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A nutritious diet, including fresh foods and produce, is integral to how we manage and maintain our health. These foods support healthy blood vessels, nerves, and organs and give us the nutrients we need to function properly and stay well.
When we eat a poor diet, especially as we age, we are at a much higher risk for noncommunicable diseases.1 Chronic conditions like diabetes are exacerbated by nutritionally-deficient foods that can cause spikes in blood sugar levels (hyperglycemia), can lead to nerve damage, vision loss, heart disease, and even premature death.2
- Ley SH, Hamdy O, Mohan V, Hu FB. Prevention and management of type 2 diabetes: dietary components and nutritional strategies. Lancet, 2014 Jun 7
- Centers for Disease Control and Prevention. Food and Nutrition Insecurity and Diabetes: Understanding the Connection
Social determinants of health—conditions in the environments where people are born, live, and work that have a major impact on their health, well-being, and quality of life—also play a major role in health outcomes. Communities that lack access to safe housing, adequate transportation, education and job opportunities, lack nutritious foods (also known as food deserts), opportunities for physical activity, and experience higher levels of discrimination and violence typically experience wider health disparities and inequities.1
One such community in Tulsa, OK is North Tulsa, an area of about 17,000 residents just north of the city’s downtown. According to the Tulsa Equality Indicators 2020 Report, residents of North Tulsa are nearly half as likely to earn a living wage as residents of South Tulsa. The percentage of individuals at or above 200% of the poverty level in North Tulsa is 39% versus South Tulsa at 72.9%. And the life expectancy gap between North and South Tulsans is an average 8.4 years. North Tulsans have less jobs, less access to public transportation, and are twice as likely to use the emergency room as those residing in South Tulsa.2 And the Health Department reports North Tulsans have the highest difficulty accessing fresh foods (35.5% vs 21.3% in South Tulsa).3
- Healthy People 2030, Social Determinants of Health
- Tulsa Equity Indicators Report, 2020
- Tulsa Health Department’s 2022 Community Health Needs Assessment
The Centers for Disease Control’s 500 Cities Project reports generally higher rates of disease occurring in the north and northeast part of Tulsa. Rates of diabetes ranged from over 20% in North Tulsa to less than 8% in South Tulsa and the affluent areas of Midtown Tulsa. A similar pattern was reported with heart disease—over 10% in North Tulsa compared to less than 4% in more affluent areas—and high blood pressure with over 50% compared to less than 25%.1
While Black and Native Americans have two times higher prevalence of diabetes than their white counterparts2, they have dramatically different mortality rates at 39.8% and 50%, respectively, compared with 18.2% for whites. And of the five zip codes in Tulsa County with the highest mortality rate for diabetes, three of the five are in North Tulsa (74127, 74106, 74110).3
- Centers for Disease Control’s 500 Cities: Local Data for Better Health (CDC 500 Cities),
- Diabetes by Race/Ethnicity, American Diabetes Association
- 2019 Community Health Needs Assessment St. John Broken Arrow, Tulsa County, Oklahoma
Lack of access to nutrient-dense foods, or food insecurity, especially within these economic and systemic challenges, create an environment where North Tulsans often experience lower self-efficacy in managing chronic diseases and higher illness-related risks, such as unchecked A1c levels and higher blood pressure.
The consequences of unmanaged diabetes can be dire for both Tulsans and the larger health care system. One study estimates that “80% of premature deaths due to heart disease, stroke and diabetes could be prevented via modifiable factors such as improved nutrition and physical activity."1 And the cost estimate for a 1-2% reduction in a patient’s A1c level is upwards of $24k per person per year in health-care-related expenses.2
- Troesch B, Biesalski HK, Bos R, et al. Increased Intake of Foods with High Nutrient Density Can Help to Break the Intergenerational Cycle of Malnutrition and Obesity. Nutrients. 2015
- Allison Hess, BS, CWP1, Michelle Passaretti, MSN, RN, CCM1, and Stacy Coolbaugh, MBA, RDN, LDN1, Fresh Food Farmacy, American Journal of Health Promotion
The federal Healthy People 2030 program suggests that public health interventions that focus on helping everyone get healthy foods are key to reducing food insecurity and improving health. Without formalized food prescription programs at the national or state level, physicians can recommend that patients eat a nutritious diet, but there isn’t a formal—or reimbursable—way to prescribe these activities through most insurance or state-run health plans. And even when their doctors make these recommendations, patients like those in North Tulsa still don’t have access to the fresh foods and education they need to manage their diabetes successfully.
That’s why we started FreshRx!
Why did we start FreshRx in Tulsa?
A nutritious diet, including fresh foods and produce, is integral to how we manage and maintain our health. These foods support healthy blood vessels, nerves, and organs and give us the nutrients we need to function properly and stay well.
