Date of Graduation

Fall 12-15-2017

Document Type

Project/Capstone

Degree Name

Master of Public Health (MPH)

College/School

School of Nursing and Health Professions

First Advisor

Dru Bhattacharya, JD, MPH, LLM

Second Advisor

Melissa Akers, MPH, CPH

Abstract

Chronic disease has emerged as the predominant public health challenge of the 21st century. Chronic diseases like cardiovascular disease, cancer, type 2 diabetes and obesity have maintained their top positions as the leading causes of poor health, disability, death, and high health-care expenditures for over a decade. Health and hunger go hand-in-hand. Today over 15 million households in the United States struggle with food insecurity, meaning they do not have sufficient access to food that meets their dietary needs for an active and healthy life. The issue of food insecurity in cities like San Francisco, California is exacerbated by the high cost of living and food prices over 20% higher than the national average. Dr. Hilary Seligman, a national expert on food insecurity and an advocate for strategic upstream interventions to support healthy dietary intake and food security in low-income communities, launched EatSF in 2015. EatSF is a free fruit and vegetable voucher program designed for low-income San Franciscans living in the Tenderloin, South of Market and Bayview Hunter’s Point neighborhoods, the neighborhoods with the highest health disparities, poverty rates, and greatest food accessibility challenges in the city. EatSF is part of the UCSF Center for Vulnerable Populations’ Food Policy, Health, and Hunger Research Program. The program has achieved rapid success and in 2018 will be expanding to Vouchers4Veggies as it works to serve as a model for national replication. My internship experience with EatSF is highlighted in this Master’s Project and Capstone. In addition, background information on the domestic hunger safety net, a review synthesizing the current literature on fruit and vegetable voucher programs, food prescription programs, and double-value “matching” programs, and policy implications and recommendations specific to long-term program funding through sugar-sweetened beverage taxes are included.

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