Audio file
THIT406 End Child Hunger Final.mp3
#46 � Healthy Living Starts at the Table
Trina Filan
Thank you for joining us for this episode of talking health in the 406 where we're one community under the Big Sky I'm Trina Filan a public health evaluator.
Margaret Mullins
And I'm Margaret Mullins the social determinants of health program manager.
Trina Filan
Today we're talking with representatives of 2 Montana nutrition and food security organizations farm connect Montana and the Montana partnership to end childhood hunger also known as mount Peck we may be referring to this organization as Mont Peck throughout. The discussion our guest today will be talking about how good nutrition and systems change work to improve access to fresh local and healthy food is important to montanans health and well-being Lisa Lee and Ken Miller are Co directors of month Peck and. Food systems change advocators and Ian Finch is food access program director at armor connect Montana. Welcome to everyone.
Margaret Mullins
So we know you all because we've worked together in the past on supporting projects that involve healthcare systems prescribing healthy food to patients with chronic diseases and measured food insecurity our paths. Intersect often on topics related to nutrition food prescriptions in public health for instance we've talked about household food vulnerability the lack of consistent access to adequate and nutritious food. Food production and nutrition access in Montana and connection to public health and chronic disease prevention and management. So let's just start with you each talking a little bit about your organizations and roles what are the goals of your organizations and what kinds of projects are you currently focusing on why don't we start with you Kay Ann and Lee. Sir.
Lisa Lee
The Montana partnership to end childhood hunger is going into our 3rd year as a nonprofit and had been a statewide coalition before this since 2011 we've always been focused on food systems changed and childhood hunger for good and this just means that we are trying to make the system work so that all kids can consistently. Eat French quality food every day even in the most eastern corners of our state and to us yes fresh quality food includes locally sourced. How we do our work is more about communities taking the lead and our role it has been to provide support to help make it happen and our mission really with mount Peck is to fund engage in and drive sustainable solutions to food systems challenges with the goal of creating strong healthy? Montana communities where children and their families can eat fresh quality food every day.
KayAnn Miller
To expand on what Lisa just said there we have some really cool programs that we are working on we have what we call rule school networks across the state these are groups of schools that are near each other. Geographically so there's an eastern Montana group there's a group around the chouteau area for example and we have some other groups as well the thing that's really cool is that we are able to work with these groups to address. Systems challenges that are making it hard for them to serve fresh quality food to kids in their school meal programs for example one of the things that's really hard is for school foodservice directors to connect up with local producers. And get the food into their school and then budget accordingly for it so we provide technical assistance around those 2 issues as examples we've got a really large project. Running sort of if you looked at the map of Montana and cut it in 3 equal slices this project is running in that middle slice and it is all about building a an economically viable sustainable food supply chain. In that area of the state where once you get off the the Interstate delivery and distribution is very difficult for schools they're being dropped from their supply road. Schools are driving 45 miles one way to pick up their own ingredients for lunch as opposed to being able to get ingredients delivered and so those are the kinds of issues that we work on every day and the reason why we work on those partially is health related because we want school. It's uh. To be able to eat really healthy quality food as opposed to more highly processed and older processed foods that that come out of a a box and are are heat and meat.
Margaret Mullings
Thanks KayAnn that's really good information Ian.
Trina Filan
How about you?
Ian Finch
Hi everyone thank you so much Margaret and Trina and great to hear from Lisa and Kan on the important work of mount Peck again I'm the food access program director at farm connect Montana and our organization 's mission is to grow a healthy local food community by conserving farmland supporting beginning farmers and ranchers and making local food accessible for all. And we work on that systems change as well and kind of thinking of it as from soil to fork and we really. You you know understand that the food and nutrition access questions we have and outcomes we want to see at the end of that food chain really rely on the food supply itself just like can was saying in the schools you know we're looking to really help produce healthy. Nutritious local foods that both support the resilience and health of the soil the economy and those consumers at the end of. The chain and really the mission of our organization tailors into 3 different program areas that we work on as well and I'll be mostly talking about our food access program today but we do just to mention briefly for that system 's work we are working with Missoula County and farmers in western Montana with the Montana Land Trust to actually conserve. Farmlands so that Montana. And especially western Montana where we have a lot of production capacity can continue to produce those healthy local foods with those beginning farmers and ranchers that we work with well into the future and actually in the last 3 years are beginning farmer and rancher team has helped launch 47 new farms in western Montana which is really awesome those new farmers. Are then connected to farmers markets and other food access programs through our food access program and the current iteration of that the way we work on food and nutrition access is by specializing in what are called nutrition incentive program? Arms and we kind of leverage and work off of other public assistance programs like snap to basically drive that spending of those benefits to local food producers through farmers markets farm stands CSA programs which are food box programs that people subscribe to and get a box 12 week. Once a month. And then we match that spending through the nutrition incentive basically encouraging people to you know go out and find those healthier local fruits and vegetables to engage with the food system and you know there are some kind of sub goals there for food and nutrition access where we really want to see people increasing their consumption of those local fruits and vegetables. But that means also supporting community connection so. You know getting people out to actually build relationships with farmers and ranchers to understand what Montana seasonality looks like and what we're finding is that that translates into people advocating more for their own food and ways they get their food and what that food looks like and so we really work to understand what participants. Want we work through coalitions and to really listen for what models and communities in Montana are looking for on how to get food from field to plate and then we lean into those models. And and so right now we have Montana 's double snap dollars program where we match snap spending at those kind of redemption locations I was talking. About dollar for dollar. We have the senior farmers market nutrition program which looks to support the aging population in both you know increasing access to those fruits and vegetables but also increasing their connection to their. Community. And then most recently which is the topic of this conversation today is our produce prescription program where we've really found meaningful partnerships with folks like mount Peck with the healthcare industry hospitals across the state to be a little bit more intentional about the way we're prescribing fruits and vegetables for people who have you know might be at risk of certain. Food related diseases or other ways to really start treating and thinking about prevention of those health outcomes in addition.
Trina Filan
To the local food work we do thank you. So. We know from our work with you all that what you do is multifaceted it's complex as we will talk about a little bit later working on a system has to happen from many angles right to change it to have an impact on peoples. Understanding of it and their interaction with new ways of engaging with food and health but before we get into all of that good stuff. You all are very passionate about what you do and we were wondering if you could talk a little bit about how you came to this work and why you are so passionate about it and anybody can start but we'd like to hear from you all.
Lisa Lee
Green street no for your question yeah hi this is Lisa I feel like. Like uh for me I started as a registered dietician and I started working in the clinical setting and and found myself quite frequently at a patients bedside after having heart surgery for example or chronic diabetics where I'm trying to provide. Nutrition counseling to them and to hope to hopefully help manage their situation and I found it. Quickly became frustrating where there was just less emphasis on prevention and more and more folks were just ending up in these situations and the last person you want to talk to is a dietician after seeing 5 or 6 other health professionals and then I show up and start talking about yeah let's try to make very significant nutrition. And food changes right in in your everyday life that's a hard thing to have a conversation about and just see someone make extreme changes. And to me that just lit the fire to move more into the work around prevention and focus more on nutrition and and food in general just to get better health outcomes so people don't. Find themselves in those situations to begin with so that's how I ended up where. Yeah.
