A recent clinical study led by UNC Health and funded by Blue Cross and Blue Shield of North Carolina (Blue Cross NC) has found that providing modest monthly grocery cards for produce results in greater improvements in blood pressure than distributing pre-selected boxes of healthy food.
The Healthy Food First trial, conducted by researchers at UNC Health and the UNC Schools of Medicine and Public Health, sought to determine the most effective way to deliver healthy food to individuals experiencing food insecurity. The study included nearly 450 participants who were randomly assigned to receive either a $40 monthly food subsidy or a box of pre-selected healthy foods. Some participants also received telephone-based lifestyle counseling and advice from community health workers on following a heart-healthy Mediterranean diet.
“Our objective for the trial was to find an intervention that would improve blood pressure among participants who were experiencing food insecurity,” said Seth A. Berkowitz, MD, MPH, study co-leader, associate professor in the UNC Department of Medicine, and a principal investigator at the Cecil G. Sheps Center for Health Services Research. “Study participants could receive two options, either a $40 food subsidy or a box of pre-selected healthy food. We found that both groups saw a decrease in blood pressure, but the participants who received the food subsidy had even lower blood pressure than the participants who received the food box.”
Food insecurity affects more than 1.5 million people in North Carolina, including one in five children, limiting access to nutritious foods and contributing to chronic health conditions such as high blood pressure. In 2021, Blue Cross NC partnered with UNC Health Alliance and a team of researchers to address food security among at-risk members with hypertension.
Colleen Briggs, Vice President of Corporate Responsibility at Blue Cross NC, said, “This research offers powerful insights into how we can more effectively address diet-related chronic conditions to meet the needs of North Carolinians. As we deliver on our Purpose to improve the health and well-being of our members and communities, we’re investing in food-based programs that advance better health outcomes and drive affordability through smarter, preventive care.”
The study found that participants who received the $40 monthly food subsidy showed an average drop in blood pressure from 138.42/84.87 at baseline to 132.8/80.5 after six months. Those who received the food box saw their average readings decrease from 137.96/84.62 to 135.3/82.1 over the same period.
“We heard from study participants that they often could not eat the way they thought they should for their health because healthy food is just too expensive,” said study co-leader Darren DeWalt, MD, MPH, Chair of the Department of Medicine at UNC Health. “The results of our research show that the food subsidy made a big difference. That extra flexibility allowed them to eat the kind of healthy food they enjoy, and their blood pressure numbers went down.”
Alice Ammerman, DrPH, another study co-leader and director of the UNC Center for Health Promotion and Disease Prevention, noted: “While plenty of evidence exists about how food insecurity can affect someone’s blood pressure, this study is the first effort to look directly at how to intervene and limit this type of health risk.” She added, “While the food subsidy did lead to a larger drop in blood pressure among participants, those who received the food box also experienced a slight blood pressure decline. No matter the means of how participants received their food or whether they participated in the study for six or 12 months, we witnessed a drop in both food insecurity and blood pressure among all participants. This is evidence that this kind of intervention can work.”
Dr. Mark Gwynne, President of UNC Health Alliance and Chief Value Officer for UNC Health said, “This type of collaboration not only strengthens the bridge between research and real-world care delivery, but it also ensures that the insights we gain directly inform how we care for patients. The outcomes of this study will guide us in creating more effective strategies to support our most vulnerable populations, reduce health disparities, and improve the overall well-being of communities across North Carolina.”
The Healthy Food First trial reflects Blue Cross NC’s ongoing commitment to initiatives aimed at improving access to nutritious foods and addressing chronic health conditions across North Carolina.
To read more about Blue Cross NC’s work or access additional information about its programs and initiatives visit http://www.bluecrossnc.com.
For details on UNC Health’s services and mission visit unchealth.org.
