The health system has created a mobile farmers market, grocery store, and ‘food pharmacy’ to address community health needs in food desert neighborhoods.
By Matt Skoufalos | September 20, 2023
Virtua Mobile Grocery Store bus. Credit: Matt Skoufalos.
In September 2022, NJ Pen was among a group of journalism fellows chosen to participate in the Stories Invincible reporting project, an effort to connect with Camden City residents on key issues in their community.
Our contribution to the project is an exploration of the efforts to bring a grocery store into the city, which has been labeled a food desert community (FDC) by the New Jersey Economic Development Authority (NJEDA) for its limited access to nutritious food.
In this installment, we explore mobile solutions to food insecurity engineered by the Marlton-based Virtua Health System. Via its Eat Well program, the outreach-based initiatives have created a stopgap for families living in areas where nutritious food is inaccessible.
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As organizations work to combat hunger in food desert communities across New Jersey — municipalities where residents lack reliable access to nutritious food — mobile programs are gaining traction until permanent solutions (i.e., building more grocery stores) can be reached.
In Camden City, the Eat Well initiative begun by Virtua Health in 2017 has expanded food access across communities of need in Camden and Burlington Counties by delivering low-cost, healthy grocery options in places where people either can’t shop for them locally, or lack the means to travel elsewhere.
Virtua established the program after its 2016 community health needs survey revealed that its patients most needed access to fresh, affordable produce, said April Schetler, its Associate Vice President of Community Health Engagement.
In 2017, the health system rolled out its Mobile Farmers Market van, a converted Ford Econoline bus brimming with low-cost fruits and vegetables. Then, in 2019, “we started dreaming a little bigger,” Schetler said.
That dream manifested itself in the Virtua Mobile Grocery Store, a decommissioned NJ TRANSIT city bus outfitted with shelving and refrigeration units to support a downscaled shopping experience.
Virtua executives Debra Moran (left) and April Schetler in the Virtua mobile grocery store. Credit: Matt Skoufalos.
Three to four times weekly, the mobile grocery parks at different locations throughout South Jersey, offering residents a chance to shop for healthful staple goods that they can’t find if they live in food deserts, where grocery stores don’t exist, and “food swamps,” in which the only options are high-calorie, low-nutrient fast foods that contribute to chronic health conditions.
“People don’t have reliable access to transportation,” Schetler said, “so we go straight into the community.”
Although the programs generate some revenue at the register, Schetler said, they’re funded primarily by philanthropic donors. Groceries are purchased weekly from purveyors, and include staple goods as well as seasonally rotating items.
As the program has established its consistency through the years, regular shoppers have grown more amenable to speaking with Virtua staffers about their other health needs, which the health system has met with mobile pediatric and health screening vehicles. Program coordinators see that as a bigger win for community health goals.
“It comes down to trust,” Schetler said. “Our customer base is so loyal that now they’re trusting us with other services, like blood pressure, blood-glucose, and cholesterol screenings.”
“Everyone that is a customer has grown as a loyal customer,” said Debra Moran, Virtua Senior Vice President of Health Equity & Community Programs. “We always take care of the sick. But we decided back in 2017 that we want to meet our residents where they are as opposed to where we think they are.”
Melanie Ernest, Director of Community Health Engagement at Virtua, said that 80 percent of the people the mobile farmers market serves, and 92 percent of those the mobile grocery store serves, are repeat customers. In total, the programs facilitated 35,500 individual transactions in the past year.
“We can get to areas where there’s not a full-service grocery store,” Ernest said; places that are “not transportation-rich, and don’t have other farmstands.”
Melanie Ernest and Gabriel Rodriguez of the Virtua Mobile Farmers Market. Credit: Matt Skoufalos.
Importantly, she noted, at a time when grocery prices are up more than 4 percent from 2020 levels, according to the latest consumer price index (CPI) report from the U.S. Bureau of Labor Statistics, the Eat Well program is helping families keep costs down.