KayAnn Miller
This is cayenne and for me it's it's all about the kiddos I have volunteered with organizations that support kids. For almost 50 years now but the the thing that's really important to me is a good foundation for all Montana kids so that. They have a. An opportunity to grow up nourished and make the most of their health and turn that into a life that's really important to them.
Ian Finch
Oh well this is Ian and great question.
Speaker
I'll I guess.
Ian Finch
I'll start my journey to kind of food and agricultural systems actually started I think when my family moved from Pennsylvania through Minnesota to Montana eastern Montana about 4 generations ago in the early 1900s as part of the homestead. Act. And my family 's history you know has been part of the farming and ranching community in Montana for over 100 years and in the modern generation that also means that we have the responsibility to understand what that history where that came from what it did to agricultural systems how it affected the people who were living here since time immemorial. Umm and really figuring out how we as modern day humans work to simultaneously acknowledge and honor our own ancestors while thinking about ways that we can change and move forward in a way that supports the land and all of the people who live here. And I think I really had that learning through college here at the University of Montana in 2006 I moved to Missoula I went through the environmental studies program it has a really strong food and farming emphasis area where I didn't even know I was kind of blindsided by it and I was like Oh my gosh these food systems. Are so complex they reach everyone I mean every single person interacts with the food system you cannot avoid it and you can either interact with a food system in a way that increases disease? Where you can interact with the food system in a way that increases health and I really saw an opportunity with my interest in agriculture and my interest in health to really merge that through the work I do here at farm connect Montana and I've been doing this work for about the last 5 and a half years and I've been working in food systems in Montana for? About the last 20 years.
Margaret Mullins
Thanks to all of you I I really enjoyed hearing what led you all to this work so thank you for that. You are involved in a lot of projects that are multifaceted and complex in fact both of your organizations are working towards changing Montana 's food systems to learn more towards health and well-being you've all brought up health frequently and the discussion that we've had so far so let's leave into the idea of systems. Change by talking a little bit about why nutrition is important for the prevention and the management of chronic diseases like diabetes high blood pressure and cancer. OK so this question is for all of you really how challenging is it to convince people that nutrition and healthy food access are important and real issues that can help them. To be healthier.
Lisa Lee
I love this question thank you Margaret I feel like we are in both a food and health crisis across Montana right now we're seeing very high rates of food insecurity and very high rates of diet related health issues including diabetes heart disease hypertension obesity. You know looking at hunger alone we have 40% of our kids in school that qualify for free and reduced price school meals we predict as an organization that there are over 92,000 kids across Montana that struggle with hunger of the 92,000. Will blade 36 to 39,000 kids are below the poverty? New line but our work in schools allows us to talk to principals and superintendents daily and we're hearing that there's such there's a much bigger gap of people falling through the cracks now many families don't qualify for those federal nutrition programs and their income isn't enough to get by so. They are looking to school meals as a lifeline and we only see healthcare as a way to support all of the work that schools are doing because they're reach is extensive and both schools. And health centers are in very rural communities which we have many of across our state in terms of the health crisis research shows that food habits as children lead to 6 in 10 adults living with one or more diet related chronic diseases. We have heart disease stroke and die. Being some of the leading causes of death in Montana and in recent years heart disease was the leading cause of death followed by stroke at 6th place and diabetes at 9th place in Montana overall you know to magnify the issue too when looking at American Indian. Montanans they have much higher rates of these diet related health issues and have a median age at death 15 to 17 years younger than white montanans it's just the reality of what we're living in. And and then we looked specifically at obesity right among adults and this is increased by 25% since 2017 overweight and obesity as we know are risk factors for death due to chronic diet related health conditions all of what we've already mentioned from heart disease. To diabetes to cancer and stroke and there are just. Strong correlations between food insecurity and being overweight or obese due to the trauma of being food insecure which leads to unhealthy eating habits like overeating when food is available or choosing highly processed foods that quickly give you that feeling of satiety so I just feel like. For many reasons we can't underline it enough that nutrition equals health but at the same time Margaret your question hit home for me because we are still not seeing nutrition. As medicine across our state right and that's why you often hear of the term food is medicine we'd love to see more of it we'd love to see healthcare be more proactive and work more upstream and many hospitals are across our state but it's not common. Practice yet and we need to make it common practice we can't rely on pharmaceuticals getting us through situations we need to start thinking that the food we put in our bodies at such a young age and how we're forming the.
Trina Filan
Is?
Lisa Lee
Eating habits at such a young. Age. Equal our health as we get older right and we're seeing much younger kids you know start having heart disease and other other things younger in middle school and and in high school so let's prevent it. Let's get on top of it I think the last thing I just want to mention here is just that I was I had the opportunity of being one of many as part of the. State health improvement plan process to determine the state 's top 3 priorities over the next 5 years as where you Trina and Margaret so it's nice to see you at this table too but it took many months to review the data and discuss the prioritization criteria such as the magnitude the seriousness. The uh feasible strategies the urgency the intersections of different disease States and etcetera but the group landed on the top 3 priorities and they are behavioral health cardiovascular health and maternal. And when looking at cardiovascular health the leading cause of death in Montana we can honestly say that good food can help change this so let's start now.
Margaret Mullins
Thank you Lisa.
KayAnn Miller
Well this is KM you know and I mentioned that I'm I'm all about the kiddos and you know there. Have ability to see succeed? And so one of the things that is really important to me is how nutrition and fresh quality food impact their ability to do that and so. Being able to eat fresh quality often locally sourced food does it few things for kids in schools for example when they can eat more nutritious school meals in large longitudinal studies. We see significant reduction in anxiety mood. Behavioral disorders suicide nurse visits absenteeism. So being in school feeling good being able to work well those are important success factors and. If you look at kiddo 's 10 to 15 years old who don't have adequate nutritional value yes in their foods they are 2 and a half times more likely than other kids to experience anxiety and depression? During the school day and at home the other thing that I think is really interesting is that when kids can eat adequately nutritious food as opposed to mostly ultra processed or highly processed food we also see reductions in bullying. And we see improved test scores we see improved ability to concentrate and we see that these performance. Metrics. Can be seen among kiddos starting in kindergarten if they have better nutrition they're doing better in school?
Margaret Mullins
Thanks Karen.
