Human Health and Soil Health

Soil Health is Human Health

As soil health declines, human health follows suit. Our society is in the throes of a wide-spread, but little talked about chronic health crisis. 10,000 baby boomers turn 65 every single day in the United States with an average of 15 or more prescription drugs per year and more chronic health conditions than any generation has ever seen.  As a healthcare advocate,  I see the fallout of our flawed food system that originates from our failing soil systems on a daily basis. 

After completing my Masters in Gerontology at the University of Southern California and studying soil science through the Soil Advocacy program at Kiss the Ground, I began my journey to understanding the connection between longevity and soil health. In response to this new knowledge, I moved back home to Tulsa, Oklahoma and began implementing a community program aimed at solving both problems: rapidly deteriorating soil health and the corresponding decline of human health. Not only does the program hit two birds with one stone, but it also creates community by connecting patients and the public with local, regenerative farmers. Regenerative Agriculture is public health.

 Prescribing Local, Regenerative Food as Medicine

There are approximately 200 produce prescription programs in the United States where doctors prescribe fruits and vegetables as medicine. The programs all vary a bit in nature while mostly focusing on Type 2 Diabetes by prescribing and providing some combination of produce and education. Out of all these programs, Oklahoma’s produce prescription program, FreshRx Oklahoma, is unique. We only source from local and regenerative farmers, many of whom have conducted the Haney Soil Test through Regen Ag Labs and are Regeneratively Certified through Soil Regen. The program provides a wholesale market alternative for local farmers willing to grow fruits and vegetables in a system with no chemicals, maximum crop diversity, cover crops, limited tillage, and some livestock integration. In other words, implementing all of the soil health principles! The participants report they have never really liked eating vegetables before but now they do because the taste and the quality is so good! And while the naturally grown food tastes great, the health outcomes are even more extraordinary.  FreshRx Oklahoma partners with primary care physicians and clinics to connect their patients to local, regeneratively grown produce. The program is prescribed by physicians who are champions for food as medicine. FreshRx began with a focus in North Tulsa, a predominantly low-income area without a grocery store for 14 years and a lifespan difference from south Tulsans of nearly 11 years! Of the 5 zip codes in Tulsa County with the highest mortality rate for diabetes, 3 of them (74127, 74106, 74110) are in North Tulsa where the main choices to eat are places like McDonald’s, Taco Bell, and Dollar General.

Humble Beginnings

The beginning of this unique food as medicine program started with Dr. Kent Farish, a primary care physician at Crossover Health Services in North Tulsa. Dr Farish approached the Tulsa Food Security Council expressing concern that his diabetic patients were suffering in spite of being compliant with their treatment plans.  While they were taking their medication and showing up for doctors’ appointments, their diabetes was still out of control. Dr. Farish understood something classically referred to as the social determinants of health. These are all the things that affect someone’s health outside of the clinic setting like food access, transportation, emotional health, jobs, family dynamics, and more. The Tulsa Food Security Council formed a committee to design a food prescription program called FreshRx for North Tulsa. They raised $185,000 to serve 50 North Tulsans with uncontrolled diabetes with an A1C of 8.0 or higher (those in great risk of amputation, kidney failure, stroke, and death). Because of my training and interest in both human health and soil health, I was selected to fundraise and administer the program. In 2021, we launched FreshRx with 52 patients from Crossover Health Services. Our team built a small local cohort of farmers who were vetted for their soil health practices and who were committed to growing for the program around the Tulsa area.

The FreshRx ‘Food is Medicine’ North Tulsa program provides a combination of free, local, nutrient-dense fruits and vegetables and educational classes for twelve months to those with uncontrolled Type 2 diabetes with an A1C level of 8.0 or higher in the north Tulsa area. The program consists of three-parts: (1) Bi-weekly boxes of fresh food, (2) nutrition cooking classes and (3) clinic evaluation check points. The program focuses efforts in the north Tulsa area, a food desert with a predominant population of people of color and Native Americans and black, with a significantly shorter life expectancy compared to those living in south Tulsa. 

Goals and Success

The goals and objectives of the program are to improve health metrics, increase consumption of fresh fruits and vegetables, improve participant’s knowledge of nutrition, and improve patient’s ability to self-manage chronic conditions. The elements of the program include communication with participants, local produce sourcing and distribution, cooking and nutrition education classes, and tracking health outcomes. The program partners with local clinics and primary care physicians to prescribe the program with a goal to reduce participants’ A1C levels by 1-2% in twelve months. With the help of the primary care physicians, FreshRx tracks A1C levels, blood pressure, and weight every three months and tracks mental health and nutrient intake. 

In the program’s first year, FreshRx saved the state of Oklahoma an estimated $750,000 in health care costs. Nearly 80% of the 52 participants graduated after 12 months and 75% of those had some type of reduction in their A1C level with an average reduction of 2.2%. The largest A1C reduction was from 14.0 to 6.9. Collectively, the cohort lost 296 pounds. For many, this could be the difference between life or death. In a comparable study, the Fresh Food Farmacy Geisinger study estimates the health care cost savings from $16,000 – $24,000 per year per participant who reduces their A1C by 1-2%. 

Simultaneously, FreshRx has supported 20 locally based small and medium size farmers by providing a consistent alternative wholesale market on which to depend. Many farmers reported that they would not have survived the pandemic without the support of this program. To further support the producer network, FreshRx partners with the Oklahoma Conservation Commission (OCC) and the Oklahoma Association of Conservation Districts (OACD) to provide technical assistance to farmers. FreshRx also helped four different farmers get funding for hoop houses through the Natural Resource Conservation Service (NRCS) in order to extend the production season of those operations. As a result of creating a cohort of farmers, the program supplies food to the FreshRx participants and then opens up to the public to buy any food overages serving as an aggregator and USDA retailer who also accepts SNAP/EBT benefits. The Food Bank of Eastern Oklahoma will then buy any overages which additionally provides relief to farmers eliminating the concerns of overharvesting and waste.

The Movement Continues

After the pilot’s successful first year, funders and community stakeholders committed to a second year to serve 100 patients and FreshRx expanded to partner with 6 clinics for referrals. Most recently, FreshRx was awarded the first USDA GusNIP Produce Prescription grant ever received in the state of Oklahoma and is funded through 2025 with Langston University serving as the program’s Institutional Review Board. FreshRx has been highlighted in 12 local news stories, the Tulsa People magazine, the Tulsa World and Oklahoma Today. FreshRx hopes to expand and create localized chapters with local cohorts of farmers to supply patients with real, nutrient dense, medicinal food in underserved areas across the nation. Food is medicine and regenerative ag can regenerate people!