August 22, 2024 • 44 mins
In this insightful episode of the Regenerative by Design Podcast, host Joni Kindwall-Moore chats with Erin Martin from Oklahoma FreshRx. They discuss the profound impact of a unique produce prescription program that’s reshaping healthcare through regenerative agriculture. Dive into a discussion about the power of local, nutritious food in treating chronic health conditions and promoting overall community wellness.
Key Topics Covered:
- Introduction to Oklahoma FreshRx: Explore the origins and mission of a program where doctors prescribe regenerative fruits and vegetables to people with type 2 diabetes.
- Impact on Health: Erin shares compelling data on how the program has improved health outcomes through regular access to fresh produce, cooking classes, and nutrition education.
- Educational Challenges and Successes: Learn about the challenges of changing dietary habits and the successful strategies implemented to educate and empower participants.
- The Role of Community and Culture: Discover how Oklahoma FreshRx addresses cultural and community-specific needs, ensuring that dietary changes are sustainable and appropriate.
- Future Goals and Expansion: Erin discusses the future of food as medicine, potential program expansions, and how other states can replicate their successful model.
Guest Bio: Erin Martin is a pioneer in integrating agriculture with healthcare. Through her leadership at Oklahoma FreshRx, she's helping to forge a path toward a healthier future where food is a fundamental part of patient care.
Mentioned in This Episode:
- FreshRx Oklahoma’s approach to combining healthcare with regenerative agriculture.
- The significant health improvements participants have experienced.
- Erin’s vision for expanding the reach of produce prescription programs nationwide.
Call to Action: Interested in how food can revolutionize healthcare? Visit Erin’s website at erinwmartin.com for resources, upcoming workshops, and ways to get involved in the food is medicine movement.
Closing Thoughts: This episode is a must-listen for anyone passionate about the intersection of health, agriculture, and community empowerment. Erin Martin's work exemplifies how innovative thinking and community-focused initiatives can create sustainable health improvements across the nation.
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Thank you for tuning in to another episode of Regenerative by Design. Join us next time as we continue to explore innovative solutions to some of today's most pressing environmental and health challenges.
Regenerative by design is hosted by Snacktivist. Snacktivist creates baking mixes and finished products that are allergy-friendly, soil, water, and carbon-focused, all while radically impacting human nutrition by transforming staple foods into something more than just empty calories. Visit snacktivistfoods.com to learn more.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
Joanne, hello, everyone. You are listening to the regenerative by design podcast where we will begetting to the root of health, climate, economics and food. I am your host. Joni quinwell Moore, join me on this journey as we explore the stories of individuals and organizations who are working to realign our food system with both human health and the health of our planet. Welcome everybody. Thank you so much for joining us on the regenerative by design podcast. Joni, your host. And today we have Erin Martin from Oklahoma, fresh RX, again, I am so excited, because we had her on the
(00:36):
podcast way back in 2022 so it's been a while, and she has been doing the most incredible work,absolutely impressive to watch from the outside. And I'm going to have her give us a little recap today. So welcome, Erin, I'm so happy to see you.
So happy to be here. Joni, thank you so much. I can't believe it's been two years since we did thatpodcast. And yes, we have, we have grown and changed, and just for people's background, fresh RX, Oklahoma is a produce prescription program where doctors prescribe local regenerative fruits and vegetables to people with type two diabetes, and they get free food every other week for an entire year, plus cooking and nutrition classes every single month, and then they go to health metric checkpoints, where we measure their a 1c weight and blood pressure. And the response has been
(01:29):
enormous. And it's just been we've been really changing lives and reversing lifestyle, lifestyledisease, 100%
and I think when I first started following your work years back as a nurse. And I was like, I was indiabetic educator for many years, and in addition to working in ICU and building policies and procedures for diabetes management inpatient like, this was always what we were like, you know, all of us in the field were like, This is what's missing, is access to nutrient rich, fresh foods and instruction and support on how to use them, because you can't have one without the other. Like, we know that there's a there's a major barrier that people have, not only accessing these types of
(02:12):
fresh foods, but what to do with them. Like, how do you guys tackle that? Like, let's just dig rightin. I'm excited to hear all about it. Yeah. And we've had
to fine tune like our education and how we get people engaged, and how we get people to feel likethey have agency over their own lives and that they're empowered, and that they're fully equipped to continue to make these behavioral changes and and there is an access barrier, right? So we remove the access, and then we actually have to teach people how to use this food. And it's amazing how many food is medicine programs just kind of throw fruits and vegetables at people and expect them to know what to do with it. So we have a wide range of education. We actually use the food that we
(02:55):
provide to do cooking demos, and we do things that people would like and even have people try newthings. So we have local chefs that are kind of locally famous that come in and do these fun cooking demos. They can leave with a recipe from that cooking demo, and very simple things, like things making sure recipes have things in there that people can afford, so not having like South in a normal store, in a normal store and that people can actually afford and cost effective ways of stretching that food, like can you can some of your extra cucumbers and make pickles or sauces and
(03:33):
letting them know how to really even shop on a budget, or even if they're shopping at $1 General,how to shop as healthy as you can at $1 general, like really meeting people where they are and giving them tools and tips during the program, but also connecting them with resources and how to use, like their SNAP food stamp type of benefits, and how to use double up benefits, which actually doubles their SNAP benefits for fruits and vegetable purchasing and where they can use those and how to access this nutrient rich food. So we're constantly providing education, meeting them where
(04:09):
they're at, and really empowering them to make those decisions. And we've seen incredible behavioralchanges because of that.
Yeah, you're bridging the divide, you know, and I think for so many years, the education andimplementation of diet centered interventions for, you know, metabolic syndrome diseases like, you know, high blood pressure, diabetes management, etc, has not bridged that divide of like, understanding that we have to meet the patient where they're at. We have to understand what they have access to, what's culturally appropriate for food. There's no point in telling somebody, Hey, don't do this, but we want you to do this and they live in a rural community and they don't have any
(04:51):
access to that stuff, or they can't afford it, which is also a huge deal, also access to cooking.Implementation, we always wanted to do a program where. So we would provide things like, you know, cooking tools and and materials, so that people are like, oh, you know, I would love to make this, but I don't have the right cooking pots, or I don't, yeah, the tools are important.
(05:13):
We provide a starter kit that includes cooking utensils, a cookbook. How do you store your produce?And that's a big thing. Like, you don't want to put certain things in the fridge actually that doesn't have certain produce, and then some produce, you better do that. And so we, we have this really good starter kit that gives them those things. We've also had situations where people didn't their fridge went out right during the program. And so we've gotten we've got fridges donated, and so we've done different things like that. And I think back to your point. I think you know, doctors
(05:49):
may say you need to have more leafy greens, or nutritionists may say this or that, but you reallyhave to have a program, and what I am calling now a healthcare delivery model that really hands hold hand, holds people through these processes and helps them make a change. It's not going to happen by someone saying, in 10 minutes, this is what you need to do. It's a program that helps teach people, and that's why it's a year, you know, and we don't prescribe insulin for six months. So why are we going to prescribe food and behavioral change that may be generations of improvement that needs to
(06:26):
happen? That's why the doctors love prescribing this, because they know it's not an extra pill, it'snot another shot, and they know when they send people to us that we're going to handhold them and support them and empower them to make these changes, and that's what it takes. It takes a lot of work and people to be willing to be empathetic and meet people where they are and understand what the low income experience is and what resources are
(06:53):
available. Because there never lived it. You don't know. You really don't know.
You don't know. And that's why also having people who are working in these in these programs orthese healthcare delivery models, is having people that can relate. So I have people that actually on our team that grew up in this area, that lost 100 pounds, like they know what this is like, and they can tell and relate to the people that we serve. We see so many programs motivate, I'm sure, motivate them and inspire them, and then our members inspire other members from their weight loss. And it's just a really, it's like we're creating community healing and creating community around
(07:35):
food. And that's what's a little bit different than just a food giveaway type program, or justthinking,
yeah, like rethinking the whole community dynamics around food, like we underestimate how powerfulthat is. It's a design feature, like, if your whole love of food and your connection, your emotional connection to food, is reinforced through the lens of unhealthy food choices, in that because you look you equate love to those things, you're like, Well, my mom makes this for me, and I know it's not very healthy, but you know, if we really address those community interactions at that nurturing and food preparation point where suddenly they create new connections around love and connectivity
(08:18):
through something that makes them feel really Good and actually fosters health.
