The Delta GREENS (Growing a Resilient, Enriching, Equitable, Nourishing food System) Food is Medicine Project

The Mississippi Delta is renowned for its rich culture, agricultural history, and fertile soil. Yet, health inequities tied to discrimination, poverty, and racial exclusion persistently plague its Black residents. Mississippi’s extreme poverty stems from racial capitalism and the South’s slavery-based agrarian economy, the remnants of which still linger. As example, Bolivar, Washington, and Sunflower, three neighboring Delta counties, around 30% live at or below the poverty level. High obesity rates affect over 50% of women and over 40% of men, while diabetes rates are nearly double the national average. 

To combat these problems, community stakeholders, such as growers, health and agriculture educators, food retailers, and community-based organizations, have been working to increase access to fresh, locally-grown food and by creating economic opportunities for local farmers. The Delta GREENS FIM Project, a collaborative effort by Tougaloo College, Ruben V. Anderson Center for Justice, Center for Science in the Public Interest (CSPI), Delta Health Center, and Tufts University, seeks to enhance and support this work in Bolivar, Washington, and Sunflower counties.

This collaborative project capitalizes on the recent success of community-based efforts by the Reuben V. Anderson Center for Social Justice (RVA Center) at Tougaloo College, as well as decades of community-engaged research at Tufts University, including prior nutrition work in the Delta region. The Delta GREENS FIM Project’s primary goal is to improve health outcomes by bolstering the local food economy and developing an FIM program at the Delta Health Center, which ideally will generate both economic and health benefits for the community. Tufts University has had a presence in the Mississippi Delta since the mid-1960s when the late Dr. H. Jack Geiger, a physician, human rights activist, and professor emeritus at the School of Medicine, partnered with Tufts to establish the country’s first community health centers, including the Delta Health Center in Mound Bayou, involved in the Delta GREENS FIM Project.

Although FIM initiatives like produce prescription programs demonstrate significant potential for addressing nutrition insecurity, no studies have rigorously assessed FIM programs’ impact using a randomized controlled trial measuring objective cardiometabolic risk factors among minority populations in persistently disadvantaged communities.

A total of 150 participants will enroll into the FIM intervention over a 12-month period, while a control group of 150 individuals without access to the intervention will serve as a comparison. Researchers will regularly assess body mass index (a marker of obesity), hemoglobin A1c (an indicator of diabetes risk and control), dietary intake, and other measures for both groups.

The Mississippi Delta, with its unique cultural and agricultural background, faces ongoing health disparities rooted in historical racial inequality and poverty. By collaborating with community members and leaders and building upon previous successes, the Delta GREENS FIM Project aims to address these challenges with the hope of becoming a model for addressing nutrition insecurity and chronic disease issues in communities across the nation.

Aim One

To design a novel intervention that bolsters the local food economy and delivers Food is Medicine programming to a minority population within communities with persistent disadvantage.

Aim Two

To test whether the novel intervention reduces health disparities by improving outcomes related to obesity and diabetes among a rural minority population. Outcome measures are (*primary):

1. 1. Individual-level:
      1. Behavioral: Increase fruit and vegetable consumption*
      2. Biological: Decrease obesity (BMI)*, diabetes risk (HbA1c)*, and systolic blood pressure
   2. Community-level:
      1. Physical environment: Increase production and distribution of fruits and vegetables
      2. Sociocultural environment: Institute access to produce and decrease food insecurity
      3. Healthcare system: Decrease health care utilization

Aim Three

Generate a replicable and scalable food economy model to reduce obesity and improve diabetes. The model will focus on adults living in areas with disadvantage and make sustainable Food is Medicine policy recommendations related to SNAP, Medicare/Medicaid, and the Farm Bill to state and federal legislatures.