Farm to Families: Empowering Nourishment in Urban Communities

by Providenza Loera Rocco, JD, MSW, MBE

     My earliest childhood memories are set around the dinner table—watching my Italian grandmother, never sitting down, working to make sure everyone was fed first course and second course, and maybe even a third course. She always included a pasta dish, greens, and a meat dish. My grandmother was an excellent cook, never reading a recipe book, but taking from the foods she grew up with and replicating them with her own flair. I loved being at my grandmother’s table because there we had conversations, and we had love. It was there I felt most comfortable and most nourished.

     Food is medicine. Food heals and touches physical and mental health. Food is self-expression. Food is joy. Food is memory. Food brings together family and neighbors and loved ones.

     But eating healthy and having access to healthy foods is a privilege in the United States and around the world. One in nine people around the world go to sleep hungry every night. A fast food hamburger costs as much as a corner store banana. Chicken nuggets are cheaper than fresh strawberries. 

     And while we experience food scarcity at alarming rates, we also experience massive food waste. In the United States, food waste is estimated to be 30 to 40 percent of the food supply. 

     The COVID-19 pandemic has had an enormous impact on food security and food availability during this past year, disrupting how people get food, how people afford healthy foods, and how people might help to feed each other.

     Twenty-one percent of Philadelphians are food insecure. In North Philadelphia, where I have the privilege of working, food insecurity runs as high as 30 percent. Food insecurity does not happen in a bubble. It occurs because of lack of affordable housing, health problems, social isolation, inadequate wages, and rising medical costs. North Philadelphia is overrun with corner stores, but there is not a grocery store within walking distance of where I work.

     People want to be healthy. People want to eat healthy foods. But cost and access are huge barriers.

     To help work with the community to provide nourishment and variety in affordable food options, a program called Farm to Families was developed in 2016 as a partnership between Temple University Katz School of Medicine and the St. Christopher’s Foundation for Children. This program allows people to get fresh fruits and vegetables from local farms at low cost. Farm to Families creates access to healthy foods. It allows clients to have a choice when feeding their families that is not solely dependent on cost. The program also allows health care providers to write prescriptions for fresh food at low or no cost for patients.

     Farm to Families is not a typical co-op model. We view nourishment through an urban bioethics lens. We think a lot about what it means to work with community members to promote agency and capacity for health. Food insecurity statistics can often create a narrative of disempowerment in communities. That narrative can make a community look weak or uninformed. Those narratives are wrong. I have come to learn that most people want to eat vegetables and healthy foods, and they enjoy sitting around the family table, just as I did as a child. Clients do not need prescriptive diets, but they want fresh fruits and vegetables, and often will travel long distances to attain them. Farm to Families offers a variety of foods, so whatever is in season is delivered to clients, and in that variety lies much opportunity for self-expression. 

     We work with students from our Center for Urban Bioethics master’s programs to check in on clients, to establish relationships with clients, and as a result we learn from each other. Through community cookbooks, check-in calls, and relationship-building, Farm to Families expands upon the traditional food pantry or co-op. Clients have choices, clients are cared for, and the importance of food is never underestimated. 

     We have the ability to solve food insecurity in the United States, and for years and years we have not. That does not serve justice. We continue to place Wegman’s and Trader Joe’s in suburbs and leave corner stores in our most underserved communities, accentuating systemic racism; reinforcing redlining divisions; perpetuating racist, classist, and uninformed notions of who is worthy and unworthy of healthy foods. That does not serve justice. Beneficence and justice call upon us to uplift our communities so that there is equal access to healthy foods. Eating healthy should not be a privilege in the United States. 

     The Farm to Families model is a blend of community nourishment, community empowerment, and community engagement. That model can be replicated. The idea that food is medicine and that health systems can and should work with communities to help provide that food can become mainstream IF we accept our obligation to end food injustice and replace it with food justice. 

     We must nourish our communities as we nourish our families by providing access, choice, and affordability. 

Providenza Loera Rocco, JD, MSW, MBE, is an assistant professor at the Center for Urban Bioethics at Temple University Lewis Katz School of Medicine. Enza has a master’s degree in social work from the University of Pennsylvania School of Social Policy and Practice, a master’s degree in bioethics from the University of Pennsylvania Perelman School of Medicine, and a law degree from Temple University Beasley School of Law. Her focus is on legal and ethical issues in end-of-life care, food insecurity, urban bioethics, policy, and animal ethics. Enza also serves as a lecturer at Simmons University School of Social Work and Drexel University College of Health Professions. She also is a health care ethics consultant and serves on Temple Hospital’s ethics committee. Enza has three kids, two dogs, and lots of cats.