We actually change the way that the system works. The design starts to change, and that's when westart seeing it transfer to the next generation. Yes, and we've seen that happen already, like we've seen someone from a family member, like a grandparent who's raising grandkids, because that's what happens. We see that they're bringing that food home, they're cooking it, they're giving it to their grandkids. And we've even had people who are not in the program, but maybe live in those households. They've also had health outcomes because they've been influenced by their mother or their
(08:54):
grandmother. And so we're seeing the generational healing and the ripple effect that this iscausing. And so kids are getting even though kids may not be a direct member of our program, they're getting exposure to this, and they're watching their parents heal themselves. And so that's that's creating a new synapse in the brain and and we've totally separated ag and local food systems. We've totally separated that from the healthcare world, and trying to reintegrate them and build a bridge together is so important. I got to go and tour the Appalachian Regional Health System in Kentucky,
(09:34):
like a couple weeks ago, and they actually had the CEO from the hospital system and the Secretary ofAgriculture, sitting at the same table, doing a cooking demo together, speaking the same language around local food and health outcomes. And I was just like, this is the type of leadership that has to happen, and people have to start being able, like the Secretary of Ag was able to talk about food in the context of a healthcare. System that needs to be a regular conversation that's going on and making sure needs to become the norm like so amazed to see that. I was like, Yes. I was like, let me
(10:15):
Oklahoma. So yes,
that is so novel, and I'm so happy to hear especially in states like Kentucky that do lead thenation in incidence of diet related disease and and, you know, mortality rates related to diet like, it's absolutely imperative, because when you look at the state impact, like, just even, like a GDP level, equality of life level, it is significant. And I've when I lived in I went to nursing school in upstate New York, and they had a program there that was specifically focused on rural health delivery delivery systems, and so diet and access to food was a big deal there. And we, my husband,
(10:54):
I did a road trip down to Tennessee and back, and we got to go through Kentucky. And I wasabsolutely floored, as someone who grew up on the West Coast and had lived in Alaska, very different lifestyle, very different set of diet related diseases in the population. I was blown away by the impact that it was having on people. And so to see Kentucky leading that conversation is like extra special, because I think the urgency there is just so profound. So that's really cool. Who are the people in your program? Erin, like, how do the physicians find out about you and how do they match
(11:28):
the patient that they're caring for to your program? Like, do they triage it? Is there a set ofcriteria?
Yeah, we do, because we are grant funded. We do have certain zip codes that we're supposed to beserving so and they do have to have type two diabetes. So usually the doctors know about us from either we visit those clinics and we provide flyers, and we also do some clinician education. We created a prescription form for the doctors to actually be able to just send over a prescription. And believe it or not, clinics are still faxing. So there's a fax form, and then we're working on a web form to kind of facilitate more of that. But some of them still prefer that. So they can do
(12:12):
that. They send over baseline of where they are, with their A, 1c, their weight, blood pressure, andthey just send them right over to us, and then we contact that person, we do a kind of a pre screen to make sure that they're going to be a good member, which means they have the ability to store food at their home and cook it. So they do have to have some way to, even if it's just a toaster oven, that's fine. They have to have a way to kind of cook something, and then a way to store it, and then just be willing to communicate and show up to show up to get the food and get cooking classes, or
(12:49):
they can receive delivery and do virtual classes. And we have a ton of technical assistance and helpon that end. So there's all these flexible ways to interact with our program, but we do hold people accountable. And there's there's providing them agency in that. And so predominantly, we serve the black community in North Tulsa. A lot of them are also Native American. And then just about six months ago, we started working with the Muscogee Creek Nation to serve their pre diabetic population. And so they have a federal grant for four years to serve 400 pre diabetic folks. So
(13:23):
we're not only working in North Tulsa, but also Muscogee Creek Nation. And then we have some otherother things, other irons on the fire. So who knows? We're hoping to kind of create a funding pathway for these programs through health insurance. We're trying to continue to stimulate the farmers and who knows from here, but that's kind of who we serve right now, and mostly women actually,
(13:46):
well, well, you know, historically speaking, women are usually the most apt to be doing the cookingin the household. That is still something, that is a thing. I mean, we're seeing that change, but by and large, women drive purchasing at the grocery store, and they also dictate what gets cooked, and do a lot of the labor, a lot of the labor at the kitchen level. So, you know, really addressing women as a important demographic and change around household eating patterns is so important. But I'm really, really happy to hear that you're addressing prediabetes. You know what? I remember being
(14:19):
a CDE and working in rural Montana, when a lot of a big body of research came out in the late twolike prior to 2010 that really gave us proof, like we needed it. But you know what we did? I guess, that we could reverse pre diabetes. And that set into motion a whole bunch of initiatives at the state level in Montana, where I was living, where suddenly it was like, okay, we can reverse pre diabetes. We now have proof. So let's put in these systems in rural communities to help them get access to diets, dietary ingredients that are going to help diminish the you know, evolution into
(14:59):
four. Full blown diabetes that now is, you know, difficult to manage and and likely irreversible. SoI I found that to be so fascinating to me as a nurse, because I think I had always assumed that prediabetes was reversible, and so to hear it come down from a state agency of like, hey, surprise everybody. It was really shocking to me, but I'm happy to hear that there's actually an intentional program, especially working with tribal nations, because we I worked with Indian Health Services and in tribal populations for many years as a healthcare bedside practitioner. And there's a special set
(15:34):
of circumstances that are present on reservations and in our native peoples with diabetes andaffecting very young people that are at the prime of their learning and earning ages. And so if you could just take a second to talk about that, I'd love to hear about it.
Yeah, and there's some pretty disturbing numbers. I mean, I know that they're experiencing foodinsecurity as at a much higher rate, and I would argue to say more nutritional insecurity as well reframe it. But I did. I did get to present to all 39 nations in Oklahoma. Many of you listening probably will know the history in Oklahoma. There's been a new movie made in a book around what happened in Oklahoma to native folks, and we once had in the 1920s we had the richest black community in the entire nation, and we also had the richest Native American population in the entire
(16:30):
world per capita, which was the Osage Nation. And it was because of the oil boom there and the landrights and so people started getting diabetes back then, and diabetes is happening more prevalent in the Native American populations, because, number one, what they have access to, but it's such a stark difference from their original native diet. And they're they're not their bodies are not responding well to all this stuff. And the really disturbing statistic I found when I presented to all 39 nations last year was that after the year 2001 out of two children, 50% born. After the year
(17:13):
2000 if nothing's changed, we'll get type two diabetes, one out of two children, diabetes that areNative American or Alaskan native, and that's really disturbing, because basically it's like one out of five people now, and generally are having, like, pre diabetes or diabetes, and it's maybe even more now, but one out of two, that's 50% of Native Americans. So they're getting it at a much higher rate. And what's really, what's really exciting and sad is that Native Americans created some of the most nutrient dense food in the varieties that they crossbred over 1000s and 1000s of years. And
(17:57):
that's why regenerative ag really inspires me, because the corn we get now is like 5% protein andturns to starch and sugar, basically. And then there are variety. It's been totally a nutritional
standpoint. And there was sophisticated agronomy and genetics happening in Native nations beforecolonization happened, and we forget about that, like, we think all of that started with Mendel, and it's just not true. No,
(18:29):
up to, like, there's one, there's a corn variety that's up to, like, 19% protein, and it's like, noone, they could live on squash, corn and beans, because they had all this incredible nutrients. And so it's one of my priorities, is to get more native varieties of food, not only for the nations that we serve, but also for anyone to have access to more nutrient rich indigenous foods, and to really stimulate a new market around that, and get more people to purchase that, the more that we start stimulating the supply and infiltrating that into food, is medicine programs, into schools, into
(19:08):
restaurants, like, the healthier we're all going to be. Like, it has to be redesigned or it's wellintegrated. Yeah,
and that design process does have to involve many different players. Like it's you've got theconsumer buy in to drive the engine, in the sense of the market, but it's like an agronomy genetics riddle. It's a farmer riddle. It's a value chain and the processor riddle. There's so many people that have to be involved to make those changes. That's why, like, I always call it a real design it's a design endeavor. It's like, you really have to be high level and understand that all those stakeholders have to work together to change the norms of the market. And I think corn epitomizes a
(19:47):
lot of that, where we've taken the genetics and we've driven it very intentionally towardsbenchmarks that don't actually serve the interest of human health or climate resiliency. Necessarily, and so I always say it's the efficiency versus effectiveness equation. We've been very focused on efficiency as far as carbohydrates or calories per acre, you know, but we've ignored effectiveness, which is positive human health outcomes and climate resiliency long term. And we need to realign that equation. But it's it's taken us decades to get to this point
(20:22):
that right there, like I was just saying, I say this so much, but like, quantity has nevertranslated to health outcomes. Like I always say to people who ask us, How many pounds of produce Do you provide? I said, we don't measure in pounds, because pounds doesn't attribute to anything, right? It doesn't attribute to health outcomes. That's like caring about the how big your house is, and not about the foundation. And that we need to be we need to be measuring these programs based on outcomes. Pounds has nothing to do with it. Has nothing to do with it. It has to do with the
(21:01):
nutritional integrity of the food and people's ability to understand, to be empowered to make goodchoices and to know how to access and that's what needs to change, is funders who are funding and grants, other types of funders like outcomes, need to be correlated With what matters, not just based on pounds or a system change.
