Vouchers for Veggies — a program of EatSF, which was founded by Dr. Hilary Seligman — can be exchanged at grocery stores or farmer's markets for fresh fruit and vegetables.
Vouchers for Veggies — a program of EatSF, which was founded by Dr. Hilary Seligman — can be exchanged at grocery stores or farmer's markets for fresh fruit and vegetables.

Q&A: Dr. Hilary Seligman fights food insecurity in S.F. with fresh fruits and veggies

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Dr. Hilary Seligman’s work in food insecurity began with a patient. When she asked a man she had just diagnosed with prediabetes what he ate for lunch, he told her: a piece of Spam between two cinnamon rolls. It was filling, and the only thing he could afford.

Dr. Hilary Seligman
Dr. Hilary Seligman

Seligman, 40, is a professor of medicine, epidemiology and biostatistics at UCSF and is on the faculty of the Center for Vulnerable Populations at S.F. General Hospital. She is also an expert in food policy, working with the Centers for Disease Control and Feeding America, and is the founder of EatSF, which works to get healthy foods into the hands of low-income residents. She says 1 in 4 San Franciscans are food insecure.

EatSF has pioneered Vouchers 4 Veggies (V4V), which gives participants access to fresh fruits and vegetables at free or reduced cost. V4V also operates as a pilot program in L.A. The organization also works with the San Francisco Department of Public Health and the Special Supplemental Nutrition Program for Women, Infants, and Children.

Originally from Houston, Seligman came to the Bay Area in 2000 to complete her residency in internal medicine at UCSF, and never left. She is a member of Congregation Emanu-El in San Francisco. 

Tell me how the EatSF program works.

EatSF is a healthy food voucher program. We create the financial infrastructure for community-based organizations and clinics in San Francisco to provide a voucher. Think of it as a prescription for fruits and vegetables. When a doctor writes you a prescription, there’s an infrastructure in place for you to take that piece of paper, that electronic prescription, to a pharmacy where that prescription is filled. When I thought as a physician about what it would take to get [patients] healthy food, there isn’t a similar system. So what we decided to do…is to create that infrastructure. You can take that voucher to your local community market or grocery store or farmers market, and they will recognize it and allow you to redeem it for healthy foods.

What makes the issue of food insecurity in the Bay Area different?

Any area that has a really high cost of living is going to have a high food insecurity rate because people’s budgets are constrained. The more money you spend on your rent, the less money you have to spend on your food. That’s one thing working against us in San Francisco. There are many opportunities in San Francisco as well. We have grocery stores and farmers markets in almost all areas of the city. We also have a lot of people in the community who are really invested in supporting better dietary intake and healthier food access for everybody in San Francisco. [EatSF’s] goal is that every person in San Francisco, regardless of their income, their race, their religious background, will have access to healthy fruits and vegetables.

Why is it important?

We have an epidemic of obesity and diabetes in the United States. That epidemic is really driven by the deluge of empty calories that are available in our food system and the marketing of these foods to people in every sector of our environment. It isn’t surprising that people’s intake of healthy foods has gone way down over the previous 40 and 50 years. It isn’t surprising that obesity and diabetes have skyrocketed in that time as well. We have an enormous food system problem.

EatSF is supported by foundations and individual funders. What can average people do to help combat food insecurity in their communities?

You can support your local food bank. You can make sure that you are talking to your elected officials about the importance of food insecurity in your district. There are people experiencing food insecurity in every district in San Francisco, and in every county in the Bay Area. It’s really important that we remind our elected officials that we think this issue is important. We can vote for leaders that share our concerns about food insecurity. We’re the richest nation in the world, and for one out of 10 households in the United States to report being food insecure I think is a real shame on the United States. We need to really make sure that we are voting to support policies that help people become more food secure.

Do Jewish values influence what you do?

My work is informed by my Jewish upbringing, which emphasized empathy, collaboration, community and of course tzedakah. Judaism also emphasizes the value of simple kindnesses for people who are sick — which includes, of course, something to eat.

Lillian Ilsley-Greene
Lillian Ilsley-Greene

Lillian Ilsley-Greene was a staff writer at J. from 2022-2023.