Poor nutrition and food insecurity are drivers of poor health, diet-related diseases, and health disparities in the US. State Medicaid Section 1115 demonstration waivers offer opportunities to pilot food-based initiatives to address health outcomes and disparities. Several states are now leveraging 1115 demonstrations, but the scope and types of utilization remain undefined. To fill this gap, we conducted a systematic analysis of state Medicaid Section 1115 applications and approvals available on Medicaid.gov through July 1, 2023. We found that 19 approved and pending 1115 waivers address nutrition, with 11 submitted or approved since 2021. Fifteen states provide or propose to provide screening for food insecurity, referral to food security programs, and/or reporting on food security as an evaluation metric. Thirteen provide or propose to provide coverage of nutrition education services. Ten provide or propose to provide direct intervention with healthy food. The primary target populations of these demonstrations are individuals with chronic diet-sensitive conditions, mental health or substance use disorders, and/or who are pregnant or postpartum. Since 2021, state utilization of Medicaid 1115 demonstrations to address nutrition has accelerated in pace, scope, and population coverage. These findings and trends have major implications for addressing diet-related health and health equity in the United States.

A poor-quality dietary pattern is a leading risk factor for chronic disease and death in the United States, and the costs of medical care continue to unsustainably rise. Despite this reality, nutrition training for physicians fails to adequately prepare for them to address the complex factors that influence diet-related disease. Expanding nutrition education for physicians-in-training is imperative to equip them for the growing demand of food is medicine services and is also supported by recent policy efforts in the United States as well as the governing bodies of graduate and undergraduate medical education. A multisector approach that links graduate medical education, clinical care delivery innovation, and health and food policy experts provides momentum to advance nutrition education as a core strategy for food is medicine expansion globally.

Our national and international food system has implications for a wide range of issues that are important across the political spectrum and include improving he

Food waste is a major contributor to climate change and a barrier to environmental sustainability. As such, reducing food waste is estimated to be one of the most promising strategies to reverse global warming. One way to address food waste is to implement effective policies, which requires an understanding of the impact of current policies on food waste and other relevant outcomes. The current study examined the impact of United States (U.S.) states’ date label policies on food waste and foodborne illness. We found that states with more date label restrictions had greater waste, but this effect was not significant. In addition, date label restrictions and foodborne illness were not related. This shows that current date label policies do not help to reduce food waste or improve public health. In other words, current U.S. state food waste policies do not promote sustainability. We discuss the implications for date label policy content and offer future research directions.

This essay is adapted from Emily Broad Leib’s remarks at the 2015 Seattle University Law Review Symposium, Re-Tooling Food Law: How Traditional Legal Models Can Be Re-Tooled For Food System Reform, held March 6, 2015 at Seattle University School of Law. The essay examines the essential skills law schools and lawyers can bring to the field of Food Law and Policy. It begins by relaying the author's personal background and journey to the field of Food Law and Policy, then defines this field of law and shares some metrics about the field’s growth over the past few years. To explain what this field looks like in practice, the piece then introduces four fundamental legal tools that make lawyers well situated to foster change in the food system. Concrete examples based on the Harvard Food Law and Policy Clinic’s work illustrate the use of each tool. The essay ends by advocating for more lawyers in this field and discussing some of the opportunities that exist for new lawyers seeking to pursue this work as a career or a passion