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

This project tests whether a multi-level, community-based intervention to build a sustainable local food economy, paired with Food is Medicine programming, can improve health in the Mississippi Delta. The Delta has a rich agricultural history and some of the nation’s most fertile soil, yet its residents have faced generations of economic hardship, food insecurity, and limited access to resources. About 77% of Mississippi counties meet the U.S. Department of Agriculture’s definition of a food desert. The project focuses on Bolivar, Washington, and Sunflower, three contiguous Delta counties with high rates of poverty and chronic disease. Of their roughly 100,000 residents, more than 65% are Black/African American and about 30% live at or below the poverty level. Obesity rates are high (over 50% of women and over 40% of men), and the diabetes rate is nearly double the national average.

To address these problems, community stakeholders, including growers, health and agriculture educators, food retailers, and community organizations, have worked to expand access to fresh, locally grown food and create economic opportunities for local farmers. The Delta GREENS FIM Project, a collaboration among Tougaloo College, the Reuben V. Anderson Center for Justice, the Center for Science in the Public Interest (CSPI), Delta Health Center, and Tufts University, supports and strengthens that work in the three counties.

The project builds on recent community-based efforts by the Reuben V. Anderson Center at Tougaloo College and on decades of community-based research at Tufts University, including prior nutrition work in the Delta. Its primary goal is to improve health by strengthening the local food economy and developing an FIM program at Delta Health Center, generating both economic and health benefits. Tufts has worked in the Delta since the mid-1960s, when the late Dr. H. Jack Geiger, a physician and professor emeritus at the School of Medicine, partnered with Tufts to establish the country’s first community health centers, including Delta Health Center in Mound Bayou.

Although FIM initiatives such as produce prescription programs show strong potential to address nutrition insecurity, no study has rigorously tested an FIM program in a randomized controlled trial that measures objective cardiometabolic risk factors in a rural, low-income population.

The trial will enroll 150 participants in the FIM intervention over 12 months, with a control group of 150 who do not receive the intervention. Researchers will regularly assess hemoglobin A1c (an indicator of diabetes risk and control), dietary intake, and other measures in both groups.

The Mississippi Delta’s distinct cultural and agricultural setting, combined with long-standing poverty and limited economic opportunity, has produced persistent chronic disease burdens. By partnering with community members and leaders and building on prior successes, the project aims to become a model for addressing nutrition insecurity and chronic disease in communities across the country.

Aim One

Design an intervention that strengthens the local food economy and delivers Food is Medicine programming in a rural community with high rates of poverty and chronic disease.

Aim Two

Test whether the intervention improves obesity and diabetes outcomes in a rural, low-income population. Outcome measures are (*primary):

1. Individual level
   1. Behavioral: increase fruit and vegetable consumption
   2. Biological: reduce 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: expand access to produce and reduce food insecurity
   3. Health care system: reduce health care utilization

Aim Three

Generate a replicable, scalable food economy model to reduce obesity and improve diabetes outcomes. The evidence from this sustainable Food is Medicine model, focused on adults in rural areas, will be widely disseminated.