Addressing Unmet Social Needs

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The causes of poor health in the communities AHS serves are rooted in poverty and discrimination, which are closely interrelated. These create barriers to access to quality education and housing, safe environments, good jobs with fair pay, nutritious food, and other resources that promote and sustain good health. This leads to a vicious cycle of intergenerational poverty and poor health. AHS connects patients and their families with community-based resources to address social needs and improve their health including access to nutritious food and to social services.

“My doctor told me about Food Is Medicine. The first class gave me hope. It literally saved my life. It gave me my spark back. I started to care about myself and about others.”

Tammy Frankfather | Food is Medicine Participant | Hayward Wellness

Food is Medicine

Food insecurity—limited or uncertain availability of nutritious food—affects individual and community health and is a root cause of chronic disease. It is prevalent among AHS’s patients and has been exacerbated by the COVID-19 pandemic. Food is Medicine is an innovative solution developed at AHS’s Hayward Wellness Center and delivered in partnership with community-based organizations including Open Source Wellness and Dig Deep Farms. It has three core components:

  • Group medical visits that reduce social isolation and encourage physical activity
  • Access to affordable, nutrient-rich, pesticide-free, locally-grown, medically-supportive fresh produce and medically-tailored meals
  • Provider training in how to use “food as medicine” to treat, prevent, and reverse chronic disease (e.g., diabetes, hypertension)

“As a primary care provider, I know that by providing some teaching and tools around healthier choices, maybe I won’t need to have my patient take a second or third medication. Food Is Medicine gives us another way, that’s more long lasting, for a patient to make changes.”

Sumita Kalra, MD
Medical Director
Hayward Wellness

Program Impact

Significant increases in daily consumption of fruits and vegetables and physical exercise

Reduction in depression and anxiety

Reduction in blood pressure

“We help people navigate the twin ravages of cancer and poverty and their devastating impact on individual and community health. Our work lies at the intersection of race, class, and place-based inequities in health care and social safety-net systems. We navigate specific to patients’ burdens and bring dignity to people’s lives.”

Zhonnet Harper
Cancer Patient Navigator

Patient Assistance and Navigation

All too often, patients are forced to make difficult choices between paying for basic necessities like housing and food and seeking medical care. As a result, they may forego preventive services and postpone needed medical treatment, which compromises their health. Another barrier to seeking timely medical care is lack of understanding of how to navigate the complex health care system. The Patient Assistance Fund provides direct financial assistance—such as for emergency payment of rent and/or utilities, food, transportation—so patients can focus on getting the care they need. The Patient Navigation Program helps patients apply for and receive needed services and resources to meet their needs. The Health Advocates Program helps patients connect with and apply for publicly available support including CalFresh (food stamps), housing, legal assistance, and more.

Program Impact

Prevention of eviction and shut-off of utilities

Increase in screening rates for, and early diagnosis of, chronic conditions and cancers

Treatment regimens maintained

Improved health outcomes