New Rockefeller Foundation Research Finds ‘Food is Medicine’ Could Unlock $45 Billion for States

NEW YORK | March 11, 2026 — Food is Medicine (FIM) programs, which provide produce prescriptions and medically tailored meals and groceries to people with diet-related conditions, could generate more than $45 billion in state economic activity, create 316,000 jobs nationwide, and generate $5.6 billion for America’s small and mid-sized farms if scaled to reach the 43 million Americans who need them most, according to new research released today by The Rockefeller Foundation. The report, “From Farm to FIM: The Economic Impact of Local Food is Medicine,” reveals that when states design FIM programs to prioritize local farms and food businesses, they can transform healthcare spending into a powerful driver of rural development and economic growth for all 50 U.S. states.

“Food is Medicine programs are already improving the health of communities around America. Now, we are starting to understand how nutritious, locally sourced food can also drive economic growth,” said Rajiv Shah, President at The Rockefeller Foundation. “At a time when too many Americans are struggling with poor health and rising costs, this report shows that Americans can eat better and save lives, money, and farms.”

According to the U.S. Centers for Disease Control and Prevention (CDC), 129 million Americans suffer from a chronic disease, 75 million have two or more, and 90% of U.S. healthcare spending goes towards managing and treating chronic conditions. FIM interventions have demonstrated significant healthcare cost savings, with medically tailored meals alone projected to save $23.7 billion annually while avoiding 2.6 million hospitalizations if scaled to all eligible patients. At the same time, American agriculture — especially small and mid-sized farms, which represent over 90% of U.S. farms — faces increasing financial strain, with more than 20,000 farms disappearing annually in recent years. The U.S. Bureau of Labor Statistics projects that employment of agricultural workers will decline by 3% from 2024 to 2034. This new analysis shows that, in addition to already proven health benefits, states can maximize economic returns by investing in local Food is Medicine programs.

America’s Small Farms Stand to Benefit

From Farm to FIM: The Economic Impact of Local Food is Medicine finds that small and mid-sized family farms across the United States could capture at least $5.6 billion in new revenue from Food is Medicine programs. Additionally, a stable FIM market can give these family farms the predictability and confidence to invest in their businesses, expand their production of healthy foods, and revitalize agriculture by transitioning to more regenerative growing practices that create soil health and environmental benefits.

The economic benefits also come from local, trusted providers delivering food and nutrition programming. When FIM dollars remain in-state, they circulate through local businesses providing food aggregation, processing, storage, transportation, meal preparation, and delivery services. The analysis estimates these activities could support 316,000 new jobs in related sectors across rural, urban, and suburban regions.

All 50 U.S. states stand to benefit if healthcare dollars are spent on FIM programs. The state-by-state economic projections for potential farmer revenue and new jobs created are:

• Alabama: $47,415,000 in potential farmer revenue; 6,380 jobs
• Alaska: $4,537,000 in potential farmer revenue; 610 jobs
• Arizona: $64,854,000 in potential farmer revenue; 6,130 jobs
• Arkansas: $32,138,000 in potential farmer revenue; 4,320 jobs
• California: $511,926,000 in potential farmer revenue; 32,050 jobs
• Colorado: $39,852,000 in potential farmer revenue; 3,770 jobs
• Connecticut: $16,160,000 in potential farmer revenue; 2,170 jobs
• Delaware: $11,222,000 in potential farmer revenue; 840 jobs
• Florida : $208,040,000 in potential farmer revenue; 19,670 jobs
• Georgia: $115,872,000 in potential farmer revenue; 10,960 jobs
• Hawaii: $12,334,000 in potential farmer revenue; 920 jobs
• Idaho: $29,853,000 in potential farmer revenue; 1,870 jobs
• Illinois $96,205,000 in potential farmer revenue; 9,100 jobs
• Indiana: $100,961,000 in potential farmer revenue; 7,530 jobs
• Iowa: $40,168,000 in potential farmer revenue; 3,000 jobs
• Kansas: $21,190,000 in potential farmer revenue; 2,850 jobs
• Kentucky: $52,628,000 in potential farmer revenue; 7,080 jobs
• Louisiana: $50,433,000 in potential farmer revenue; 6,780 jobs
• Maine: $22,055,000 in potential farmer revenue; 1,650 jobs
• Maryland: $27,850,000 in potential farmer revenue; 3,750 jobs
• Massachusetts: $30,167,000 in potential farmer revenue; 4,060 jobs
• Michigan: $212,908,000 in potential farmer revenue; 13,330 jobs
• Minnesota: $72,996,000 in potential farmer revenue; 4,570 jobs
• Mississippi: $29,516,000 in potential farmer revenue; 3,970 jobs
• Missouri: $68,809,000 in potential farmer revenue; 6,510 jobs
• Montana: $16,532,000 in potential farmer revenue; 1,230 jobs
• Nebraska: $10,285,000 in potential farmer revenue; 1,380 jobs
• Nevada: $23,999,000 in potential farmer revenue; 3,230 jobs
• New Hampshire: $15,541,000 in potential farmer revenue; 1,160 jobs
• New Jersey: $49,151,000 in potential farmer revenue; 4,650 jobs
• New Mexico: $32,531,000 in potential farmer revenue; 2,430 jobs
• New York: $292,065,000 in potential farmer revenue; 18,290 jobs
• North Carolina: $114,123,000 in potential farmer revenue; 10,790 jobs
• North Dakota: $7,868,000 in potential farmer revenue; 740 jobs
• Ohio: $257,449,000 in potential farmer revenue; 16,120 jobs
• Oklahoma: $37,481,000 in potential farmer revenue; 5,040 jobs
• Oregon: $78,626,000 in potential farmer revenue; 4,920 jobs
• Pennsylvania: $173,023,000 in potential farmer revenue; 10,830 jobs
• Rhode Island: $6,144,000 in potential farmer revenue; 830 jobs
• South Carolina: $37,938,000 in potential farmer revenue; 5,100 jobs
• South Dakota: $5,417,000 in potential farmer revenue; 730 jobs
• Tennessee: $61,492,000 in potential farmer revenue; 8,270 jobs
• Texas: $315,096,000 in potential farmer revenue; 29,800 jobs
• Utah: $17,587,000 in potential farmer revenue; 2,370 jobs
• Vermont: $8,776,000 in potential farmer revenue; 660 jobs
• Virginia: $125,790,000 in potential farmer revenue; 7,880 jobs
• Washington: $110,806,000 in potential farmer revenue; 6,940 jobs
• West Virginia: $21,160,000 in potential farmer revenue; 2,850 jobs
• Wisconsin: $89,694,000 in potential farmer revenue; 5,620 jobs
• Wyoming: $8,443,000 in potential farmer revenue; 630 jobs