Ian Finch
What amazing uh information being shared I I love learning about how food and nutrition at the childhood level really impacts people because I couldn't agree more with Lisa and Kan it all starts with kids when it comes to building that next generation of food and nutrition advocates both for themselves and for our community and so? The work there is of utmost. And beyond that you know I think convincing people to make those changes for themselves is multifaceted in that you have to both in the community has to both show people kind of the way forward give that glimmer of hope because I think. In the modern day and age in addition to what Lisa was talking about with the food and nutrition crisis that we see happening in health crisis there is a extreme cost of living crisis. And people these days I mean most people these days unless you are a tech billionaire are living with pretty limited resources and for people who have the most limited resources you have to make really really hard decisions between cost of healthcare your rent your utilities. Your cell phone bill and so many of those costs are fixed right your rent is fixed and if you don't pay it you're getting evicted and you don't have control over that whereas when it comes. The food people have a lot of agency in how they choose to spend their money on food which is awesome agency is great and we really want people to be able to make those choices for themselves but you have to have an empowerment model when you're trying to convince people to make those changes and I think in order to do that people need to see. Both that the access is there and that you know when they are told or when they decide to make that change there needs to be a way for them to get that food and a lot of the times that might not exist you know a lot of really rural communities there are gas stations there are convenience stores. And the the chain the line of those healthy fruits and vegetables and you know I think everyone on this color probably agree local fruits and vegetables are higher in nutrient density they're more fresh those foods might not be available so where I'm going with this is that I think in order to have someone make the choice themselves. To pursue a healthier food. Future the way that we at least address it first is providing a financial incentive to do so because we acknowledge that people just need a little help in in order to make that tough choice to pursue those healthier foods that may or may not be more expensive and providing that financial incentive is a gateway for that person to engage with those. It's to learn about those foods make connections with those food providers in prep. Users and then that kind of wrap around support that discovery of community I think is where that empowerment begins and people start realizing wow like this isn't even just about me and my food this is also about the way I interact with my world and just to share a little data from our program we just published a paper called nutrition incentives in action in the journal of agriculture. Big systems and community development and one of the findings are evaluators kind of found through the data we had 372 response. Says was that 80% of the people who were using our financial incentives to shop at farmers markets felt an increase in their connection to their community as a result of the program in a higher percent 85% feel like by using the financial incentives to support local farmers they're actually able to make a difference in their community. And so it's not even just about are we eating the right types of foods and are we pursuing that health there's this community aspect and. These programs and I want to talk about nutrition education and I'm sure we'll talk about that later that's another critical aspect of of giving people the the knowledge and the tools that they need to make those decisions and nutrition education is not just about what nutrients are and what foods and how to do that it's so much more broad than that and I'm sure Lisa could talk much more about that. I'm in no means a registered dietician or a prop. Personal in nutrition but we're seeing those really positive data points and I just want to share one other that wasn't in the published paper but is data that we're gonna follow up on about 5 years ago when we started our evaluation process we saw that our double snap dollars participants who were shopping at farmers markets were claiming that they were. Only there 80% of them were claiming they were only there because of the financial incentive and the benefit otherwise they wouldn't be shopping at farmers. Yes Fast forward 5 years later this past year that number dropped to 30% of our participants were shopping at the farmers market only because of the benefit which means that all those people who were previously shopping only because of the benefit are now shopping because they have converted to local food advocates and they are now going to farmers markets because they believe that it's the right thing to do and they're supporting their community. Whether or not they have those benefits and so we're seeing really positive outcomes there and we definitely are planning to follow up with some of that through future.
Margaret Mullins
Thank you Ian I feel very inspired by all of your comments here because despite some of the challenges you've all sort of indicated that you know with some data and great data provided there from all of you knowledge some financial incentives that help make those connections that just empower people and community. There's so much we can do to start moving that needle even more forward so that people have this sort of education that we that we need and want them to have so thank you all.
Trina Filan
I have a question that's specifically for Mont Peck and it regards something I read. On your website. You mentioned that you're focused on nutrition density and nutrition security I was wondering. If you would talk a little bit about those ideas and? Why most Montana communities are unable to access nutrition dense?
Speaker
2.
Trina Filan
Lights and the kinds of work that you're doing to support movement toward those.
KayAnn Miller
Goals if you look at the nutrition research peer reviewed published nutrition research in the United states. Across the life cycle so including kids teens adults seniors. Uh. Prior to birth moms the whole thing across the life cycle there are some nutrients that. Are really important all across the lifecycle and there's 24 of those as a matter of fact and 21 of them are consumed below the recommended daily allowance in the United states so we're not getting? Enough. So when you are eating what we're calling a nutrient dense diet. Thus the diet to us that is giving you access to all of those nutrients in the amounts that are appropriate. To you depending on how old you are and where you're at in your life cycle. So in Montana the the nutrients with the with particularly high inadequacy rates are vitamin D that contributes of course to our suicide rate here in the state and we had a meeting one time. With the suicide coordinator for the Department of Public Health and Human services and he also has a private practice working with adolescents who are contemplating suicide or who have attempt. It and vitamin D is the first thing that he recommends for those immediate folks immediately the other nutrients that we don't see enough of in this state are vitamin E calcium magnesium dietary fiber. Omega 3 fatty acids zinc folate and potassium and especially something like potassium you get from food and. But having enough potassium in your body at least in my family 's experience contributes to stroke and heart attacks and you know Lisa mentioned that heart disease is one of the the key things that we see in Montana as a primary cause of death in the state so. Nutrient density again to us is eating those. Foods that provide those diets and why is it hard to get that in the state well you know over time we've lost rural grocery stores we're losing infrastructure in the state in terms of ability to process. Some locally grown foods we've certainly improved in meat processing overtime but vegetables. Then uh some other foods were still have a ways to go there and you know there are communities where you can't just run by the grocery store on your way home because there isn't a grocery store that impacts people 's ability to get food if you're a. One person food service director in schools and you're feeding all the kids and your deliveries from the main food suppliers are no longer available because of your rural location and you're having to drive long distances to pick up the food you're. South that impacts the kind of food that you can bring back to the school you gotta have something that survives the drive right and. It's still. Complies with health code when you show up with it at. The school so. That impacts kids ability to get nutrients and those 2 things are just a real challenge in Montana given the size of the state. The space between locations you know just the rurality of where we.
Margaret Mullins
Live.
Lisa Lee
Like to add just a few more things I feel like keyan touched on most of it but the critical pieces that were missing now across across Montana but across the nation are the inability to cook like we once did it's just been lost over the last couple of generations. You know we live in a convenience society right where it's just easy to grab ready made foods for us and that works and has worked well but the fact is now we are trying to go back to the way things were before and learn those critical skills. Around just cooking and preparing basic meals cooking from scratch understanding nutrition So what Ian already mentioned around nutrition education there is no standardized nutrition education in our schools all of our schools. Are controlled locally here in Montana and that means that there's no overarching system where we can rely on one thing and make sure it's standardized across our state so really focusing in on not only having the skills to cook learning about foods? Because if you introduce new foods or scratch made food when kids are not used to that. It changes your palate right you oftentimes need to taste it a couple times before it becomes more normalized so we are in this weird place unfortunately across our state and across the nation where we have to relearn those types of things where. Nutritional in Healthcare is playing a key role so I'm very excited to talk about examples of programs across the state that are are starting to work on this but it matters really you know like when we're looking at school nutrition. The kids that are eating at school are getting up to 75% of their calories through school meals and snacks So what we're serving at schools matters to these kiddos so if they're getting food from a box that's prepackaged highly processed that's what they're carrying with them for a lifetime. Right if we're starting to introduce scratch made cooked food as well as locally sourced foods integrating more within. That that world it allows kids to try things in a positive environment where they're tasting they're seeing their friends do something similar and at the same time getting nutrition education learning about the foods and like why they're important to feeling good as as human beings and you know carrying those critical. Goes forward so for all those reasons they can mentioned I just wanted to hone in on the fact that we've lost some of these key skills that were once just commonplace and now. Why not?
Trina Filan
Thank you both yes I am ashamed to admit that I have fond memories of dayglo gravy on Turkey from elementary school I love that I lived for the day we had dayglow gravy on Turkey and mashed potatoes so I had to learn Mashed potato.
