depression

Reducing Depression Through Mobile Food Markets

A new study found that Community Health Center patients who obtained fresh produce, dairy, and meats at The Greater Boston Food Bank’s free mobile market, experienced improvements in their mental health over three years.

Healthcare-community nutrition programs, such as clinic-based food pantries, medically tailored meal deliveries, and “produce prescription” programs, are known to reduce food insecurity and improve diet quality and chronic conditions, such as diabetes and cardiovascular disease. And while food insecurity has been linked to depression, no study has evaluated the direct impact of these nutrition interventions on mental health as a primary outcome.

Now, a new study led by a School of Public Health researcher is closing this gap with a new analysis of a monthly onsite mobile food market program run by the Greater Boston Food Bank (GBFB) and eight partnering community health centers (CHCs).

Published in the journal NEJM Catalyst Innovations in Care Delivery, the study found that CHC patients who utilized free produce, dairy, and high-protein foods at the GBFB mobile market experienced a reduction in depressive symptoms. Mental health improved for all mobile market participants, but people who were diagnosed with moderate or severe depression before they began shopping at the market experienced the largest improvement.

These findings underscore the multiple benefits of healthcare-community partnerships, the researchers say.

“It is important to remember that community-based interventions may have important positive effects that go beyond their primary outcome,” says study senior author Yorghos Tripodis, professor of biostatistics. “Furthermore, this study emphasizes the importance of food security in various aspects of a person’s health.”

For the study, Tripodis and researchers utilized electronic medical records from the CHCs and mobile market utilization from the GBFB to evaluate changes in depressive symptoms among a total of 3,071 CHC patients who obtained food from the market from 2016 to 2020. To measure changes in mental health, the researchers referenced the Patient Health Questionnaire (PHQ-9) score, a nine-item instrument widely used for screening, diagnosing, monitoring, and measuring the severity of depression.

A majority of participants were enrolled in Medicaid and spoke Spanish as a primary language, and about half received Supplemental Nutrition Assistance Program benefits.

During the three years of the program, each mobile market visit was associated with a 0.05-point decrease in the PHQ-9 score. Participants who were diagnosed with moderate or severe depression before the start of the program experienced a 0.27-point decrease in the PHQ-9 score. On average, participants with depressive symptoms attended the market 6-7 times during the study period.

The researchers emphasize that similar partnerships or social programs should consider the potential large-scale benefits of their interventions—benefits that could reach community members that are perhaps outside of their target population. Healthcare-community partnerships are often geared toward patients with poorly controlled chronic conditions, but program such as food mobile markets could provide physical, mental, social, and economic benefits to multiple populations.