One hospital's prescription for fighting hunger

One way Providence Milwaukie (Ore.) Hospital tackles food insecurity and hunger in its community is by writing “prescriptions” for healthy meals and cooking classes.

The hospital last year opened a “community teaching kitchen” and “food pharmacy” on its campus to teach patients how to prepare recipes that are part of a healthy lifestyle. Participants in the classes are largely low-income patients and most suffer from one or more chronic illness, like diabetes, obesity or hypertension.

The hospital screens patients to determine if they are struggling with hunger. Doctors, like Jill Christensen, M.D., a family medicine specialist who helps oversee the program, have referred more than 500 families to the kitchen.

Doctors also write prescriptions for food to be redeemed at the hospital’s food pharmacy, where patients can go weekly to receive up to three days’ worth of produce, dry and frozen goods. Organizations like the Oregon Food Bank, Bob’s Red Mill Whole Grain Store and Pacific Foods contributed more than 17,000 pounds of food through September for the hospital’s food market.

A hospital-based market and kitchen helps eliminate the stigma often associated with people going to a neighborhood food pantry, Christensen says. “It feels like it is part of their health care,” she says. “The warm, welcoming atmosphere at the kitchen is a huge part of why people come back.”

In 2015, the hospital’s foundation raised more than $450,000 and renovated an old medical building into a 2,090 square foot group-sized kitchen with long counters and accessible by wheelchair.

During the course of six weekly two-hour classes, chefs, dieticians and volunteers work directly with patients – typically 12 to 13 patients per class – to practice every step of meal preparation. The kitchen currently runs three concurrent courses based on “Cooking Maters” curriculum developed by nonprofit anti-hunger organization Share Our Strength.

The teaching kitchen uses microwaves, toaster ovens and ranges similar to what might be in a patient’s home. Patients receive all the ingredients needed for that week’s recipe so they can recreate it at home.

The classes are designed to help patients cook healthy and tasty meals that cost $10 or less per family serving in less than 20 minutes. “They are taught to stretch $10 to make a healthy meal for their families,” Christensen says. “And they are sent home with a bag of groceries to make that same meal.” She adds “there is always at least one nutritional message that is part of the curriculum.”

Many of the patients referred to the kitchen and pharmacy because of food insecurity also are connected to a “navigator” from a community outreach organization. The navigator works with families to identify and find ways of overcoming barriers to getting enough nutritious food, and addresses other social or economic issues that affect patients’ health. 

“Food is such a basic need, and if people are struggling with getting enough to eat, then they are probably struggling with much more,” Christensen says. “We are looking to impact those social determinants of health to help people improve their quality of life and health.”

She says patients benefit more from the cooking class and personalized counseling than from general recommendations about making healthy lifestyle changes.

“I talk to my patients about good nutrition and health, but I see how much more they get from doing this class,” Christensen says. “It has been a life changer for many, and it gives me hope for the future of medicine.”