Understand the needs of the community before determining a strategy. This is not a one-size-fits-all approach and it is critical to understand the issues first.

Engage existing community-based organizations as part of the strategy and promote collaboration. It is important to note that this is a multifaceted approach and community relationships are critical.

In many parts of the United States, there is a crisis caused by people having limited access to healthy & affordable food options. This in turn is creating a host of health and social problems. What exactly is a food desert? What causes a food desert? What are the secondary and tertiary problems that are created by a food desert? How can this problem be solved? Who are the leaders helping to address this crisis?

In this interview series, called “Food Deserts: How We Are Helping To Address The Problem of People Having Limited Access to Healthy & Affordable Food Options” we are talking to business leaders and non-profit leaders who can share the initiatives they are leading to address and solve the problem of food deserts.

As a part of this series, we had the pleasure of interviewing Allison Hess.

Allison Hess is the Vice President of Health Innovations for Geisinger. She has been part of the Geisinger family for 15 years and is responsible for the oversight and implementation of health and wellness programs for Geisinger patients and insured members, employees, and community members. Her most recent work involves community-based strategies to address food insecurity and other social determinants of health, spearheading programs like Geisinger’s Fresh Food Farmacy.

Thank you so much for doing this with us! Before we dig in, our readers would like to get to know you a bit more. Can you tell us a bit about your “backstory”? What led you to this particular career path?

I wasn’t aware at the time, but my career path was probably being shaped at a very early age when I would spend time with my grandmother, who worked tirelessly on mission-driven initiatives like food insecurity. She was very influential throughout my childhood and adulthood and instilled in us the value of helping others and supporting underserved members of the community. As a young adult, I recognized my passion for health education. I started in the provider space at a local community hospital that had a robust and well-established community health education program, where I was able to gain additional skills, certifications, and experience. After gaining tremendous and invaluable experience, I transitioned to Geisinger, where I am fortunate to have the opportunity to help design and oversee innovative health delivery programs like Fresh Food Farmacy. Being part of an integrated delivery system affords the opportunity to leverage a variety of resources, use robust data for analytics and co-develop technology solutions with our innovations team.

Can you share the most interesting story that happened to you since you began your career?

I can speak to the most moving experience in my career, and that has certainly been my interaction with the participants in the Fresh Food Farmacy. This program often has a profound impact on many aspects of a participant’s life, not just their diabetes management. And for many, it is also the first time in years that they have not only been able to see positive changes in their health, but also don’t have to worry about how they will provide food for themselves and in many cases, their families. So, we often receive heartfelt messages about how this program “saved my life” or “gave me hope.”

Are you able to identify a “tipping point” in your career when you started to see success? Did you start doing anything different? Are there takeaways or lessons that others can learn from that?

I am fortunate that I have had a long list of mentors in my career at Geisinger who have enabled me to grow. My work in health and wellness started as a “new product” in the product development area as wellness was really starting to gain some traction for insurers. After a short time, I was moved out of that area (because after six months you could no longer be a “new” product) and spent time on the insurance sales area of the business as a value-added service strategy. That time allowed me to recognize that wellness should not just be a value add; it should be part of a larger population health strategy. Wellness and prevention strategies present an opportunity to get upstream of the chronic conditions that impact a person’s health and cost of care. From there I moved into the health services/population health areas of the organization and continued to develop a team and expand my portfolio with continued support from leaders in that area. The tipping point for me was likely the transition to Geisinger, which allowed me to be creative, develop strategies, build a team, and have access to resources that were instrumental in supporting my career growth through mentoring and constructive feedback. It was a journey that came with hard lessons along the way, and I valued every misstep as an opportunity to improve and learn.

None of us are able to achieve success without some help along the way. Is there a particular person to whom you are grateful who helped get you to where you are? Can you share a story about that?

I referenced earlier my grandmother, who just passed away during the pandemic at age 91. I would be remiss if I didn’t note her as she was and is my inspiration and guiding compass in my life. She instilled qualities in me growing up that I truly feel helped shape who I am today. She always looked for an opportunity to help somebody in need, whether it was on a mission trip to another country or close to home in her community or church. I remember in her 80s, she would drive to the roughest areas of Harrisburg to help tutor young students. Her ability to make people feel valued, special, and loved was something I have always looked up to. If a 3 dollars wooden spoon broke, she would tape the handle even though she could easily afford another one because there was an option to use that 3 dollars on somebody else who was in need. I will always admire her thoughtful decision-making, strong work ethic, honesty, compassion for others and ability to live simply. She always looked for opportunities to help and serve others.