(21:25):
Yeah, theology, it's deep. It's a system level change of like, our values,
yeah, it's a whole perspective and understanding. And so we just try to help, help like. And whensomeone asks me that question, it's like a great opportunity to say, here's why we don't measure in pounds, and why I don't think that's a good measure of success.
(21:46):
Only pounds you're measuring are people's loss on their personal bodies. And you know, with moremicronutrient rich and and better balanced food, it's like people are their satiation drive. It changes dramatically once they're not chronically malnourished, and that just turns on. It's like a switch that gets turned on in our bodies. And my personal belief is that the microbiome is also involved in that, that it starts to create this like crazy craving pathway, where our body thinks it's starving, and it starts to seek out all these very high calorie foods, and it's, it's hard to
(22:22):
resist, because that's a that's a biological drive. There's a physiological phenomenon happeningthere that our body and our brain is going, Uh oh, you are malnourished. Go find food. But a bag of Hot Cheetos is just going to make it worse. Like, what they need is, like, micronutrient, rich foods that are not just providing fat, sodium and carbohydrates, but all the other things that you know, the other 90% of things that really create health and support the immune system. And as awful as covid was, I don't ever want to take away from how disastrous it was and and horrible for people
(22:58):
with all of the deaths, complication, economics, everything, but it did open up our eyes to the riskthat's associated to diet related diseases when it comes to mortality against things like viruses. And I've been really impressed with the response from tribal nations, right? Exactly. It was a mind opening event, and I in fact, we should have you out to the inter tribal health conference and the food sovereignty conference out here. We have some amazing initiatives happening in in my neck of the woods, and Idaho, Washington, Oregon, and where we have these communities and these inter tribal
(23:36):
coalitions coming together to really address food system, security through the lens of nutrition andactually promoting vitality, not just, you know, how it has been for decades. And I lived on the Flathead Reservation for a while in Montana, and you know, the only store in town was literally nothing but Top Ramen and frozen pizza and beer and soda pop. And I just remember, like, thinking to myself, these kids that have grown up there in Arlene, Montana, and you know, the next town is quite a ways away. You have to have a car, and you have to have a car that's reliable, that could get you
(24:14):
to Missoula, or could get you up to the Flathead Valley. And if that, if you don't have that, thatis all you had access to was some canned chili, frozen pizzas and Top Ramen and and then we wonder why we have these like long term health impacts that started a very young age. So I am so grateful for the work that you're doing. Erin, it's so needed. And I think that you guys are science driven enough too, where you're collecting the data that can prove a new model and integrate it into deeper levels of systemic change, like the work you're doing at the political level, at the advocacy level,
(24:48):
insurance, health systems, etc. So could you give us a little update on where you're at on that?Because you've been speaking in Washington, you've been just crushing it. It's amazing. It's.
So much attention on this issue, a very bipartisan issue, there's people on either sides of theaisle. It's like we need something that unites us so much right now, and it's been really cool to see. So I got to testify before Congress. I think it was in March or April, a few months ago, and it was under the Older Americans Act. And so what people, if people don't know what that means that the counties, every county in the United States gets funding for congregate meal programs, for Meals on Wheels, for federally qualified health centers to serve older adults. And so our argument was, we
(25:39):
should enhance these programs to actually produce some health outcomes through these meal programs,through including produce prescription and other food as medicine interventions into these county fundings. And so right now, we're just trying to find any type of Avenue and every avenue we can to insert a funding stream for produce prescription program at a federal level, for the longest time, the farm bill has been paying for these produce prescription programs, which were partly funded through through the USDA, but they've been footing the bill for these incredible health outcomes
(26:14):
that are happening through these programs. And so the argument is now we want Centers for Medicareand Medicaid, which is our federal healthcare agency, to start paying for these and it behooves the healthcare industry to pay for it, because they're the one benefiting from the cost savings,
and they should be. Those externalities are crippling to our healthcare system.
(26:35):
It's insane, and it'd be so much easier to do this preventatively and to have this be a healthcareintervention and a treatment plan and a care model. And so we, just about a year ago, we formed the food as medicine Policy Coalition of Oklahoma. We have about 100 members across the state of Oklahoma wanting to include food as medicine as a covered insurance benefit for our Medicaid population. So that's low income on a state level. And there's nine states that have already done this in the United States, both very conservative states and liberal states. So Alaska just passed
(27:16):
theirs, and they've included indigenous foods as a part as a covered benefit. Hawaii included localprocurement as a requirement for their food as medicine programs. And we have five more states that their law is pending, and so Oklahoma hopes to be on the front half of that as far as all the states, but we think in about five years, CMS Centers for Medicare and Medicaid at the federal level will federally legalize this, but we're seeing managed care organizations, insurance plans and Medicare Advantage plans already including these in interventions. They already have the ability to
(27:57):
pay for value added benefits, or something called in lieu of services, they can choose how they wantto intervene with someone's life, because they if they do it well, they get to benefit. They get to keep the money that they've saved. And my argument is that organizations like mine who are saving the health insurance money we should share in that cost savings and that sustainable model. So right now, we're in negotiations with some health plans making sure that the financial design of this is mutually beneficial and creates a sustainable model for us to continue to serve but also to expand
(28:40):
and scale these services at the same time.
Incredible. You know, even if you just focused on the portion of the population that can be sparedfrom entering dialysis for the last potentially decade of their life, like it is such a it's such a huge chunk of healthcare spending. And I knew it was big because I'd spent a lot of time in dialysis centers in my nursing career. But when I was talking to Carter Williams and we were talking about actual financial spend on things like dialysis, it really illuminated it to me that like even just focusing on that one spending and like having a strategy and a design in place of, how can we keep
(29:22):
people from getting to where they ever need dialysis, which is driven mostly by diet relateddisease, uncontrolled, high blood pressure and diabetes, those are the two leading causes of patients ending up in end stage, renal failure and kidney or kidney failure. I'm trying to not use medical terms, but um, you know, when you think about it like that and you equate it, that's something you have a very simple mathematical equation that like people, like politicians and insurance people, and maybe the reluctant out there. When you can break it down to a simple math
(29:52):
problem, and you're like, look, this spending here can equal this savings here, and it's huge.Savings. Like, like you said, B billions,
or why you could ever see so return on investment for non financial people. Like, if you can startspeaking in those terms, like, one of the great things I talk about it is they say, if you reduce someone's a 1c measure by one to two points in the year, that's equates to 16 to $24,000 in healthcare cost savings per year per person, and it only maybe cost $3,500 a year to serve them. And we've not only have we been able to reduce someone's a 1c by two points, but we've some we've had someone reduced by eight points from 13.6 to a 5.4 and so you're talking about insane amount of
(30:41):
savings, the best investment anyone could ever make. It's insane. So that's what the states want toknow, is like, how much is this going to cost us, and when are we going to get the return on investment? So we're trying to work to make sure there's this cost benefit analysis based on real data, based on what we've been able to produce, and saying, if we scale this, this is how much you can save. And we actually had the University of Oklahoma look at some of our data and say, if we scaled this to 1200 people, it would cost us about $3 million to do it, but we would save the state
(31:13):
of Oklahoma $25 million in healthcare cost savings. So it's like, it's a new brainer, and we'redoing development with those same dollars, with the farmers. So then you've got economic development and dollars being that same dollars being spent in the community and being kept there. And so that's another generate, generator of funds and cost savings. So it's an enormous investment that should be no brainer, like reduction
(31:43):
of transportation costs, that is like a greenhouse gas impact point, like the externalities, go onand on, and you know, it is a no brainer. I 100% agree with you, and I love it when people have the ability to put this into a mathematical equation, that people who don't see it as no brainer can suddenly see and have that aha moment and connect the dots for the first time. And when, you know, I think when we can do that, that's when things can move forward really, really quickly. And you know, we're, we're getting to the top of the hour. Erin, I can't believe how fast the time is going, but
(32:15):
before we adjourn, and we'll have to have you back again next time, next year, so we can just keeptrack of your journey via podcast. But who are your farmers and how do you find them? I think we talked about it a little bit a couple of years ago, but perhaps it's changed because your program has grown. Tell us a little bit about your sourcing program.
