Prescription Veggies?

It has long been known that poorer families are less likely to eat a variety of fruits and vegetables, and more likely to eat processed, calorie-dense foods. But how to reverse this trend has long been a matter of debate. One approach has been around for years, but has only recently garnered media attention: issuing vouchers, or coupons, for low-income families to use at farmers’ markets.

As reported in a recent New York Times article[1], Massachusetts — which was the first state to have such a program, in the 1980’s; since then 35 others have followed suit — has partnered with a nonprofit group called Wholesome Wave to provide funding for the latest version of the program. In this pilot project, three health centers located in low-income areas are giving coupons in the amount of $1 per household member per day to participants, eventually encompassing 50 families of four. The program aims to provide participants directly with an extra serving of fruits and vegetables each day, hoping that in the process they will develop healthier habits that lead to further behavioral changes. The health centers will assess weight loss and other potential health benefits in participating children; if the program is thus deemed successful, it may be expanded to other clinics and neighborhoods.


But programs such as this face a number of potential drawbacks. One is that many farmers’ markets are seasonal, closing for the winter. It is not known whether participants will be able to maintain lifestyle changes when they must purchase fruits and vegetables on their own from supermarkets. Another unknown question is whether simply adding fruits and vegetables to their diet will encourage poor people to reduce their intake of high-calorie processed foods, or whether this is the best way to change dietary habits.

Other programs aimed at encouraging fruit and vegetable consumption in low-income neighborhoods have not been met with success. In 2007, Mayor Michael Bloomberg of New York City announced a plan[2] to increase available licenses for fresh fruit and vegetable carts in low-income areas, known as the “Green Carts” program. Earlier this year, the New York Daily News reported[3] that only 326 of 1,000 potential new licenses have been granted due to a lack of demand. This is even with the help of a private foundation that has spent $1.5 million on helping potential vendors buy carts and find suitable locations to operate. The trend may be changing however, as the city received 826 cart applications ahead of a deadline this spring. A notable difference between the New York City program and the Massachusetts one, of course, is that in Massachusetts consumers are given direct aid to buy fruits and vegetables; in New York they must spend their own money.

What do you think — does it make sense to spend some public money directed toward health clinics on fruit and vegetable “prescriptions,” in the hope that this will save money in the health-care system overall? Would such programs be worth it even if they did not save money? If they led to only modest health improvements? Should vouchers cover all fresh fruits and vegetables, rather than just local farmers’ markets? Should the federal government subsidize fruit and vegetable growers to reduce the overall cost of produce? Should it stop subsidizing wheat, soy, and corn farmers, which some people blame for the availability of cheap junk food? Leave a comment below!

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