Caitlin Whyte (Host): Welcome to In Their Words. In our last episode focusing on the UPMC Pinnacle Foundation Farm to Hospital Program, Dr. Kimberly Mudge shared the vision that helped bring this initiative to life at UPMC Memorial. Now, we're taking a closer look at how that vision is growing.

I'm joined by Dr. Andy Dessel, Director of Strategic Initiatives for the UPMC Pinnacle Foundation. Drawing on his expertise working at the intersection of food insecurity and health, Dr. Dessel shares how fresh produce from the farm is reaching patients today, the connection between access to nutritious food and better health, and the opportunities ahead to expand the impact of the Farm to Hospital Program. From food as medicine to addressing food insecurity across our communities, this conversation explores what's possible when we think about health beyond the walls of a hospital.

This is In Their Words, brought to you by the UPMC Pinnacle Foundation and UPMC in Central PA.

Dr Andy Dessel: Hi, I am Andy Dessel, and I serve as the Director of Strategic Initiatives for the UPMC Pinnacle Foundation. So, the common theme throughout my career has really focused on education and on service. So, I had previously served as an AmeriCorps VISTA, and that was in many ways the start of the idea of getting involved in nonprofit philanthropic type of work. And that led me to the Governor's Office of Citizen Service, more on the administrative side of AmeriCorps, where I worked with a variety of programs that served a number of different needs, whether it was working with veterans and military families, whether it was working on economic opportunity projects, or food insecurity and other health-focused initiatives.

So, that led me then to the Central PA Food Bank. I was there for nearly six years, where I served as the health innovations manager. And in that role, I was responsible for really building the structure and the partnerships and the processes to really build out the food bank's food insecurity and health-focused work, where I was able to really work with a variety of different stakeholders, different health systems, insurers, government agencies, to really work on this idea of using food as medicine and food as health.

And then, that's where I was actually then connected with the UPMC Pinnacle Foundation, where on the food bank side, I worked with the foundation and the team on the partnership with UPMC. And then, that has now led me to this role.

I think over the past 10, 15 years, the entire healthcare ecosystem has recognized that these things called social determinants of health, which in a lot of ways are not surprising, that where we grow up, what we eat, our daily habits and behaviors all have a really profound impact on our health, and food and food insecurity and nutrition security, enough research and evidence has emerged in recent time that really paint a very clear picture that when folks have access to healthy, nutritious food, that can contribute to better health outcomes physical health outcomes, so that means reduced chronic disease, things like type two diabetes, hypertension, obesity. But also, mental health benefits as well, because you can think of food insecurity as a cycle, and it becomes a vicious cycle for folks who have that uncertainty of where food is coming from, and that can affect their employability and their employment status. And then,, this cycle just continues, and that further exacerbates related health concerns.

And so, it's become very apparent that anyone working in the health ecosystem, whether on the provider side, the insurer side, the philanthropic side, the more we can do to address these social determinants of health, particularly food insecurity is one where we really can do a lot of very good work.

There's a lot of low-hanging fruit, if you will. Although it's still a very complex issue. We can improve the health of our patients, of our community members, and that's something that is really important and that we need to continue to make sure that that alignment exists between all these different stakeholders to make sure that there is consistent access to high quality, fresh, nutritious food and education and resources to make sure that folks have access to these really critical resources that promote positive health outcomes.

So right now, the produce items that are being grown and cultivated at the Memorial Farm mostly will go into the cafeteria at Memorial and are cleaned and processed, and then are distributed through the cafeteria service. They're distributed as part of patient meals, and they're available for sale as well. Bigger bags, like grocery bags that community members, employees, patient families are able to then take with them.

Another really exciting opportunity and where we see a lot of growth potential, and potential for really high-impact work is using a lot of that produce in our food as medicine type work.

So, I'll give you some examples. Recently, we have supported the procurement of a refrigerator in the infusion center with Hillman. In that refrigerator when patients are in there for their treatment, there are bags of produce that was grown at the farm and that was then sorted and then cleaned and processed with our food service partners. Those patients for free are able to take that produce with them with the idea of improving their health in a very accessible format right then and right there.

Another really exciting initiative that we've been supporting is with the UPMC Weight Management, where we are providing these produce bags as a part of their shared medical appointment model, where patients are already going in to see their providers and then are getting really high quality education and tips and resources, and they're also able to walk out that very appointment with this high quality nutritious produce. And that's in many ways what we see the farm really representing and really standing for, is it continuing to expand those food as medicine type of initiatives, where we're partnering with our clinicians and we're able to use the food, use this really high quality produce as a part of their treatment plan, as part of preventative medicine.

And so, in many ways, that is really the mission and the vision of where the Farm to Hospital program is going. And when you think of one single tomato, one single cucumber that's growing in that farm, the life of those produce items, ultimately, the goal is to get them into the hands and into the mouths of our patients. And that can contribute to better health.

As we continue to build the infrastructure, one of the projects that I've been working with our team on a lot is how can we get that produce beyond just York and beyond just Memorial? How can we get it to the other hospital locations in Central PA? We're still in the early stages of that. And so, some of the produce right now we may not necessarily be able to use. And then, the Fresh Fruit Farms is able to take that and provide that in some of the other distribution channels that they have.

