Health Doesn't Start in the Exam Room

This past fall, I made a visit to upstate New York to meet with a spectrum of folks involved in the food ecosystem. I was working on a regional food hub feasibility study, which meant a lot of conversations about infrastructure, supply chains, and distribution models.

But what stuck with me wasn't just the logistics. It was how often healthcare came up. Farmers shared stories about the lack of healthcare resources for their employees. Food pantries talked about how their community struggled to get the basic care they needed. How the nearest clinic was 30 minutes away.

The neighborhoods struggling with food access were the same ones struggling with healthcare access. Same families. Same barriers. Same cycle of managing crisis instead of preventing it.

And the more I've talked about this with friends in public health since then, the clearer it's become: we can't solve food deserts without thinking about healthcare. And we probably can't solve healthcare access without thinking about food.

But we keep treating them as separate problems.

The Real Pattern

When a community is a food desert, it's rarely just about the missing grocery store. You see fewer primary care clinics. Less preventive care. Higher chronic disease rates. More emergency room visits for things that should have been caught earlier.

These gaps aren't about individual choices or community deficits. They're systemic failures that require systemic solutions.

We separate these into different buckets. Food access is one initiative. Healthcare delivery is another. Economic development is somewhere else.

But people don't live in buckets. A parent managing diabetes needs both insulin and affordable produce. A kid with asthma needs both an inhaler and housing without mold. An older adult needs both medication management and a way to get groceries. Totally healthy people still need to be able to get preventative care, and healthy food options fall under “preventative care.”

What Works

Community food and health centers make more sense to me. Places that put food access, nutrition support, clinical care, and education under one roof.

Think about how that works. Someone comes in for a doctor's appointment. The provider asks about food access like they ask about blood pressure. If there's an issue, the person doesn't get handed a list of food banks across town. They go down the hall and pick up groceries. Maybe they talk to a nutritionist. Maybe they sign up for a cooking class or connect with community resources.

The care doesn't end at the exam room. The food support isn't disconnected from the health support. The whole thing is designed around how people actually live.

That's what food as medicine looks like when you take it seriously. As infrastructure, not as a pilot program.

But You Can't Just Drop a Building Into a Neighborhood

Here's the thing though. You can't just build a "community food and health center" and expect it to work. That's how you end up with beautiful buildings that sit empty.

Modular approaches make more sense. Start with one real need and one working solution. Build with the community, not for them.

Maybe it's a mobile market that shows up every week. Then someone realizes they could add basic health screenings while people shop. Then a local clinic starts offering cooking demos with the produce. Then employment programs get involved because people want to work there.

You don't design the whole thing on day one. You design something flexible enough to grow with the community.

The infrastructure I care about is adaptable. It meets people where they are today and has room to become something bigger tomorrow.

Start small. Build trust. Add the next piece when it makes sense. Repeat.

Where Do We Go From Here

When we talk about addressing food deserts, we need to include healthcare in that conversation. As part of the solution, not as an afterthought.

For healthtech builders, that means getting closer to communities. Understanding what infrastructure already exists. Building with people, not for them. Creating tools that work with existing resources instead of expecting communities to adapt to our products.

It also means being honest about what technology can and can't do. An app won't fix a food desert. But it might help a community health center coordinate care and food access better. It might help a family navigate the resources that exist. It might give providers data to advocate for bigger changes.

And most importantly, it means building things that can start small and grow. That meet communities where they are. That add the next layer when it makes sense, not because we planned it on day one.

Health starts in neighborhoods. In kitchens. With access to basics.

The work that matters is building tools that make integrated, community-centered care actually possible. Tools that are flexible enough to grow with communities. Tools that help close the gaps for people who don't have access.

That's where the real opportunity is.