Fresh produce: A new prescription for high blood pressure in Cuyahoga County, OH

Martha Halko

At A Glance

As of 2017, over 600 low-income patients with high blood pressure have better access to nutrition education and affordable produce in Cuyahoga County. Partners across the county developed the Produce Prescription Program for Hypertension to connect residents in need to healthy eating information and resources. Staff at 6 clinics and 31 farmers’ markets have received training and technical assistance to carry out the program. Patients receive prescriptions in the form of vouchers for fresh produce at no cost when they visit the clinic monthly.

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Public Health Challenge

A 2012 Cuyahoga County Community Health Needs Assessment found that nearly 4 in 10 Cuyahoga County adults had diagnosed high blood pressure, which can increase the risk of heart disease and stroke. A diet that is rich in fruits, vegetables, and whole grains and lower in sodium can help prevent and manage high blood pressure. However, a 2010 county assessment found that about 25% of Cuyahoga County residents lived in “food deserts,” neighborhoods with limited access to healthy foods. The county includes Cleveland, where half of city residents lived in food deserts. To improve access, Cuyahoga County expanded the number of farmers’ markets in low-income areas and required that these markets accept Supplemental Nutrition Assistance Program (SNAP) benefits. Still, even with these efforts, farmers’ markets remained underused.

Find Out More

From produce prescription programs to mobile farmers’ markets, communities around the country are finding creative ways to bring locally grown food directly to those who need better access to healthy options. To learn more about the Produce Prescription Program in Cuyahoga County, visit This project is supported by the Centers for Disease Control and Prevention’s Racial and Ethnic Approaches to Community Health cooperative agreement.

Most patients are surprised to learn that when it comes to lowering high blood pressure, healthy eating can be as beneficial as taking medicine.
- Mike Sreshta

Martha Halko
5550 Venture Dr

Parma, OH 44130
Phone: 216-201-2001

Atlanta, GA 30348
Centers for Disease Control and Prevention

Contact CDC

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Health Improvement Partnership-Cuyahoga (HIP-Cuyahoga) adapted the Produce Prescription Program for Hypertension to improve access to affordable fresh produce among low-income residents with high blood pressure to encourage healthier purchasing and eating. In July 2015, the program began linking patients from 3 local clinics to 20 area farmers’ markets. Patients received prescriptions (vouchers worth $40) when they made monthly clinic visits to discuss healthy eating, set nutrition goals, and get their blood pressure checked. The vouchers could be redeemed for fresh fruits and vegetables at participating farmers’ markets. Doctors could now provide patients the means to eat healthier food.

What's Next

To ensure continued success with the Produce Prescription Program for Hypertension, HIP-Cuyahoga makes regular site visits and follow-up calls to participating clinics. Program staff provide participating farmers’ markets with technical support for tracking voucher redemption. Moving forward, the Produce Prescription Program seeks to expand its collaboration with local clinics. In addition, program organizers want to continue to improve access to fresh produce and other healthy foods by increasing the number of participating farmers’ markets. Overall, the goal is to bring this intervention to a larger number of Cuyahoga County residents through additional partnerships.


In 2015, 224 of over 600 patients with high blood pressure at three Cleveland area clinics participated. Survey and market data show that they learned to better manage their condition by using their prescriptions to eat healthier. Overall, 86% of participants visited at least one farmers’ market; the average participant visited twice; and 82% of participants reported trying a new fruit or vegetable. A total of $15,140 worth of program vouchers were redeemed at the farmers’ markets. Participants’ average daily servings of fruit increased from 1.6 to 2.4, and average daily servings of vegetables increased from 1.7 servings to 2.5. Participants also reported cutting weekly fast food consumption in half (1.3 average days to 0.7 days). In 2016, 377 patients from six clinics enrolled and achieved similar dietary improvements.