A new $6.6 million grant from the National Institutes of Health (NIH) to the Friedman School of Nutrition Science and Policy at Tufts University, in collaboration with the Reuben V. Anderson Institute for Social Justice at Tougaloo College, Delta Health Center, and the Center for Science in the Public Interest (CSPI), will fund the collaborative development of community-based programs to increase local production and consumption of fruits and vegetables in the Mississippi Delta.
If successful, it is believed the effort will simultaneously lower risk factors that result in the region having some of the highest rates of obesity and diabetes in the U.S.—and ultimately save billions in healthcare costs.
Although the Mississippi Delta has some of the U.S.’s most fertile soil and is deeply rooted in cultural values, generations of communities in Mississippi have experienced health inequities intertwined with discrimination, poverty, and racial exclusion. Over 77 percent of Mississippi counties meet the U.S. Department of Agriculture’s definition of food deserts.
The project focuses on three counties—Bolivar, Washington, and Sunflower—where over 65 percent of the 100,000 residents identify as Black or African American and about 30 percent live at or below the poverty level. More than 50 percent of women and 40 percent of men living in these counties have obesity, and the rate of diabetes is almost double the national average.
To develop the program, the team from the four institutions—as well as Tufts University School of Medicine and Tufts Medical Center—will engage a variety of local stakeholders, including growers, health and agriculture educators, food retailers and community-based organizations.
“We are excited to work with our collaborators in the Delta to build on efforts already underway to increase access to locally grown fresh food and create economic opportunities for local farmers,” said Christina Economos, dean ad interim of the Friedman School, the New Balance Chair in Childhood Nutrition, professor of nutrition, and co-principal investigator on the grant. “Together, we will be expanding on decades of impactful community-engagement studies at Tufts addressing health disparities across the U.S.”
The study is an outgrowth of the Food is Medicine (FIM) movement, which recognizes the link between nutrition and chronic diseases. FIM programs include such things as health clinic mobile food markets, patient prescriptions to obtain and eat healthier food, and produce delivery mechanisms that make healthier foods like fruits and vegetables easier to access for those in food deserts.
Until now, no rigorous, randomized control trials have evaluated the impact of these programs in lowering disease risk among low-income and underrepresented communities with persistent challenges accessing food, Economos said.
A group 150 individuals will be enrolled to use the intervention over a 12-month period. They and a control group of 150 individuals who do not have access to the intervention will have assessments of their body mass index (an indicator of obesity), hemoglobin A1c (a measure of diabetes risk and control), dietary intake, and other measures taken at regular intervals.
“This program could literally go from seed to D.C.,” said Julian D. Miller, director of Tougaloo College’s Reuben V. Anderson Institute for Social Justice, the Pre-Law Program and assistant professor of political science. Miller is an attorney and co-principal investigator for the study.
“We are excited to have the resources to work together with people in the community to develop a novel intervention that bolsters the local food economy and delivers food as medicine,” said Robin Boyles, chief program planning and development officer from Delta Health Center. “We look forward to then learning whether the program can actually reduce health disparities by improving participants’ body mass index and hemoglobin A1c.”
“This is a major effort to both build local food economies and integrate nutrition into the healthcare system and federal social safety net programs such as SNAP (formerly called food stamps) and Medicare/Medicaid,” said Miller. “We hope to identify effective, scalable ways to use food to ease disparities, lower rates of diseases such as diabetes and heart disease and save billions of dollars annually in healthcare costs.”
Tufts University’s involvement in the Mississippi Delta region dates back to the mid-1960s, when the late Dr. H. Jack Geiger, a physician, human rights activist, and professor emeritus at the School of Medicine, teamed up with Tufts to create the country’s first community health centers. They began with one in Mississippi (Delta Health Center in Mound Bayou) and one in Boston’s Columbia Point housing project. Senator Edward Kennedy visited the Boston location and was so impressed by the progress that he lobbied for funding to start a national network of health centers, which was granted soon after. Now, the baton has been passed to this collaborative research team, which is proud to carry on the work.
“This study can fill critical knowledge gaps necessary to advocate for improved nutrition through SNAP, Medicare, and Medicaid,” said Sara John, senior policy scientist at CSPI. “CSPI is excited to work with Tufts University, Tougaloo College, and the broader Mississippi Delta community through our partners at Delta Health Center to continue to enact and expand evidence-based, community-centered policies to improve healthy food access.”
“This project embodies many of the strategic research priorities—and the core values—of Tufts University,” said Bernard Arulanandam, vice provost for research at Tufts. “The interdisciplinary nature of the work, which weaves together knowledge from experts in public health, nutrition, and social justice, will benefit the communities involved for years to come. But more importantly, it will involve them in the project, incorporating their thoughts and experiences and demonstrating the value of researchers listening carefully to the very people they hope to help.”
This work is supported by the National Institutes of Health’s National Institute on Minority Health and Health Disparities, grant number R01MD018208.