Introduction

Hippocrates wrote “Let food be thy medicine and medicine be thy food.” St. Christopher’s Foundation for Children (SCFC) has taken that mantra to heart with its FreshRX program. An outgrowth of the Foundation’s award-winning Farm to Families food program launched in June 2010, FreshRX empowers local physicians to use fresh food as a tool to combat the adverse effects of poor nutrition. FreshRX disrupts the traditional medical mindset by offering doctors the chance to hand out an entirely new type of prescription—one for apples, carrots, broccoli and a whole host of farm-fresh foods.

Launched in June 2010, St. Christopher’s Foundation for Children’s Farm to Families (F2F) initiative was originally established to address the issue of inadequate access to healthy food in North Philadelphia. The concept—a modified community supported agriculture (CSA) program relying on numerous community partnerships to offer boxes of farm-fresh, wholesome foods at wholesale pricing on a year-round basis—was born out of internal strategic planning along with community needs assessments demonstrating that North Philadelphia families had extremely limited or no access to fresh, healthy food. If fresh food was available, it was often cost-prohibitive, especially compared with the highly subsidized, processed alternatives.

FreshRX takes Farm to Families one step farther by recognizing and responding to the specific health and psychosocial impacts of both a poor diet and food insecurity, including increased illnesses and hospitalizations, poor attention and academic performance and, especially troubling, a significantly higher risk of depressive disorders and suicide attempts.¹

Background

St. Christopher’s Foundation for Children serves an eight-zip-code section of North Philadelphia². The community comprises more than 300,000 residents, over 67 percent of whom are minority.³ More than 46 percent are living on incomes of below $25,000 a year, and more than 30 percent of residents are children under 18.3 In addition, as many as 67 percent of children are overweight or obese depending on the specific zip code.⁴ Almost two-thirds of adults reported consuming less than the daily requirements of fruits and vegetables, while more than half reported eating fast food at least once a week.⁴

St. Christopher’s Foundation for Children launched its Farm to Families initiative in response to this high incidence of hunger and food inequities in North Philadelphia. The goals are to provide increased and improved options to healthy food so families can improve their health and well-being, to teach families about healthy eating through practical, engaging food education and to create policy changes at the city and state level to further increase access to healthy, nutritious foods.

Working with an extensive network of community partners with the SHARE Food Program as its hub, Farm to Families supplies North Philadelphia families with weekly boxes of produce at a cost of only $10 (medium box) or $15 (large box). Each box is filled with fresh fruits and vegetables, usually valued at double the purchase price. Additional a la carte items—including local eggs, meat, and seafood—are also offered at affordable prices. Cash, credit and SNAP benefits are all accepted for payment.

Strategic partnerships are the bedrock of the Farm to Families initiative. Over the lifetime of the program, more than 18 organizations⁵ have played a role in the development, implementation or evaluation of the program. These include community-based organizations, schools and universities, health institutions and evaluation and policy consultants. The Farm to Families initiative is a true multi-field collaborative, creating new partnerships and strengthening existing ones. SCFC is using the expertise and capacity of individuals and institutions to create a new model—one that not only goes far to help hundreds of North Philadelphia families eat healthier and live better, but also is replicable and scalable to meet the needs of other at-risk communities.

Since its inception, Farm to Families has directly touched the lives of more than 1,100 North Philadelphia families, helping them to access wholesome foods to improve their health and well-being. Setting its roots within community-based organizations has enabled Farm to Families to create a personal environment that goes beyond food access to actively support and encourage healthy behavior changes. Farm to Families itself has evolved substantially as understanding of the issues has deepened. For example, increased access to healthy foods only addresses tip-of-the-iceberg issues. Effective nutrition education and long-term behavior change are critical. As a result, Farm to Families has shifted its emphasis from strictly food access to a focus on improving health through nutrition.