Plants Over Pills In Fight Against Chronic Illness

“Growing our own” may not be a new concept, but it’s growing in popularity as more people look to plant-based solutions for ills that continue to plague the Black community at disproportionate rates.

The “food as medicine” movement has picked up steam, with “food pharmacies” bringing farmers market-style events to underserved communities across the country and health care providers handing out “prescriptions” for produce rather than pills.

In 2023, the U.S. government promised to provide $52 million in grants to improve dietary health and access to fresh fruits and vegetables for vulnerable families through its national Gus Schumacher Nutrition Incentive Program (GusNIP).

According to the U.S. Government Accountability Office, diet-related chronic health conditions – including cardiovascular disease, some cancers, type-2 diabetes, and obesity – account for half of the country’s annual deaths and more than half of the $383.6 billion in government health care spending.

Bay Area Assemblymember Mia Bonta recently introduced Assembly Bill 1975, which aims to improve health outcomes and reduce health care spending by transitioning medically supportive food and nutrition interventions to permanent benefits under Medi-Cal. If passed, this legislation would make California the first state to provide these services as covered benefits.

Medically supportive food and medically tailored meals are among “optional services” available to California residents on Medi-Cal. The California Advancing and Innovating Medi-Cal program describes medically supportive foods as nutrient-rich whole foods used as a medical treatment to address specific health conditions.

A medically supportive meal program was started in 2018 to specifically address people living with congestive heart failure and was later expanded to include those with other chronic conditions. Evaluation of the program found a reduction in emergency room visits and hospital stays, which in turn meant a decrease in hospital costs for individuals. Interventions include the delivery of food after a hospital stay, assistance from registered dieticians, access to food pharmacies, and cooking and nutrition classes.

“Adequate food and nutrition are fundamental in preventing and treating chronic conditions, particularly among Californians of color who are disproportionately affected,” Bonta said in a statement. “Making these interventions permanent would advance health equity by providing services to those impacted by diet-sensitive chronic conditions.”

According to the lawmaker, more than 26,000 Californians accessed medically supportive food and nutrition services as of July 2023. Access to healthy foods is also a priority in the California Legislative Black Caucus’ landmark reparations bill package.

You Are What You Eat

The issue gained state and national attention thanks largely to grassroots-level work. Advocates say the historic lack of programs and services and support shows that communities of color can’t wait for or rely on government entities to always act in Black folks’ best interest.

“We’ve got to start growing our own food and stop selling the land that we do own,” says Dr. Umar Johnson, a nationally recognized activist and school psychologist.

Dr. Johnson is looking for land in Delaware to build a school that will teach children, and their families, how to eat healthy from the root to the plate.

“We can improve the quality of the food we eat by educating our parents on how to prepare it for themselves,” he said in an online discussion about diet, education and economics in the Black community.

“It’s going to be difficult to make any lasting change to any people or any community if that change is not normalized into the culture,” Johnson adds. “Right now, eating healthy is still a marginalized area of activity for Black people; eating healthy is a specialty activity amongst Black people. That’s a problem because if it’s a specialty, that means that most people do not do it.”

In a March session hosted by the local group African Americans for Balanced Health, Dr. Johnson mentioned how poverty and other factors can lead to unhealthy eating habits.

“Poverty dictates a certain type of diet,” he said, pointing to historic economic disparities, mass incarceration and the proliferation of fast food restaurants in low-income neighborhoods as contributors to poor health outcomes.

“I don’t think Black people, African people, understand the extent to which a lot of the diseases that we’re catching are related to the impoverished diet,” he said. “We’re often eating alone and on the go.” For many Black youth, “the fact that my Black parents have to work three jobs to pay the bills, dictates that I get my breakfast on the move, my lunch on the move, and my dinner on the move.”

AABH co-founder Bobbyie Waters started eating – and thinking – differently in her 30s, when she found a lump in her breast. Waters healed with the help of a naturopathic doctor she met at a Black bookstore who taught her about the power of whole foods and herbs.

“I told myself I would never be sick like that again,” she says.

Waters maintained a vegetarian lifestyle for eight years. Today, while she occasionally eats fish, her habits lean more toward juicing and a raw diet.

“If you eat 80% raw and 20% cooked, you’re doing good,” she said. 

Lots of stores boast their food products as being “natural” or “organic,” but they really aren’t, she says.

“I tell people, if you can’t read it, don’t eat it,” Waters said of many of the preservatives in today’s foods. “Nothing tastes better than good health.”

Christen Brown would agree. Brown adopted a natural diet when his son, El Iyah Amen, was diagnosed with sickle cell disease as a toddler. Today, the Browns don’t consume meat or dairy and their three children have never eaten fast food. El Iyah, now 11, no longer has the painful episodes, or crises, associated with sickle cell disease.

“We don’t eat things that have soy in it, which is pretty much 90% to 95%, maybe even more than 95%, of packaged and processed foods because soy prevents iron absorption from happening inside the body. So we move forward with it by just understanding the nutritional sciences. What foods actually clean and can support blood development?” Brown lists “the spirulinas, the chlorellas, the moringas, the African yams, the cassava, and the chlorophylls. We’re heavy on smoothies with raw fruits and things like that.”

While many children complain about eating fruits and vegetables, Brown’s children love them. Exposure matters, he says.

“We had a garden in our backyard. And when our son was younger, he used to go out and pick a watermelon, an eggplant or some squash and bring it in the house. That was like a magical moment for him.”

Many African American staple foods lack anti-sickling nutrients, Brown says. Growing your own isn’t a trend, but a necessity.

