OP-ED: Workforce Diversification in Practice: Food Is Medicine as the Proof Point

By Chiamaka Chine, MPH, PMP

Few initiatives demonstrate the importance of workforce diversification more clearly than Food Is Medicine programs, particularly those embedded within chronic condition management and designed to be culturally tailored rather than culturally generic. As health systems increasingly invest in nutrition-based interventions to address diabetes, hypertension, and cardiovascular disease, Food Is Medicine has emerged as a promising strategy. Yet its success depends less on the novelty of the intervention and more on the composition of the workforce responsible for designing and delivering it.

Conceptually, Food Is Medicine appears straightforward: improving nutrition improves health outcomes. In practice, it is among the most complex interventions healthcare systems attempt, because food is inseparable from culture, identity, memory, and tradition. Dietary behaviors are shaped by family norms, economic realities, migration histories, religious practices, and access to culturally familiar ingredients. Effective nutrition interventions for diverse populations, therefore, require deep cultural fluency, an understanding that cannot be developed through clinical training alone, and cannot be outsourced to generic program templates.

Too often, health systems rely on standardized “healthier substitutions” that unintentionally strip cultural relevance from nutrition guidance — brown rice in place of white, baked instead of fried, salad instead of stew. While well-intentioned, these approaches frequently underperform because they ask individuals to abandon familiar foods rather than adapt them. The result is predictable: low adherence, disengagement, and programs that appear sound in design but fail to achieve sustained impact. Research on culturally tailored dietary interventions demonstrates that programs grounded in cultural relevance are associated with stronger participation and improved glycemic outcomes.

This challenge highlights why workforce diversification is not a philosophical commitment, but a clinical necessity.

When Food Is Medicine initiatives are designed in partnership with culturally rooted experts, such as community health workers, nutrition educators, program designers, and clinicians who share cultural backgrounds with the populations they serve, the framing of the intervention changes. The focus shifts from restriction to adaptation. The central question becomes not which foods should be eliminated, but how familiar and culturally significant foods can be prepared in ways that better support chronic condition management without sacrificing taste, meaning, or identity. 

This dynamic is evident in culturally specific food practices, including those within Nigerian American households. In my own experience as a 1st-generation Nigerian-American, improved health outcomes were achieved not by abandoning traditional foods but by modifying preparation methods. My parents substituted olive or avocado oil for red palm oil in soups such as egusi or okra, or used oatmeal-based alternatives to reduce the glycemic impact of fufu. They even preferred baking plantains rather than frying them to avoid unnecessary calories from frying oil. These adjustments preserved taste, texture, and cultural significance while improving nutritional value and supporting better blood sugar control.

This type of knowledge does not originate in clinical guidelines or nutrition textbooks. It is embedded in lived experience, passed through families and communities, and shaped by an intimate understanding of which substitutions are acceptable and which would fundamentally alter a dish. Recognizing cultural foodways as assets rather than barriers is essential to effective program design. Without a diversified workforce, this expertise is often absent from decision-making tables, resulting in interventions that are technically sound but culturally disconnected.

From my experience, collaboration with external partners focused on sourcing locally relevant, culturally familiar foods has been central to program effectiveness. When culturally aligned staff and community-rooted organizations inform program design, decisions related to meal composition, ingredient substitutions, preparation guidance, participant engagement strategies, and evaluation approaches are grounded in lived experience rather than abstraction. These design choices influence not only what food is provided, but how programs are communicated, how success is defined, and how participants are supported over time.

Evidence supports the effectiveness of these workforce-informed approaches. Evaluations of medically tailored meals and culturally responsive nutrition programs demonstrate improvements in dietary intake, reductions in healthcare utilization, and stronger management of chronic conditions such as diabetes and heart failure. Similarly, research on community health worker–led interventions shows improved engagement, higher retention, and better chronic disease outcomes among historically excluded populations. 

The distinction is not whether a Food Is Medicine program exists, but whether it functions as intended. Programs designed without community representation may meet internal benchmarks for implementation while failing to achieve sustained behavior change. In contrast, programs shaped by diversified, culturally aligned teams are more likely to achieve higher participation rates, stronger adherence to nutrition recommendations, and outcomes that persist beyond the intervention period.

Food Is Medicine initiatives do not fail because communities resist change. They fail when health systems overlook the expertise that already exists within those communities. Workforce diversification ensures that this expertise is present, compensated, and empowered from the outset, rather than retrofitted after engagement declines. It also creates pathways for community-rooted workers to advance into leadership roles, further strengthening institutional capacity to design equitable care models.

If healthcare institutions expect Food Is Medicine interventions to deliver meaningful clinical impact, they must invest in diversified teams capable of translating cultural knowledge into operational design. This requires intentional investment in workforce pathways, professional advancement opportunities, and partnership models that value community expertise as core infrastructure. Absent that investment, programs risk substituting assumption for insight and mistaking activity for effectiveness.

The Social Mission Alliance For Us All Campaign is a vehicle to activate the community of health care professionals, educators, trainees, and the communities they serve to advance structural changes aligned with SMA’s vision for health professions training: health professions education in which social mission is present, prominent, and valued to drive health equity and improved health for individuals, families, and communities. A part of the For Us All campaign is a media narrative effort that will highlight the material impacts these kinds of advancements have on patients, communities, clinicians, learners, and educators. These stories are a template for what we should be striving for in our healthcare and health professional training institutions. BlackDoctor is a proud For Us All campaign coalition partner and will be publishing essays that share a vision of healthcare that advances health for all members of society.  

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