Cultural and place-based wisdom for implementing 'food is medicine' programs in North Carolina

The Food Is Medicine movement integrates food-based interventions into health care to address diet-related health conditions and food insecurity. Both the food and health systems that are a part of Food Is Medicine, however, have a history of contributing to health inequities through discriminatory policies and practices. Community-based organizations (CBOs) play a vital role in bridging these systems with their communities by centering their cultures, histories, and relationships in their Food Is Medicine programs. This Commentary highlights the work of six North Carolina CBOs that emphasize cultural safety and authentic relationships. By integrating local traditions, such as Black cultural heritage and Southern Appalachian farming, these organizations foster belonging and trust while addressing systemic inequities. As Food Is Medicine expands, larger businesses and institutions are delivering services that often prioritize efficiency and standardization over cultural and care-centered approaches, threatening to sideline the essential contributions of CBOs. Policy makers and health systems must ensure that CBOs remain central to the movement, preserving their role in delivering holistic Food Is Medicine solutions that honor local histories and truly serve the unique needs of their communities.