“We understand chronic disease in this country, and then we attribute it to access to land, Black farmers and our ability to do for ourselves,” he adds. “If we look at the last 100 years, Black farmers in this country have lost nearly 95% of their land, which means that the culturally specific foods that we would be growing to be able to address our health needs are no longer available. We’re eating at a European standard, which is not good for us. A lot of the chronic diseases that are manifesting now are in direct relation to the nutrient deficiencies that are a response of a colonized people.”

Brown works with Black farmers to create moringa supplements for people with sickle cell throughout the country through his website, creationofsociety.com. His products are sold locally at the Nubian Beauty Supply Store inside the African Market Place.

‘Root’ Work

The concept of food as medicine traces back to Africa. Herbs were cultivated to remedy countless ailments, from migraines and muscle strains to inflammation and infertility. Individuals who possessed such knowledge were revered as healers. In America, their knowledge was shunned and often labeled as sorcery or “dark magic.” Similarly Indigenous people looked to the land, not only to nourish their bodies but to heal them. Today, like African descendants, they too struggle with preserving “the old ways” that benefited and strengthened their communities.

With the help of a grant from the Centers for Disease Control and Prevention, the Sacramento Native American Health Center launched its Healing Ways services in 2018 to, in part, help connect the community to healthy traditional food that can reduce risk factors for chronic disease. The local nonprofit Alchemist also partnered with SNAHC to run its Fruit and Vegetable Prescription Program, which promotes fruit and vegetable consumption by giving patients farmers market vouchers.

Food as medicine proponents and medical practitioners haven’t always seen eye to eye, but sometimes their worlds collide. To be eligible for the USDA’s GusNIP grant, participants must be a health care provider or partner with one. The American Heart Association has identified diet as one of the top modifiable risk factors for heart disease and the disproportionate effects of racial, economic and social disparities on diet quality.

“These issues need to be addressed with policy and public health measures that ensure greater access to fruits, vegetables, grains, and beans, which have been shown to help prevent and reverse heart disease, as well as diabetes, high blood pressure, stroke, and cancer,” reads the organization’s website.

Medical professionals also are speaking up about how adopting plant-based diets can help reduce inequitable outcomes. While promoting Minority Health Month in April, Dr. Columbus Batiste, a leading cardiologist for Kaiser Permanente in Southern California, highlighted growing research suggesting that adopting a plant-based diet could greatly improve health outcomes for Black Americans.

“Individuals who closely adhere to the diet demonstrate a 16% lower risk of death, as well as a reduced susceptibility to heart attacks and strokes compared to those who don’t stick to the diet as closely,” Dr. Batiste said in a statement.

He has seen change firsthand.

“For many of my patients, it has been a lifesaver,” he says.

Dollars And Common Sense

In America, where Blacks toiled for generations on plantations and farms for other people’s benefit, many have tried to distance themselves from their agricultural pasts. Blacks have done so to their detriment, says cultural historian Michael Harris.

As chair of the California Black Agriculture Working Group, Harris supports Black food producers and initiatives in the 2024 Farm Bill that include recommendations for increasing funding for produce RX programs and financial allocation for sustainable farm-to-institution programs.

The Congressional Budget Office’s February 2024 baseline for USDA Mandatory Farm Programs and the Supplemental Nutrition Assistance Program places projected outlays in the farm bill at nearly $1.5 trillion between the fiscal years 2025 and 2034. That amount is down 3.5% from the previous 10-year period.

Collaboration between public and private stakeholders is critically important, Harris says.

“That’s the only way we’re going to change diet-related health outcomes,” he says. “We want to work with the pharmaceutical companies to incentivize the consumption of fresh fruits and vegetables. You have to incentivize the people who are making money by getting sick people well. And if you incentivize other people – farmers, the grocery stores, the distributors – then things change.”

In February, Harris connected with Rep. Barbara Lee, who serves on the House Appropriations Subcommittee for Agriculture, as she addressed visitors at the annual Capital City Black Expo. The lawmaker’s long history with food security at the public policy level dates to her appointment as a legislator to California’s agriculture committee by then-Assembly Speaker Willie Brown. She also has been vocal about her own past reliance on food stamps to help feed her family.

“So much of my work has been around food security, making sure the SNAP benefits are not tied to work requirements, making sure that our Black farmers receive the justice that they’re due, and also leading the charge on food as medicine,” Lee says.

In February 2023, Congressmember Lee and Secretary of Health and Human Services Xavier Becerra secured $2 million in federal funding to begin a national food-as-medicine program, which aims to integrate food and nutrition programs into health care to improve health and lower health care costs by combating chronic disease.

“It’s extremely important that you go to your Congress members to try to get some of this money for your communities here in Sacramento,” she told the Black Expo audience. “It’s only $2 million, but there are other accounts within the federal government that have money that can be used for programs to begin to help people instead of being dependent on medicines – through your physicians, of course – but to use food as medicine. It will save lives.”

Harris agrees that such programs can be game-changers. “You’re going to get a box of organic produce, farm fresh to you, coming to your house, that’s scanned with your EBT card,” he says. “If you have $2,500 a month for insulin, you can spend $400-$500 for [medically supportive] food. Everybody’s not getting off of insulin completely, but you’ll need less dosage and will have lessened side effects.”

Planting the seeds for healthier outcomes hasn’t always been popular, but advocates say they’ll continue to do it as lives depend on it.

“I’ve been preaching this stuff forever,” Harris says. “Now we’ve got the data and we have more people looking at it and talking about it.”

Image

EDITOR’s NOTE: This article is part of OBSERVER Senior Staff Writer Genoa Barrow’s four-part series, “Hunger Pains,” focusing on food insecurity in the Black community. The series is being supported by the USC Annenberg Center for Health Journalism and is part of “Healing California,” a yearlong reporting Ethnic Media Collaborative venture with print, online and broadcast outlets across California. The OBSERVER is among the collaborative’s inaugural participants.