Yeah, farmers are like, coming out of the woodwork. I'm like, did you just decide to be a farmer?Have you been a farmer? How did I not know about you and so many farmers who are using really good practices that may not even identify as a regenerative farmer, but they're very much on the spectrum of regenerative farmers and really care to deepen their practice so and we, you know, we're seeing a lot of young people farming, which is really amazing. So when I first started in 2021 and I said, I'm only going to source local regenerative food and I'm going to do it year round, people said,
(33:08):
There's no way that you're going to be able to do that. And I was like, Okay, I like a challenge. SoI started at the farmers market, and I found about three or four producers that were using regenerative practices and actually identifying as regenerative farmers, incorporating even livestock integration in their in their product, in their production, which is sometimes really hard to do, and they're really great folks. And then I kind of went from there, and I started turning over stones and finding people online or just going out to farms. And so what we what we do now is
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we have a more in depth process. We kind of have a farmer orientation and application. They do haveto get a produce safety certificate, which we get the cost covered for them, just so they have that. We do a farm visit, and we look at their practices, making sure that they are doing what they're saying, and then we do best practices, quarterly meetings with the farmers to provide them additional resources. Several of our farmers this year got a soil health implementation plan, which means they're being paid $30,000 to implement from the state to implement additional soil health
(34:19):
principles, from cover crops to other types of practices, and these people have started growingtheir own food and growing food for the community, because they cared about their own health and they cared about their family's health. And some of them quit corporate nine to five jobs to go into this regenerative space. And very inspired, just like many of us are in this field, just very inspired of the ripple effect, and they are so happy about being able to sell the fresh RX because they don't have to sit at a farmer's market all day. We pay for the quality. We buy in a bulk
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fashion. It's a dependable market they can depend on, and they know they're. Food is going to peoplethat really need it and are healing from it was very inspiring to the farmers, but our farmers are amazing, but they're also struggling. It's hard, and we try to help with additional labor support through the Tulsa urban ag coalition that I formed with a couple colleagues. And so we send groups of volunteers out to help with farm labor. We've got the bus for high tunnels, like we've done, I've gone to bat for the farmers, because our program depends on
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them, and honestly, the fact that you depend on them and they have that established recurringrevenue stream makes them more bankable as farmers, and gives them the security that they need to invest in their farms and grow their operations, and so in that way, that's super mutually beneficial too, which is fantastic that's part of that design process, because we don't realize that we've lost so much of our access to fresh, locally grown food because the system doesn't support It, like the design principles of the system have not supported local infrastructure, even or even
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regional like here in in my region, we export all of our wheat. We grow so much of it, and we importit from Kansas, because it's just the way this system is designed. It all gets captured. All gets aggregated off. It goes to Asia, and then we're like, oh, wait, we need some wheat, so we ship it in from Kansas, you know? And it's just so bizarre, because that's a design problem, and it's a mega system issue, and we to get that to all come back together. There's so many different pieces of the puzzle that had to be rebuilt to create an engine that will function and serve the regional people
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through that lens of of health. You know that, like human health impact and climate resiliency,like, those are those two levers that I just see as the biggest issues in the future for all of us as humans, everywhere in the world. But you know, especially here in the United States, like, you know, we've got to take that very seriously today, like immediately and and start implementing those systems at a regional level so we can take back our food system. It's pretty and it's pretty impossible. It's pretty impossible to think it's as out of control as it is, but hey, it is, so
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we've got to just start rebuilding it, bit by bit, piece by piece,
absolutely. Yeah, it's going to take us all, and hopefully more people are, I think they're justbeing called to this mission, and we love to be able to regenerative AG has healed people, and we've got the data to prove it. We had a record, record weight loss this year of 117 pounds. She came off all our medications in eight months and fully reversed her type two diabetes. We can do lifestyle disease reversal. We can do it. We are doing it, and we are stimulating more healthy food in the food system. And it can be done. We're going to
(37:50):
keep moving like how hopeful. And that's again, another thing that is so needed today. You know? Imean, we just have this crazy political strife and community disconnect that's happening, and unfortunately, there's so many things that are playing into that, but it's like, how where are those messages of hope? And I think that's one of the things that I love so much about the regenerative ag movement is a it's hope driven, it's systemic, and it's totally apolitical. Like, like you mentioned, it doesn't seem like there's any it's a non partisan thing, like in my everyday
(38:24):
activities, like when talking to people, my team, the farmers I work with, it is like a it is aswath of America that is not leaning in one direction or the other. And I know a lot of people find that really hard to believe, but it's true, and it's because food touches everybody, like everybody has to eat. It's so critical to our communities and our culture, and it's, it's something that can really unify and bring people together in this special way. So this work is just so important on so many levels. Are you guys going to, like, scale this concept to other states? Um, if, say, say, I'm
(38:57):
a person living here in Idaho, and I'm like, listening to this podcast and thinking, oh my gosh, Iwant to start a fresh X, fresh RX program for Idaho. And Idaho fresh RX. Is that something that they could call you up and say, Hey, can you help us? Or do you license it? Or how does that all work? Yeah, I
am offering monthly food is medicine workshops right now. You and I'll have a new website. Hopefullyit's up by the time this airs. So it'll be Aaron W martin.com there's ways you can hire me to consult and help you create a program. We have. We'll have a free tool kit on there if you just want to get started on your own. Monthly food is medicine workshop, so you can come on and ask questions about different from different experts, including myself. And yes, I am working in some other states to help them design and implement programs. I'm working on one in Illinois. I oversee one in the
(39:51):
Mississippi Delta, so they're happening all over. And I even am working on a program, overseeing aprogram in the Netherlands. So we've had calls for. Um, all over the world. Um, Austria just reached out. Then Australia, like they want to know. They want my help to start a program. Everybody wants one, and everyone should have one. And I want the communities to own their own program, but I want them to use, um, the best practices and implement it properly, so that dollars and time and money is spent properly and getting those outcomes so that we can make real policy change. Yeah. Like,
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why reinvent the wheel? Like, if you guys have developed some systems and some processes that work,and we know that they work because we have the outcomes, like, just like, start, start, and then apply it to the nuance of your community and culture, because it's going to be slightly different. Slightly different everywhere. But like, the fact that you guys have created a system that works and it demonstrates, like, incredible effectiveness is, um, it's just something that the whole world should be paying attention to. Um, it's so, so critically important. So I love that you're expanding
(41:00):
to other areas, because I'd like to see this everywhere. You
really would we, we really are. We're finishing up on a software that we've created custom for foodis medicine programs, because there's not a great solution out there. And we're almost done, and we're so excited to help other programs have an easy way that kind of includes all the components of a food is medicine program, because there's so many logistics to have it in one place and so and we're just trying to scale so that we can support more people and provide the healing that that we know can happen. So
(41:38):
amazing. Well, Erin, thank you so much for joining us. I know you're busy, so I'm glad you took thetime to share your update and your story. For those of you who are listening and you want to hear more about Erin and her background, season one, she joined us, and we'll put the link to that one in the notes, of course, so that way you can hear Erin's whole story. We really dove into more of like your background and your history and how you became excited about regenerative Ag, and so I think this is, like so exciting. So we'll have you back again next year, and we can see what has happened
(42:11):
and track your progress, and hopefully hear about how these initiatives are doing in Australia andAustria and Illinois and Mississippi, etc. So yeah, any any plans on things beyond fresh produce, are you Have you guys looked into grains or animal products or anything like that?