You are a successful leader. Which three-character traits do you think were most instrumental to your success? Can you please share a story or example for each?

a. Hard work: I started working at an early age and paid half of my college tuition by working two jobs so I could graduate without loans. For my first professional job, I made less per week than what I was making waiting tables. It is easy to get focused on what the next level should be in your career path or your compensation, but I have chosen a different perspective and have worked under the assumption that if you work hard, opportunities will present themselves. Sometimes you take a step backward to take a step forward and it is easy to get lost in the destination and miss the importance of the journey. When I started in my role at Geisinger I was a wellness specialist with no management experience. I sought out successful leaders in the organization, attended classes made available by the organization and looked for mentoring opportunities. I welcomed additional work that pushed me out of my comfort zone and skillset, without hesitation or expectation. I used those opportunities as valuable experiences and learned from mistakes made along the way.

b. Gratitude: I try to start and end my day by thinking about what I am grateful for. I believe that keeping that perspective, even when things are challenging, is beneficial. Even when reflecting on the past year with COVID, I have tried to think about what was gained. Professionally, our team was called upon to step into key areas to help navigate through the pandemic, and they did so successfully and without hesitation. The days were long, and the work was hard, but I had an amazing team that rallied to do their part and get us through this pandemic. While work was much busier, in my personal life the pandemic made our family slow down a little with the hustle and bustle of traveling to soccer tournaments, kids’ activities and always being on the go. I had more front porch rocking chair conversations with my teenage daughters, we played board games as a family that we hadn’t played in years, we walked every night with my mom and our dog and spent the year connecting in a more meaningful way. While we are now welcoming a little more hustle and bustle with sports and other activities starting back up, I will forever be grateful for the quality time spent and the “slow down” in my personal life that allowed me to prioritize how we spend our personal time.

c. Empathy/Self-reflection: I think empathy and compassion are important in many roles, but especially in healthcare. Understanding that things are not always within our control and accepting when that is the case has allowed me to be more empathetic in situations. I believe leadership is something that you work on and grow into, and should include ongoing self-reflection, adaptation, and personal growth. It is important to be able to identify personal areas of opportunity and come up with solutions to address them.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

“Everything happens for a reason.” This has helped me so many times in my personal life and my career. Trying to understand how I can learn from the challenging times, recognizing that life isn’t always easy and doesn’t always make sense, and finding gratitude in the middle of a storm has helped me so many times. I truly believe that our perspective and outlook directly impact our overall health and our ability to cope. This life lesson rings especially true when my husband (then fiancé) was diagnosed very unexpectedly with late-stage Lymphoma when we were in our early 20s. At the time, I remember being devastated with the news that this would be a hard battle to fight. Watching how he embraced the fight, continuing forward with his college education through treatments and days where he struggled to get out of bed, always with a grateful heart and a positive mindset, has inspired me through any challenges I have faced in life. When we were told that we wouldn’t be able to have children due to the extensiveness of treatment, we adjusted our life plan and decided to focus on completing our education, embracing our career journey, and traveling. Six years later our first daughter entered the world and 22 months after that her sister was born. It is sometimes hard to let go and recognize when you aren’t in control, but when you do, it makes it so much sweeter when things turn out differently than you expected.

Ok super. Let’s now shift to the main part of our discussion about Food Deserts. I know this is intuitive to you, but it will be helpful to expressly articulate this for our readers. Can you please tell us what exactly a food desert is? Does it mean there are places in the US where you can’t buy food?

​Yes, and often in places that you wouldn’t realize. Food deserts are geographic areas, usually in urban areas, where it is difficult to obtain healthy food due to limited or nonexistent grocery stores or food distribution options. There may also be limited transportation options that make it challenging for individuals who live in a food desert to obtain healthy food.

Can you help explain a few of the social consequences that arise from food deserts? What are the secondary and tertiary problems that are created by a food desert?

​People who live in food deserts have a higher risk of obesity, diabetes, and cardiovascular disease. Individuals also have a more difficult time controlling existing diet-responsive conditions like diabetes and hypertension.

Where did this crisis come from? Can you briefly explain to our readers what brought us to this place?

There are several factors that impact food insecurity. Our first Fresh Food Farmacy location was opened in an area that was economically thriving during the coal boom in Pennsylvania and had sufficient jobs and a tax base. As the coal industry declined and businesses moved out, the area became economically depressed. However, generations of families lived and stayed in that area…it was home. Our Scranton location is in a food desert, so there just aren’t healthy food options available for residents. Food insecurity is prevalent due to several factors including employment, income, race/ethnicity, and disability. An individual’s risk of food insecurity is greater when the money needed to purchase basic household items, including food, becomes limited or unavailable.

Can you describe to our readers how your work is making an impact to address this crisis? Can you share some of the initiatives you are leading to help correct this issue?

