Founded: 1970
Budget: $49.5 million
Patients served in 2020: 25,689
Patient visits in 2020: 133,418
Employees: 421 372 FTEs
Providers: 41 57 FTEs
Locations: 10

It’s still dark, chilly and damp when the core team gathers at the distribution site at 5:30 in the morning. Moving fast, they start setting up tables and canopies for the volunteer check-in. 

The food trucks arrive between 5:30 and 6 am. They unload 10 to 12 pallets of food -- different types of fruits and vegetables.  

By 6 am they are organizing the sorting stations. 

At 7 the volunteers come, usually 12 to 15 of them, and get screened. Then they start filling the bags with produce. It’s an assembly line, moving steadily from station to station, vegetable to vegetable. Put in a head of lettuce, then a bag of potatoes, two bunches of celery, two heads of Brussel sprouts, a melon, four oranges ….

By 9 am the first wave of senior citizens arrive to pick up their bags. At 10 the general public is invited to come in. There is no sign up, no registration, no qualification. Anybody who needs food can just walk up and get some. The operation usually shuts down by noon. 

This is happening twice a week in West LA, at 2509 Pico Boulevard in Santa Monica and at another location in Venice.  On any given day, from 800 to 1100 bags of healthy produce are distributed at each site. All at no cost, funded through CalFresh. 

This isn’t a food pantry. This is healthcare. 

These are some of the most affluent communities in the state – in the nation – yet food insecurity is rampant. So the local federally qualified health center, the Venice Family Clinic, has stepped up to fill the gap.

“To live in Santa Monica is expensive. Grocery stores around here are high end,” says Rigoberto A. Garcia II, director of health education at the Venice Family Clinic. Nevertheless, many residents live in Section 8 apartment buildings, especially southeast of the airport, toward Culver City. The low-income population is not especially visible, but it is numerous. 

The Venice Family Clinic is the only community health clinic in West LA. Its 12 sites serve people from a wide swath of the city. About 40% of the clients are Latinos. And many patients are homeless. 

“Access to healthy, nutritious food prevents a lot of diet-related chronic diseases,” said Tony Kuo, MD, Director of the Division of Chronic Disease and Injury Prevention at the Los Angeles County Department of Public Health.

“Over the last decade you see the issue around childhood obesity, and, of course, adult obesity. Also heart disease, high blood pressure, and diabetes,” Kuo said. “Being able to help people eat better and gain access to nutritious food seems simple, but it’s really very hard. Yet it’s very effective if you’re trying to prevent health conditions down the road.” In Los Angeles County nearly 40% of low-income households experience food insecurity, he said. 

Venice Family Clinic is trying to demonstrate the link between diet and health. “Treating food as medicine is a big topic, as a social determinant of health,” Garcia said. “We all understand it somewhat, but when you talk about different cultures and backgrounds,” the USDA-recommended healthy food plate doesn’t always connect. 

For the low-income families who are the Venice clinic’s patients, there is no inexpensive little grocery store nearby. At a typical Latino grocery, the fruit and vegetables are more than likely riper, ready to eat, but lower in price. Bell peppers might be $1.50 a pound, compared to $1.50 apiece at Whole Foods. In Santa Monica it’s cheaper to go to McDonald’s. 

Venice Family Clinic started out as a free clinic in 1970. Even though it has been a FQHC for a number of years, it still has a free clinic mentality. And an entrepreneurial spirit. 

“We’re not your average health center to start with,” Garcia said. “We have an amazing senior leadership team that is trying to be innovative with how we provide care. We started to see there was an issue with food in the area. Blood pressure was high. Obesity was high. Diabetes was high.” 

About five years ago, as the health center was thinking about opening a new clinic, it decided to incorporate a teaching kitchen. Not in a separate facility, but right in the pediatric waiting room.

“We are making smoothies with not so much fruit and sugar, but with kale and greens,” said Vanessa Fernandez, a nutrition specialist on staff. “We show how to make food fun.”

Before the coronavirus pandemic, the clinic hosted at least two cooking demonstrations a day. “We wanted to ease the kids’ anxiety as they wait for the pediatrician. Also, to get them involved, we have childproof knives, so they can get acclimated to the kitchen, and see a fruit or vegetable they haven’t seen before,” Fernandez said. “We keep the recipes simple, and child friendly. It’s one of our best assets in terms of building relationship with the community.”