I think that the quality of those things, like people having better access to higher quality meat,would be absolutely great. I think the question is, how they can get access to that. What we've seen in the studies around reducing a 1c it's really that they're deficient in the fruits and vegetables. But as we create the local food system, we want to have better quality grain and better quality meat in that system. So that's really pertains to a lot of the food hub work that I'm working on in Tulsa, and just promoting that everywhere. And so if that can be more accessible to people with diet
(43:04):
related disease, I absolutely think that that should be a part of their journey as being able tohave access to better food, better protein, better quality, because obviously we've even seen where there's so much more phytonutrients and like regeneratively grown beef. And of course, I would love people to have access to that as well. So I absolutely support all that, and want to just keep producers producing better stuff as well, but being supported and doing that incredible
(43:33):
well. On that note, awesome. We will make sure that we put your contact information to your websitein the chat. And for those of you who are listening and excited about this. Please share this episode with your friends and family, community, wherever you share, whether that's LinkedIn or Facebook, Instagram, Tiktok, whatever, because we need to get this message out. This is so important. And thank you for your support and joining us on the regenerative by design podcast. This episode
(43:59):
of the regenerative by design podcast is brought to you by snackdiv nation elevating climate smartcrops and regenerative supply chains through innovative products and transparent market development.
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(44:35):
You.
Joanne, hello, everyone. You are listening to the regenerative by design podcast where we will begetting to the root of health, climate, economics and food. I am your host. Joni quinwell Moore, join me on this journey as we explore the stories of individuals and organizations who are working to realign our food system with both human health and the health of our planet. Welcome everybody. Thank you so much for joining us on the regenerative by design podcast. Joni, your host. And today we have Erin Martin from Oklahoma, fresh RX, again, I am so excited, because we had her on the
(00:36):
podcast way back in 2022 so it's been a while, and she has been doing the most incredible work,absolutely impressive to watch from the outside. And I'm going to have her give us a little recap today. So welcome, Erin, I'm so happy to see you.
So happy to be here. Joni, thank you so much. I can't believe it's been two years since we did thatpodcast. And yes, we have, we have grown and changed, and just for people's background, fresh RX, Oklahoma is a produce prescription program where doctors prescribe local regenerative fruits and vegetables to people with type two diabetes, and they get free food every other week for an entire year, plus cooking and nutrition classes every single month, and then they go to health metric checkpoints, where we measure their a 1c weight and blood pressure. And the response has been
(01:29):
enormous. And it's just been we've been really changing lives and reversing lifestyle, lifestyledisease, 100%
and I think when I first started following your work years back as a nurse. And I was like, I was indiabetic educator for many years, and in addition to working in ICU and building policies and procedures for diabetes management inpatient like, this was always what we were like, you know, all of us in the field were like, This is what's missing, is access to nutrient rich, fresh foods and instruction and support on how to use them, because you can't have one without the other. Like, we know that there's a there's a major barrier that people have, not only accessing these types of
(02:12):
fresh foods, but what to do with them. Like, how do you guys tackle that? Like, let's just dig rightin. I'm excited to hear all about it. Yeah. And we've had
to fine tune like our education and how we get people engaged, and how we get people to feel likethey have agency over their own lives and that they're empowered, and that they're fully equipped to continue to make these behavioral changes and and there is an access barrier, right? So we remove the access, and then we actually have to teach people how to use this food. And it's amazing how many food is medicine programs just kind of throw fruits and vegetables at people and expect them to know what to do with it. So we have a wide range of education. We actually use the food that we
(02:55):
provide to do cooking demos, and we do things that people would like and even have people try newthings. So we have local chefs that are kind of locally famous that come in and do these fun cooking demos. They can leave with a recipe from that cooking demo, and very simple things, like things making sure recipes have things in there that people can afford, so not having like South in a normal store, in a normal store and that people can actually afford and cost effective ways of stretching that food, like can you can some of your extra cucumbers and make pickles or sauces and
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letting them know how to really even shop on a budget, or even if they're shopping at $1 General,how to shop as healthy as you can at $1 general, like really meeting people where they are and giving them tools and tips during the program, but also connecting them with resources and how to use, like their SNAP food stamp type of benefits, and how to use double up benefits, which actually doubles their SNAP benefits for fruits and vegetable purchasing and where they can use those and how to access this nutrient rich food. So we're constantly providing education, meeting them where
(04:09):
they're at, and really empowering them to make those decisions. And we've seen incredible behavioralchanges because of that.
Yeah, you're bridging the divide, you know, and I think for so many years, the education andimplementation of diet centered interventions for, you know, metabolic syndrome diseases like, you know, high blood pressure, diabetes management, etc, has not bridged that divide of like, understanding that we have to meet the patient where they're at. We have to understand what they have access to, what's culturally appropriate for food. There's no point in telling somebody, Hey, don't do this, but we want you to do this and they live in a rural community and they don't have any
(04:51):
access to that stuff, or they can't afford it, which is also a huge deal, also access to cooking.Implementation, we always wanted to do a program where. So we would provide things like, you know, cooking tools and and materials, so that people are like, oh, you know, I would love to make this, but I don't have the right cooking pots, or I don't, yeah, the tools are important.
(05:13):
We provide a starter kit that includes cooking utensils, a cookbook. How do you store your produce?And that's a big thing. Like, you don't want to put certain things in the fridge actually that doesn't have certain produce, and then some produce, you better do that. And so we, we have this really good starter kit that gives them those things. We've also had situations where people didn't their fridge went out right during the program. And so we've gotten we've got fridges donated, and so we've done different things like that. And I think back to your point. I think you know, doctors
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may say you need to have more leafy greens, or nutritionists may say this or that, but you reallyhave to have a program, and what I am calling now a healthcare delivery model that really hands hold hand, holds people through these processes and helps them make a change. It's not going to happen by someone saying, in 10 minutes, this is what you need to do. It's a program that helps teach people, and that's why it's a year, you know, and we don't prescribe insulin for six months. So why are we going to prescribe food and behavioral change that may be generations of improvement that needs to
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happen? That's why the doctors love prescribing this, because they know it's not an extra pill, it'snot another shot, and they know when they send people to us that we're going to handhold them and support them and empower them to make these changes, and that's what it takes. It takes a lot of work and people to be willing to be empathetic and meet people where they are and understand what the low income experience is and what resources are
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available. Because there never lived it. You don't know. You really don't know.
You don't know. And that's why also having people who are working in these in these programs orthese healthcare delivery models, is having people that can relate. So I have people that actually on our team that grew up in this area, that lost 100 pounds, like they know what this is like, and they can tell and relate to the people that we serve. We see so many programs motivate, I'm sure, motivate them and inspire them, and then our members inspire other members from their weight loss. And it's just a really, it's like we're creating community healing and creating community around
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food. And that's what's a little bit different than just a food giveaway type program, or justthinking,
yeah, like rethinking the whole community dynamics around food, like we underestimate how powerfulthat is. It's a design feature, like, if your whole love of food and your connection, your emotional connection to food, is reinforced through the lens of unhealthy food choices, in that because you look you equate love to those things, you're like, Well, my mom makes this for me, and I know it's not very healthy, but you know, if we really address those community interactions at that nurturing and food preparation point where suddenly they create new connections around love and connectivity
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through something that makes them feel really Good and actually fosters health.