Margaret Mullins
Lakes.
Trina Filan
Yes I had to learn a lot of food skills as I as I grew up as well so thank you both for talking about that yes so.
Margaret Mullins
It's important to sort of remember right that changing systems really require efforts from all angles Ian you kind of have a different focus you've said that farm connect Montana works on supporting local farmers and improving farmland access improving people 's access to healthy local foods. So can you just talk some more about how these focus areas support systems change around nutrition and well-being for montanans.
Ian Finch
That's an excellent question and you know again the food system needs to reflect all of the food system actors or the players that you have in your community and so everything is interconnected and I would say that. It really you know when you're working with farmers you are working with aggregators you were working with food processors. You work with getting that food then to consumers. And then those consumers need to prepare that food at home like Lisa was was talking about and then that food also goes into. A waste stream. And all of those elements are what make up this really large food system that we. Have and in order to make really meaningful change across that system you really I believe that you need to have feedback and input from all of those stakeholders which is a huge challenge because you know so many there are so many organizations there are so many people who have a piece of the puzzle? And it's really easy to get siloed into your piece of the puzzle when you know grants funders. Programs are really specific and you kind of work with what you can pull down from the universe in order to fulfill your mission and sometimes you know no one can do all of those things no one person no one organization could possibly address the whole food system and the health crisis it's so multifaceted. And so you really do need to lift the coalitions and you know I think great examples are mount pack mount Peck is a coalition it grew from that knowledge of all of those partners across the state. We at farm connect Montana you know we have a beginning farmer and rancher steering committee for a beginning farmer and rancher programs we have double snap dollar steering committee in a Montana produce prescription collaborative where we really seek an attempt to get all of those voices at the table whether it's our board of directors or again with these steering committees for our programs. And you know it's not even just the food system actors I didn't even mention the the policy the law the governments. There is so much that happens at the federal and state levels that then inform how immunity actors and players can leverage those government resources can leverage private resources in order to do this and so all of those players need to be part of the team in Montana we do have. Several other coalitions that are less program related that farm connects a part of and I think mount pack as well there's the grill Montana food policy coalition that coalition really looks at what happens with policy at the Montana level to make food more accessible to increase our production. And we have an amazing 33 by 33 initiative sponsored by abundant Montana and I believe we're both coalition partners of as well and that's really seeking to get 33% of the food on Montana 's plates to be produced in Montana by 2033 and that's really stemming from you know the statistic. That we've seen in making the rounds where in 1950 Montana produced 70% of its own food and in this current era I think it's something like 5% or less of the food we eat is actually produced in. Montana. And so that. As well is seeking to really identify who are all of the system players how do we get everyone at the table and I think what's really cool now and I'm so sorry to to speak on behalf of mount pack but this this initiative to really include the healthcare players as as you know actual actors. In this and you know do they have skin in the game they are working with all of these preventable diseases and costs at the end the healthcare system is so expensive for prevention so how do we work all the way through and I'm really excited to see those healthcare players coming to the table through partners like mount Peck. Others it just kind of helps complete this picture for me of the food system how it's used and then how it's used to treat or prevent disease.
Margaret Mullins
And that was that was the perfect segue to our next question actually it's a really great explanation of the largesse right of system change there are just so many moving pieces and I really like how you could identify so many of those and it helps really make us aware of of what's involved and you're talking about Healthcare is. Augment Trina has another question for.
Trina Filan
You so as you have both or all alluded to and as we said at the beginning the reason we have worked together in the past and know each other. Is because we've all been engaged? In some way in a program called food prescription or food RX or food is medicine or nutrition is medicine there are many ways to say this right. And the gist of these programs is to connect people who identify or screen as food insecure or nutrition insecure at healthcare systems or at community food providers. To connect them to healthy food access programs right and when when our programs have done these these these projects we have to throw in a chronic disease component so the patient. Screens for having high blood pressure or diabetes and then is referred to.
Speaker
2.
Trina Filan
Uh. A food bank that is or a food pantry that is participating in this food RX program and there is an exchange of referral and a connection of that patient to affordable accessible healthy food sometimes locally produced sometimes. Arranged in other ways. It. So this is a cool project and each of your organizations has a different sort of association with how that rolls out but we'd really like to dig into it and talk a lot about these food prescription programs how you got involved with them. The benefits of them there's a long running evaluation of these programs and their effectiveness so let's just get into it tell us about your organizational affiliation with food prescription programs and. And what what results they have how do you. Uh make them work from your perspective and and what are. The results so far.
Ian Finch
So we've been in the nutrition access world at farm connect for about the last 10 years I failed to mention earlier we're turning 20 years old this year how we're celebrating our 20th anniversary and for about half of that time we've been focused on food access in addition to the farmland conservation and beginning farmer and rancher development. Pieces of the puzzle. And I think we ended up getting involved in kind of the food for health space once we really discovered and acknowledge that the programs we were already running double snap dollars some of these other kind of farmers market based nutrition programs were really increasing people 's health outcomes and so we saw these indicators that oh wow food really does make a difference. The people and that was all self reported you know through. Participant interviews through our surveys and so we said OK how do we kind of look at this a little bit more closely and I'll say we've been for the last 5 years grantee through a federal program that's incredibly important it's called the Gus Schumacher nutrition incentive program or known as Gus snip and and. Really that program shares goals that our food access program does to increase fruit and vegetable consumption connecting through connecting people to their food. Says and making that economic change by increasing the amount of of dollars that are flowing into local food system so it was a really good fit and we have been a grantee of that program for our but our called nutrition incentive programs under that grant program which is the snap match program that same grant program that we were already a part of. Then added this component of produce prescription grants and it was 3 years ago where the federal government actually made a lot more money available for those programs through the American rescue plan act which was a COVID ara piece of legislation. And that just opened up the program for grantees to expand into produce prescriptions when they may have already been providing nutrition incentives so it was a really natural fit and I'll also say a lot of the partners we had across the state for snap match program double snap dollars had voiced to us that snap wasn't always the best fit. To the type of programming they wanted to have you know some people have to choose between snap or other programs and so they wanted to see something that was decoupled from this. Kind of really large.
Speaker
Which?
