A new $6.6 million grant from the National Institutes of Health (NIH) to Friedman School Nutrition Science and Policy at Tufts UniversityIn collaboration with the Reuben V. Anderson Institute for Social Justice in Tougaloo College, Delta Health Center, and the Center for Science in the Public Interest (CSPI), it will fund the collaborative development of community programs to increase local production and consumption of fruits and vegetables in the Mississippi Delta.
If successful, it is believed that this effort will simultaneously reduce the risk factors that lead to some of the highest rates of obesity and diabetes in the region – and ultimately save billions in healthcare costs.
Although the Mississippi Delta has some of the most fertile soil in the United States and is deeply rooted in cultural values, generations of communities in Mississippi have suffered from health inequality intertwined with discrimination, poverty, and racial exclusion. More than 77 percent of Mississippi counties meet the USDA definition of food deserts.
The project focuses on three counties — Bolivar, Washington and Sunflower — where more than 65 percent of the population of 100,000 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 are obese, and the incidence of diabetes is nearly double the national average.
To develop the program, a team of the four institutions – as well Tufts University School of Medicine Tufts Medical Center – will engage a variety of local stakeholders, including farmers, health and agricultural educators, food retailers and community organizations.
“We are excited to work with our collaborators in the delta to build on efforts already underway to increase access to fresh, locally grown food and create economic opportunities for local farmers,” Christina Economosdean Temporarily of the Friedman School, New Balance Chair in Childhood Nutrition, Professor of Nutrition, and Grant Co-Principal Investigator. “Together, we will expand upon decades of influential community engagement studies at Tufts University to address health disparities across the United States.”
The study is an outgrowth of the Food Is Medicine (FIM) movement, which recognizes the link between nutrition and chronic disease. FIM programs include things like mobile food markets for health clinics, patient prescriptions for healthy food and eating, and the production of delivery mechanisms that make healthy foods like fruits and vegetables easier to reach for those who live in food deserts.
To date, Economus said, no rigorous randomized control trials have evaluated the impact of these programs in reducing disease risk among low-income and under-represented communities facing persistent food access challenges.
A group of 150 individuals will be enrolled to use the intervention over a 12-month period. They and a control group of 150 individuals who did not have access to the intervention would receive assessments of 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 can literally go from home to the capital,” said Julian de Miller, director of the Rubin Anderson Institute for Social Justice at Togalo College, a pre-law program and associate professor of political science. Miller is an attorney and co-principal investigator for the study.
“We are excited to have the resources to work alongside people in the community to develop a new intervention that supports the local food economy and provides food as medicine,” said Robin Boyles, chief program planning and development officer at Delta Health Center. “We look forward to seeing if the program can actually reduce health disparities by improving participants’ BMI and hemoglobin A1c.”
“This is a major effort to build local food economies and integrate nutrition into the health care system and federal social safety net programs like SNAP (previously called food stamps) and Medicare/Medicaid,” Miller said. “We hope to identify effective and scalable ways to use food to reduce disparities, lower rates of diseases such as diabetes and heart disease and save billions of dollars annually in healthcare costs.”
Tufts University Involvement in the Mississippi Delta dates back to the mid-1960sWhen the late Dr. H. Jack Jaeger, a physician, human rights activist, and professor emeritus at the College of Medicine, with Tufts to establish the nation’s first community health centers. They started with one in Mississippi (Delta Health Center on Mound Bayou) and one at Columbia Point housing project in Boston. Senator Edward Kennedy visited the Boston site and was so impressed with the progress that he lobbied for funding to start a national network of health centers, which was granted soon after. Now, the wand has been handed over to this collaborative research team, which is proud to continue the work.
“This study could fill critical knowledge gaps needed to advocate for improved nutrition through SNAP, Medicare, and Medicaid,” said Sarah John, CSPI’s chief policy scientist. “CSPI is excited to work with Tufts University, Tugalo College, and the broader Delta Mississippi community through our partners at Delta Health Center to continue enacting and expanding evidence-based, community-focused policies to improve access to healthy food.”
“This project embodies many of the strategic research priorities – and core values - of Tufts University,” he said. Bernard ArolanandamVice Dean of Research at Tufts University. “The multidisciplinary nature of the work, which weaves knowledge from experts in public health, nutrition and social justice, will benefit the communities involved for years to come. But most importantly, it will engage them in the project, incorporating their ideas and experiences and demonstrating the value of listening carefully to the people they hope to help.”
This work is supported by National Institutes of Health National Institute on Minority Health and Health Disparities, grant number R01MD018208.
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