We actually change the way that the system works. The design starts to change, and that's when westart seeing it transfer to the next generation. Yes, and we've seen that happen already, like we've seen someone from a family member, like a grandparent who's raising grandkids, because that's what happens. We see that they're bringing that food home, they're cooking it, they're giving it to their grandkids. And we've even had people who are not in the program, but maybe live in those households. They've also had health outcomes because they've been influenced by their mother or their
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grandmother. And so we're seeing the generational healing and the ripple effect that this iscausing. And so kids are getting even though kids may not be a direct member of our program, they're getting exposure to this, and they're watching their parents heal themselves. And so that's that's creating a new synapse in the brain and and we've totally separated ag and local food systems. We've totally separated that from the healthcare world, and trying to reintegrate them and build a bridge together is so important. I got to go and tour the Appalachian Regional Health System in Kentucky,
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like a couple weeks ago, and they actually had the CEO from the hospital system and the Secretary ofAgriculture, sitting at the same table, doing a cooking demo together, speaking the same language around local food and health outcomes. And I was just like, this is the type of leadership that has to happen, and people have to start being able, like the Secretary of Ag was able to talk about food in the context of a healthcare. System that needs to be a regular conversation that's going on and making sure needs to become the norm like so amazed to see that. I was like, Yes. I was like, let me
(10:15):
Oklahoma. So yes,
that is so novel, and I'm so happy to hear especially in states like Kentucky that do lead thenation in incidence of diet related disease and and, you know, mortality rates related to diet like, it's absolutely imperative, because when you look at the state impact, like, just even, like a GDP level, equality of life level, it is significant. And I've when I lived in I went to nursing school in upstate New York, and they had a program there that was specifically focused on rural health delivery delivery systems, and so diet and access to food was a big deal there. And we, my husband,
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I did a road trip down to Tennessee and back, and we got to go through Kentucky. And I wasabsolutely floored, as someone who grew up on the West Coast and had lived in Alaska, very different lifestyle, very different set of diet related diseases in the population. I was blown away by the impact that it was having on people. And so to see Kentucky leading that conversation is like extra special, because I think the urgency there is just so profound. So that's really cool. Who are the people in your program? Erin, like, how do the physicians find out about you and how do they match
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the patient that they're caring for to your program? Like, do they triage it? Is there a set ofcriteria?
Yeah, we do, because we are grant funded. We do have certain zip codes that we're supposed to beserving so and they do have to have type two diabetes. So usually the doctors know about us from either we visit those clinics and we provide flyers, and we also do some clinician education. We created a prescription form for the doctors to actually be able to just send over a prescription. And believe it or not, clinics are still faxing. So there's a fax form, and then we're working on a web form to kind of facilitate more of that. But some of them still prefer that. So they can do
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that. They send over baseline of where they are, with their A, 1c, their weight, blood pressure, andthey just send them right over to us, and then we contact that person, we do a kind of a pre screen to make sure that they're going to be a good member, which means they have the ability to store food at their home and cook it. So they do have to have some way to, even if it's just a toaster oven, that's fine. They have to have a way to kind of cook something, and then a way to store it, and then just be willing to communicate and show up to show up to get the food and get cooking classes, or
(12:49):
they can receive delivery and do virtual classes. And we have a ton of technical assistance and helpon that end. So there's all these flexible ways to interact with our program, but we do hold people accountable. And there's there's providing them agency in that. And so predominantly, we serve the black community in North Tulsa. A lot of them are also Native American. And then just about six months ago, we started working with the Muscogee Creek Nation to serve their pre diabetic population. And so they have a federal grant for four years to serve 400 pre diabetic folks. So
(13:23):
we're not only working in North Tulsa, but also Muscogee Creek Nation. And then we have some otherother things, other irons on the fire. So who knows? We're hoping to kind of create a funding pathway for these programs through health insurance. We're trying to continue to stimulate the farmers and who knows from here, but that's kind of who we serve right now, and mostly women actually,
(13:46):
well, well, you know, historically speaking, women are usually the most apt to be doing the cookingin the household. That is still something, that is a thing. I mean, we're seeing that change, but by and large, women drive purchasing at the grocery store, and they also dictate what gets cooked, and do a lot of the labor, a lot of the labor at the kitchen level. So, you know, really addressing women as a important demographic and change around household eating patterns is so important. But I'm really, really happy to hear that you're addressing prediabetes. You know what? I remember being
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a CDE and working in rural Montana, when a lot of a big body of research came out in the late twolike prior to 2010 that really gave us proof, like we needed it. But you know what we did? I guess, that we could reverse pre diabetes. And that set into motion a whole bunch of initiatives at the state level in Montana, where I was living, where suddenly it was like, okay, we can reverse pre diabetes. We now have proof. So let's put in these systems in rural communities to help them get access to diets, dietary ingredients that are going to help diminish the you know, evolution into
(14:59):
four. Full blown diabetes that now is, you know, difficult to manage and and likely irreversible. SoI I found that to be so fascinating to me as a nurse, because I think I had always assumed that prediabetes was reversible, and so to hear it come down from a state agency of like, hey, surprise everybody. It was really shocking to me, but I'm happy to hear that there's actually an intentional program, especially working with tribal nations, because we I worked with Indian Health Services and in tribal populations for many years as a healthcare bedside practitioner. And there's a special set
(15:34):
of circumstances that are present on reservations and in our native peoples with diabetes andaffecting very young people that are at the prime of their learning and earning ages. And so if you could just take a second to talk about that, I'd love to hear about it.
Yeah, and there's some pretty disturbing numbers. I mean, I know that they're experiencing foodinsecurity as at a much higher rate, and I would argue to say more nutritional insecurity as well reframe it. But I did. I did get to present to all 39 nations in Oklahoma. Many of you listening probably will know the history in Oklahoma. There's been a new movie made in a book around what happened in Oklahoma to native folks, and we once had in the 1920s we had the richest black community in the entire nation, and we also had the richest Native American population in the entire
(16:30):
world per capita, which was the Osage Nation. And it was because of the oil boom there and the landrights and so people started getting diabetes back then, and diabetes is happening more prevalent in the Native American populations, because, number one, what they have access to, but it's such a stark difference from their original native diet. And they're they're not their bodies are not responding well to all this stuff. And the really disturbing statistic I found when I presented to all 39 nations last year was that after the year 2001 out of two children, 50% born. After the year
(17:13):
2000 if nothing's changed, we'll get type two diabetes, one out of two children, diabetes that areNative American or Alaskan native, and that's really disturbing, because basically it's like one out of five people now, and generally are having, like, pre diabetes or diabetes, and it's maybe even more now, but one out of two, that's 50% of Native Americans. So they're getting it at a much higher rate. And what's really, what's really exciting and sad is that Native Americans created some of the most nutrient dense food in the varieties that they crossbred over 1000s and 1000s of years. And
(17:57):
that's why regenerative ag really inspires me, because the corn we get now is like 5% protein andturns to starch and sugar, basically. And then there are variety. It's been totally a nutritional
standpoint. And there was sophisticated agronomy and genetics happening in Native nations beforecolonization happened, and we forget about that, like, we think all of that started with Mendel, and it's just not true. No,
(18:29):
up to, like, there's one, there's a corn variety that's up to, like, 19% protein, and it's like, noone, they could live on squash, corn and beans, because they had all this incredible nutrients. And so it's one of my priorities, is to get more native varieties of food, not only for the nations that we serve, but also for anyone to have access to more nutrient rich indigenous foods, and to really stimulate a new market around that, and get more people to purchase that, the more that we start stimulating the supply and infiltrating that into food, is medicine programs, into schools, into
(19:08):
restaurants, like, the healthier we're all going to be. Like, it has to be redesigned or it's wellintegrated. Yeah,
and that design process does have to involve many different players. Like it's you've got theconsumer buy in to drive the engine, in the sense of the market, but it's like an agronomy genetics riddle. It's a farmer riddle. It's a value chain and the processor riddle. There's so many people that have to be involved to make those changes. That's why, like, I always call it a real design it's a design endeavor. It's like, you really have to be high level and understand that all those stakeholders have to work together to change the norms of the market. And I think corn epitomizes a
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lot of that, where we've taken the genetics and we've driven it very intentionally towardsbenchmarks that don't actually serve the interest of human health or climate resiliency. Necessarily, and so I always say it's the efficiency versus effectiveness equation. We've been very focused on efficiency as far as carbohydrates or calories per acre, you know, but we've ignored effectiveness, which is positive human health outcomes and climate resiliency long term. And we need to realign that equation. But it's it's taken us decades to get to this point
(20:22):
that right there, like I was just saying, I say this so much, but like, quantity has nevertranslated to health outcomes. Like I always say to people who ask us, How many pounds of produce Do you provide? I said, we don't measure in pounds, because pounds doesn't attribute to anything, right? It doesn't attribute to health outcomes. That's like caring about the how big your house is, and not about the foundation. And that we need to be we need to be measuring these programs based on outcomes. Pounds has nothing to do with it. Has nothing to do with it. It has to do with the
(21:01):
nutritional integrity of the food and people's ability to understand, to be empowered to make goodchoices and to know how to access and that's what needs to change, is funders who are funding and grants, other types of funders like outcomes, need to be correlated With what matters, not just based on pounds or a system change.
(21:25):
Yeah, theology, it's deep. It's a system level change of like, our values,
yeah, it's a whole perspective and understanding. And so we just try to help, help like. And whensomeone asks me that question, it's like a great opportunity to say, here's why we don't measure in pounds, and why I don't think that's a good measure of success.