“This research makes clear that Food is Medicine isn’t just a health intervention — it’s an economic opportunity for farmers, rural communities, and local food systems across the country,” said Jenny Lester Moffitt, Vice President of Farmland Protection and Strategic Priorities at American Farmland Trust and former Under Secretary for Marketing and Regulatory Programs at USDA. “Programs that intentionally connect healthcare spending with local agriculture, create market opportunities that help farmers stay on their land while strengthening the health, resilience, and prosperity of our communities. By building stronger connections between healthcare and agriculture, we can ensure that farmland stays in production and farmers have viable markets for the healthy foods they grow.”

Design Will Determine Impact

The report emphasizes that states’ economic benefits depend on intentional policy choices and highlights best practices for FIM program design. States that embed local sourcing preferences into Medicaid contracts, use multi-year purchasing commitments, and invest in food system infrastructure can multiply the impact of FIM spending. Without explicit local sourcing requirements, healthcare dollars are likely to flow to large national distributors instead of strengthening local economies.

From Farm to FIM: The Economic Impact of Local Food is Medicine also includes analyses for policymakers at different stages of Food is Medicine implementation. Case studies from Massachusetts, Oklahoma, and California demonstrate how organizations are already operationalizing and benefiting from local procurement within FIM delivery models.

The Rockefeller Foundation commissioned Dalberg Advisors to provide the economic analysis in From Farm to FIM: The Economic Impact of Local Food is Medicine, guided by a team of advisors. The analysis was conducted between September 2025 and January 2026 with support from a core advisory committee and other experts, including agricultural economists, farmer organizations, food aggregators and distributors, FIM providers, health and agriculture policy experts, and others.

From Farm to FIM: The Economic Impact of Local Food is Medicine is part of The Rockefeller Foundation’s more than $220 million “Big Bet” on nutrition initiatives benefiting people, the planet, markets, jobs, and beyond. This includes a $100 million commitment to expand Americans’ access to FIM programs, including supporting vital research and improved policy implementation and communications. Since 2019, The Rockefeller Foundation has supported FIM programs and invested in research to improve their effectiveness and understand their benefits and costs.

About The Rockefeller Foundation

Investing $30 billion over the last 113 years to promote the well-being of humanity, The Rockefeller Foundation is a pioneering philanthropy built on unlikely partnerships and innovative solutions that deliver measurable results for people in the United States and around the world. We leverage scientific breakthroughs, artificial intelligence, and new technologies to make big bets across energy, food, health, and finance, including with our public charity, RF Catalytic Capital (RFCC). For more information, sign up for our newsletter at www.rockefellerfoundation.org/subscribe and follow us on X @RockefellerFdn, Instagram @rockefellerfdn, and LinkedIn @the-rockefeller-foundation.

About Dalberg Advisors

Dalberg Advisors is a strategic advisory firm that combines the best of private-sector strategy skills and rigorous analytical capabilities with deep knowledge and networks. The firm works collaboratively with partners across the public, private, and philanthropic sectors to promote inclusive growth and help clients achieve their goals. Dalberg Advisors puts impact at the center of decision-making. Founded in 2001, Dalberg Advisors now has over 450+ full-time staff spread across 29 global locations, bringing global perspectives to local solutions for over 1600 clients. Dalberg.com | LinkedIn