A Food is Medicine initiative called the Delta GREENS (Growing a Resilient, Enriching, Equitable, Nourishing food System) Project is connecting local agriculture with clinical healthcare to transform community wellness in the Mississippi Delta.
Administered by Tufts University Friedman School of Nutrition Science and Policy, the initiative aims to tackle high rates of diet-related chronic illnesses like diabetes and heart disease in one of the nation’s most under-resourced regions. Through produce prescription programs and other community-led interventions, this goal is not only attainable, but necessary.
Approximately 17 percent of Mississippi households faced food insecurity between 2022 and 2024, according to the U.S. Department of Agriculture.
“People can’t afford healthy food. A lot of people are impoverished… living check to check,” Charity Bruce Sweet, Director of the Economic Justice Campaign at the Mississippi Center for Justice, tells Food Tank. “A lot of people would rather make sure that they have lights or that they have water, and sometimes that means that they are sacrificing their health and wellness.”
The lack of public transportation infrastructure leaves rural residents geographically isolated, explains Sweet. Generations of systemic segregation and discrimination further restrict access to livable incomes, healthcare, and fresh food.
“Realistically, it’s so hard when it’s based in systems that are not built to help people,” Sweet says.
Rebuilding local food access requires reshaping a regional supply chain dominated by industrial commodity farming. “Most of the land is tied up in cotton and soy and other commodity products that are grown to a large degree in that area,” Christina Economos, Dean of the Friedman School, tells Food Tank.
To overcome this structural hurdle, the Delta GREENS Project targets both ends of the food system simultaneously. On the supply side, the project provides small-scale farmers with the capital needed to cultivate fruits and vegetables locally. It connects study participants to the produce through a year-long produce prescription program that delivers weekly produce boxes alongside nutrition education.
Researchers are also examining if the 12-month intervention creates lasting dietary habits once the program ends. Economos asks, “Once the program is over, do people default back? Or do they figure out how to redistribute their income to stay the course with healthy eating?” She notes that time stress and employment demands make preparing fresh food a daily challenge for working people.
Medicaid Section 1115 demonstration waivers let states pay for services outside conventional medical care, including produce prescriptions and other food-is-medicine programs. Currently, only 13 states have federal approval to do so, according to Tufts University’s Food is Medicine Toolkit. Mississippi is not among them, with no demonstration pending.
States can also cover some nutrition supports through home- and community-based services authorities, but that coverage targets people at risk of institutional care and may be capped at no more than two meals a day. Still, state-level health insurance frameworks remain an important part of food-is-medicine programs not only in Mississippi, but nationwide.
“If you… allow people to have access to healthcare while also working to build infrastructure and give them healthy foods, we can really cut down so many of these diseases,” remarks Sweet.
In the absence of state Medicaid coverage, local non-governmental organizations step in to fill the gaps. Still, providing fresh produce alone does not solve the immediate realities of working families, including time poverty, lack of cooking essentials, or local dietary preferences.
“We’ve got to zoom in and take out all the big picture and think, ‘how do I help Joe and Susie?’” Martha Allen Price, Executive Director of Extra Table, tells Food Tank. “We know half the battle is getting those kids to eat around the dinner table for a mom or dad who’s worked two jobs.”
Extra Table purchases food directly from manufacturers to deliver to pantries across Mississippi, prioritizing shelf-stable, familiar items over perishable produce that requires extensive prep work or goes unused.
“It takes time and effort and spices and knowledge and cooking essentials. And so, our food—it’s always shelf-stable,” Price says, explaining that unfamiliar items like brown rice or black beans are frequently left behind by pantry visitors because they do not fit regional food traditions.
To provide immediate, culturally resonant nutrition, Extra Table developed Extra Full, a shelf-stable red beans and rice meal kit fortified with a custom vitamin mix tailored to Mississippi health statistics.
“In the South, we meet around the table, we meet on the front porches… Food is a hug,” Price says. “And we wanted to create a product, for us, that was a mobile volunteer opportunity [and] got more families around the dinner table.”
Ultimately, building an equitable food system in Mississippi requires both top-down policy research and immediate, ground-level relief—combining legal advocacy for Medicaid-funded food-is-medicine initiatives with practical, culturally tailored community support.
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Photo courtesy of Hannah W., Unsplash
