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Shop with Your Doc is part of a broader and
still growing movement in US medicine to shift the focus away from simply
treating disease toward caring for the whole person. It is meant to help people
make educated, healthy choices one grocery cart at a time. Across the country,
hospitals are setting up food banks and medical schools are putting cooking
classes on the curriculum. Nonprofits are connecting medical centers with
community resources to ensure that low-income Americans have access to fresh
fruits and vegetables.
For centuries, Western medicine's mission
was to cure disease. But over the past generation, two generation, two
significant trends are of concern to the medical community, says Timothy
Harlan, executive director of Goldring Center for Culinary Medicine at Tulane
University in New Orleans. Healthcare costs began to soar (激增), and relatively
inexpensive, poor-quality food became more common. "There's a very straightforward
link between people improving their diets and improving the condition that they
have," Dr. Harlan says.
The connection drove the medical and
nonprofit communities to rethink their approach to health. What emerged was the
concept of the "social determinants of health"—the notion of taking into account the biological, physical, and
socioeconomic circumstances surrounding a patient. A healthy person isn't just
someone who is free from disease, the theory goes; he or she also enjoys "a
state of complete mental, physical and social well-being."
The question the medical community now
faces is how to get patients—especially low-income
families—to recognize these
determinants and make it possible for them to eat and live healthier. In
Boston, medical experts responded by creating an on-site pantry (食品室) at Boston Medical Center.
Since its founding in 2002, the pantry has evolved into a kind of nutrition
center where primary care providers at BMC send patients for food. Today the
pantry, which gets 95 percent of its stock from the Greater Boston Food bank,
hosts free cooking classes and serves about 7,000 people a month. The Greater
Boston Food Bank has also launched its own initiatives, striking partnerships
with four community health centers across the state to offer free mobile
produce markets. The organization also helped develop toolkits (软件包) that map local pantries,
markets that accept government food vouchers, and other resources.
At Tulane in New Orleans, Harlan is leading
the development of a curriculum that combines medicine with the art of food
preparation. His philosophy: Doctors who know their way around a kitchen are
better at helping their patients. And empowering patients to take charge of
their own diets is one way to help them deal with the incredible costs of
health care, Harlan says. The curriculum has since been adopted at 35 medical
schools around the United States. Chipping away at bad habits is a good place
to start getting patients to think about the choices they make for themselves
and their families, say Dr Maureen Villasenor, the Orange County pediatrician (儿科医生).