Food is Medicine: The Equity Imperative

Bengucan Gunen, MSPH; Sushraya Jay, BA, MPH; Anne-Charles Zimmer, BS, BA, MS; Lilian Shin-Cho, PhD; Katarina E. AuBuchon, PhD - Health Equity SIG

The Food is Medicine (FIM) movement has grown in popularity over the past decade, and FIM was recently announced as a highlighted topic for the National Institutes of Health (NIH), Office of Nutrition Research¹. FIM programs are based on the premise that a healthy diet can reduce chronic disease risk by integrating pre-made meals, groceries, produce, vouchers, counseling, and education into healthcare services.² FIM approaches are uniquely positioned to address chronic disease among those most at risk: individuals facing food insecurity.

Food Insecurity and Food is Medicine

People experiencing food insecurity bear a disproportionate burden of chronic disease, and food security is inequitably distributed. In the United States, food insecurity is more prevalent among individuals who identify as Black, indigenous American, or Hispanic³ (vs. White), immigrants (vs. native-born Americans),⁴ and residents of rural (vs. urban) communities.⁵ Food insecurity stems from financial root causes⁶ and mirrors longstanding inequitable patterns of chronic disease burden, such as those based on race⁷ and rurality.⁸ Limited access to healthy, affordable food increases chronic disease risk, and chronic disease exacerbates food insecurity through medical costs, lost wages, and a greater need for nutritious foods.⁹

In 2023, the Department of Health and Human Services launched FIM initiatives to prevent diet-related chronic diseases and promote food security.¹⁰ Initial studies¹¹ indicate that FIM programs may reduce hospitalizations and health care spending if implemented at nationwide.^12,13 As FIM research and practice continue to grow, equity must remain a central priority to address health inequities.

Food Is Medicine Inequities

Though the importance of reaching marginalized and high-need populations is widely discussed in FIM literature, few studies document how existing interventions achieve these goals.

There is limited research on FIM approaches in rural populations,¹⁴ and rural settings often have low rates of participation for similar nutrition programs.¹⁵ While delivery-based FIM approaches may reduce transportation and mobility barriers, not all FIM programs follow this approach.¹⁶ Additionally, uninsured individuals may be ineligible to participate in FIM due to lack of coverage.¹⁷

FIM programs are also often not designed to accommodate a variety of cultural dietary preferences. Culturally-responsive implementation in ethnically diverse populations will require building capacity to provide meals that reflect the cultural foodways of a community, including understanding of how foods are prepared and consumed within households.¹⁸

Call to Action for Behavioral Scientists

Without attention to existing food access inequities, FIM efforts risk missing opportunities to improve the health of communities most impacted by food insecurity and chronic illness.

Advocates, researchers, and administrators must incorporate a health equity lens into implementation, evaluation, and scaling of FIM programs to ensure that access and benefits are applied to reduce – not replicate – health inequities. Behavioral scientists might use frameworks like EPIS (Exploration, Preparation, Implementation, Sustainment) to seamlessly integrate FIM efforts into the community.¹⁹ Partnering with community-based organizations can help ensure FIM programs meet local needs.²⁰

FIM is a promising avenue in behavioral medicine to tackle the chronic health issues facing the US population in 2026 and beyond. Given the NIH’s focus on FIM, we expect that research dollars will be directed into testing innovative approaches and understanding their impact on health. By employing a health equity lens, behavioral scientists can ensure that FIM focuses on the communities who need it the most, resulting in a healthier nation for all.

References:

1. National Institutes of Health. Grants & Funding: Food Is Medicine. June 3, 2026. https://grants.nih.gov/funding/find-a-fit-for-your-research/highlighted-topics/78
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8. Centers for Disease Control & Prevention. Preventing chronic diseases and promoting health in rural communities. Web Page. Centers for Disease Control and Prevention. Updated December 19, 2024. https://www.cdc.gov/health-equity-chronic-disease/health-equity-rural-communities/index.html
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