But the vision is really that ultimately all this produce is going to be able to go to all of our hospitals, and it'll help support all of the programming that we're doing, and potentially to continue to support the broader charitable food network. But a lot of that depends on the type of expansion and the quantity and the capacity that we ultimately end up having year-round.

The Central PA Food Bank and their partners with Feeding Pennsylvania have collected a lot of really insightful data over the past several years that really have helped to give us a much clearer sense of who are our neighbors and our community members that are visiting the food pantries that exist throughout certainly the UPMC Central PA territory and then also who we've helped enroll in SNAP benefits.

And it's become really clear there's a lot of misconceptions about who experiences food insecurity. Significant portions of folks that either are supported by the existing community pantries or enrolled in SNAP benefits are actually under 18. It's a significant number, of 30, 30-ish, 40%. We can check the exact number, but it is a significant number, are kids. Another significant number are those who are over 55. A lot of senior citizens in many cases experience food insecurity. A lot of veterans also experience food insecurity.

And so, it's a very complex issue, and it's something that we also have to recognize is not necessarily a permanent status. In many ways, when we look at the average person's savings, we are all in many ways very vulnerable and maybe more vulnerable than we realize. We're one paycheck away, one missing paycheck away from experiencing food insecurity ourselves. And that's why it is so important to make sure that this charitable food network is strong and is available. Because even if it's not something that one of us experiences today or one of our friends or our family members, that could change tomorrow. And it's really important then to make sure that the resources are in place, that the structures, the processes are in place to be able to support people. Because any of us could be impacted by food insecurity more than we may realize and more than we may think. And that's why it's really important to make sure that that support and that support system exists.

I think success is going to come in a number of different forms. Whenever we've had the opportunity to really scale up our capacity and support some of the existing health education programs that already exist or will be developed, when we're able to track health measures, that is certainly going to be one form of success. That we can help say that because of the produce and because of the programming that the foundation has been able to help support, and the education initiatives, and the quality of care that patients are already getting with UPMC, that's going to be one form of success. That because of this, we can say that this person's A1c levels, this person's blood pressure, this person's whatever the particular biometric is, this produce and these programmatic efforts help to make that person healthier.

I think another bucket of success is going to look like the broader community, the broader communities that we're supporting. What do our food insecurity rates look like? And that's something where, again, as the UPMC Pinnacle Foundation, we've provided a lot of resources to really trusted key partners that are supporting that charitable food network, and making sure that we have accurate and reliable data to make sure that we're deploying these resources in the most high impact way possible.

So hopefully, in many ways, we're able to also see the food insecurity rates in Dauphin County, Cumberland County, York County, Lancaster County, all the counties that we're serving and all the surrounding areas reduced. That's something else that we can see as success. We want to continue to see a strong charitable food network supporting the existing pantries and our food bank partners.That's another form of success.

So whether it's the specific health improvement metrics, whether it's the network, whether it's broader food insecurity rates have decreased, and whether it's more folks have access to high quality nutritious foods, these are all going to be examples of how we can measure the success and the effectiveness of these initiatives and all these different programming efforts that we're trying to support

It's really important that all of our community members, our partners, all of our neighbors understand just how important food insecurity is and how it does impact all of us, that higher rates of food insecurity are associated with higher healthcare costs that we all end up paying.

And so, when we can take that lens and an appreciation that in many ways we all are connected, we're going to be able to have a stronger food system where we're going to be able to ensure that all of our neighbors have access, reliable, consistent access to healthy, nutritious food. And so, we're not just talking about food insecurity, but in a way that's not healthy. We're also talking about nutrition security, and these are all these types of ideas and programs that ultimately support our patients. And that means when our patients are supported and our families are supported, we have stronger communities that benefit all of us. And thankfully, the work of the UPMC Pinnacle Foundation is really helping to sustain this high impact work, and it's all ultimately contributing to these stronger communities that we're trying to help to support, and that's something that is really important.

And for all of our partners and our donors, you're making a really big impact. Sometimes that impact may take time. Sometimes it may not always be visibly apparent right away, but please know that it's there and that support is essential to continue to support all these initiatives and to support this future vision where everyone has access to this really high quality, nutritious food and can really maximize their potential and can really live their fullest life live in a very healthy way. And that's something that the foundation has done a really nice job of supporting a variety of different efforts and will continue to.

Caitlin Whyte (Host): From fresh produce grown at UPMC Memorial To a larger conversation about food insecurity, prevention, and community health, the Farm to Hospital Program demonstrates how food can become an important part of supporting healthier patients and communities.

As Dr. Dessel shares, the vision for the future is to continue expanding this work, connecting more patients with nutritious food and building partnerships that can help strengthen communities across Central Pennsylvania.

To learn more about the Farm to Hospital program and how you can support this work, visit the UPMC Pinnacle Foundation website. Thanks for listening to In Their Words. Be sure to follow the podcast, and if you enjoyed this episode, please consider rating, reviewing, and sharing it.