Health educators and medical sector leaders gathered in Fayetteville on Thursday (April 2) at the Northwest Arkansas Health Summit to discuss the challenges of healthcare access in rural Arkansas and the benefits of programs focusing on “Food as Medicine” strategies.
Arkansas ranks last in the nation for food insecurity, with 28.8% of adults lacking access to nutritious food. The national average is 13.7%. Arkansas also sees high rates of diabetes and other chronic diseases that can drive up healthcare costs while also reducing mortality rates.
Dr. Eliza Short, a research scientist at the Omaha, Neb.-based Center for Nutrition and Health Impact and a dietician, works with families to improve nutrition behaviors. Short said food insecurity has been linked to increased risk of chronic health diseases and also more make managing those conditions more challenging.
Her recent work included a local study that was a medically tailored grocery intervention, and was developed for individuals in Northwest Arkansas who were experiencing food insecurity in the context of managing type 2 diabetes. The pilot test lasted for 12 weeks and included an educational curriculum in addition to medically tailored food boxes.
Study participants include white, Marshallese and Hispanic people, and their food boxes were tailored to suit their cultural preferences. Households were given recipes to try and videos to watch and share regarding preparation techniques. The study was food-focused to measure how changes in diet could impact blood sugar levels, A1C, and hemoglobin measures in blood samples.
The tailored food boxes included lean protein, fresh fruits and vegetables, and whole grains, avoiding highly processed foods. Short said it took time to get the participants active in the community-sharing phase, but once they did, the activity and adoption of healthy food consumption increased.
The study reported that participants who started the study with an A1C reading of 9.9 ended the experiment with a 9.1 reading. She said the drop was statistically meaningful as a measure of managing diabetes. She also noted it was just 12 weeks, but the learning and satisfaction rates were high among the participants.
Lisa Stafford, senior vice president of research and outreach at Community Clinic, also spoke about the clinic’s focus on food as a medical intervention since 2021. The Northwest Arkansas primary care health provider works with food banks and local agriculture partners to provide fresh food bags to patients identified as food insecure, those trying to manage chronic diseases and expectant mothers at risk for gestational diabetes.
Since 2021, Community Clinic has distributed more than 6,000 bags of community-supported agriculture fresh produce bags in partnerships with local growers and food hubs. Stafford said the medical care organization has served more than 1,600 patients through its food programs.
“As we started hearing from our patients and understanding some of their needs, we began to integrate food into our work,” Stafford said. “Food became more than an intervention in a program. It became a clinical strategy for the Community Clinic, and there are a few things that we really anchored on. We always want to center around our patients and their realities. Three things that bubble to the top are chronic disease, last-mile barriers and culturally specific access.”
She said chronic conditions need healthy food support in addition to health education. The other is lifestyle barriers, things like transportation, work schedules, and how to have storage for fresh produce.
“These are all realities that our patients have to overcome, to incorporate food into their everyday life, to support their health and well being and their health and well being,” she said. “And then the third thing is culturally specific access. We live in a region with such vibrant and diverse populations, and that’s where we bring in our community members to help advise us to understand what those things are that meet their dietary needs and food profile preferences.”
Challenges with the healthy food bag program have included transportation to the clinic each week to pick up the bag. Larger bags are now handed out biweekly. She said while some recipients loved the colorful produce, they had no idea how to prepare it. That’s where coaching and education come in. She said the education component is crucial for behavior changes that can lead to healthier lifestyles.
The work has resulted in sustained engagement, significant weight loss and reductions in A1C numbers among diabetics. Stafford said Community Clinic and its partners continue to look for ways to make this program sustainable while also expandable.
Also discussed was the $290 million in federal funding recently received by the State of Arkansas from the Trump Administration’s Big Beautiful Bill. Arkansas Department of Finance and Administration Secretary Jim Hudson said during a panel discussion on rural health that, unlike other federally funded programs, there is enough money coming over the next five years to move the needle in a positive direction.
Some patient and rural hospital advocates say the federal funding for rural care will not come close to making up for deep – almost $1 trillion over 10 years – Medicaid and other federal healthcare spending cuts in the broader federal bill.
Hudson said all the money will be awarded, and programs and agencies that get funding will need to show how the intervention is sustainable, expandable and addresses needs across improved outcomes, access to preventive care by a community-driven approach to nutrition, physical activity and chronic disease management. He said the funds will not go to failing rural hospitals as capital infusions. The funds can go to expand capacity and access in those facilities that have a viable future.
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