(21:46):
Only pounds you're measuring are people's loss on their personal bodies. And you know, with moremicronutrient rich and and better balanced food, it's like people are their satiation drive. It changes dramatically once they're not chronically malnourished, and that just turns on. It's like a switch that gets turned on in our bodies. And my personal belief is that the microbiome is also involved in that, that it starts to create this like crazy craving pathway, where our body thinks it's starving, and it starts to seek out all these very high calorie foods, and it's, it's hard to
(22:22):
resist, because that's a that's a biological drive. There's a physiological phenomenon happeningthere that our body and our brain is going, Uh oh, you are malnourished. Go find food. But a bag of Hot Cheetos is just going to make it worse. Like, what they need is, like, micronutrient, rich foods that are not just providing fat, sodium and carbohydrates, but all the other things that you know, the other 90% of things that really create health and support the immune system. And as awful as covid was, I don't ever want to take away from how disastrous it was and and horrible for people
(22:58):
with all of the deaths, complication, economics, everything, but it did open up our eyes to the riskthat's associated to diet related diseases when it comes to mortality against things like viruses. And I've been really impressed with the response from tribal nations, right? Exactly. It was a mind opening event, and I in fact, we should have you out to the inter tribal health conference and the food sovereignty conference out here. We have some amazing initiatives happening in in my neck of the woods, and Idaho, Washington, Oregon, and where we have these communities and these inter tribal
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coalitions coming together to really address food system, security through the lens of nutrition andactually promoting vitality, not just, you know, how it has been for decades. And I lived on the Flathead Reservation for a while in Montana, and you know, the only store in town was literally nothing but Top Ramen and frozen pizza and beer and soda pop. And I just remember, like, thinking to myself, these kids that have grown up there in Arlene, Montana, and you know, the next town is quite a ways away. You have to have a car, and you have to have a car that's reliable, that could get you
(24:14):
to Missoula, or could get you up to the Flathead Valley. And if that, if you don't have that, thatis all you had access to was some canned chili, frozen pizzas and Top Ramen and and then we wonder why we have these like long term health impacts that started a very young age. So I am so grateful for the work that you're doing. Erin, it's so needed. And I think that you guys are science driven enough too, where you're collecting the data that can prove a new model and integrate it into deeper levels of systemic change, like the work you're doing at the political level, at the advocacy level,
(24:48):
insurance, health systems, etc. So could you give us a little update on where you're at on that?Because you've been speaking in Washington, you've been just crushing it. It's amazing. It's.
So much attention on this issue, a very bipartisan issue, there's people on either sides of theaisle. It's like we need something that unites us so much right now, and it's been really cool to see. So I got to testify before Congress. I think it was in March or April, a few months ago, and it was under the Older Americans Act. And so what people, if people don't know what that means that the counties, every county in the United States gets funding for congregate meal programs, for Meals on Wheels, for federally qualified health centers to serve older adults. And so our argument was, we
(25:39):
should enhance these programs to actually produce some health outcomes through these meal programs,through including produce prescription and other food as medicine interventions into these county fundings. And so right now, we're just trying to find any type of Avenue and every avenue we can to insert a funding stream for produce prescription program at a federal level, for the longest time, the farm bill has been paying for these produce prescription programs, which were partly funded through through the USDA, but they've been footing the bill for these incredible health outcomes
(26:14):
that are happening through these programs. And so the argument is now we want Centers for Medicareand Medicaid, which is our federal healthcare agency, to start paying for these and it behooves the healthcare industry to pay for it, because they're the one benefiting from the cost savings,
and they should be. Those externalities are crippling to our healthcare system.
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It's insane, and it'd be so much easier to do this preventatively and to have this be a healthcareintervention and a treatment plan and a care model. And so we, just about a year ago, we formed the food as medicine Policy Coalition of Oklahoma. We have about 100 members across the state of Oklahoma wanting to include food as medicine as a covered insurance benefit for our Medicaid population. So that's low income on a state level. And there's nine states that have already done this in the United States, both very conservative states and liberal states. So Alaska just passed
(27:16):
theirs, and they've included indigenous foods as a part as a covered benefit. Hawaii included localprocurement as a requirement for their food as medicine programs. And we have five more states that their law is pending, and so Oklahoma hopes to be on the front half of that as far as all the states, but we think in about five years, CMS Centers for Medicare and Medicaid at the federal level will federally legalize this, but we're seeing managed care organizations, insurance plans and Medicare Advantage plans already including these in interventions. They already have the ability to
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pay for value added benefits, or something called in lieu of services, they can choose how they wantto intervene with someone's life, because they if they do it well, they get to benefit. They get to keep the money that they've saved. And my argument is that organizations like mine who are saving the health insurance money we should share in that cost savings and that sustainable model. So right now, we're in negotiations with some health plans making sure that the financial design of this is mutually beneficial and creates a sustainable model for us to continue to serve but also to expand
(28:40):
and scale these services at the same time.
Incredible. You know, even if you just focused on the portion of the population that can be sparedfrom entering dialysis for the last potentially decade of their life, like it is such a it's such a huge chunk of healthcare spending. And I knew it was big because I'd spent a lot of time in dialysis centers in my nursing career. But when I was talking to Carter Williams and we were talking about actual financial spend on things like dialysis, it really illuminated it to me that like even just focusing on that one spending and like having a strategy and a design in place of, how can we keep
(29:22):
people from getting to where they ever need dialysis, which is driven mostly by diet relateddisease, uncontrolled, high blood pressure and diabetes, those are the two leading causes of patients ending up in end stage, renal failure and kidney or kidney failure. I'm trying to not use medical terms, but um, you know, when you think about it like that and you equate it, that's something you have a very simple mathematical equation that like people, like politicians and insurance people, and maybe the reluctant out there. When you can break it down to a simple math
(29:52):
problem, and you're like, look, this spending here can equal this savings here, and it's huge.Savings. Like, like you said, B billions,
or why you could ever see so return on investment for non financial people. Like, if you can startspeaking in those terms, like, one of the great things I talk about it is they say, if you reduce someone's a 1c measure by one to two points in the year, that's equates to 16 to $24,000 in healthcare cost savings per year per person, and it only maybe cost $3,500 a year to serve them. And we've not only have we been able to reduce someone's a 1c by two points, but we've some we've had someone reduced by eight points from 13.6 to a 5.4 and so you're talking about insane amount of
(30:41):
savings, the best investment anyone could ever make. It's insane. So that's what the states want toknow, is like, how much is this going to cost us, and when are we going to get the return on investment? So we're trying to work to make sure there's this cost benefit analysis based on real data, based on what we've been able to produce, and saying, if we scale this, this is how much you can save. And we actually had the University of Oklahoma look at some of our data and say, if we scaled this to 1200 people, it would cost us about $3 million to do it, but we would save the state
(31:13):
of Oklahoma $25 million in healthcare cost savings. So it's like, it's a new brainer, and we'redoing development with those same dollars, with the farmers. So then you've got economic development and dollars being that same dollars being spent in the community and being kept there. And so that's another generate, generator of funds and cost savings. So it's an enormous investment that should be no brainer, like reduction
(31:43):
of transportation costs, that is like a greenhouse gas impact point, like the externalities, go onand on, and you know, it is a no brainer. I 100% agree with you, and I love it when people have the ability to put this into a mathematical equation, that people who don't see it as no brainer can suddenly see and have that aha moment and connect the dots for the first time. And when, you know, I think when we can do that, that's when things can move forward really, really quickly. And you know, we're, we're getting to the top of the hour. Erin, I can't believe how fast the time is going, but
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before we adjourn, and we'll have to have you back again next time, next year, so we can just keeptrack of your journey via podcast. But who are your farmers and how do you find them? I think we talked about it a little bit a couple of years ago, but perhaps it's changed because your program has grown. Tell us a little bit about your sourcing program.
