FoodRX and extra $15 for veggies: Innovative ways to address nutrition insecurity

At participating farmers markets, low-income shoppers using their EBT cards get an extra $15 to spend on fruits and vegetables, thanks to a federal nutrition incentive program. “Being able to get organic vegetables is amazing,” says KC Ochoa. Photo by Kathryn Barnes/KCRW.

Food banks and other emergency feeding programs stepped up like never before during the height of the pandemic. In June and July of 2020, the LA County Food Bank reached 1.45 million people. 

But the problem persists. According to a recent USC report, one in 10 households in LA County remain food insecure, meaning they struggle to provide their family with three meals a day.

“The conversation around hunger often leads to a conversation about getting food to people in need. But what I think is often missing in that conversation is the quality of food,” says Dipa Shah-Patel, who heads up nutrition programs at the LA County Public Health Department. 

The term “nutrition insecurity” is popping up in conversations about hunger and food insecurity. Organizations and governments are putting a greater emphasis on the quality of food reaching low-income people, who are often most likely to suffer from diet-related diseases like obesity and type-2 diabetes.

Here’s a look at two innovative approaches to address nutrition insecurity.

Incentivizing nutrition

About 25 EBT shoppers take advantage of the Market Match program at The Route One Farmers Market in Vandenberg Village each week, and new people learn about it every Sunday. Photo by Kathryn Barnes/KCRW.

The U.S. Department of Agriculture provides grant money to grocery stores and farmers markets that agree to double the amount low-income EBT shoppers can spend on fruits and veggies.

The Route One Farmers Market in northern Santa Barbara County joined the Market Match program in June 2020. Fresh fall produce currently line the booths: squash, peppers, swiss chard, and the last peaches of the season.

“We can run your card for however much you’d like to spend in the market, and we can double the first $15,” manager Shelby Wild tells one customer swiping their EBT card, also known as CalFresh in California. “How much would you like to charge your card?”

“$15,” they say.

“And we’ll give you another $15, so you’ll have $30 to spend in the market,” says Wild.

Kel Ferguson stops by to grab her market tokens. She’s been participating in the Market Match program for about two years.

“I didn't really know how to cook vegetables at all until finding out about the program,” she says. “I was just trying to stretch my dollar, and there was a sign up that literally said, ‘Stretch your EBT, go to the farmers market.’”

Kel Ferguson (right) learned about the Market Match program while living in Santa Cruz and trying to stretch her EBT dollars. She’s fallen in love with produce so much that she now works a booth at the Route One Farmers Market on Sundays. Photo by Kathryn Barnes/KCRW.

Shopping at the market became cheaper than shopping at the grocery store, she says. And when vendors see she’s paying with EBT tokens, they often throw in a little extra.

“There's the nutrition aspect, but there's also all this intention that I have,” she says. “When I wake up in the morning and eat something I’ve prepared, I feel better about my choices already.”

You can find out which markets near you offer Market Match here.

It’s still very uncommon for grocery stores to double SNAP benefits for produce. According to LA County, Northgate Market is the only brick-and-mortar retailer participating in LA. They offer the program, called Más Fresco, at six of their stores in Southern California, including one in Inglewood and one in South LA, and plan to expand it to all 42 locations early next year.

Prescribing produce like medicine

Health care providers around the country are experimenting with prescribing produce the same way they do pharmaceutical drugs. Courtesy of Sansum Diabetes Research Institute.

Though you may follow your doctor’s advice when it comes to what medicine to take, it’s easy to slack off a bit when it comes to diet recommendations. But what if your health care provider could write you a prescription for fruits and veggies, subsidized through your health insurance, just like pharmaceutical drugs?

That’s what David Kerr is trying out at the Sansum Diabetes Research Institute (SDRI) in Santa Barbara.

“I don't think people wake up in the morning and say, ‘I’m going to eat really bad food today. I'm determined to eat terrible food because I want to be ill,’” he says. “There’s something much more to this. And this starts to get into the politics of food, access to better food, and the cost of better food.”

With that in mind, SDRI piloted a program called Farming for Life with 30 people who had or were at risk of diabetes. Their doctor wrote a prescription for fresh produce, and the patients “filled the prescription” by picking up a free weekly box of local fruits and vegetables.

Patients participating in the Farming Life program pick up free, local produce weekly. Courtesy of Sansum Diabetes Research Institute.

The diabetes clinic measured their weight, waist circumference, blood pressure, and sleep and pain levels before the program began. Ten weeks later, they took those same measurements. 

“What we found is that if you improve access to better food, good things happen,” said Kerr. “Their blood pressure comes tumbling down. Their waist circumference goes down. For those who had diabetes, their blood glucose control improved really quite markedly. If I had a drug that did all those three things, it'd be a blockbuster.”

Roughly 400 people have now enrolled in the program. Kerr hopes the data collected will help prove to policymakers and health insurance companies that allowing doctors to prescribe produce will ultimately save the healthcare industry money.

You can find out about other produce prescription programs across the country here.


Nutrition incentives and produce prescriptions are only two on a long list of possible solutions. 

There are veggie rescue organizations, gleaning programs, free cooking classes at public libraries, and affordable housing initiatives, since a major barrier to cooking healthy meals is simply not having an adequate kitchen space.

It’s a both/and approach, and there’s plenty of room at the table for new ideas.