We have been looking at the ways health centers set themselves apart from other providers by not just preventing illness but addressing the factors that cause it. Tackling the social determinants of health is not a new concept. In fact, when the health center movement first took root in rural Mound Bayou, Mississippi, 50 years ago, the focus was not just on medical care but the environmental factors that were causing poor health, such as hunger and malnutrition. The book, Community Health Centers: A Movement and The People Who Made it Happen, by Bonnie Lefkowitz, describes how the health center founding physician, H. Jack Geiger, MD, became “infamous” for prescribing not just baby formula, but groceries for patients, who often did not have access to food, or could not afford it. “The last time I looked at a medical text, the specific remedy for malnutrition was food,” Dr. Geiger said with a smile. The first health center, which Geiger co-founded, also operated a farm co-op, not just because many residents in the rich agricultural county were hungry, but because they wanted jobs. Nearly 6,000 people were recruited as worker/owners of the farm co-op, according to Lefkowitz. Fast forward five decades and Community Health Centers are still stretching the bounds of primary care by focusing on nutrition and diet. As we’ve written in a previous post, health centers are trying to address “food deserts,” meaning poor neighborhoods where fresh produce is not readily available. And where that happens, one often encounters high rates of obesity and diabetes. In fact, a recent study in the American Journal of Preventive Medicine documents that moving to an economically challenged neighborhood can expand one’s waistline. All though more research is needed to definitively establish a cause, the authors speculate that a more deprived neighborhood can encourage consumption of unhealthy foods or make it hard to stay fit. Meanwhile, many health centers continue the tradition of prescribing fresh food and making it available. In Humboldt County, California, for instance, food insecurity is an issue for patients at Open Door Community Health Centers, which is why a nurse started a community and wellness garden that is maintained by staff and community volunteers. The garden is open to all and anyone is welcome to harvest food, though they are asked to contribute a little time for maintenance in exchange, such as weeding the beds of Swiss Chard, beets, lettuce and kale. Health centers also often operate food pantries, or host farmer’s markets to ensure their patient populations can access healthy foods. Depending on the health center, one can also finding cooking classes to ensure better eating habits, particularly among diabetics, and nutrition education classes.