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Second Opinion: Addressing Food Insecurity in California

One in four Californians currently struggle with food insecurity, which is defined as a lack of consistent access to enough food for an active, healthy life.

Dr. James Cruz

Historically, food insecurity has impacted the Black and Hispanic communities disproportionately but even more so in this last year. The pandemic has been an equal opportunity destroyer of lives and livelihoods, and communities of color have been most adversely impacted by COVID-19. Throughout communities of color, food insecurity became aggravated due to the social and economic impacts of COVID-19 including parents and caregivers not being able to work. With this loss of work, it shone a spotlight on the reality of a lack of resources to purchase enough food. This has created an additional health barrier particularly among minorities who already have health equity disparities. 

How does one define “enough food?" From a clinical perspective, it means enough of the right types of food. For example, those with hypertension need access to fresh food, or foods that are low in salt. During the lockdown, fresh food became scarce, and people had to rely on canned goods. Limitations on the types of available food can have a lifelong impact on the individual. As a clinician, I understand that we must address the intersection of health and social determinants and its impact on outcomes. If a pregnant woman doesn’t have access to enough of the appropriate types of food to provide an adequate and proper source of nutrition, it will impact the baby’s growth and development.   

At Blue Shield of California Promise Health Plan (Blue Shield Promise), we are committed to exploring and investing in opportunities that provide innovative approaches to health equity that are reflective and responsive to the needs of the community. We are working hand in hand with our communities, which are lacking basic resources, to ensure that residents are able to access the right kinds of food so they can lead an active, and healthy life, based on their age and medical conditions. Over the last 18 months, Blue Shield Promise has supported small organizations like East Side Riders Bike Club that provides meals to Watts, California residents, and large organizations like the Kitchens For Good in San Diego. Both immediately started providing meals to residents after the state shut down.   

Blue Shield Promise’s president and CEO, Kristen Cerf, pushed for creating access to healthy food by supporting organizations that provide resources to communities as the COVID-19 pandemic highlighted the hunger problem that already existed. She led the charge to work closely with our partners to distribute the correct type of food to our members. Beginning in February and through the summer, we are hosting free food drives that are open to everyone. 

However, we recognize that there is still so much more to do. Even though we turned the corner regarding infections caused by COVID-19, we will need to deal with the aftermath of the destruction. The damage will linger with us for a number of years. We can influence change to help address food insecurity and other social determinants of health, by recognizing that clinical issues and public health issues are dependent upon each other. Supporting and replenishing our public health infrastructure, we will ensure that in addition to improving the social and health issues that people face every day, we can also weather the impact of a future health care crisis.  

Helping people lead an active and healthy life is central to Blue Shield Promise’s mission. The mission begins with providing members with a trusted source of information and educational resources. The environment where our members live, work or play is directly responsible for their health care outcomes. So, when there are deficiencies or deficits in the social and environmental infrastructure where they live, there is a direct consequence of poorer health outcomes.  

At Blue Shield Promise, we are working towards providing resources and expanding services which improve the lives of our members. We proudly operate five Community Resource Centers with our partner, L.A. Care.  These Community Resource Centers aim to improve health outcomes for our members and the community at large. Given the significant increase in demand for telehealth appointments during the pandemic – and the reality that many low-income individuals may reside in a digital desert or lack the funds to pay for a mobile data plans –telehealth hubs were implemented at each resource center location.

Health inequities are pervasive and persistent, and have real, lasting impact on people's lives - higher positivity rates for COVID-19, higher mortality rates during or following childbirth, and shorter lifespans. DD Johnice, vice president of the Health Transformation Lab at Blue Shield of California, oversees the Health Equity team, which encourages all of us to take an active role in eliminating inequities.

Her team’s efforts include enhancing and harnessing meaningful data to identify and prioritize gaps in order to reduce those inequities – both among our members and within the communities we serve.  

Blue Shield Promise recognizes the importance of working with community-based organizations to prevent diseases and make healthy living options more accessible, especially in underserved communities. Promoting healthy living can result in better health for more people, as well as improving health outcomes, especially among the most vulnerable populations.

We rely heavily on our partners to help us continue to be a hub for resources and advocacy to prevent diseases, and make healthy living options more accessible to underserved communities. But, we must take caution that we are not shifting the burden back to them. It is our goal to help close the gap.

Blue Shield of California, parent company to Blue Shield Promise, began to address these critical issues through the deployment of community health advocates at our Community Resource Centers. The Community Health Advocate Program is aimed at promoting preventative measures to help manage member health, identify health risks, and improve access to care. These professionals have helped Blue Shield Promise members with personalized support in a variety of settings. Additionally, they are equipped with innovative technology and collaborate with community organizations to address health and social disparities.

It represents the beginning of our journey to become a true “health” plan that improves the well-being of our members and all Californians.

At Blue Shield Promise, we will continue these efforts and others well into the years to come. Our focus is on our members’ needs, and preparing for whatever may come. 

Dr. James Cruz is interim chief health officer at Blue Shield of California Promise Health Plan.