Since it was established in 2017, the Virtua mobile farmers market has kept prices for its fruits and vegetables flat.
For just $3, shoppers can get a bag of six produce items, like potatoes, apples, bananas, and onions. If they need more, larger bags (12 items for $6, and 20 for $9) are also available.
As compared with retail supermarket goods, “These prices have not gone up,” Ernest said.
The average transaction at the mobile grocery store ranges from $10 to $15, and mobile farmers market customers paying with SNAP (Supplemental Nutrition Assistance Program) benefits receive a dollar-for-dollar match, doubling their purchasing power. There are no eligibility requirements to shop either the mobile farmers market or grocery store.
In 2018 and 2019, Virtua repurposed the onsite food pantry programs at its Mount Holly and Camden City campuses into the Food Farmacy, a combination dietetic consultation and hunger relief outpost. There, patients with health conditions that require significant dietary changes, or who are screened for food insecurity in a physician visit, can meet with a health professional to get necessary supports.
At the Camden City Virtua Food Farmacy, dietitian Caroline Rudkin receives patients referred from healthcare or social service agencies for monthly consultations on a six-month basis. There, she helps them begin planning lifestyle changes to mitigate chronic conditions like diabetes, hypertension, heart disease, obesity, and malnutrition.
Her office is complete with a small, rotating selection of fresh, frozen, and shelf-stable groceries to send home with patients. In addition to providing access to healthy foods that they may not normally be able to buy in their communities, Rudkin also educates her patients about new recipes and ingredients to introduce to at home.
“We talk about health goals, nutrition education, and at the end of the appointment, we go shopping,” she said.
Dietitian Caroline Rudkin in the Camden City Virtua Food Farmacy. Credit: Matt Skoufalos.
In addition to coaching patients on healthy eating choices, Rudkin also provides information on where they can find low-cost, nutritious foods, including the Virtua mobile food programs and the Virtua Health Community ConnectionVirtua Health Community Connection, a database of free and reduced-cost resources.
“It’s all about meeting health goals in a realistic and attainable way,” she said.
“They come in and get information from me, and when they come back, we talk about tracking health goals.
“You’re coming back here in a month,” Rudkin said; “I’m going to hold you accountable.”
Rudkin sees 20 to 30 patients weekly in one-hour consultations, and works to help them make healthier food choices not only as a palliative to chronic conditions, but as a preventive measure to stave off future concerns.
“I think ‘food is your medicine’ is a great place to start,” she said. “Treat your body in a way that it was intended to be treated. Starting with a foundation of healthy eating is always better [than correcting behaviors].”
When families don’t have enough to eat at home, they’ll typically plug holes in their grocery shopping with some combination of supplemental benefits and goods from food pantries.
For residents whose circumstances are described by the ALICE (Asset-Limited, Income-Constrained, Employed) designation — working people who don’t qualify for benefits but who still aren’t making enough money to cover their bills — Schetler believes the Virtua food-insecurity programs can help close those gaps in food desert communities like Camden City, Pennsauken, and Woodlynne.
However, in such towns, “the long-term vision is at least one grocery store that’s safe and open in a place where they can access it,” she said.
Food Bucks prescription and resources at the Virtua Food Farmacy. Credit: Matt Skoufalos
Although state funding and grant programs are available to help establish such businesses in communities of need, policy advocacy is another mechanism for doing so.
To that end, Schetler said Virtua joined the Food is Medicine Task Force established by the Milken Institute of Santa Monica, California.
She believes other stopgap measures that address food insecurity as a community health issue — like insurance-covered prescriptions for healthy foods — could someday emerge as another mechanism for combating what is essentially a problem of income discrepancy.
“Hunger isn’t just in the communities you think it’s in,” Schetler said.
Stories Invincible is supported by the Community Info Coop in partnership with the Movement Alliance Project, thanks to original funding from the Geraldine R. Dodge Foundation and the New Jersey Local News Lab Fund, a partnership among Dodge, Democracy Fund and the Community Foundation of Louisville.
