Food for thought: A vision for generative ‘Food is Medicine’

In this article, we review the history of the Food Is Medicine movement, discuss the extractive nature of many Food Is Medicine models in the US, and present our vision for a generative model of Food Is Medicine centered on community-based organizations (CBOs) and local food systems. Many Food Is Medicine initiatives are driven by CBOs, but too often the CBOs participating in these programs are undervalued. The combination of inadequate payment rates, capacity needs, and complex administrative requirements prevents CBOs from realizing their full potential and threatens their sustainability. In a generative model, Food Is Medicine programs operate through mutually supportive partnerships among payers, health systems, and vendors; CBOs have the resources, capacity, and infrastructure needed to source food from small- and medium-size local farms, hire and retain staff with appropriate expertise, and distribute culturally relevant foods tailored to community preferences. Regional systems to manage administration and contracting for Food Is Medicine programs could reduce the burden on CBOs. Philanthropic organizations and health care partners should expand efforts to advance a generative approach to Food Is Medicine.