Grace Recker is a fourth year student at the University of Iowa College of Medicine. She recently completed a rotation with DMARC as part of her senior capstone. During her time with DMARC, she learned more about how policy and advocacy can shape the social determinants of health for many of her future patients.
Read below to hear her reflections on engaging with food insecurity during the Iowa State Legislative Session and the Double Up Food Bucks (DUFB) program.
Spending time with DMARC during my fourth year of medical school has been one of the most enriching and impactful experiences of my training. As a physician-in-training, it’s quickly apparent that understanding health care goes beyond mastering medicine itself. A key lesson I’ve learned is that consideration of the social determinants of health, factors like housing, education, employment, and food security, is integral to providing comprehensive care. These social factors not only affect the well-being of patients but also influence how they engage with and implement medical recommendations. Importantly, these factors are shaped by policy, which is where advocacy becomes critical.
One of the most meaningful insights I gained while working with DMARC was learning about the Double Up Food Bucks program. This nutrition incentive initiative is designed to improve access to fresh fruits and vegetables for low-income families who use SNAP (Supplemental Nutrition Assistance Program). For every dollar spent on fresh produce, participants receive an additional dollar to spend on produce. This program, which includes participation from grocery stores, farmers markets, and co-ops, has shown great promise in improving nutrition for underserved populations. Currently funded by both private and federal sources, DMARC is advocating for a state investment of $1 million to expand the program across Iowa, where it remains limited in scope. Although this proposal has not passed in previous years, it has gained significant traction in the state legislature this year, reflecting growing recognition of the program’s value.
As a future family medicine physician, I see the profound impact of such programs in promoting healthy eating, particularly when the cost of fresh, nutritious food is a significant barrier. Poor nutrition is a leading contributor to diet-related diseases like obesity, diabetes, and heart disease. A diet rich in fruits and vegetables can lower blood pressure and reduce the risk of cardiovascular disease and stroke, yet Iowa ranks #31 in the nation for fruit and vegetable consumption. Improving nutrition requires collaborative efforts through policy, community initiatives, and health guidance in clinical settings.
I had the opportunity to witness the legislative process firsthand and actively participate in discussions surrounding critical bills. Through this experience, I learned how to be an engaged citizen, partake in productive conversations, and use my voice to advocate for change. This experience has solidified my commitment to advocating for policies that enhance public health and benefit our communities. I am deeply inspired by the tireless work of DMARC and similar organizations, which amplify the voices of underserved populations and work relentlessly to create meaningful forward progress. Their efforts have fueled my passion for advocacy, and I look forward to continuing this important work throughout my career as a physician.