Ian Finch
Recognized as a federal program it's a it's a federal state shared program and they wanted to see a different way and so we were asked to pursue the gust net produce prescription opportunity which we did that program has now been funded for the last 3 years we've had around 900 families participate in that produce prescription program. And just as Trina was saying our model is very similar to what DHS has seen in the past where we have registered dietitians nurses sometimes physics. Since you know treating patients identifying income food security status and then disease risk and then making prescriptions for fruits and vegetables to treat those disease risks and our evaluators at Montana State University have done an excellent job at collecting both pre and post surveys. From those participants. And those clinics at the midway point actually are also taking labs and doing a little blood work and are tracking things like cholesterol and other indicators for heart health or diabetes and results are really early and you know even though we've been implementing for 3. Years research and evaluation takes a really long time to make sense of all of the data and to and to generate something that's maybe a little more meaningful than you know participant a increase their die and fruits and vegetables by 0.5 cups per week we have data like that but we're really interested in you know is a prescription for food lowering. People 's LDL cholesterol is it supporting peoples HBA one CM and so we're excited to see those coming out hopefully at the end of this year and so hopefully people will check back in with farm connect Montana and our website for some of that that. Uh I do want to say just really quickly. I I just participated in and we published a little thing through the American Heart associations healthcare by food initiative where gusset grantees all got together and came up with what best practices do project leaders recommend for produce description projects and I'm happy to share those it's it's 5 quick points. Them if this is the appropriate. Time and really what we're seeing is that one it's really important to carefully select your partners and and the sites that are implementing the program because based off of their capacity location logistical capability those factors really can make a breaker program and so it's really important to make sure that you have all of those foundational pieces in place. And I would add that it is the right fit for that clinic you know every clinic is going to have a different flow of how they treat patients and it's really important to understand. What those flows? Look like to have a positive pro. And the study found that providing added services to just the provision of food is almost just as critical as the provision of the food itself and really what that's saying is the nutrition education component what Lisa was talking about building those skills so that participants can actually make use of the food and you know if they have a CSA. The box they might get 2 cabbages in their box that week so it's really important for people to know how to use 2 cabbages in a week you know preservation is so important and not these other skills that. People have that. The the 3rd best practice that was just kind of released in this report was using a participant centered project design so in addition to understanding what the clinics flow looks like it's really important to see how those participants want to interact with the program and where they want to source their food not everyone wants to have to go to a CSA pickup site every week you know some people really want to be able to go to that grocery store. At their convenience throughout the day the weekend and increase access that way. The 4th was to leverage technology and systems for data sharing monitoring and participant tracking and so that really looks like and it's a it's a huge hurdle to cross but you know EHR 's electronic health records how are those shared under data use agreements so we can actually understand what's happening in our programs and so that's a really important thing to consider. And you know always protect participants identities and their data is their data it is not ours and so doing things in a de identified aggregated way. And then the 5th was designing projects with an understanding of the community socioeconomic environment challenges and strengths and so again that's really looking at what food system pieces are in place in that community and what can we actually reasonably expect if there is enough farmers market we can't build a program where we're going to be prescribing people to get local food at a farmers market we're going to have to as. Program implementers. Consider changing the way we're approaching the project in order to best serve those participants and hopefully participants are you know their feedback is taken into account before a project is even implemented during the design phase so those were the 5 best practices really high level and that that American Heart Association study found.
Lisa Lee
I feel like we're coming in from the position at mount pack where we're seeing that healthcare can do more to support food nutrition and health strategies in their community and improve nutrition and health outcomes we can't go out at this alone. We keep talking. Ohh partnerships and collaboration and it's true it especially in such a geographically large state as Montana is we need to continue to lean on different partners in this work and healthcare can bring many resources and capacity to layer in additional support to schools that have become nutrition hubs. And especially the rural and frontier communities where it's really hard to get fresh quality. Food now I think as mount Peck we've started as a Grand Tour to help launch some of these food prescription programs across the state and many years ago when mount pack was still statewide coalition we actually worked with the Montana chapter of the American Academy of Pediatrics as they rolled out the food insecurity. Reading through their membership. Now now pack kind of came on board to create those county food resource lists to support the referral process once patients were screened positive for food insecurity so that was just an early on interesting partnership as step one to healthcare seeing the importance and getting more involved. But nutrition and Healthcare is a term we've come up with that's more broad as Trina you've mentioned there's so many terms around. Yes that it really goes beyond produce prescription programs and allows healthcare to best meet the needs of their communities from access to fresh quality food especially in the rural communities which is not easy as we've mentioned but also nutrition education and schools to cooking classes. You screening for food insecurity and now there are in the works there is a nutrition screening tool so that is something coming that we should follow. So uh but it's really looking at healthcare as an innovative response to to finding ways to address nutrition and health in their communities I guess from our work we had the pleasure of working with Ian and Bridget at farm connect and then Trina and Margaret. You all at the Department of Public Health and Human services on the food summit that was in Missoula back in September and this was. Just you know a way to bring folks together from existing programs to to show that these are programs that are building momentum across the state but how do we look and connect people better how do we help collaboration exist at a local community level. How and what are the biggest needs coming from this group and I think from that it really showed us as a whole that? Funding and sustainability where the hot topics of existing food prescription program specifically is like when they're all stretched looking for funds which typically come from grants how do we get this done and then what happens when a grant run runs out or staff you know moves on into other positions so how do you look differently at this. And I think from our perspective at mount Peck we started looking at how do we better support these existing programs and so we kind of brought this initiative in under our partner group monthly meeting. Please which essentially evolved into a learning collaborative for the nutrition and healthcare work and it's through this this partner group that we discussed strategies to better fund and sustain existing programs so we kind of took that summit and started peeling away the layers and looking deeper. After the issues that affect almost every program that's in Montana today but yeah with this learning collaborative we can you know help them see how raising awareness about the program internally. Through healthcare builds their support shows outcomes gets health the healthcare team more invested and then allows them to grow their program in a much more sustainable way we also bring experts in like the American Heart Association to share more resources and research. In this area there's just so much out there. But we all know how hard it is to be in that survival mode of getting programs going and feeling like they're fully funded and sustained so you can you know get above water and start looking at other ways to cross connect and collaborate with partners etcetera but at the same time. It was such a need too for new programs in the nutrition and healthcare field that we found ourselves trying to provide that layer of support and resources training that the new programs really need it. And So what that looks like is really getting on calls and meetings early on to talk through like sometimes it's just they see food RX see food prescription programs and they're like we want to do that right and it seems so easy but there's so many layers to building the program right from the get go. Uh so you know we talked to them about starting out and how to sustain these programs and secure funding and collaborate with local partners to strengthen the program but we dive into the more nitty gritty conversations of how to be creative to meet the. Those local needs and you know Trina you mentioned within your question of starting out with having the referral be to food banks but that's not the end all be all right many programs across our state are referring to grocery stores and having vouchers to especially albertson's. Because they have a presence and almost many communities across the state especially the rural area. These 2 and it tends to be more affordable and food banks are constantly pressed for more and more these days with food insecurity being in crisis mode but as you mentioned and the focus of foreign connect being around local food boxes we are seeing some programs being able to manage that. It is more costly so you just have to talk through with new program. Where are the people that are needing some like food support how can they easily get this food is choice important and what what are the program costs etcetera you know that you can help sustain over time so I think all of these leads to just better programming and models and? Strengthens the programs in general but I feel like we're seeing such innovative programs and I have to mention the rocky boy tribal health. Produce prescription program and nutrition education program they have a holistic model in doing both food access and education it's a long term grant which they were able to successfully get awarded and they're building partnerships along the way it's just one program to watch. And they are offering a number of community