Seriously consider food co-ops and/or government subsidized private supermarkets. With more and more people developing preventable chronic diseases that could largely be mitigated by better nutrition, the burden of food desert failures is going to fall on every taxpayer. Better to be proactive about change than pay a higher price later for our shortsightedness.
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 Josh Itano.
Joshua Itano is the co-founder and CEO of CareCar, a health plan benefit administrator and tech-enabled health services platform. Itano attributes the foundation for his knowledge of value-based care, population health and business leadership to his time at the startup Alignment Healthcare. There, he discovered how much of an impact a company like CareCar could have on someone’s health.
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’ve been working in healthcare and startups for the past two years, certainly within the last decade. I was with a company called Alignment Healthcare and was lucky to be one of the early hires on that team before we raised capital there. Alignment Healthcare set me on my journey of value-based care and population health. It was both a health plan and a general healthcare organization focused on value-based care and population health. It was from there that I learned about the problems I’m trying to solve today. So, we had patient populations that did not have access to their care because of transportation barriers and it was a big enough problem for me to want to solve, so I left to try and solve it.
Can you share the most interesting story that happened to you since you began your career?
I think the most exciting time or the most rewarding and interesting moment I had was having the opportunity to work with a company called Global Unites, which was a conflict-resolution youth driven peace movement. We were meeting in Sri Lanka, and I was with UN representatives, PhD’s — and it was an interesting moment in that I felt that everyone in the room thought that they were under qualified to be in the room, including myself. We sort of had a laugh about that — because everyone in the room thought the person next to them had done so many amazing things and was so qualified but everybody was having the same exact thought about the person next to them. It was just an interesting moment — I don’t know exactly what it means but it’s certainly something and it was just a neat experience to be there and be a part of an organization that was trying to drive peace movements across conflict areas around the world.
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 don’t know if there’s a tipping point, but I would say that our progress and my progress has largely been driven by adhering to a certain set of values — and trying to live by those. For us at CareCar and for me personally, accountability is our number one value. And you know, we’re not always perfect at it, I’m not always perfect at taking accountability and/or owning things that I see but I try to be, and I think we try to be. That, along with sticking to a certain set of principles will almost always guarantee success.
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 have so many people. It feels wrong to just say one person. I don’t believe that one person helped me get here, I have several mentors. At Alignment Healthcare, Scott Reid, one of the founders, he certainly mentored and helped me get to where I am. He also had an interesting background, kind of similar to mine. I don’t have a business degree, I came into the private sector, into the world of startups and ventures and enterprise with essentially zero experience and Scott was always there to share his experiences. You know, he’s had multiple successes, multiple acquisitions and he was able to share with me all the successes, all the ups and downs. And whenever I need anything, he is always there to help — and I try to pass that on as well. Sometimes, time is more valuable than anything, especially with people who have experience, so I try to do the same thing.
Chief Rob Roy, Seal for the Navy, was a mentor for me in that world. He’s the one that drilled the accountability mindset into me. Guys in that world are brutally direct and honest with you and when I was working with him, he had a way of making you be very honest with yourself about your faults and your strengths — and recognizing those, working on each of those and putting serious efforts in everything you do. Sort of a do-or-die mentality.
Yeah, I would say those two folks were very critical to at-least where I am today.
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?
I already talked about accountability. But I think the other things we need to do as leaders in any role is serve. I consider leadership as a servant position, in the sense that everybody works for somebody — as Bob Dylan said. And even though I’m the boss, I still have people that I report to. And honestly, I report to my employees, I report to my customers in understanding that my position is a position of service. But what I’m serving is not just the folks under or above me, but to the larger mission of what we’re trying to accomplish. I think always have an eye on the big picture and not letting the micro affect the macro, as opposed to the macro affecting the micro — so don’t get caught up in the small things, always keep your eye on the big picture and make sure we’re working in service towards that. So, accountability, leadership and always driving towards the big picture.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
“There’s no shortage of remarkable ideas, what’s missing is the will to execute them.” -Seth Godin
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?
To me, a food desert means you live in an area where you don’t have readily available access to food. By readily available, I mean easy to get to, easy to purchase from with a certain level of food that’s accessible at that point you’re trying to get to it. Folks who are living in both cities and rural areas in the US have a higher chance of food insecurity — and we’ve seen patients with reduced mobility struggle to find access to 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?
Nutrition and health are a major problem in the US. A certain amount of folks are getting diagnosed with type-two diabetes as early as four-years-old. What tends to happen, at least from my experience from the communities that we work with, is that folks who have limited access to food — they can go to both ends of the food security spectrum. That’s malnutrition, from not enough caloric intake to incredibly poor nutrition because options are not available. So, when the options are available, they tend to take quick-fix options, which leads to nutrition-based diseases. Most commonly diabetes, but also kidney failure, chronic kidney disease, those kinds of things.
I would say those are the most severe consequences to lack of food access — is that you are either malnourished or you have poor nutrition because of the habits you have socially.
Where did this crisis come from? Can you briefly explain to our readers what brought us to this place?
