Pat Mueller knows all about healthy eating, the kind that helps keep the rash and weakness of dermatomyositis at bay and got her off the steroid that caused annoying weight gain.
“Five fruits and veggies per day. Lean meat. Avoid highly processed foods. Avoid the whites, the sugars, the flours,” said Mueller. “What we put in our bodies is very important.”
Sitting at a long table at the bustling Heinz-Menaker Senior Center, Mueller declared her lunch of chicken, Brussels sprouts and brown rice as acceptable. She has taught herself the lessons in nutrition that her fellow center members and others are about to learn, through a new initiative tackling chronic disease in the community.
The Chronic Disease Prevention Program is a partnership of UPMC Pinnacle and the Central Pennsylvania Food Bank, in conjunction with Heinz-Menaker Senior Center in Harrisburg. Their combined efforts will bring more fresh fruit and vegetables into the community, paired with screenings and education on the links between diet and health.
A Dent
Chronic diseases are the leading causes of death and disability in America, according to UPMC Pinnacle. Affecting 190 million Americans—nearly two out of three—their cost to the health care system from 2016 to 2030 is projected to be an incredible $42 trillion, according to the Partnership to Fight Chronic Disease.
That is, if nothing changes. Officials with the Chronic Disease Prevention Program hope that leveraging their resources will make a dent. They can achieve their individual missions without “reinventing the wheel and by breaking down siloes,” said Tina Nixon, UPMC Pinnacle’s vice president of mission effectiveness and chief diversity officer.
“At the food bank, they understand hunger and access to food,” she said. “Where can we partner to bring in the healthy component of prevention education and how to utilize the foods you’re receiving if you have a chronic disease?”
Add assessments for such leading chronic conditions as high blood pressure, diabetes and high cholesterol, and “we are able to catch things early and provide the resources and tools so individuals don’t have to come into our hospital.”
For about a decade, the Central Pennsylvania Food Bank has expanded its capacities for acquiring, storing and distributing fresh and frozen meats and produce, said Executive Director Joe Arthur. In recent years, the food bank has also connected with health care providers and insurers at the intersection of health and food insecurity, because a doctor’s order to eat healthy foods can be an insurmountable challenge for some patients.
“The guidance to eat more fruits and vegetables is wonderful advice, but if you don’t have the dollars to do that consistently and steadily, it becomes more of a struggle,” Arthur said. “One of the coping mechanisms is to eat cheaper, less healthy foods.”
Barriers preventing access to fresh food include more than a scarcity of grocery stores. Unemployment and low incomes limit buying power. Unsafe neighborhoods make it hard to venture outside. Those without cars have to lug grocery bags home on the bus. Even those with access to groceries might need “some education and tactics around shopping” in the produce section, said Arthur.
“About 45 percent of the food Central Pennsylvania Food Bank provides is actually fresh or frozen,” he said. “That stacks up pretty well to the American grocery cart, but there’s more work to be done around the education part and the access part of it. With health care moving very rapidly to help patients in that way, it’s a natural partnership.”
Food Oasis
For the recent “Chronic Disease Prevention Program” kickoff, the Central Pennsylvania Food Bank delivered lettuce, apples, zucchini and milk to the Heinz-Menaker Senior Center. Nestled in a central part of Harrisburg, Heinz-Menaker could be called a food oasis in a food desert.
The center serves lunches provided through Dauphin County, and it is the county’s largest Meals on Wheels distributor, delivering to about 40 clients daily, according to Executive Director Les Ford. The food pantry, unique for stocking fresh and frozen meats, provides food for the kitchens of qualified center members and community residents.
The chronic disease initiative introduced fresh produce, dairy and eggs to Heinz-Menaker’s food pantry, stocked in a space equipped with a refrigerator funded by UPMC Pinnacle. While the Central Pennsylvania Food Bank delivers the pantry’s boxed and canned staples on Fridays, center personnel arrange for produce deliveries on Mondays, to assure freshness through the week.
UPMC Pinnacle nursing staff offers health screenings and chronic disease management to center members, while food bank personnel will supplement nutrition education already provided by Penn State, said Ford.
Ford hopes to see members “take a more focused approach to their diets, specifically the fruits and vegetables.” The center’s served lunch is separate from the food pantry, but, as Ford said, “I hear the complaints when we serve them lunch that doesn’t have a green vegetable.”
“Now we have the opportunity to acquire those, supplemental to our luncheon, but still just as important,” he said. “I hope they will take that to heart and use those wisely even when we cannot provide them here in the institutional meal.”
Poised for Growth
As the center positions itself as a community resource, Ford also hopes for a ripple effect beyond its walls.
Institutions have always struggled to keep food fresh, but, as the center takes on the challenge, “by virtue of us having this footprint in the community, we hope to make people in the surrounding community aware of the urgency of their health, their nutrition and the preparation and consumption of fruits and vegetables.”
Food insecurity, like other embedded health issues, affects all segments of the midstate’s unique mix of rural, urban, suburban and “quasi-urban” regions, said Nixon. The chronic disease program is a sort of pilot, with UPMC Pinnacle collecting and assessing baseline data and, in time, rolling findings into its ongoing community outreach. From there, it’s a matter of building trust between institutions and community residents.
“We know it takes three years to see a significant change,” Nixon said. “We’re talking about changing human behavior. Especially with the senior population, it’s changing the way you’ve eaten for the majority of your life. That’s a mountain to climb, but if you do it the right way and you’re culturally conscious of how to go about it, it’s a win-win, and you will see changes.”
Joint efforts between health care and food banks are sustainable and poised for growth because “this is a money-saver for chronic diseases,” Arthur said. Everyone should pay attention to their eating habits—“myself included,” he added—but the elderly are among the most vulnerable to the consequences.
“Those things don’t need to be solved with medications or more appointments and medical intervention,” Arthur said. “As a culture, we’ve known that for a long time, but in recent years, that preventative medicine has become a movement. We feel like we can be a valuable partner in that movement.”
