In New York City, Choosing Healthy and Active Lifestyles for Kids (CHALK) is looking to transform healthcare’s role in community wellness with a food as medicine model. To advance this work they offer a training program to help pediatric residents better understand social determinants of health and the importance of interdisciplinary intervention.
CHALK is an obesity prevention program in collaboration with the Division of Community and Population Health at NewYork-Presbyterian and Columbia University Irving Medical Center (CUIMC). Kyle Murray, Community Program Lead at CHALK, tells Food Tank that their workshop “serves as an entry point to CHALK’s expansive community work for the residents.”
The program is led by Murray, along with his colleague Dr. Ileana Vargas, an endocrinologist from the Naomi Berrie Diabetes Center. Offered monthly, the 2.5-hour workshop, complete with a cooking demonstration, is attended by every class of pediatric residents at NewYork-Presbyterian/Columbia University Irving Medical Center.
The workshop focuses on nutrition education strategies, and provides pediatricians with support in motivational interviewing—a client-centered counseling approach that takes a problem-solving approach—along with culinary medicine, and culturally competent medical nutrition therapy. By emphasizing food is medicine and challenging the typical nutrition education model, this training works to deepen the impact of clinical care plans and interventions.
According to Murray, social determinants of health, which can include a patient’s long commute, low wages and/or access to healthy food, can drive families towards convenient, low-cost, and often unhealthy, ultra-processed foods. This lack of resources, time, or money can also potentially lead to higher rates of chronic diseases.
By addressing social determinants of health alongside individual behaviors, CHALK advocates for sustainable, health-boosting dietary changes, offering support to families facing the daily challenges of being food insecure or other uncertainties. “By bridging the gap between the community work and the clinical work, while training pediatricians to lead on social drivers of health and interdisciplinary intervention, food as medicine becomes something more than a cliché,” Murray tells Food Tank.
CHALK’s training emphasizes that improving your diet doesn’t demand drastic lifestyle changes. “Less than 0.5 percent of pediatric patients in the United States eat the USDA-recommended five servings of fruits and vegetables each day, so almost any change in eating patterns would make a positive impact,” Murray points out. He believes that small, positive shifts, such as incorporating more vegetables into traditional meals, can yield significant health benefits.
Recognizing the immense challenges posed by social determinants of health, CHALK’s work also extends beyond the clinician’s office. “We connect people to resources to lighten their social and material burdens,” Murray says. “Our role is to provide the right tools to address their needs, so that in the moment the patient is ready to make a move, they know they can use a resource we’ve furnished them.”
CHALK’s efforts have helped to shape a resource network involving families, schools, healthcare institutions, and community-based organizations. This comprehensive approach, such as providing fresh produce to food insecure families and offering health classes in public schools, is helping create a sustainable environment for healthy living.
For more than 15 years, this collaborative initiative by NewYork-Presbyterian and Columbia University Irving Medical Center, has been a part of New York City’s public health infrastructure. With pediatric residents leveraging institutional resources for community benefit, CHALK’s culturally competent and empathetic training is reshaping wellness in Northern Manhattan and beyond.
“CHALK’s work is anything but typical,” Murray tells Food Tank. “This work helped us build trust and rapport with a wider swathe of our patients and wider community than ever before. It is a flagship example of our model wherein we provide patients with material and educational connections to strengthen our clinical work. The community responded to us with utmost gratitude, but we continue to be moved and driven by the needs we have yet to meet.”
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