IMG_3900 (002)On a beautiful spring day I took a walk during my lunch break through the urban neighborhood surrounding the hospital, wishing for a convenient place to buy a piece of fruit.

I discovered, as if conjured, a vintage trolley tucked in a driveway between medical office buildings. A table laden with apples, carrots, potatoes, and leafy greens leaned against it, creating the ambience of an open-air market. Charmed, and curious about its purpose, I climbed the two steps into the trolley.

Inside, a refrigerated case contained meats and dairy products. The walls were lined with shelves containing packaged goods such as bulgur, brown rice, beans, and more fresh fruits and vegetables. I plucked an orange, noticing it was priced by the piece, not by the pound.

I had multiple questions for the clerk as I handed her a quarter to pay for the orange.

A food prescription program.

The trolley, it turned out, is a mobile grocery store in partnership with the hospital, piloting a “food prescription” program. It arrives weekly, traveling to other sites the rest of the week. Cash, cards, and food stamps are accepted. Outside, a caseworker seated on a camp chair gave food vouchers to qualified customers below a specific income level. A dietician also provided budgeting assistance, with tips on healthy food choices and simple food preparation.

Food deserts.

In oncology nursing, I spend a lot of time telling patients food is medicine. Nurses working with renal, diabetic, or cardiac patients do the same. But for some patients, healthy food choices are as out of the reach of their pocketbooks as many prescription medications.

People living in food deserts (more than one mile away from a grocery store in an urban setting, or 10 miles or more in rural areas) lack access to fresh meat, fruit, and vegetables. Mobile grocery stores are a shopping alternative designed to meet these challenges.

Health literacy and food choices.

Health literacy also influences food choices. Studies indicate that access to fresh, unprocessed foods alone does not improve community health. Access must be paired with education. That’s why the fruits and vegetables in the trolley were priced by the piece. Figuring how much a single orange costs priced by the pound is confusing. Knowing the price of the orange outright helps people on limited incomes budget, a necessity for healthy meal planning.

It’s also easier to carry the makings of a meal home in small amounts if you depend on walking, bicycling, or public transportation.

Food nutrition labels.

Food nutrition labels can be as difficult to understand as hospital discharge instructions. The ability to understand both of these are measures of health literacy.  Terms such as low sodium versus unsalted and natural versus organic are confusing. Low health literacy and unfamiliarity with dietary principles affects food choices as much as lack of access.

The availability of caseworkers or a dietitian at the mobile grocery store addressed this barrier to improved nutrition and health.

I remain charmed by the vintage trolley grocery store. Food is medicine. Mobile grocery stores offer more than a food bank by addressing the challenges patients face improving their health and/or maintaining it through food access and education.