The Fresh Food Farmacy uses food as medicine for our chronically ill community members and has also been a platform for addressing other social determinants of health. During COVID, we were able to quickly stand up an emergency food box distribution program using our Fresh Food Farmacy locations to serve any community member in need. We are retaining that program to run alongside the Farmacy. In addition, we recognized that food insecurity was not the only social determinant our patients were facing, and we have continued to develop solutions including Neighborly, a digital platform available to any member of the community that allows them to search for resources for transportation, food, housing, etc. We have a community network with more than 12,000 resources that are available to any member in the community. Lastly, this work has allowed us to partner closely with food banks and other community-based organizations in a more meaningful way and learn from one another. We are focused on identifying the needs and issues of our community members, using data to drive programming, all while getting the care our patients and community members need closer to where they live and work.

Can you share something about your work that makes you most proud? Is there a particular story or incident that you found most uplifting?

​ I think what makes me most proud is the commitment from our employees and their passion to help our patients. I can think of a situation when we were delivering an emergency meal box to an elderly couple during the winter, and during that visit the staff member took the time to check in and see if there was anything else they needed. It was identified that they were struggling to pay for heating fuel. When that was identified, we were able to use available funding to help them address this crisis. From a patient perspective, I have two stories. The first is when Tom, one of our patients, wrote a song about the Fresh Food Farmacy and sang it to the entire team (accompanied by guitar) during a staff meeting. It was a heartfelt rendition of his journey in the program and offered some perspective on how this program impacted him. The other instance is when another participant, Rita, graduated from the program. While we don’t have an official end date for participants, she was able to get herself out of a situation of food insecurity and had controlled her diabetes so well that she felt she no longer needed the program. She started the program with an HbA1c of 13.8. She was 181 pounds; her LDL was 209 and her triglycerides were 312. After working with the care team, implementing lifestyle changes, and securing food for herself, her husband and the three grandchildren she was raising, she dropped her HbA1c to 5.4, her weight to 135, her LDL to 49 and her triglycerides to 76. We held a small graduation ceremony for her with a cap and gown, as she disclosed that she had not ever graduated high school. Her sense of accomplishment and the heartfelt support from her care team made me incredibly proud.

In your opinion, what should other business and civic leaders do to further address these problems? Can you please share your “5 Things That Need To Be Done To Address The Problem of People Having Limited Access to Healthy & Affordable Food Options”? If you can, please share a story or example for each.

  1. Understand the needs of the community before determining a strategy. This is not a one-size-fits-all approach and it is critical to understand the issues first.
  2. Engage existing community-based organizations as part of the strategy and promote collaboration. It is important to note that this is a multifaceted approach and community relationships are critical.
  3. We need sustainable support and funding to continue this work. Many of these programs are provided with philanthropic funding or grants. Extensive work must be done to demonstrate the value of our program, which has on average dropped HbA1c 2.0–2.5 points, while medications that drop 0.5–1.0 are prescribed and funded without hesitation.
  4. Measure impact. One of the reasons our program is so successful is that we put a lot of effort into collecting baseline data and measuring impact.
  5. Align national strategies in this space. There is a lot of great work and recognition of the value of this work, but much of it is not aligned. There is opportunity to better align initiatives to allow for additional support.

Are there other leaders or organizations who have done good work to address food deserts? Can you tell us what they have done? What specifically impresses you about their work?

I have been impressed with the grassroots efforts by many local individuals who have been driven to make an impact in their communities. In our coverage area, we have two local food pantries that have allowed us to pilot a more scalable version of the Fresh Food Farmacy because of their innovation and commitment to healthy food options in their community. These leaders not only understand food insecurity and the importance of healthy food but are committed to their communities and are passionate about this work. Partnerships like this have allowed us to expand our model, reduce the overall costs of the program and reach more people. I have had the opportunity to meet many amazing people who run food banks or food distribution for their communities, and there is commitment, compassion and dedication that is hard to match.

If you had the power to influence legislation, are there laws that you would like to see introduced that might help you in your work?

The approach to addressing social determinants of health is currently fragmented. The ongoing support for sustainable programs is challenging, largely due to fragmentation and uncertain funding streams. The work often falls back on healthcare systems or community-based organizations without the infrastructure to support it. While the efforts from all these areas are commendable, lack of coordination can produce other downstream challenges and continued fragmentation. Data should be driving decisions; the impact should be measured, and funding should be consistent. We don’t hesitate to pay thousands of dollars for medications, but when it comes to prevention, getting upstream, and getting to the root cause, we sometimes falter as the return on the investment isn’t as easy to measure or attribute to this work. We must put as much emphasis on prevention and getting upstream as we put into treatment.

You are a person of enormous influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂

I think right now coming out the other side of the pandemic, I would inspire a movement that is centered on kindness. There is so much discontent and confrontation, but if we stay rooted in kindness and treat others with an authentically kind heart, I do believe that would foster continued good for the greatest number of people.

How can our readers further follow your work online?

More information about the Fresh Food Farmacy is online at geisinger.org/freshfoodfarmacy.

This was very meaningful, thank you so much, and we wish you only continued success.