Hmong farmers, HealthEast write prescription for better health: Veggie boxes

Partnership provides patients with free produce each week during the summer.

Fresh onions, strawberries and greens from a Veggie Rx box.
The contents of a Veggie Rx box are laid out on a table inside of the University of Minnesota Physicians Phalen Village Family Medicine Clinic in St. Paul. The Veggie Rx program provides patients with free produce each week during the summer.
Evan Frost | MPR News

For years, doctors have been urging their patients to eat more fruits and vegetables to maintain their health.

But for many people — especially those who can’t afford to eat well or who have few fresh food choices nearby — that’s easier said than done.

Enter the Hmong American Farmers Association and HealthEast. Since 2016, they’ve partnered to provide fresh fruit and vegetable boxes to patients, giving people the opportunity to eat healthier on a regular basis. In turn the Veggie Rx partnership supports local Hmong farmers and helps doctors build stronger relationships with their patients.

Each week during the summer, families receive a HAFA community supported agriculture — or CSA — box brimming with fresh produce plucked from the fields in Vermilion Township. Veggie Rx boxes are free for patients.

“We have so many hidden causes when it comes to heart disease or diabetes or obesity that are related to diet, and if we could not only help people access healthy food ... and if we can make it in a way where people are eating things they’re familiar with, hopefully, they’ll be more apt to eat it,” said Pakou Hang, executive director and co-founder of the Hmong American Farmers Association. “I think it can only be a win-win.”

A perfect pairing

For HAFA, partnering with HealthEast made sense, especially because the health system operates St. John’s Hospital in Maplewood, where a significant number of patients are Hmong.

Minnesota is home to the nation’s largest urban Hmong population and St. Paul and Maplewood have the No. 1 and No. 5 highest concentration of Hmong in the state.

But the program does not only serve the Hmong community. Veggie Rx is open to all families in need struggling with food insecurity as well as a condition that requires healthy eating. Most of the patients in the program have diabetes, prediabetes, heart disease or obesity.

In the pilot year, HAFA received project funding from the Center for Prevention at Blue Cross and Blue Shield of Minnesota. Just 10 CSA boxes went out to families at HealthEast’s Roselawn clinic in St. Paul. They were an immediate hit.

“Everyone at our clinic loved it. The patients really loved it,” said Dr. James Letts, who works at the Roselawn medical center. “It was the beginning of a great partnership and it’s grown over the years.”

In its second year, the number of participating families quadrupled and by the third, some 60 families were receiving Veggie Rx boxes. Now, more than 100 families receive CSA boxes and the program has also expanded to a fifth clinic this year. There’s even a waiting list at one medical center.

It’s currently funded by the Fairview Foundation, following the merger of Fairview and HealthEast in 2017.

But HAFA just doesn’t provide fresh fruit and vegetables. It also teaches people about farming, along with providing a primer on what comes in each box.

Much of the bounty is familiar to most consumers: onions, potatoes, spinach, carrots and watermelon. But the boxes also include produce more familiar to Southeast Asians, like lemongrass, bok choy and lemon balm. HAFA farmers grow more than 160 varieties of fruits, vegetables and flowers.

“Usually, we have to do some education about how to preserve or store what’s in the CSA,” Hang said. “We also highlight a vegetable in the box and give people recipes and how they can cook it.”

HAFA also alerts Veggie Rx participants to what’s happening on its 155-acre farm in Dakota County, in an effort to introduce participants to the people providing their food.

“It’s important for us to teach those of us who are no longer farming what it takes to farm,” Hang said.

Then at the end of the season, HAFA invites each family to the farm where they can take a tour and share a meal, all in the name of forging deeper relationships.

A ‘game-changer’ for doctors, patients

It’s not just HAFA and HealthEast patients working to build closer ties. The Veggie Rx program has also played a big role in strengthening ties between doctors and patients.

Participants no longer feel like they’re just being prescribed medication to manage their health, sometimes with little progress, nor are they only showing up to their clinics and seeing their providers when sick. Instead, they get to leave the clinic each week with fresh produce, making the experience of visiting their medical center much more positive overall.

A bag of vegetables sit on a walker.
A patient pushes a walker holding her produce from the Veggie Rx program.
Evan Frost | MPR News

“Our clinic for years has encountered families who are facing food insecurity and often felt like we didn’t have much in our toolbox to offer those families,” Letts said. Veggie Rx has been a “game-changer,” he said.

“Most of the doctors, all they want to do is just help but all they can do is prescribe medicine,” said Rochelle Richardson, 50, who joined Veggie Rx last year. “But with this program, it helps.”

She had already been trying to change her eating habits to alleviate her high blood pressure and high cholesterol when Letts recommended her for the Veggie Rx program. Prior to joining the program, it hadn’t always been easy to incorporate fruit and vegetables into her daily diet.

“I’m eating more of what I can get a hold of, not-so-healthy food,” Richardson said.

Since joining the program, she’s seen her health dramatically improve — she’s dropped more than 50 pounds and has even been taken off some of her medication.

She’s participating in the program again this year, and it was apparent just how excited she was for the start of the new season a few weeks back when she revealed how prepared she was.

“I got a whole deep freezer ready for it,” she said.