class. And a lot of people are showing up you know when things are going right when people show up especially in rural places so that is one that I'd love to share more about if anyone 's interested and can give you connection to that program but I also want to just. There are one more example around creativity of building programs because it I think produce prescription programs. Has had so much success that we often forget to mention those that are not parties prescription programs and one is here in Helena is the harvest of the month program through Saint Peters health and in partnership with the Helena school district? And this program started through the local kids nutrition. Which has been together for some time and it brings food partners together from across the county to address childhood hunger and nutrition and Saint Peters health was at the table when the coalition was accepted for a food corps member many years ago and then food Corp actually the program itself went away? Montana so we were looking at how to fill this gap that we were working towards with harvest of the. And Saint Peters health was at the table and wanted enroll in this and could clearly see the health impacts by working more upstream so they actually took it to their leadership and got approval for for budgeting for this program and you know it's really looking at. The value based care which Montana is behind the times for to keep costs down and keeping people out of the hospital right so it was just so. UM rewarding to watch healthcare and take such a big step and probably I think it was at least 5 years ago that this happened where they wanted food to play a bigger role because hospitals are only one component of the patients health and nutrition and healthcare initiatives help to manage and prevent food related. Honey diet related diseases here so very briefly harvest of the month and Helena is coordinated by staff at Saint Peters health it is really operated through all 11 elementary schools across our community. Harvest of the month features one local food item per month and the harvest of the month coordinator through Saint Peter 's health comes in monthly to each elementary school and teaches 4th graders about this food item brings items to taste test around the food items of it's carrots. They might make us carrot salad salad let's say you know. And create a little Lesson plan around carrots and then do a little taste testing with the kiddos but what we saw soon enough is that the coordinator at Saint Peters health couldn't be everywhere and it's a big job with 11 elementary schools so she reached out to Carol college as well as the family. Consumer science teachers at our Helena high school and capital high school here and we have actual students in high school or college students coming in to teach some of these. Classes and it's really taken off and away where you know these 4th graders are learning critical skills nutrition education cooking because they even have this little Charlie cart that Helena feature has and loans to just broaden peoples skills but 4th graders remember it. When there's high school students coming to talk to their class and about food and all of a sudden they like the food more and they remember what just happened because it's kids mentoring other kids in such a positive environment? I mean so it's really taken off it's helped to build nutrition education and greater outcomes because it's exposing kids to more and different foods and a variety of foods and they learn these eating habits and a lot of them actually are going now into family and consumer science classes later in high school. With a much higher educational component around nutrition education where the teachers prior said they had no baseline nutrition education. They had the first month 3 months of every school year really trying to go back go back over the basics of nutrition education before even getting to the actual curriculum so yeah it's created just such a a a great thing for our community I'm here in Helena so I can see it first hand and through my kiddos. So I think these programs are just bringing so much more to the communities and allowing partnerships to to thrive in this environment.
Trina Filan
That that is amazing what a cool program.
Margaret Mullins
I will just say there are several people we work with over here in the chronic disease prevention health improvement Bureau that have children that have gone through the 4th grade here in our communities and are very familiar with this program and it is so well received the kids remember it at the end of the school year and moving forward and we know there's. So much they don't remember. No it is it's a it's pretty impressive so thanks for going into detail on that.
Trina Filan
Yes I appreciated all of that discussion because it really highlights how many different partners can be involved. In improving nutrition and health outcomes right schools grocery stores local nonprofit organizations public health hospitals and healthcare systems and local farmers and the ability. Of almost all entities to participate in some way in improving community connection to health nutrition well-being to have people become illuminated. And about how they themselves can intersect with improving local economies for example the folks who receive snap dollars to go to the farmers market and then realize that they are supporting. Farmers so there are all kinds of opportunities to partner. And to work together but you also know that creating partnerships is sometimes not straightforward like it's it's not just knocking on someone 's door and saying hey let's do some stuff would that it were so but one of the things that we have heard in our work. On food prescription and other kinds of programs that connect clinical workers to community based organizations is that sometimes it's hard to figure out how to. How to even take the first step toward partnership and that's one of the things that both of well you alluded to in what you've been talking about that starting the relationship and figuring out the rules and the groundwork and what actually everybody's going to do? In the partnership that all needs to be worked out so could you talk a little bit. About. How? To foster relationships that lead to these interesting. Projects how do you foster those relationships between partners that may not see themselves as logical partners like. For example a healthcare partner and. A grocery store or a food provider.
Lisa Lee
I feel like. Sometimes it can. Feel tough to enter into a new partnership but a lot of times you have this shared goal so that's the starting point in having that conversation and you know especially in such rural communities you don't want overlap you want to be working together to strengthen each other 's programs. For for example like around nutrition education programs there are just so many partners in this space trying to fill that. The app that major gap that exists and it could be from diabetes education to harvest of the month lessons in schools it could be family cooking classes hosted by MSU extension agents that are just such a variety of programs available. And only helps. The healthcare institution that's working on food prescription programs for example instead of just handing out food if you already have a resource and dedicated capacity and support in your community that's providing nutrition education you lean on each other right. And I think sometimes initially it's just like we don't want to step on people 's toes so that converse initial conversation can be. Hard but you have to go there because we lack the capacity and the resources in a big state like ours so the more you can just lift up what's already successful and existing in your communities will only make you stronger and I think it's. It's just such a benefit when you can go for a much larger collaborative grant together as organizations which is usually what's being asked for now by funders and only lifts up both of your organization so we highly encourage people to. Go in and not be afraid to have those initial conversations and sometimes they might take more time but especially for new programs before you get going have those conversations because you don't want to backtrack later and will only strengthen your program from the get go.
Ian Finch
I couldn't agree more with what Lisa said and I'll just add I think then. Developing new relationships it's so important to not carry too strict of an agenda your own agenda and what you want to see the outcome be it's really important as an individual to be really open to changing your own beliefs to changing your own approach to really meet in the middle with whatever. Partner or partners and you're looking to work with and to to really be open to that change internally yourself before trying to implement something and doing that through coalition work like we've been talking about is just so important so I just wanted to add that as well.
Speaker
Oh.
KayAnn Miller
From my perspective folks have a lot of fear about reaching out to an organization that they don't know anything about but that they believe might have common interests and just really important to overcome that and and begin to build those relationships. For example if you know with the thinking about ourselves only as the Montana partnership to end childhood hunger and really focused on well gosh we have to talk to other people who are like us whether we do that out.
Lisa Lee
Of.
KayAnn Miller
Because that's how we're thinking about the problem. Or because that's what we're comfortable with or that's who we know then we miss out on partnerships with other organizations whether those are agricultural organizations or individual farmers and ranchers or pediatricians in.
Lisa Lee
No.
KayAnn Miller
Tiny spots in Montana they're just really need to I think to form good sustainable partnerships that are capable of addressing a systemic problem we really have to think about.
Trina Filan
Who?
KayAnn Miller
Interacts with the food and the humans all the way through the cycle from when the seed goes in the ground. And to when it comes out when it's processed when it's consumed when a kid visits a doctor or an eye specialist or a dentist or all the way around that circle we need to engage with with people who are in that circle not just our friends.
Trina Filan
I would also like to add that one of the things that we've heard occasionally from the healthcare system side is that it's very easy. Yep. To lose track of a project like a a food prescription or a nutrition is medicine project in the midst of all of the other things that have to happen right because clinical focus is very clinically focused and so. And a food is medicine food prescription program is a little outside of ones regular. Dealings in a healthcare system so. Undertaking a project like this with the healthcare system it wouldn't be bad to set up regular interactions right with with the person you're working with in the healthcare system and by regular I mean probably at least every other week. Just check in and make sure that everybody's radars include this program so that you can feel like there's a a connection beyond just referring somebody to get a food box or whatever the whatever the setup is. Just because you're you're building a new kind of relationship with a partner that may not think. In the same ways that. You think of if you're coming from a food perspective so I just wanted to add that on behalf of all healthcare providers who might be wanting this but also don't know how to start.
