‘Research Made Possible’ podcast: Gustafson addresses food insecurity to improve health

ANNOUNCER: Have you ever wondered who is doing the research that will impact your future? The “Research Made Possible” podcast lets you meet those people and learn how research at the University of Kentucky is changing what’s possible in Kentucky and beyond. Here’s Erin Wickey from Research Communications.  

ERIN WICKEY: The University of Kentucky’s Alison Gustafson is forming partnerships across campus and in communities throughout the Commonwealth to address food insecurity and its impact on the health of Kentuckians. Gustafson is the Gatton Foundation Endowed Chair and professor in the Department of Dietetics and Human Nutrition at the UK Martin-Gatton College of Agriculture, Food and Environment. She launched and now leads the Food as Health Alliance, founded in 2022 with support from the Office of the Vice President for Research’s Emerging Themes Program. In this podcast, we’ll hear more about the Food as Health Alliance and the innovative strategies to improve community well-being across Kentucky. 

ALISON GUSTAFSON: I really focus on addressing food insecurity as a key determinant on the pathway to diet-sensitive chronic disease outcomes. So when we think of diabetes or hypertension—certain cancers, cardiovascular disease—what we've really seen in our state and across the nation that those who are food insecure are then more likely to have type II diabetes, more likely to have hypertension. We can't say causation. We just know that there's a strong association between those two. So most of my work has really focused on how do we improve food insecurity so that we can then improve health outcomes among a variety of populations—one of them being people in eastern Kentucky, but also other rural communities and urban communities as well.  

WICKEY: The Food as Health Alliance was one of the first recipients of the American Heart Association’s initiative Health Care by Food™ award. The initiative gathers evidence to demonstrate clinical and cost effectiveness, ensuring patients with diet-related diseases or risk factors can access food-as-medicine programs through insurance.  

GUSTAFSON: We applied for the American Heart Association inaugural and their title is called, “Health Care By Food”. So a lot of people are using food as medicine. But really, we want to look at the bigger system of health care by food. And so what that looks at is, are clinic providers screening for food insecurity? And then we want to understand, how are we going to refer those patients who've been identified as food insecure that also have hypertension or type II diabetes? And then ultimately, what kind of program or package are we going to offer them to improve their health outcomes? We were one of the first recipients through the American Heart Association and to date, we're very excited. We've enrolled 180 Medicaid adults, 18 to 64 with partnerships with UK Health Care and Appalachian Regional Health Care.  

WICKEY: Gustafson was also recently awarded a Humana Foundation research grant in partnership with University of Louisville Health to test a nutrition intervention aimed at lower-resource families with nutrition-related conditions. 

GUSTAFSON: So we want to understand, how does providing food for the adult, but then also for the child in the household that's experiencing food insecurity—how can that improve health outcomes among the adult, but then also among the child or children that are residing in that home? When we think about it from different levels of challenges, on the individual level of challenge, one definitely is transportation. So we know that when addressing social determinants of health, one of those being food insecurity, it is highly connected to also transportation. And so, one of those challenges we've had to overcome in our research is, how do we get the food actually to the person's door? So we've been partnering with Instacart, DoorDash, which has been an amazing partner, to get those meals or meal kits delivered to the patient door. And so the reason that's really important from a research and policy perspective is, we know that our federal and state government could work on maybe partnerships with our industry partners to look at waiving those fees or other ways we can address the unbanked. What we really hope is that we can be working in two silos that also cross lines. We hope that our research informs policy. And the reason that's important is that in our state right now, we've been working hand-in-hand with our state leadership to move forward with this program called, “In Lieu of Service”. And so what that does is it allows insurance to cover a food as medicine program as a medically covered benefit. What we want to show over time among thousands of Kentucky residents—not hundreds, thousands—that providing these food packages that are tailored for diabetes, hypertension, we can move the needle on health outcomes and on food insecurity.

WICKEY: Thank you for listening to the Research Made Possible Podcast. Click “News” on our site, research.uky.edu, to learn more.