Memorial Sloan Kettering Cancer Center
Program: Healthy Food & Community Change
Area of Work: Health
Grant Purpose: FOOD Program
Proper nutrition is essential for cancer patients, who are compromised by the disease, treatment, and side effects. Low-income cancer patients who cannot afford and obtain healthy foods, have lower rates of treatment adherence and completion, a reduced quality of life, and suffer from higher rates of depression and anxiety compared with non-food insecure patients. As patients experience unemployment, reduced income, and increased medical expense spending related to their intensive treatment regimens, food insecurity worsens.
Food to Overcome Outcome Disparities (FOOD) — a program within Memorial Sloan Kettering’s Immigrant Health and Cancer Disparities Service — addresses the glaring food and nutrition gaps among the medically underserved. The goal of the program is to ensure that there is food availability, accessibility, and appropriate use for an important at-risk population of patients with cancer and other chronic diseases.
The FOOD program began in 2010 with a dedicated, medically tailored pantry at Bellevue Hospital Center. During the pilot year, the investigators screened New York City hospitals serving low-income patients and found that more than half of patients identified as food insecure. Today, Memorial Sloan Kettering’s (MSK) FOOD Program is a city-wide, hospital-based pantry program designed to address food insecurity among low-income cancer patients in active treatment.
Purpose: To scale up the FOOD program to serve more patients and to pilot new options for patients to access food.
The FOOD program serves patients both during and after treatment, and now includes:
- Hospital-based pantries for patients as well as their families in twelve locations in the Bronx, Brooklyn, Manhattan, Queens, and Long Island:
- NYC Health + Hospitals/Coney Island
- NYC Health + Hospitals/Elmhurst
- NYC Health + Hospitals/Kings County
- NYC Health + Hospitals/Lincoln
- NYC Health + Hospitals/Queens
- NYC Health + Hospitals/Queens
- Montefiore Medical Center
- The Brooklyn Hospital Center
- The Ralph Lauren Center, MSK
- The Brooklyn Infusion Center, MSK
- The Rockefeller Outpatient Center, MSK
- MSK Nassau
- Fresh vegetable access through mini farmer’s markets at clinics, as well as the NYC Health Bucks Program, which patients can use at farmers markets to increase their purchasing power
- “Food navigators” to educate patients on healthy nutrition, provide guidance on how foods can help control treatment-related side effects, and connect patients with other food resources, such as SNAP (food stamps), meal delivery services, and local pantries and soup kitchens
- An online training course for physicians and other clinicians to educate them about food insecurity and its health impacts
- Partnerships across the city with health care and food organizations
Culturally competent care is a key dimension of FOOD’s model. At participating hospitals, staff members are bilingual in Spanish, Mandarin, Cantonese, Bengali, Russian, French and Arabic. Patient trust is most easily gained in their own native language. Pantries carefully track their inventory, and culturally tailor their pantry offerings to the populations they serve.
Since 2011, the FOOD Program has distributed more than 300,000 nourishing meals to more than 3,800 unique patients and their families. In 2019 alone, 67,000 meals were distributed. Breast cancer is the most common cancer among patients benefiting from the FOOD program, followed by prostate, colon and lung cancer, and more than two-thirds of patients reported having multiple, coexisting diseases. Over 75% of patients had lost their employment after receiving a cancer diagnosis, and more than 70% of patients were identified as being food insecure. MSK’s evaluations have demonstrated impact in several key dimensions:
- Participation in the Program impacted food insecurity scores positively.
- Among patients who supplied food security data, 93% of those whose food security improved by the 6-month study mark completed treatment, compared to a treatment completion rate of 86% for patients who remained food insecure.
- Quality of life scores and depression scores also showed improvement, with severely depressed patients showing a 50% reduction in depressive symptoms over time.
In addition, the Illumination Fund connected leaders of the FOOD initiative to City Council members to identify opportunities to reach more patients, including those who are undocumented and thus ineligible for food stamps. FOOD has also benefited from connections with the Illumination Fund’s other Healthy Food & Community Change grantees and partners, including the NYC Food Policy Center at Hunter College and the New York Academy of Medicine.
Response to COVID-19
Despite stay-at-home orders, some of their most vulnerable patients continued to go to the clinic to receive lifesaving treatments. The FOOD team has been working with hospital administrators, social workers, and frontline staff to ensure that that food is always available to patients across the twelve pantry sites. However, during the height of the crisis, many of their patients could no longer visit the clinics at all of our hospital-based FOOD pantries because of virus exposure risk. To ensure that patients still get the food they need, FOOD staff implemented a food delivery program to provide contactless deliveries to patients living throughout NYC and Long Island. Through a partnership with both taxi drivers in their other programs and other MSK staff, FOOD has delivered more than 40,000 meals to the doorsteps of more than 350 unique cancer patients since the quarantine began in March. In addition, their FOOD Navigators have been connecting patients over the phone with other food resources such as Get Food NYC, free school meals, and the SNAP program. Finally, during this time, FOOD is responding to an unprecedented demand for other resources, such as help with securing safe transportation to appointments, assistance speaking with cancer providers, navigating the public benefits system, connecting with legal and financial aid, and accessing psychosocial support. Through another MSK-based program, the Integrated Cancer Care Access Network (ICCAN), they can address these non-food needs to ensure that patients are receiving comprehensive assistance.