Rockefeller Foundation report links food prescriptions to farm revenue, job growth

New research from The Rockefeller Foundation finds that expanding Food is Medicine programs — which provide produce prescriptions and medically tailored meals and groceries to people with diet-related chronic conditions — could generate more than $45 billion in state economic activity, create 316,000 jobs, and deliver $5.6 billion in annual revenue to America’s small and mid-sized farms if scaled to reach the estimated 43 million Americans who need them most.

The report, “From Farm to FIM: The Economic Impact of Local Food is Medicine,” released Wednesday, examines whether routing healthcare dollars toward locally sourced food can simultaneously improve public health and stimulate rural economies. The foundation commissioned Dalberg Advisors to conduct the economic analysis between September 2025 and January 2026.

“Food is Medicine programs are already improving the health of communities around America,” Rockefeller Foundation President Rajiv Shah said in the release. “Now, we are starting to understand how nutritious, locally sourced food can also drive economic growth.”

Food is Medicine initiatives have roots in community-based nutrition support programs that expanded during the HIV/AIDS epidemic, when organizations in cities such as Boston, New York City and San Francisco began providing medically tailored meals and nutritional support to people living with HIV/AIDS, according to literature on the field including a presidential advisory published in the American Heart Association journal Circulation. Many of those organizations have since expanded their missions to serve people with a broad range of chronic illnesses.

The report arrives as chronic disease strains both public health and federal spending. According to the CDC, 129 million Americans suffer from at least one chronic condition, 75 million have two or more, and roughly 90% of U.S. healthcare spending goes toward managing those conditions. The foundation said medically tailored meals alone could save $23.7 billion annually and prevent 2.6 million hospitalizations if deployed at scale.

American agriculture faces mounting pressure as well. The report notes that more than 20,000 farms disappear annually, and the Bureau of Labor Statistics projects agricultural employment to decline 3% from 2024 to 2034. The foundation argues that routing healthcare dollars toward locally sourced food could provide small and mid-sized farms — which represent more than 90% of U.S. farms — with a stable, predictable market.

The report emphasizes that economic returns hinge on deliberate policy choices. States that embed local sourcing preferences into Medicaid contracts, establish multi-year purchasing commitments and invest in food system infrastructure stand to see the greatest returns. Without such requirements, the foundation warns, healthcare spending is likely to flow to large national distributors rather than local economies.

Jenny Lester Moffitt, vice president at American Farmland Trust and a former USDA undersecretary, said in the release that programs connecting healthcare spending with local agriculture can help farmers remain on their land while strengthening community health and economic resilience.

Case studies from Massachusetts, Oklahoma and California are included to illustrate how local procurement is already being operationalized within Food is Medicine delivery models.