When we eat a poor diet, especially as we age, we are at a much higher risk for noncommunicable diseases.1 Chronic conditions like diabetes are exacerbated by nutritionally-deficient foods that can cause spikes in blood sugar levels (hyperglycemia), can lead to nerve damage, vision loss, heart disease, and even premature death.2
- Ley SH, Hamdy O, Mohan V, Hu FB. Prevention and management of type 2 diabetes: dietary components and nutritional strategies. Lancet, 2014 Jun 7
- Centers for Disease Control and Prevention. Food and Nutrition Insecurity and Diabetes: Understanding the Connection
Social determinants of health—conditions in the environments where people are born, live, and work that have a major impact on their health, well-being, and quality of life—also play a major role in health outcomes. Communities that lack access to safe housing, adequate transportation, education and job opportunities, lack nutritious foods (also known as food deserts), opportunities for physical activity, and experience higher levels of discrimination and violence typically experience wider health disparities and inequities.1
One such community in Tulsa, OK is North Tulsa, an area of about 17,000 residents just north of the city’s downtown. According to the Tulsa Equality Indicators 2020 Report, residents of North Tulsa are nearly half as likely to earn a living wage as residents of South Tulsa. The percentage of individuals at or above 200% of the poverty level in North Tulsa is 39% versus South Tulsa at 72.9%. And the life expectancy gap between North and South Tulsans is an average 8.4 years. North Tulsans have less jobs, less access to public transportation, and are twice as likely to use the emergency room as those residing in South Tulsa.2 And the Health Department reports North Tulsans have the highest difficulty accessing fresh foods (35.5% vs 21.3% in South Tulsa).3
- Healthy People 2030, Social Determinants of Health
- Tulsa Equity Indicators Report, 2020
- Tulsa Health Department’s 2022 Community Health Needs Assessment
A nutritious diet, including fresh foods and produce, is integral to how we manage and maintain our health. These foods support healthy blood vessels, nerves, and organs and give us the nutrients we need to function properly and stay well.
When we eat a poor diet, especially as we age, we are at a much higher risk for noncommunicable diseases.1 Chronic conditions like diabetes are exacerbated by nutritionally-deficient foods that can cause spikes in blood sugar levels (hyperglycemia), can lead to nerve damage, vision loss, heart disease, and even premature death.2
- Ley SH, Hamdy O, Mohan V, Hu FB. Prevention and management of type 2 diabetes: dietary components and nutritional strategies. Lancet, 2014 Jun 7
- Centers for Disease Control and Prevention. Food and Nutrition Insecurity and Diabetes: Understanding the Connection
Lack of access to nutrient-dense foods, or food insecurity, especially within these economic and systemic challenges, create an environment where North Tulsans often experience lower self-efficacy in managing chronic diseases and higher illness-related risks, such as unchecked A1c levels and higher blood pressure.
The consequences of unmanaged diabetes can be dire for both Tulsans and the larger health care system. One study estimates that “80% of premature deaths due to heart disease, stroke and diabetes could be prevented via modifiable factors such as improved nutrition and physical activity."1 And the cost estimate for a 1-2% reduction in a patient’s A1c level is upwards of $24k per person per year in health-care-related expenses.2
- Troesch B, Biesalski HK, Bos R, et al. Increased Intake of Foods with High Nutrient Density Can Help to Break the Intergenerational Cycle of Malnutrition and Obesity. Nutrients. 2015
- Allison Hess, BS, CWP1, Michelle Passaretti, MSN, RN, CCM1, and Stacy Coolbaugh, MBA, RDN, LDN1, Fresh Food Farmacy, American Journal of Health Promotion
The federal Healthy People 2030 program suggests that public health interventions that focus on helping everyone get healthy foods are key to reducing food insecurity and improving health. Without formalized food prescription programs at the national or state level, physicians can recommend that patients eat a nutritious diet, but there isn’t a formal—or reimbursable—way to prescribe these activities through most insurance or state-run health plans. And even when their doctors make these recommendations, patients like those in North Tulsa still don’t have access to the fresh foods and education they need to manage their diabetes successfully.
That’s why we started FreshRx!
Program Outcomes
Patients
Economy
Farmers
Meet the Founder
I grew up in Bixby and went to TU for a business law and management degree. I was on track to be a lawyer when I realized that what I cared most about, was actually advocating for human rights. When I was younger, I had worked at Burgundy Place, a retirement community in Tulsa. I loved that job and was excited to go to work every day helping seniors. So I applied to a master’s program in gerontology and was lucky enough to get accepted to USC Leonard Davis School of Gerontology, the number one program in the world! I was thrilled!
During my studies, I continued to gain experience working in all levels of long-term care, including affordable housing. I witnessed how the system actually hurts us more than helps us as we get older—and realized I wanted to help. So I began to study longevity and centenarians living in Blue Zones. It seemed like food played a pretty big role in life span. I became interested in not just our food, but how it’s grown. I got a certification in Regenerative Soil Advocacy so that I could study the connection between soil quality, nutrient density, and chronic health conditions.
When I moved back to Tulsa after graduating from USC in Los Angeles, I learned about the differences in life span between North and South Tulsans. The highest mortality rates for diabetes in Tulsa County were in North Tulsa. I saw this as a direct violation of human rights. I had to do something about the poor quality of food available in North Tulsa.
Starting FreshRx gave me the opportunity to work on many things of vital importance to me—supporting the longevity of underserved communities, decreasing food insecurity, supporting the environment, revitalizing the agricultural economy, and decreasing system-wide health care costs. And most importantly, it gave me a chance to bring healing through food as medicine.