Yeah, farmers are like, coming out of the woodwork. I'm like, did you just decide to be a farmer?Have you been a farmer? How did I not know about you and so many farmers who are using really good practices that may not even identify as a regenerative farmer, but they're very much on the spectrum of regenerative farmers and really care to deepen their practice so and we, you know, we're seeing a lot of young people farming, which is really amazing. So when I first started in 2021 and I said, I'm only going to source local regenerative food and I'm going to do it year round, people said,
(33:08):
There's no way that you're going to be able to do that. And I was like, Okay, I like a challenge. SoI started at the farmers market, and I found about three or four producers that were using regenerative practices and actually identifying as regenerative farmers, incorporating even livestock integration in their in their product, in their production, which is sometimes really hard to do, and they're really great folks. And then I kind of went from there, and I started turning over stones and finding people online or just going out to farms. And so what we what we do now is
(33:41):
we have a more in depth process. We kind of have a farmer orientation and application. They do haveto get a produce safety certificate, which we get the cost covered for them, just so they have that. We do a farm visit, and we look at their practices, making sure that they are doing what they're saying, and then we do best practices, quarterly meetings with the farmers to provide them additional resources. Several of our farmers this year got a soil health implementation plan, which means they're being paid $30,000 to implement from the state to implement additional soil health
(34:19):
principles, from cover crops to other types of practices, and these people have started growingtheir own food and growing food for the community, because they cared about their own health and they cared about their family's health. And some of them quit corporate nine to five jobs to go into this regenerative space. And very inspired, just like many of us are in this field, just very inspired of the ripple effect, and they are so happy about being able to sell the fresh RX because they don't have to sit at a farmer's market all day. We pay for the quality. We buy in a bulk
(34:55):
fashion. It's a dependable market they can depend on, and they know they're. Food is going to peoplethat really need it and are healing from it was very inspiring to the farmers, but our farmers are amazing, but they're also struggling. It's hard, and we try to help with additional labor support through the Tulsa urban ag coalition that I formed with a couple colleagues. And so we send groups of volunteers out to help with farm labor. We've got the bus for high tunnels, like we've done, I've gone to bat for the farmers, because our program depends on
(35:29):
them, and honestly, the fact that you depend on them and they have that established recurringrevenue stream makes them more bankable as farmers, and gives them the security that they need to invest in their farms and grow their operations, and so in that way, that's super mutually beneficial too, which is fantastic that's part of that design process, because we don't realize that we've lost so much of our access to fresh, locally grown food because the system doesn't support It, like the design principles of the system have not supported local infrastructure, even or even
(36:05):
regional like here in in my region, we export all of our wheat. We grow so much of it, and we importit from Kansas, because it's just the way this system is designed. It all gets captured. All gets aggregated off. It goes to Asia, and then we're like, oh, wait, we need some wheat, so we ship it in from Kansas, you know? And it's just so bizarre, because that's a design problem, and it's a mega system issue, and we to get that to all come back together. There's so many different pieces of the puzzle that had to be rebuilt to create an engine that will function and serve the regional people
(36:42):
through that lens of of health. You know that, like human health impact and climate resiliency,like, those are those two levers that I just see as the biggest issues in the future for all of us as humans, everywhere in the world. But you know, especially here in the United States, like, you know, we've got to take that very seriously today, like immediately and and start implementing those systems at a regional level so we can take back our food system. It's pretty and it's pretty impossible. It's pretty impossible to think it's as out of control as it is, but hey, it is, so
(37:13):
we've got to just start rebuilding it, bit by bit, piece by piece,
absolutely. Yeah, it's going to take us all, and hopefully more people are, I think they're justbeing called to this mission, and we love to be able to regenerative AG has healed people, and we've got the data to prove it. We had a record, record weight loss this year of 117 pounds. She came off all our medications in eight months and fully reversed her type two diabetes. We can do lifestyle disease reversal. We can do it. We are doing it, and we are stimulating more healthy food in the food system. And it can be done. We're going to
(37:50):
keep moving like how hopeful. And that's again, another thing that is so needed today. You know? Imean, we just have this crazy political strife and community disconnect that's happening, and unfortunately, there's so many things that are playing into that, but it's like, how where are those messages of hope? And I think that's one of the things that I love so much about the regenerative ag movement is a it's hope driven, it's systemic, and it's totally apolitical. Like, like you mentioned, it doesn't seem like there's any it's a non partisan thing, like in my everyday
(38:24):
activities, like when talking to people, my team, the farmers I work with, it is like a it is aswath of America that is not leaning in one direction or the other. And I know a lot of people find that really hard to believe, but it's true, and it's because food touches everybody, like everybody has to eat. It's so critical to our communities and our culture, and it's, it's something that can really unify and bring people together in this special way. So this work is just so important on so many levels. Are you guys going to, like, scale this concept to other states? Um, if, say, say, I'm
(38:57):
a person living here in Idaho, and I'm like, listening to this podcast and thinking, oh my gosh, Iwant to start a fresh X, fresh RX program for Idaho. And Idaho fresh RX. Is that something that they could call you up and say, Hey, can you help us? Or do you license it? Or how does that all work? Yeah, I
am offering monthly food is medicine workshops right now. You and I'll have a new website. Hopefullyit's up by the time this airs. So it'll be Aaron W martin.com there's ways you can hire me to consult and help you create a program. We have. We'll have a free tool kit on there if you just want to get started on your own. Monthly food is medicine workshop, so you can come on and ask questions about different from different experts, including myself. And yes, I am working in some other states to help them design and implement programs. I'm working on one in Illinois. I oversee one in the
(39:51):
Mississippi Delta, so they're happening all over. And I even am working on a program, overseeing aprogram in the Netherlands. So we've had calls for. Um, all over the world. Um, Austria just reached out. Then Australia, like they want to know. They want my help to start a program. Everybody wants one, and everyone should have one. And I want the communities to own their own program, but I want them to use, um, the best practices and implement it properly, so that dollars and time and money is spent properly and getting those outcomes so that we can make real policy change. Yeah. Like,
(40:27):
why reinvent the wheel? Like, if you guys have developed some systems and some processes that work,and we know that they work because we have the outcomes, like, just like, start, start, and then apply it to the nuance of your community and culture, because it's going to be slightly different. Slightly different everywhere. But like, the fact that you guys have created a system that works and it demonstrates, like, incredible effectiveness is, um, it's just something that the whole world should be paying attention to. Um, it's so, so critically important. So I love that you're expanding
(41:00):
to other areas, because I'd like to see this everywhere. You
really would we, we really are. We're finishing up on a software that we've created custom for foodis medicine programs, because there's not a great solution out there. And we're almost done, and we're so excited to help other programs have an easy way that kind of includes all the components of a food is medicine program, because there's so many logistics to have it in one place and so and we're just trying to scale so that we can support more people and provide the healing that that we know can happen. So
(41:38):
amazing. Well, Erin, thank you so much for joining us. I know you're busy, so I'm glad you took thetime to share your update and your story. For those of you who are listening and you want to hear more about Erin and her background, season one, she joined us, and we'll put the link to that one in the notes, of course, so that way you can hear Erin's whole story. We really dove into more of like your background and your history and how you became excited about regenerative Ag, and so I think this is, like so exciting. So we'll have you back again next year, and we can see what has happened
(42:11):
and track your progress, and hopefully hear about how these initiatives are doing in Australia andAustria and Illinois and Mississippi, etc. So yeah, any any plans on things beyond fresh produce, are you Have you guys looked into grains or animal products or anything like that?
I think that the quality of those things, like people having better access to higher quality meat,would be absolutely great. I think the question is, how they can get access to that. What we've seen in the studies around reducing a 1c it's really that they're deficient in the fruits and vegetables. But as we create the local food system, we want to have better quality grain and better quality meat in that system. So that's really pertains to a lot of the food hub work that I'm working on in Tulsa, and just promoting that everywhere. And so if that can be more accessible to people with diet
(43:04):
related disease, I absolutely think that that should be a part of their journey as being able tohave access to better food, better protein, better quality, because obviously we've even seen where there's so much more phytonutrients and like regeneratively grown beef. And of course, I would love people to have access to that as well. So I absolutely support all that, and want to just keep producers producing better stuff as well, but being supported and doing that incredible
(43:33):
well. On that note, awesome. We will make sure that we put your contact information to your websitein the chat. And for those of you who are listening and excited about this. Please share this episode with your friends and family, community, wherever you share, whether that's LinkedIn or Facebook, Instagram, Tiktok, whatever, because we need to get this message out. This is so important. And thank you for your support and joining us on the regenerative by design podcast. This episode
(43:59):
of the regenerative by design podcast is brought to you by snackdiv nation elevating climate smartcrops and regenerative supply chains through innovative products and transparent market development.
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(44:35):
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