The United States has the most expensive health care in the OECD. In 2023 per person health costs were $US13,432, with the comparable country average at $US7,393.[1] Despite spending nearly twice the OECD average on health care, the United States performs poorly on avoidable mortality, chronic disease burden, and healthy life expectancy, indicating weak value for money rather than simply higher population health risks.
There is, however, reason to be optimistic. The Food is Medicine movement is gaining momentum nationwide. Broadly speaking, Food is Medicine refers to a set of health-care interventions that integrate food and nutrition into clinical care for people living with diet-related chronic disease or food insecurity. These include medically tailored groceries, produce-prescription (Produce Rx) programs, vouchers, and associated nutrition counselling as part of clinical care for people with diet-related chronic disease or food insecurity. Delivery models vary from home-delivered meals and grocery boxes to food vouchers linked to prescriptions and cooking or nutrition education, and are usually paired with screening and referral in clinical settings. More information is available at the US Department of Health and Human Services website.
The regenerative agriculture connection
On 10 December, the US Secretary of Agriculture and U.S. Health and Human Services Secretary Robert F. Kennedy, Jr. announced a $US700 million Regenerative Pilot Programme “to help American farmers adopt practices that improve soil health, enhance water quality, and boost long-term productivity, all while strengthening America’s food and fiber supply”. Read more on the USDA website.
This video emphasises how Food is Medicine initiatives can break down the silos between agriculture and health. The outcomes are connected and holistic including reversing desertification, reducing greenhouse gasses, enhancing biodiversity, improving human health and nutrition, and as one speaker puts it, “reminding us of what it means to be human”.
Financial advantages
In Aotearoa the health budget, while far more modest per person than the U.S., is a black hole that will keep absorbing whatever money successive governments devote to it. The U.S. experience offers some insight into how upstream interventions might help. A Tufts University study estimated that nationwide implementation of one intervention, medically tailored meals, if initiated nation-wide, “could save approximately $23 billion in health care costs in the first year alone and prevent more than 2.6 million hospitalisations annually related to complications from diabetes, heart disease, and cancer”.
Could we replicate the Food is Medicine movement here?
The U.S rollout is complex shaped by the diversity of State Government approaches interacting with Federal initiatives. Our economy is about the same size as Oklahoma – the State where Erin Martin, featured in the video above is working on the food system. You can also hear her talking about it in this Investing in Regenerative Agriculture podcast.
Food is Medicine is not a sudden innovation. The movement has been decades in the making. While it has had a boost from the Republican -led Making America Healthy Again movement, the previous Biden Administration supported it on the back of decades of food security and health initiatives. Universities, the American Heart Association, other NGOs, and communities are collaborating on Food is Medicine initiatives.
Perhaps the lesson for Aotearoa is not to wait for a single national programme, but to encourage greater collaboration across health, agriculture, and community sectors — with the hope that, in time, political leadership will follow.
I am grateful for editorial feedback from an AI language model, which helped me clarify structure and tone. Responsibility for the views expressed remains entirely my own.
Climate Action Tai Tokerau 