Produce Prescriptions

For SUSANNAH SPRATT, food is about choice and access – and the ways food can change health outcomes and lives. 

“Food is a right,” she says, “and everybody should have access to high-quality food and the ability to choose what they eat.” 

Spratt oversees all of Feast Down East’s Mobile Market operations across New Hanover, Pender, and Brunswick counties, while also spearheading the organization’s Food Rx initiative, a program developed in partnership with Novant Health.  

Feast Down East is a Burgaw-based nonprofit that focuses on supporting local agriculture while also feeding and educating the community. The nonprofit’s Mobile Market sends two refrigerated vans throughout the region to various locations as pop-up farmers markets. Food Rx, which was recently refunded, connects Novant Health patients facing food insecurity with fresh, locally sourced food through Feast Down East’s network of participating farmers. 

Spratt’s path to this work began in Greenville, North Carolina, where she was born and raised and later attended East Carolina University, where she earned both bachelor’s and master’s degrees in public health. During graduate school, her academic interests sharpened into a clear calling. 

“I was figuring out what exactly I wanted to do within the world of public health during graduate school,” Spratt says. While she had explored topics ranging from hepatitis B to diabetes, none quite resonated – until she began working with a professor whose research focused on food insecurity and food prescription programs in Eastern North Carolina. 

Spratt helped evaluate produce prescription and produce box programs for older adults, gaining hands-on experience with initiatives that treated food not just as sustenance, but as an intervention. “That was the first introduction to the food insecurity realm for me – food as medicine – although it wasn’t really being called that at the time,” she says. 

After graduating, Spratt knew she wanted to continue food-related work, but opportunities were limited in Greenville. She looked for communities with strong local food systems and landed in Wilmington in October 2021. She joined Feast Down East in September 2022, hired into a newly created role funded by a grant from the BlueCross BlueShield Foundation of North Carolina. “That was very exciting – and a pretty big undertaking,” Spratt says. 

Working closely with Novant Health, Spratt coordinated logistics, built workflows, and helped determine how Food Rx vouchers would be distributed, redeemed, and tracked. The program officially launched in October 2023, targeting Novant clinics with high volumes of patients with chronic illnesses.  

“Novant already had a shelf-stable food box program in place,” she says. “During regular appointments, patients are screened using the Hunger Vital Sign, a two-question assessment that asks whether they worried about running out of food or if the food they bought didn’t last and they didn’t have money to get more. If they answer ‘yes,’ patients leave their appointment with a shelf-stable food box. Food Rx was designed to supplement that support with fresh foods.” 

Eligible patients receive a voucher – currently $25, valid for three months – to shop at any Feast Down East Mobile Market location. These markets offer fresh produce, meats, eggs, and value-added products like honey, popcorn, seasonings, and elderberry teas, sourced from more than forty local farms within one hundred miles of the organization’s Burgaw food hub.  

“The closer you can source your food, the more nutrient-dense it is. Nutrients are lost the farther food travels,” Spratt says. “Being able to source locally really ensures the food quality and we’re supporting local farmers and agriculture.” For Spratt, the impact of the program became clear almost immediately. “The very first voucher customer I served at a Zimmer Cancer Center Mobile Market said to me, ‘This feels too good to be true,’” Spratt remembers. The woman shared that her husband had just been laid off and they didn’t qualify for food assistance. “She told me, ‘This really couldn’t have come at a better time.’ That really stuck with me.” 

That personal impact is now matched by measurable results. In its first full year, Novant Health data showed reductions in patient no-shows and emergency room visits among Food Rx participants. “It was really incredible to be able to see that these programs actually do work,” Spratt says. “Not only are we getting people food that they like and that will nourish their families – it’s also having an impact on their overall health.” 

Today, Spratt’s role extends beyond Food Rx. As the Mobile Market manager, she oversees operations across seventeen regular sites, ensuring markets remain welcoming, affordable, and choice-driven. “We try to empower people to make choices for themselves and their families, because everybody likes different things,” she says. “I don’t find it helpful to give somebody who doesn’t like beets a ton of beets.” 

The work is deeply personal for Spratt. “I’ve experienced food insecurity myself growing up,” she says. “So being able to help other people is very rewarding.” 

To view more of photographer Aris Harding’s work, go to arisharding.com.

Want more WILMA? Click here to sign up for our WILMA newsletters and announcements.