A Community Partnership to Reduce Food Insecurity and Improve Patient-Reported Depression

To address the growing prevalence of food insecurity and its adverse effects on health, health care organizations are partnering with community organizations to develop nutrition programs aimed at both reducing hunger and improving diet-related health. Although there has been little effort to document improvements in mental health outcomes among nutrition program recipients who receive support through a community-health care partnership, this study suggests a beneficial relationship. The Greater Boston Food Bank, a 501(c)3 organization that supplies food pantries and tracks food insecurity throughout eastern Massachusetts, has developed a mobile market (MM) intervention in partnership with community health centers (CHCs) and other community-based locations to provide free produce, dairy, and high-protein food to low-income residents of eastern Massachusetts in a farmers' market-style environment, with the primary goal to reduce food insecurity. The data collected through the CHC partnership indicate that attendance at the MM was associated with improvement in depression score among CHC patients. All MM attendees experienced improvement in depression score with increased MM utilization, but the biggest effect was for patients with a diagnosis of depression at baseline. This partnership experience demonstrates that interventions developed by health care-community partnerships may have benefits for program participants beyond the primary goal of the program. During the study period of more than 3 years, for all patients in the study, each MM visit was associated with a 0.05-point decrease in the subsequent nine-item Patient Health Questionnaire (PHQ-9) score (95% confidence interval [CI], -0.08 to -0.02), which is a measure of depression on a scale of 0 to 27. Among those who had a diagnosis of moderate or severe depression before the MM intervention (PHQ-9 higher than 9), each MM visit was associated with a 0.27-point decrease in the subsequent PHQ-9 score (95% CI, -0.33 to -0.20). Mean attendance at the MM for patients with a diagnosis of depression was 6.7 visits, which translates to a predicted 1.8-point reduction in PHQ-9 score per patient during the study period.