2018

Expanded to 6 clinics in 1 health system

Served 288 patients

2019

Expanded to 9 clinics in 4 health systems

Served 1,272 patients

2020

Expanded to 16 programs at 11 clinics in 5 health systems

Served over 3,000 patients and their familes

Piloted food delivery, launched online cooking classes, secured partnership to purchase food for Food Pharmacies

2021

Received renewal funding from Hellman Foundation Collaborative Change Initiative

Serving 450-500 patients weekly

Launched partnership with La Cocina Municipal Marketplace to offer meal vouchers

2022

2000 people served

Over 13,000 bags of food distributed

Successful partnership with Bayview Hunters Point Community Advocates to provide produce sourced by regional BIPOC organic farmers

Distributed over $48K in EatSF food vouchers and over 1400 Farming Hope meals

4 new Food Pharmacies launched

Values

Equity

Our current systems are designed to advantage certain groups while limiting opportunity for others. We believe in systems and policies which provide opportunities for everyone to be healthy, live with dignity, and achieve their full potential.

Healing

We believe that improved health empowers individuals and communities. Addressing food insecurity as a key social determinant of health requires challenging and dismantling underlying injustices in our food and healthcare systems in order to give power and agency to historically disadvantaged communities.

Partnership

Systems change requires deep, interwoven, and effective collaborations. We believe that there is tremendous opportunity for alignment between healthcare and food systems to leverage resources and co-create strategies that build resilience and capacity within both sectors to improve patient and community health.

Humility

We believe that addressing health disparities requires deep listening to those directly affected by food insecurity and chronic disease. Our programs and policies must be responsive to the needs of patients and community stakeholders, and they should have a seat at the table in decision making.