Poverty is linked to poor health for many reasons.

People who can’t afford health insurance don’t go to the doctor when they’re sick and often get sicker.

Poverty has been linked to a higher rate of diabetes, high blood pressure and other illnesses.

And without enough money to pay for housing and other necessities, low-income people often eat cheaper, but unhealthy, processed foods.

The Greenville Free Medical Clinic provides care for uninsured residents and medicines to those suffering from diabetes and hypertension, among other conditions.

Now it also hosts a weekly farmers market in partnership with Loaves & Fishes to offer patients an assortment of fresh foods to help improve their health.

Patients eagerly line up each Thursday for the apples, grapes, spinach, carrots and other fruits and vegetables that are provided free.

What’s more, researchers looking at the program’s impact have found that it’s yielding positive health results as well, said Suzie Foley, executive director of the clinic.

Poverty and poor health go hand in hand, said Dr. Georges C. Benjamin, executive director of the American Public Health Association.

 “In fact,” he said, “you’re more likely to die many years sooner than those who are more wealthy.”

Going hungry

A recent heartbreaking survey of patients revealed just how needed the farmers market is, Foley said.

Half said they had been hungry in the past 12 months but didn’t eat because they didn’t have enough money for food, she said.

And when asked if the food they bought that week didn’t last or they didn’t have enough money to get more, 37 percent said that was often true while 54 percent said it was sometimes true, she said.

Tifnye Good has been coming to the clinic for about three years.

The 49-year-old Greenville woman worked at a small business for six years, but it didn’t provide any insurance. It’s been hard finding another job since that one ended and she’s still uninsured.

In addition to the regular care she gets at the clinic, she attends a class where she learns how to manage her prediabetes.

And the farmers market has been a big part of that.

Volunteer Delores Eanes organizes produce for the free farmers market at the Greenville Free Medical Clinic on Thursday Jan. 25, 2018. (Photo: JOSH MORGAN/Staff)

“Eating properly was something I could not do without the program because it costs a lot to buy fresh vegetables and fruits,” she told The Greenville News.

“Meats are so high and putting the money you have towards meats, you can’t buy the vegetables,” she added. “Here, you get it fresh and you’re able to cook fresh. I love that.”

Healthy foods

Since she’s been getting fresh foods and learning how to prepare them, Good said she has lost more than 60 pounds.

“This has kept me from going into full diabetes,” she said. “And next check, I’m sure I will no longer even be prediabetic. I’m taking no (diabetes) medicines and no drugs for high blood pressure. The clinic has been a major asset for me.”

Julius Smith holds down two part-time jobs, one as a grocery bagger and the other doing maintenance for a home improvement store.

Neither job offers health insurance.

Jimmy Booker looks at produce available at the free farmer’s market at the Greenville Free Medical Clinic on Thursday Jan. 25, 2018. (Photo: JOSH MORGAN/Staff)

So the 59-year-old Greer man goes to the Greenville Free Medical Clinic to be treated for type 2 diabetes.

His doctor told him that eating a diet rich in fresh fruits and vegetables would make a difference in his condition. But those foods cost more than he can afford on his income.

So Smith, who is a father of two and grandfather of three, joined the diabetes class, began getting healthy food at the farmers’ market, quit eating burgers, fries and other fast food, and is proud to say he’s no longer diabetic.

“The farmers market is a great help for people who really cannot afford a lot of groceries,” he said.

“But I can come here and get an amount of food that I can eat for a week,” he added. “And it’s good, healthy food. It’s made a big turnaround for me.”

Cost and availability

The farmers market, off the clinic waiting room, displays cartons brimming with lettuces, tomatoes, oranges, bananas and other produce nearing its sell-by date from grocery stores and overstocked food warehouses, Foley said. Sometimes fresh dairy and meat products are also available.

It’s a far cry from the boxed mac ‘n’ cheese, white bread, bologna and other processed foods typically consumed because of cost or because there is no grocery store nearby.

“We incorporated this into our program recognizing that many of our patients live in a food desert and are not near a healthy food grocery store,” Foley said. “The other factor for our patients is cost. Fresh foods are often more expensive than the unhealthy foods, like the fast food restaurants with $1 menus.”

The market averages about 150 to 200 patients a month, but feeds about 500 people once their households are factored in.

Along with the market are cooking demonstrations and recipes for preparing the foods in the healthiest ways — baking instead of frying, for example.

“I frequently say, I cooked like my mother cooked and she cooked like her mother cooked,” Foley said. “Culture and the background determines the way you cook and eat food.”

The market gets different products every week. And sometimes it’s produce that clients may not be familiar with, such as bok choy, kale or pomegranates, Foley said. The healthy cooking demonstrations come in handy there, too, by showing patients how good these foods can taste.

“Many of our patients have not had much opportunity to eat healthy foods,” she said. “And there are patients who say, ‘I don’t want that.’ But they see how to fix it and get to taste it. And it’s surprising how many patients say that it’s pretty good.

“Now they feel very comfortable walking through the market line and getting a box of spinach or a carton of mushrooms or a bag of lentils and knowing what to do with it.”

Food and health

Good said she enjoys the cooking demonstrations as much as the food.

“They have different stuff every week,” she said. “And I do love pretty much everything that we’ve prepared.”

Smith agreed.

“I learn lessons here about cooking and get a lot of recipes. I go home and try them,” he said. “I got away from the fried stuff. I’m doing more baked, grilled and broiled now. And I love steaming vegetables. Baked chicken, green vegetables and brown rice is great.”

The program is based on the U.S. Centers for Disease Control and Prevention’s Diabetes Prevention Program, which promotes healthy eating and moderate exercise, Foley said.

And since it began, it’s paying off. A number of patients have lost weight, she said. Once diabetic and prediabetic patients now have normal blood sugar levels. Blood pressures have been lowered too. Some patients have even come off medications.

“Some of the preliminary results show that it is making a difference,” she said. “So it’s encouraging for us to be able to continue to provide healthy foods.”

Good food really is an important part of good health, Foley said. And the lower income population is more vulnerable.

“Men and women who are in low-income households are two to three times more likely to develop type 2 diabetes than higher-income households, for example,” she said.

“Why would we not want to step in and try to turn that around?”