Skip to content
Search

Latest Stories

Top Stories

Prescribing Produce, Powering Markets: How D.C. Is Rethinking Food Access As Health Policy

Food market, fresh produce

As federal nutrition aid is stalled by red tape and grocery deserts persist, local civic-minded organizations are responding with inventive, community-centered approaches.

Getty Images, Kvach Hanna

In Washington, D.C., where neighborhood lines often map onto life expectancies, food insecurity has become a pressing public health issue. Wards 7 and 8, with only three full-service grocery stores, sharply contrast with affluent Ward 3’s 15 outlets. That access disparity correlates with a staggering 15-year life expectancy gap between some ZIP codes east of the Anacostia River and wealthier areas to the northwest. This inequality reflects what public health experts refer to as the social determinants of health – non-medical factors, such as access to nutritious food, that influence physical well-being.

A recent survey by the Capital Area Food Bank found that food insecurity impacts 37% of D.C. Metro Area households, disproportionately affecting Black residents in D.C., where four in 10 residents have struggled to access adequate food. “Where you live in the city profoundly determines your food insecurity and, in turn, your health outcomes,” said Luisa Furstenberg-Beckman, manager for the Produce Rx program at the nonprofit DC Greens.


As federal nutrition aid is stalled by red tape and grocery deserts persist, local civic-minded organizations are responding with inventive, community-centered approaches. I had the opportunity to speak with two: DC Greens and FRESHFARM, each tackling the crisis from different angles with emerging evidence of impact.

Produce Rx: DC Greens’ Health Care Approach

Founded in 2009, DC Greens pioneered D.C.’s produce prescription model in 2012, integrating nutrition directly into health care. Under their Produce Rx program, providers at the 17 federally qualified health clinics DC Greens partners with prescribe fresh fruits and vegetables to Medicaid patients diagnosed with chronic diet-related illness. Participants receive debit-style cards, loaded monthly ($80–$120 based on their household size) for use at approved stores and markets across D.C.

The clinical framing is important: “We are at the intersection of health care and food access,” said Furstenberg-Beckman. “Food is medicine” in both preventing and treating conditions like diabetes and hypertension. A mid-year check-in enables providers to assess progress through A1C levels, BMI, and blood pressure readings.

Early results are encouraging: 35% of participants showed measurable improvement, according to internal clinical evaluation. In 2024 alone, 96% used their cards, collectively spending over $750,000 on fresh produce. After enrollment, 85% reported improved food security, and 83% felt more confident in affording healthy meals. The program also provided participants with the flexibility to incorporate various types of produce into their diets. “When people have the money to try new things, they’re able to increase the variety of what they choose,” Furstenberg-Beckman shared, describing a patient who tried kale for the first time – and loved it.

Besides direct impact, DC Greens advocates for systemic change. DC Greens Executive Director Eric Angel emphasizes that the organization uniquely combines advocacy with service, using participant data to push a Medicaid 1115 waiver that would fund produce prescriptions as reimbursable health services. “We have the infrastructure with debit cards and health care partners – we just don’t have the funds to scale it up,” Angel said, calling current federal support for such programs “an idea whose time is coming, but hasn’t fully come.” Until Medicaid pays for nutritious food, the program depends on grants and local philanthropy, both resources that limit the program’s scale.

Produce Plus: FRESHFARM’s Community Markets Model

Where DC Greens embeds nutrition within clinics, FRESHFARM embeds it within communities, focusing on farmers markets and local food economies. The nonprofit administers Produce Plus, a DC Health program that distributes $40 monthly electronic credits to 8,000+ eligible residents from June to September. Cards are accepted at 63 farmers markets and farm stands citywide, including many in low-access neighborhoods. This runs in parallel to federal programs like SNAP and the WIC/Senior Farmers’ Market Nutrition Program, which in D.C., offer just $30–$50 per year.

Nick Stavely, FRESHFARM’s director of incentive programs, describes Produce Plus as “a triple investment in nutrition, local farmers, and healthy food retail.” In 2024, participants redeemed $990,000 in benefits, a 13% increase over the previous year. A third-party evaluation showed that 98% participants reported healthier eating habits, echoing national research that links produce incentives to improved diet, blood pressure, and glucose control.

A key advantage is local economic impact. Farmers receive full reimbursement, providing a consistent revenue source that sustains and expands markets. FRESHFARM digitized the process in 2022, moving from paper tokens to prepaid cards. Stavely reported that 58% of families used at least 80% of their funds, and one-third used everything. The program’s value also lies in the user experience. Multilingual outreach, market staff referred to as “champions,” and participant feedback loops have fostered trust and seamless access.

Demand, however, outstrips funding. In 2024, 35% of eligible applicants (4,717 people) were placed on a waitlist. The program relies on D.C. council budget approvals each year, and while advocacy led to a modest increase in slots last year, many still go unserved. “More people want to participate every year, and the number we can serve is capped by funding,” Stavely acknowledged.

Overlapping Strategies, Shared Hurdles

Despite differing delivery methods, both DC Greens and FRESHFARM are addressing the same core challenge: unlocking equitable access to fresh food in neighborhoods that have been historically underserved. Their approaches, ranging from clinical integration to community markets, complement each other and underscore the broader truth that food insecurity is best addressed through multi-sector collaboration. Both programs partner with local government, healthcare systems, farmers, and vendors to build ecosystems of support.

However, policy and funding ceilings throttle their full potential. DC Greens awaits federal approval for D.C.’s Medicaid waiver, while FRESHFARM hinges on municipal budget cycles and year-to-year support. Neither program is fully benefiting from federal nutrition incentive programs, such as USDA’s GusNIP, where a more robust partnership could extend federal backing to local produce incentives and drive sustainability.