Initially the teaching kitchen was staffed by health center personnel. Later, volunteers took over those roles. Many of them are premed students from UCLA. “It’s now part of their curriculum, to volunteer at our kitchen,” Fernandez said. “As premed students, they don’t get a lot of nutritional instruction.”

When the pandemic came along, Venice saw an opportunity to supercharge its healthy eating program by preparing full meals for households. Through the clinic’s close affiliation with UCLA, said Anita Zamora, the clinic’s deputy director and chief operations officer, leadership realized that the university’s food service capacity was lying fallow because no students or staff were using campus dining halls. They arranged for Venice families to receive meals prepared by UCLA food services at an average cost of $4.69 each, paid for by a private grant. 

“We are feeding not only the patient but the patient’s family,” Garcia said. “If there are four in the family, we will feed you for four nights. So we give the 16 meals, all delivered at once, precooked. They are able to just reheat it.” 

The meals are targeted for higher needs groups, such as families with diabetes, pregnant women, children, or suffering homelessness or lack of cooking facilities. Today Venice is providing 12,700 prepared meals a week – not including the fresh fruits and vegetables initiative, which has distributed more than 34,000 pounds of produce and reached more than 1600 households over the past 12 months, according to Kuo, the county health official. 

The program at Venice could be a model for other family clinics. Traditionally, food insecurity is not necessarily dealt with in the healthcare environment, said Kuo. But maybe it should be. 

“I think as a social determinant, it could be done effectively,” he commented. Healthcare providers have the built-in advantage of being a trusted source of information for a lot of people. They are a natural owner of this outreach. 

“You think of a patient visit as a great teaching moment also,” Kuo said. “Things like food insecurity or not being able to eat healthy -- it’s a great encounter point to address it.” 

Today Venice is providing 12,700 prepared meals a week – not including the fresh fruits and vegetables initiative, which has distributed more than 34,000 pounds of produce and reached more than 1600 households over the past 12 months.

The things we eat, and how we eat them, and whom we eat them with, carry psychological associations in any human society. Vanessa Fernandez, a nutrition specialist with Venice Family Clinic, explains the particular emotional resonances around food for Latinos, and how those feelings contribute to the specific health issues faced by that community.

Food is fun, and food is culture, right? How you express yourself -- it comes from food. In America we have birthday cake, but in other countries, the birthday cake looks very different. Breakfast looks different.

My diabetic patients are used to eating ‘bread’ in the morning. You might think toast, but in the Mexican community bread is not just a slice of toast with butter, it’s like a pound cake or a pastry. So when somebody says, ‘I had coffee with bread in the morning,’ actually it’s a whole pastry or Danish or sweetbread. Culturally, they just call it bread. 

You ask them, ‘How many tortillas did you eat?’ Someone who didn’t grow up eating them might have one or two. But my patients who grew up with it, they have 10 tortillas a meal. That is part of their upbringing.

Somebody who is diabetic, that is the first thing you want to focus on. Culturally, it is hard to shake. 
When you want to address health equity, or address differences in nutritional access, you definitely want to associate it with food -- if it’s a happy time, or a sad time. 

For the most part, people want to enjoy food. Especially in the Latin community, they associate food with a good time. The better the food tastes, the better we are, the more fun we are having.  

Food is compensating for a lot. If somebody is overstressed or feels overweight, the natural inclination is to eat something that tastes good. If somebody is diagnosed with diabetes, do they take steps toward a diet? Their inclination is, ‘Well, I am going to die of something.’ It is so comforting, the association with food, that everything is going to be all right. 

My family is Colombian. We are very Latin. So much of that cultural experience is embedded in us. You give somebody something that tastes good to make them feel better … it is hard to give that up.

Healthy food is associated with a bad diet, with a bad time. It’s associated with limitations and restrictions. You are on a diet, you are compensating for the lack. It doesn’t feel like the natural thing to do, to eat healthy, because it’s not fun. 

It takes skills to navigate. A lot of behavioral health is involved. Healthy eating is associated with stigma, with the limitations. 

Or: it’s not cost effective. How do I feed my family of five or seven? Do I give them a healthy salad? When I can just go to the fried chicken place, and everybody is full and happy, versus me having to spend more time in the kitchen, and the kids are learning remotely? The challenges seem overbearing.

In the Latin community, it’s difficult. Homes are run by women; their health takes a back seat. They are trying to make ends meet. Health becomes a bigger issue, not just for themselves but for their whole family.