Margaret Mullins
It and I will also add my work as a social determinants of health program manager is working with these clinics to think more. Broadly about how they're work intersects with social needs of their patients and I think we will find over time and certainly have seen over the last few. Years that there is a lot more recognition and understanding about the completeness of that picture so it is an ideal time for food RX and people who are contributing to patient care in this realm to sort of interject themselves into the process of healthcare I think the. I think the time is just right.
Lisa Lee
I think the beauty of food RX is that it's not a one-size-fits-all approach right many times at a community level Healthcare is a big partner in this but it's usually led through a local nonprofit for example like fast black feet nonprofit serving the black feet. Has a food pharmacy program they actually have a registered dietitian on staff that can bill for medical nutrition therapy? Which is basically individualized nutrition counseling that must be provided by a registered dietitian and it's working with the southern Pagan Health Center and they both receive reimbursements from Medicaid because of of getting this approval but it's fast? Taxi that then you know turns the program into the patient is screened positive for food insecurity. Me and that patient is referred to fast black feet so the dietitian then provides nutrition education as well as food pharmacy programming so their program itself offers medically tailored food boxes to fit their needs so if it's a diabetic patient they're getting a food box that meets their needs as a diabetic. So things that they should be eating they provide recipes to go. With it the dietitian McKenzie Sachs actually provides individualized nutrition counseling as well as group nutrition classes at the local grocery store which is really cool right it's like those are the you know when you have questions as a patient and you're in that grocery store that's when your questions come to you it's really hard to sit back in an office. Setting and feel the same thing. So they're really meeting the needs with where they're at and really taking a lead in this in Montana but at the same time I have to mention land to hands program in partnership with Logan health land to hand is in whitefish and they're one of Montana 's first food prescription program. Teams and have MU 's with the different health clinics that they work with under Logan health they layer in local food boxes that's really important to land hand and they have the funding to be able to do so as soon as patients screen positive for food insecurity they are kind of brought on. Land to hance local food box. Program they actually as the program grew over time they built a partnership another partnership with the western Montana growers Co-op to continue to provide food boxes in the winter months because we have a lot of them in Montana we can't just provide local food for you know 3 to 4 months of the year. But they do it so well that how they have recipes within the the local food boxes and now it's a year long program. And very extensive so just showing greater partnerships at the local community level we have so many programs that are doing it well and have all of these unique aspects to making it work and work well.
Margaret Mullins
Well another great segue.
Trina Filan
We need.
Margaret Mullins
Really good information and that really leads me I I I was kind of getting into a little bit of that thank you Lisa and thank you all so my next question is really kind of twofold along with healthy food right we know that folks also appreciate having access to culturally relevant food and in particular in Montana. You know we have over a 7% population of American Indian. We also know that our reservations are often very rural areas and we also have a lot of communities across Montana with different levels of rurality So what I want to talk about next and you've hit upon some of it already though is you know sort of what this term means. And how both that locally grown food and culturally relevant foods benefit our unique Montana populations and that question really is for any and all of you.
Ian Finch
I can start out with just a quick comment you know as Lisa and Ken have been sharing today I think some of the absolute leaders in food prescription programs in Montana are coming from the wealth of our Native American populations and our reservation communities and I just want to echo what I was saying before I think this focus is on. Overall health and on spiritual health in addition to just the provision of food. And so I really appreciate this question because it's a big one that everyone needs to think through on you know are we doing things in a way that reinforces cultural tradition there are these other cultural traditions and foodways that are just as important for someone 's physical emotional and spiritual health and I'd really love to see a change a transition in the way. We think about food prescriptions to really incorporate what you're asking about how do we incorporate a really important foods and just as some other examples you know fast black feet in our work with them we've sponsored a few Buffalo hunts. Where we ended up paying for the permit to do the hunt and the processing of that Buffalo it was through private funds and then they used that meat in addition to fruits and vegetables that were being prescribed through the produce prescription program to create more of a holistic aspect and land to hand I think really acknowledges this too? It's not even just about culturally relevant foods it's also about the whole suite of things so in those food bags and boxes that Lisa was mentioning it's not just produce showing up in them they have all that produce coming from western Montana growers cooperative but they're also including things like healthy cooking oils. Things like spices because it's not just produce like food and culinary tradition is all of it and it all impacts our health and I think if we're just focused on fruits and vegetables we're not acknowledging that it's part of a system and that everything counts when it comes to to increasing health through food.
KayAnn Miller
I think it's important to look at. Culturally relevant food across the spectrum and one of the best examples of that in Montana in my opinion is big timber Montana where they serve the herder burger lamb burger. That is an area of Montana that overtime saw a lot of sheep ranching and all kinds of things going on there that really help shape that community and even in knowledge ING that in food I think is. Super important one of the the big stumbling blocks I think around culturally relevant food is our knowledge about what food is culture. And where food came from where did the first plant start so where is that food indigenous to. Right and if. We think about you know history and Europeans running into America 's looking for the Indies. Have to acknowledge that that revolutionized the world 's food scene so products that we think about is being? So uh from somewhere else really are indigenous to the Americas and people are already eating many of them so when we teach classes we ask people where did tomatoes come from and the number one answer is Italy. Is there associated with spaghetti sauce with Regus with lasagna all the things right? Well no they're actually indigenous to the Americas and they were a culturally relevant food here that made its way around the world corn is another example you did not eat polenta in Italy. Or have potatoes in Ireland prior to 1492 because those foods were not indigenous there. Our background new schools if you think about schools in Montana they're serving corn and they're serving squash and they're serving beans and they're serving tomatoes in all these recipes and not recognizing that those are culturally relevant foods and so part of that is just around education about what are we eating and where does. It come from. Or where did it originally come from and what does it mean to the people there or the people who brought it with them or the people who lived wherever originally and so that's a big part of the work that that we do is just that education. Process and we'll go into school and I'll be like oh I don't I don't do anything indigenous and I'll be looking at the steam table. Any thinking ohh there's succotash and it's got beans and it's got corn and it's got squash it's got some tomatoes in it yes you do do indigenous things we're just? Not aware of it right.
Lisa Lee
I love this question and just to add to Ian and kaylan's comments here providing indigenous food when serving indigenous indigenous populations means that they'll feel seen and we can celebrate other cultures and expose people to more types of food it's not only being indigenous but they are the largest. Minority hearing. Anna and when you serve culturally relevant food it aligns with some culture and traditions and language and people just eat better right this is what their experience is what they're used to so we don't need to serve other foods only in schools and restaurants. Right it's like we can expose people to new things and be accepting and celebrate the differences we also. You have one of the cool things we're working on at mount Peck with partners of ours is serving only Montana beef in Montana schools we have more cattle than people here in Montana and there is no reason why we shouldn't or can't do this and imagine the pride. That local ranchers and producers feel and the people of that community right so you're buying from bill the rancher down the street and serving his cow at the at the school and you're having you know let's do shepherd 's pie today and it it what if we have a picture of the rancher down the street. And celebrate the fact and the grandkid that goes to that school is like that's my grandpa you know like they're just so many layers here that we need to just celebrate and own here in Montana being an agricultural state so I love that question thanks.