Why It Matters, and What Comes Next

Innovations in treating food as a core component of health are emerging nationwide. Research from Harvard Medical School shows that produce prescriptions can reduce clinical risk markers while reducing health care costs. Meanwhile, communities across the country are adopting nutrition incentive programs similar to Produce Plus. However, the success of local innovation depends on policy integration and stable funding.

In D.C., where structural inequity aligns with health disparities, data shows that these programs prove what’s possible. As Furstenberg-Beckman said, “When we support folks in accessing healthy food, we’re supporting so many health outcomes – physical, mental, emotional.” Stavely notes that local farmers also benefit, as these programs create jobs, reinvest money in underserved neighborhoods, and foster stronger connections between residents and food producers.

The challenge now is scaling these efforts beyond pilots and across seasons, zip codes, and demographic groups. Expanding Medicaid coverage for nutrition, securing multi-year funding for incentive programs, and integrating produce access into broader healthcare and wellness policy could bridge the gap between interventions and system-level change.

Conclusion: From Pilot to Policy

The stories of Produce Rx and Produce Plus are more than local innovations; they are building blocks for systemic change. By bringing fresh food into clinics and neighborhoods, embedding dignity into service delivery, and centering the economic well-being of local producers, these programs model what community-based solutions can look like at scale.

They also offer particularly civic value: when public resources, nonprofits, and healthcare systems align around a shared goal – ensuring that fresh produce is simply available and affordable – health inequities can begin to shift. D.C.’s experience provides a template for targeted, data-driven, human-centered policy that treats fresh food as a fundamental right rather than a luxury.

The work continues. Healthier grocery access, broader reimbursement structures, and expanded nutritional incentives must now flow from demonstration to mainstream. If these models succeed, they could not only narrow life expectancy gaps in D.C. but also reshape how cities nationwide address the vital connection between food, health, and equity.

Bennett Gillespie is a student at Duke University and a council member of the Duke Program in American Grand Strategy. He is also an intern with the Fulcrum.

The Fulcrum is committed to nurturing the next generation of journalists. To learn about the many NextGen initiatives we are leading, click HERE.

Please help the Fulcrum's NextGen initiatives by donating HERE!

Read More

Trump-Era Budget Cuts Suspend UCLA Professor’s Mental Health Research Grant

Professor Carrie Bearden (on the left) at a Stand Up for Science rally in spring 2025.

Photo Provided

Trump-Era Budget Cuts Suspend UCLA Professor’s Mental Health Research Grant

UC Los Angeles Psychology professor Carrie Bearden is among many whose work has been stalled due to the Trump administration’s grant suspensions to universities across the country.

“I just feel this constant whiplash every single day,” Bearden said. “The bedrock, the foundation of everything that we're doing, is really being shaken on a daily basis … To see that at an institutional level is really shocking. Yes, we saw it coming with these other institutions, but I think everybody's still sort of in a state of shock.”

Keep ReadingShow less
Border Patrol in Texas
"Our communities fear that the police and deportation agents are one and the same," the authors write.
John Moore/Getty Images

Who deported more migrants? Obama or Trump? We checked the numbers

We received a question through our Instagram account asking "if it's true what people say" that President Barack Obama deported more immigrants than Donald Trump. To answer our follower, Factchequeado reviewed the public deportation data available from 1993 to June 2025, to compare the policies of both presidents and other administrations.

Deportation statistics ("removals") are not available in a single repository, updated information is lacking, and there are limitations that we note at the end of this text in the methodology section.

Keep ReadingShow less
RFK Jr. Vowed To Find the Environmental Causes of Autism. Then He Shut Down Research Trying To Do Just That.

Erin McCanlies spent almost two decades at the National Institute for Occupational Safety and Health studying how parents’ exposure to chemicals affects the chance that they will have a child with autism. This spring, Robert F. Kennedy Jr. eliminated her entire division.

Nate Smallwood for ProPublica

RFK Jr. Vowed To Find the Environmental Causes of Autism. Then He Shut Down Research Trying To Do Just That.

Erin McCanlies was listening to the radio one morning in April when she heard Robert F. Kennedy Jr. promising to find the cause of autism by September. The secretary of Health and Human Services said he believed an environmental toxin was responsible for the dramatic increase in the condition and vowed to gather “the most credible scientists from all over the world” to solve the mystery.

Nothing like that has ever been done before, he told an interviewer.

Keep ReadingShow less
When Politicians Draw Their Own Victories: Why and How To End Gerrymandering

Alyssa West from Austin holds up a sign during the Fight the Trump Takeover rally at the Texas Capitol on Saturday, August. 16, 2025.

(Aaron E. Martinez/Austin American-Statesman via Getty Images)

When Politicians Draw Their Own Victories: Why and How To End Gerrymandering

From MAGA Republicans to progressive Democrats to those of us in the middle, Americans want real change – and they’re tired of politics as usual. They’re craving authenticity, real reform, and an end to the status quo. More and more, voters seem to be embracing disruption over the empty promises of establishment politicians, who too often live by the creed that “one bad idea deserves a bigger one.” Just look at how both parties are handling gerrymandering in Texas and California, and it’s difficult to see it as anything other than both parties trying to rig elections in their favor.

Instead of fixing the system, politicians are fueling a turbocharged redistricting arms race ahead of high-stakes midterm 2026 elections that will determine control of the U.S. Congress. In Texas, Republicans just redrew congressional lines, likely guaranteeing five new Republican seats, which has sparked Democratic strongholds like California and New York to threaten their own gerrymandered counterattacks.

Keep ReadingShow less