Food insecurity is associated with obesity, hypertension, anxiety, depression, and low academic achievement. Children are more likely to face food insecurity than any other group of people.

Beginning in 2020, Duke Children’s and Internal Medicine partnered with the Eastern and Central North Carolina Food Bank to address this important problem. Given the aligned missions of helping families have access to nutritious food, the organizations decided to create an in-clinic food pantry to support the primary care and specialty clinics located in North Durham, North Carolina. This clinic cares for an underserved population of primarily underrepresented minority patients and patients insured by Medicaid. About 70% of patients identify as a non-white race and about 30% speak Spanish as a primary language. The clinic serves over 30,000 infants, children, and adolescents, and adults, and in 2024 performed over 45,000 clinic visits. About 50% of patients identify at least one social need (financial, food, housing, transportation, utilities) on the health-related social needs screening that we survey annually, and 30% identify as food insecure.

The first of its kind at Duke, the Food Market was carefully planned to ensure that families feel comfortable receiving food and are allowed choice in the items selected. Families selected the name for the pantry, “The Duke Healthy Lifestyles Market,” as a non-stigmatizing and welcoming addition to their clinical care. Dieticians ensure that the food provided will improve health and reduce risk for chronic disease. Clinic administrators ensure the pantry is compliant with regulations and safely store and distribute non-perishable food to families. Clinic staff and volunteers arrange deliveries, stock the pantry, and oversee protocols for delivering bags of food to families in clinic.

Through philanthropy, we have since been able to provide a bag of healthy food to any patient who walks into our clinic expressing a food need. While we perform screening for social drivers of health including food insecurity at well visits, we do not require this screening or a positive response to be a recipient of a food bag. The goal of the Food Market is to teach families how to access food pantries around the community, and to advocate for themselves so that they feel confident in selecting items that are both nutritious and acceptable for their families. Food bag items continue to be reviewed by our dietitians on-site to ensure nutritious content, and sample recipes are included in the bag. We also provide families with a printed list (in English and Spanish) of local food resources and information on how to sign up for government funded supplemental nutritional programs. In 2023, a Food Market Coordinator position was approved in our annual clinic budget.

The Duke Healthy Lifestyles Market has become a staple of primary care delivery. Patients ask for bags during visits, and the community is aware we offer this resource. In 2024, we provided over 4,000 bags of nutritious food to our patients and their families, providing a resource for over 16,000 household members. We also partnered with Duke's Root Causes to provide fresh produce home delivery to approximately 100 of our patients.

Since inception, we have provided over 10,000 bags and provided healthy food for over 36,000 household members. Today, we spend an average of $5,500 each month on food. We are currently utilizing some remaining NC Medicaid transformation funds, but rely on philanthropy for sustainment and growth.

Thank you for investing in this important resource for our community and families!