Trina Filan
China. Oh my gosh I love food geography it that was amazing.
Margaret Mullins
And each of you had such a wonderful perspective on how to the terminology and how you can kind of perceive what that can mean at different levels and I think it's really important. And you know even when people get a food box and they see a corabi and they're like what planet did that. Come from it's very interesting how people don't know outside their little worlds what is sort of available so I applaud all of you for the work that you do to bring somewhere some more of those indigenous and culturally relevant foods and broaden those definitions it's really great. Ian I think that this question might be for you but all of you can shine in and you've been providing us some really good information about snap and double snap dollars we know there's a lot of news regarding snap and other nutrition programs lately. Can you just talk about how these programs are important for getting healthy food into people 's hands and how some of these changes may require your programs to adapt and evolve in the future?
Ian Finch
I absolutely love this question I'm sure be saying can have have some deep insight into this question. As well so yeah you know for the last 10 years we have been matching snap dollars at farmers markets and other locations and I just wanted to mention you know montanans spend $12,000,000.00 in snap benefits every month in the state and that is a huge opportunity to capture that snap spending and make sure it gets to. You know the actual local farmers and the valuable food actors in Montana and that's why we do this work. And that that is at risk in a lot of ways with new legislation around snap you know we're seeing tighter work requirements we're seeing reduction in eligibility we're seeing more onus being put on to states to kind of pony up funds for benefits and what we're seeing more recently is that. And in the in the recent reconciliation bill that was passed states that have a certain what's called considered an error rate in their snap processing so that may be an overpayment to a participant that might be an underpayment to a participant those states are going to be targeted for providing a share of the cost of those benefits. Themselves so think about $12,000,000.00 in benefits in Montana alone if Montana State government has to start contributing to the share of those benefits that's millions and millions and millions of dollars and the state is going to have to go through a really challenging. Process to identify where that funding would come from luckily I just looked it up today Montana does not have a high error rate and so I do not think our state is going to be subjected to that particular provision of the bill and what I've heard is that outside of snap Ed which is the most critical public nutrition. Education program that I can think of which is now defunded after August 31st of this year I believe or maybe at September I've heard that the snap changes will come into effect in. 2028. And I could be wrong about that things might have changed but that does give us 3 years to really look to our partners to look to each other and really start having a conversation around what will that mean for Montana what will it mean for our programs and I've had some feedback from the community of oh if if you know snap gets reduced how will your snap match. Christian incentive program be affected will you be able to continue the program. And what I think we'll see is yes there will be a limited number maybe it will be harder to access the snap program but those who are able to still participate in that benefit are going to be looking to these community based nutrition incentive programs even more and you know the community is going to be looking to offset some of that. Production and federal support with this local support and that's going to be incredibly difficult and so you know we've got 3 years to plan around it hopefully something at the federal level will change in that amount of time but. You know it it's gonna take the whole community to really figure out how we want to either scale up the programs that we're creating how are we going to do that hopefully there's a lot of. Engagement with and contributions from the healthcare industry from health insurance companies you know places that have more capacity and have more resources will most likely need to really start chipping in to help offset some of these reductions in support.
KayAnn Miller
Want to go back to comment. Lisa was making previously about. You know the lack of of standardized nutrition education. In Montana so snap it is listeners may or may not know provides some nutrition education in some schools in some counties in Montana if the schools qualify and that is going to be missed. Because 2 leases point. People don't know how to cook anymore so if you get that call or rabbi that we were talking about in your box first of all what is it what do I do with it and we see Anna 's research shows that when kids know the answers to those kinds of questions. Their entire household eats better not only do they eat better but their entire household eats better and so one of the things that we're doing at mount pack with some supporters that we have is looking at. How can we fill that gap as collaborative coalition type organizations how can we fill that gap and how can we bring nutrition education to all kids in all schools so that all Montana families? Do you have a kid in school have an opportunity to be learning from their kiddo and eating better? As a result of what their kiddo is learning that's a tall order is probably have some policy solutions as part of that it probably has some training solutions it definitely has a collaborative solutions in terms of working with existing food and. Consumer science teachers in schools for example. And we weren't thought that by the time the the federal money runs out but we recognize the importance of solving that for the health and well-being of all montanans in the state.
Lisa Lee
I'm glad keyan mentioned the need to address the the bigger gap around nutrition education but to your question Trina without snap we will start to see that trickle down effect in higher usage of food banks and the need for the school meal programs and food prescription programs. So I think one of the things that we see at the Montana partnership to end childhood hunger is more of the on the ground needs that are increasing drastically and have been for many months we all feel it at the grocery store right. Even if you have the means you can see that the prices have increased significantly and you can easily spend $50.00 on 5 to 6. Items and walk away still thinking ah I wish I could get a few more you know this is the reality for everyone but imagine if you just didn't have the money to get and purchase a healthy healthy diet at the end. Of the day so. I I feel like it's just gonna impact the programs that are trying to meet those community needs and we as partners in the food space. We need to think very creatively and collaborating together to address these larger gaps.
Margaret Mullins
Thank you all that's really good information and when I when I hear about your perspectives on what's needed I I am for me the encouragement comes that I know you all are so driven and so passionate about the work that you do that there will be a lot of boots on the ground. As they say working to see that these systems are maintained and that people are getting what they need so I'm you make me feel hopeful.
Trina Filan
Is there anything else that you all would like to make sure? We touch upon.
Ian Finch
I just want to say as an addition that I really believe this is an opportunity and a chance for the local food system to rise to the occasion the. Impact of inflation and rising costs is really happening at a global level and while inputs for local farmers are of course getting more expensive and so those items are going to increase in cost as well. I think there's an opportunity through the collaboration that we've all been talking about today to really try to identify what structure and what mechanisms can the local food system. Not step in right it's a long process of scaling up the food system to be able. To serve schools. And institutions and all the Albertsons stores in the state it's going to be. A long road ahead. But this is like the trigger moment where we as a state we as a community can say OK if the global food system can no longer serve us because of these costs how do we do it at home and so we can really start thinking about a values based approach a values based supply chain rather than you know this conventional approach of minimizing costs. Throughout the supply chain and I just think there's a lot of work and hope to be sought after in how we go about that in our local way.
Lisa Lee
I can add one thing and it stems from EM 's comments of just institutions like schools and healthcare are a big part of the local food system but they're often overlooked and we have to come to the table altogether with open minds as to like how to start looking differently at what exists. Across Montana. I feel like we need to communicate better when looking at nutrition and health care programs and engage healthcare leadership by sharing the progress and impact of what they're bringing to the population that they serve raising that awareness but showing the value. Of nutrition in healthcare. Within their internal audience but also externally so we and the programs that exist across the state need to do better at collecting those metrics and sharing all of the nutrition and health outcomes that we're seeing because really the goal in this is to make sure that families. Can consistently eat fresh quality food to address childhood hunger but also to improve diet related health conditions?
Margaret Mullins
Thank you so much on behalf of Trina and myself and the crew behind the scenes thank you also to our fabulous. Yes if you would like more information on what was discussed today visit our website at talking health in the406.mt.gov will there be links to the information discussed and if you haven't already Please remember to rate review and subscribe to our podcast and until next time be healthy and be well.