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Getting health care right

Just What the Doctor Ordered: Healthy Food

For most of us, a trip to the grocery store to purchase fresh fruits, vegetables and other healthy foods is an everyday occurrence. But some people do not have access to life-sustaining food, because they can’t afford it, there are no healthy shopping options near their home, or other factors. This is often referred to as “food insecurity”.

According to Just Harvest, a nonprofit organization that addresses hunger in Allegheny County, where Highmark Health is headquartered, nearly 1 in 7 people face chronic hunger and food insecurity in our region. Chances are you may know someone in this category.

A lack of nutrition, especially in older adults, increases the risk for ongoing health problems. For example, without the proper nutrients, muscles start to deteriorate, there is an increased risk for infection, and it becomes more difficult for wounds to heal. Poor nutrition can also contribute to diabetes, high blood pressure, heart disease, obesity, and other conditions.

Support for Food Insecure Individuals

Annette Fetchko, Service Line Director — Center for Inclusion Health (see sidebar) at Allegheny Health Network (AHN), explains that she and her team noticed a gap in the medical care of patients with chronic conditions in Allegheny County, and it was related to food insecurity.

“Patients are able to obtain medications without a problem,” she says. “But some types of medications are required to be taken with food. We found a growing number of people who were not able to obtain necessary food to take the medications.”

When they discovered this discrepancy, they looked for ways to help individuals who do not have the ability to purchase healthy foods, or who do not live near stores that provide healthy foods. That led to creating the Healthy Food Center.

The first of its kind in western Pennsylvania, the Healthy Food Center was modeled after the ProMedica Food Clinic in Ohio. ProMedica, a nonprofit health care system, created the clinic to provide healthy food and education to food insecure individuals.

How the AHN Healthy Food Center Works

Primary care physicians at AHN screen patients by asking two questions related to food and whether or not they have enough for an entire month. When a physician determines that a patient meets the criteria, they can refer the person to the AHN Healthy Food Center.

Colleen Ereditario, manager of the Healthy Food Center and a registered dietitian

Colleen Ereditario, manager of the Healthy Food Center and a registered dietitian.

The center provides free fruits, vegetables, whole grains, and lean meats as well as foods with low sodium and sugar and low-fat dairy products. Everyone who visits the center is greeted by Colleen Ereditario, a registered dietitian and manager of the Healthy Food Center. She works one-on-one with each person to help them choose appropriate foods based on their medical needs.

Everyone leaves the center with enough free food for two to three days for all members of their household. They also receive information on healthy eating for the whole family, grocery shopping, cooking on a budget, preparing healthy recipes, and weight management.

Feedback from patients has been positive. “They are very thankful for the services,” Ereditario says, “and they are embracing the counseling and education provided.”

Patients can visit the center once every 30 days for six months. After six months, the physician may issue the patient a new referral to the center if needed.

AHN’s Center for Inclusion Health works with the Greater Pittsburgh Community Food Bank to purchase and stock food in the center. The Healthy Food Center also works with East End Cooperative Ministry (EECM) to connect people with additional resources, such as children and youth services, housing programs, and workforce development programs.

Ereditario is grateful for the opportunity to help the community become healthier. “Being a dietician at the Healthy Food Center and being able to provide patients and their family members with healthy, nutritious foods is very rewarding,” she says. “Being able to help them bridge the meal gap and also help them improve their health through nutrition is really great.”

Colleen Ereditario, manager of the Healthy Food Center and a registered dietitian, provides personal insights on how the program works

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Written question: How do patients get access to the Food Center?
Colleen Ereditario: Allegheny Health Network’s primary care physicians are asking two screening questions upon a patient’s visit. The screening questions are related to food insecurity and whether the patient runs out of food at the end of the month or not.

Written question: What’s a typical shopping experience?
Colleen Ereditario: Once they have a referral, they’ll come to the Health Food Center, which is a drop-in service. They’re able to get two to three days’ worth of food based on their household size. I will shop with them — kind of like a healthy grocery store — based on their medical needs, whether they have diabetes, cardiac disease, or high blood pressure. I’ll be able to pick out the appropriate foods for their needs. Patients are also offered nutritional resources, such as how to shop on a budget, how to cook healthy, and they’re also offered healthy recipes.

Written question: What kind of food is available?
Colleen Ereditario: We stock the Healthy Food Center with fresh fruits and vegetables, whole grains, lean meats and low-fat dairy products.

Written question: What does the Healthy Food Center mean to you?
Colleen Ereditario: Being a dietitian in the Healthy Food Center, and being able to provide patients and their family members with healthy, nutritious foods is very rewarding. Being able to help them bridge the meal gap and also help them improve their health through nutrition is really great.

The Healthy Food Center is located at 4921 Mend Way, near West Penn Hospital in Pittsburgh’s Bloomfield neighborhood.

Future Healthy Food Centers and Other Community Initiatives

Every time a patient visits the center, their weight is taken and registered. “This will allow us to eventually provide outcomes, such as a reduction in body mass index,” Fetchko explains, adding that research on other health outcomes of program participants will be ongoing.

Ereditario is working with providers to find the best model to improve access to healthy foods in other communities served by AHN. That includes plans to open more centers that will provide services and benefits similar to the one in Bloomfield. She points out that, “New food centers may look different from the current one, depending on the needs of the community, but the goal of providing access to healthy foods will remain the same.”

Close-up of a section of the protein shelves at the Healthy Food Center

Some of the healthy proteins offered at the Healthy Food Center.

The Healthy Food Center is just one of the programs that Fetchko has been involved with in her work with the AHN Center for Inclusion Health. Another is the Medical Respite Program, which helps people who are released from a hospital stay and are either homeless or are in an unstable home situation, but need follow-up medical care. The program has shelters in Bethlehem Haven and Wood Street Commons, both located in Pittsburgh, and aims to keep patients healthy and prevent readmission to hospitals. She is also involved with Positive Health Clinic, which provides primary and specialized HIV care, regardless of an individual’s medical insurance coverage or ability to pay. Located near Allegheny General Hospital on the Northside of Pittsburgh, the clinic is staffed with physicians, nurses, pharmacists, and a support team from the hospital. It has treated more than 900 patients and has extensive experience with all aspects of HIV management.

“I am grateful that Highmark Health can do something this big, and that leadership embraces what we feel is important in keeping the community healthy,” Fetchko says.

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Highmark Health and its subsidiaries and affiliates comprise a national blended health organization that employs more than 35,000 people and serves millions of Americans across the country.

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