Resources — so transportation obviously is the reason why something like this can happen. As an individual, limited access to mobility — modes of transportation to get to a food resource plays a huge part. Low-income neighborhoods typically have less well-thought-out urban design so that there’s fewer grocery stores in proximity to where you live. Or at least that happens historically, I think a lot of that has been changed recently.
I think low-income, so less disposable income to steadily purchase groceries and purchase food — so purchasing power is a big reason.
And I think that most people are extremely undereducated when it comes to nutrition and food security. When you do get the income to make the purchase and you do get the means to get there and you have something close by, what kind of purchasing decisions are you making when you’re buying groceries? Most people are uneducated in what they should be purchasing that’s going to keep them healthy and nourished. I mean you and I probably do it — we think something is good for us and it’s not, but we get it anyway — and not even because we want to do so, but because we don’t know any better — and that’s even more prevalent in low-income neighborhoods.
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 first thing we’re focused on is working with our health plan partners to construct and extend current benefits to include transport to grocery stores and other markets where people can buy food. Because you have to imagine if they can’t get to their absolutely necessary doctor appointments, they sure as hell aren’t getting to grocery stores.
Right now, we’re working on partnerships with food benefit administrators as well, to work as last mile delivery since we have so many encounters with the members already — and we have such a large network in some of our markets.
Also, next year we’ll be working on not only including meal delivery but also food prep inside the home with higher-risk patient populations — and getting that all included in their benefit structures so there’s no economic barrier as well.
Can you share something about your work that makes you most proud? Is there a particular story or incident that you found most uplifting?
There’s no single event, I’m just proud we’ve been able to continue to grow and impact as many people as we do. There are roughly 120,000 people that have access to our platform — because they’re seniors, because they’re doable, eligible Medicare/Medicaid folks. Their health plans trusted us and in managing and delivering their benefits that they have access to these things.
I’m also proud of our KPIs — how many requests come into our system and how many successes we’ve filled. When I say successes we’ve filled, I mean they’re fulfilled within a timely manner and appropriate to that particular requester or patient.
So, there is no one event or one thing — I’m just proud we’ve been able to more-or-less achieve our mission of helping people reach better health outcomes. We’re not perfect yet, but we’re certainly getting better every day and I’m proud of that and hopefully we’ll keep growing and removing barriers to healthcare.
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.
2. Education. I think we could try to figure out a way to make healthy options more understandable — I don’t know what it is but I think it would be great if there was some kind of easy mechanism to understand what the impact of food is to your body and overall health.
3. Tackle affordability. I don’t know how affordable simple healthy eating is. So, it’s certainly affordable to buy a pepper or a head of lettuce — but then you have to cook it and do all these things to it. And most people choose convenience. So how affordable are convenient, healthy foods, because typically convenient healthy foods are way more expensive than others. So, I don’t know if that’s a supply chain issue or something else but making convenient healthy foods more affordable would be something. Making unhealthy foods less affordable! Haha!
4. Meet people where they are. A common motto at CareCar, which to us essentially means, meet the need, conveniently. Think bus stop farmers markets.
5. Seriously consider food co-ops and/or government subsidized private supermarkets. With more and more people developing preventable chronic diseases that could largely be mitigated by better nutrition, the burden of food desert failures is going to fall on every taxpayer. Better to be proactive about change than pay a higher price later for our shortsightedness.
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?
There’s a company working on food security — they’re called Project Well, the founder’s name is Lauren. So, what she’s trying to do is build the access and then build the behaviors — so build the food access, the nutrition, the meal plan, train and educate them on healthy behavior, healthy eating habits and then make sure they have the constant access to making those healthy decisions. So, it’s like part delivery, part meal-prep, part all this stuff, and then the idea is to wean all that off and make sure the person then has those behavioral norms to do it themselves — and the access and means to do it themselves as well. But the idea isn’t to be like, ‘hey we’re going to make your food and cook it and deliver it to you every day because that’s unsustainable — but we’ll do it for a period of time until you develop the behavior norms to do it yourself.
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?
Honestly, I think I’d continue to push for a public health coverage option for every US citizen, while also maintaining private options. When I hear the phrase, “Medicare for All,” I’m all about it. We have a Medicare Part C & D, which allows beneficiaries to opt-in to private insurance and covers others who can’t afford it or don’t want it. Coverage and choice. In such a system, we could take a more holistic approach to healthcare, as opposed to this sick care system we have today.
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 the most important thing is happiness, and Aristotle would agree as well. With that in mind, for me, the most important movement that I would be able to drive would be a wholeness and wellness education at an early age. Understanding that your diet, your mental health are things that can be taken care of with self-care — and understanding the tools and habits you need in order to do that. And that would need to start from early on and it would need to be institutionalized.
Is there a person in the world, or in the US with whom you would love to have a private breakfast or lunch with, and why? He or she might just see this, especially if we tag them. 🙂
Two people: Barack Obama and David Chang, no questions. Obama needs no explanation and David Change simply has this huge appreciation for food and he’s just an overall awesome chef.
How can our readers further follow your work online?
This was very meaningful, thank you so much, and we wish you only continued success.
Thank you for the opportunity and for shedding light on the crisis of food deserts and what we can do to help.