18 Reasons

Food as Medicine helps low-income Medi-Cal patients with diet sensitive conditions learn cooking, nutrition, and household planning and budgeting skills that help them take control of their health. For up to twelve months, patients receive weekly boxes of home-delivered healthy groceries, sourced from local farms and grocery partners. Each week, patients attend an online cooking and nutrition class led by a primary care doctor and an 18 Reasons staff member. The program is a partnership between 18 Reasons and Contra Costa Health as part of the new statewide CalAIM initiative to use Medi-Cal funds to address social determinants of health, including food and housing. Graduates of our Food as Medicine program reported lower blood sugar levels, lower BMI, and less dependance on medication to control their diabetes.

Our Cooking Matters program offers free cooking and nutrition classes to low-income adults, children, and families. Each series of classes meet once a week for six weeks. Each class is two hours long, and is taught by a team consisting of a chef, a nutrition instructor, and a class assistant. We seek out volunteers with skills in cooking and nutrition to teach these classes, and we also train and employ graduates of our Cooking Matters as peer health educators to fill these roles. Cooking Matters classes are held at locations that offer other services to low-income families, such as shelters, schools, clinics, community centers, and subsidized housing sites. These agencies and organizations recruit participants for the classes, and we bring the instructors, food, curricula, and cooking equipment. At the end of each six-week series, we conduct an evaluation that measures positive behavior changes including increased consumption of fruits and vegetables, and an increased use of nutrition skills and knowledge when making decisions about food. In 2021, we conducted 86 six-week series of classes, taught by approximately 300 volunteers and 18 peer health educators, at 51 different locations throughout the San Francisco Bay Area, reaching over 2,000 people. Each Cooking Matters graduate takes a validated test at the beginning and end of their series to measure their food insecurity score and their behaviors and attitudes related to healthy eating. 18 Reasons effects all of the below changes in participants' lives in only 6 weeks. In our most recent data, our graduates report increased consumption of healthy foods, with 74% of graduates eating more vegetables, 78% eating more fruit, and 88% are prepping healthy meals more often at home. Graduates report a 52% decrease in consumption of sugar-sweetened beverages and an 85% increase in drinking water. Graduates are able to access more healthy food by learning to stretch their food dollars; 68% plan meals ahead of time and shop with a grocery list more often to save money at the store, 97% use the nutrition facts label more often, and 74% feel they can afford to buy more fruits and vegetables with their existing food budget as a result of the shopping skills we teach. Food insecurity in the Bay Area drops by 1% each year as the wealth in our area grows, whereas 18 Reasons is able to reduce food insecurity among our low-income participants by 12% in just 6 weeks because of the food resource management skills we teach. In 2021, we distributed over 25,000 pounds of groceries through our Cooking Matters classes, and we are on track to significantly increase that number with each year that passes. We receive about 5 new partner applications for Cooking Matters each month, meaning that demand for our programs is high. We are glad to be a local leader in food education, and the demand for our services shows us we are offering the community programs they want. Our data show us we are offering evidence-based programs proven to create lasting behavior change.

Nourishing Pregnancy is a 16 week program for Black and Latinx birthing parents during the last trimester of pregnancy and first months postpartum. Classes, workshops, cooking and nutrition education, peer support, and free groceries work together to improve health and well being for parent and child. Nourishing Pregnancy launched in 2021 to address the disparities and urgent needs of BIPOC birthers in our community. In San Francisco, 20% of Black/27% of Latinx women experience food insecurity during pregnancy, compared to almost 0% for white women. A Black infant is twice as likely to be born prematurely (14% versus 7% for White infants). Black women are more than three times as likely to die from pregnancy-related complications as white women, regardless of their income or education. Black, Latinx, and Pacific Islander women are also more likely to experience gestational diabetes, preeclampsia, and peripartum mood disorders including postpartum depression. As a community nonprofit at the intersection of food and health,18 Reasons is uniquely positioned to deliver both cooking and nutrition education and a structure for maternal health classes and workshops. Over 16 weeks, Nourishing Pregnancy offers nutrition skills and pre- and postnatal classes while peer support helps parents build relationships and support networks that will last beyond pregnancy. All birthers receive free groceries for the duration of the program, which can significantly offset food insecurity during those vulnerable months. To supplement our nutrition and food skills expertise, 18 Reasons partners with doulas, lactation consultants, postpartum depression experts, and sleep and exercise practitioners.

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