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Farm to Families: Understanding the Impact of Subsidized Produce Boxes for Families in the Clinical Setting

Statement of Problem

The COVID-19 pandemic has only deepened challenges for the nearly 1 in 4 children who were already food insecure in Philadelphia, and has created new barriers to food access for families who never previously struggled. From rising unemployment rates that disproportionately affect low-income families, to school closures that curtail access to lunch programs for the 30 million children they served each day, COVID-19 has impacted nearly every aspect of the systems that food insecure families depend on. As a result, food insecurity rates have reached staggering new heights and continue to rise: as of May 2020, more than 40% of mothers with children under age 12 reported household food insecurity since the pandemic began, compared to 15% in 2018.

Access to produce has proven to be particularly difficult for food insecure families, a population that has historically reported rates of fruit and vegetable consumption below the national average. Rising costs, low stock and strained budgets due to COVID-19 have pushed produce even farther down on the shopping list. Furthermore, due to factors including risk of contracting the virus and reduced availability of child care, families are prioritizing foods with a longer shelf life than fruits and vegetables to stretch groceries as far as possible. 


Farm to Families: Understanding the Impact of Subsidized Produce Boxes for Families in the Clinical Setting


We’re conducting a qualitative evaluation of a clinically-based produce program to advance our understanding of COVID-19’s impact on food insecurity and inform preferences for future programming.

Next Steps

Informed by participant interviews, we have transitioned the program to a sliding-scale fee-for-service model that is available to any community member or clinical staff. Participants are able to shop online for produce, and add on items like eggs, meat, cheese and yogurt. Pricing structures are determined by income, food security status and participation in federal benefit programs, with all products priced far below market value. Additionally, there is a pay-it-forward feature allowing the highest earners to help subsidize boxes for those who qualify for assistance. Families can also purchase boxes using Supplemental Nutrition Assistance Program (SNAP) Electronic Benefits Transfer (EBT).

Upcoming studies are planned to pilot a delivery option, and to optimize the pricing structure to meet the needs of families. Our hope is that our findings will advance understanding of COVID-19’s impact on food insecurity among vulnerable populations and inform the long-term sustainability and impact of a cost-subsidized CSA at CHOP to provide healthy food for families.

This project page was last updated in October 2022.

Suggested Citation

Children's Hospital of Philadelphia, PolicyLab. Farm to Families: Understanding the Impact of Subsidized Produce Boxes for Families in the Clinical Setting [Online]. Available at: [Accessed: plug in date accessed here]. 

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