The Bad River Band of Lake Superior Chippewa in Ashland County, Wisconsin has leveraged strong community collaborations to strengthen food access and build the foundation for a sustainable produce prescription program to address food insecurity and diabetes burden. Since 2024, the Bad River Health and Wellness Center, Bad River Food Sovereignty, University of Wisconsin-Division of Extension (Extension; HOP-funded), and the Wisconsin Department of Health Services (SPAN-funded) worked together to build upon the Tribe’s Food Box Program with connections to clinical care and systems to support long-term nutrition interventions. Through regular collaboration, technical assistance, and resource sharing, collaborators identified funding opportunities, improved referral and tracking processes, and increased local capacity to implement produce prescriptions. By linking healthcare and food sovereignty efforts, the initiative aims to create a sustainable model that expands access to nutritious and culturally meaningful foods while supporting chronic disease prevention and management in the Bad River community.

Public Health Challenge

The Bad River Band of Lake Superior Chippewa includes 6,945 tribal members.  Located in rural northern Wisconsin in Ashland County, the Bad River Reservation is geographically isolated and has low food access and availability. Following the closure of the community’s only full-service grocery store in 2024, Tribal members must travel more than ten miles to purchase fresh foods, which is especially difficult for those with limited transportation and financial resources. Thirty-one percent of Bad River households have incomes at or below 185% of the federal poverty line. These social and structural factors contribute to public health challenges of food insecurity and diet-related chronic disease. 

In 2025, the Bad River Health and Wellness Center reported 280 patients diagnosed with diabetes, including 261 with Type 2 diabetes, and many also managing diabetes-related health conditions. Clinical staff regularly report that many patients do not consume enough fruits and vegetables and experience nutrient and fiber deficiencies. For the Anishinaabe people, traditional foods are deeply connected to health, culture, and identity, yet barriers to accessing nutritious and traditional foods have contributed to poorer health outcomes over time. Together, these factors highlight the urgent need for innovative nutrition interventions that improve access to fresh, nutritious, and culturally meaningful produce.

Approach

Since 2024, Extension and the Wisconsin Department of Health Services collaborators met monthly with Bad River organizations to support the development of a produce prescription program that addresses food insecurity and chronic disease in the community. This effort brings together staff from the Tribal clinic, the Bad River Health and Wellness Center (BRHWC), and the Bad River Food Sovereignty department, which operates the Tribe’s food distribution program through the Fish House, a tribally owned and operated commercial kitchen. Through regular communication, technical assistance, and shared problem-solving, collaborators set the foundation to integrate clinical and food access initiatives to better meet community needs. 

Initially, collaborators focused on strengthening the Food Box Program, originally supported by Local Food Purchase Assistance (LFPA) funding but has since faced funding gaps. The biweekly Food Box program of local, fresh, and nutrient-dense foods served more than 750 Tribal members in 2025, including individuals, families, elders, and low-income community members.  From a pick list, Tribal members have been able to select traditional and other foods that fit their household’s preferences and health needs. Extension provided technical assistance, evaluation support, and opportunities for strategic planning to help sustain and strengthen the program.  

More recently, collaborators focused on strengthening connections between the clinic and food distribution systems to establish a sustainable produce prescription program. Developing the infrastructure needed to support long-term implementation of the produce prescription program is a key priority. This includes  identifying and securing additional funding sources to staff and purchase food for the Food Box Program and improving patient referral and tracking processes after referral. Through this work, collaborators are creating a coordinated and sustainable approach that increases access to healthy, culturally meaningful foods for Tribal members while supporting the prevention and management of chronic disease.

Results

This collaboration made significant progress toward establishing a produce prescription program. One important achievement was helping sustain the Food Box Program during periods of funding uncertainty. Local collaborators gained access to technical assistance and a broader network of support. As a result, the Food Box Program continued serving community members while organizations actively pursued additional funding to support long-term sustainability. 

The collaboration also strengthened connections between the BRHWC and Bad River Food Sovereignty, helping bridge clinical care and food access services. Together, collaborators are developing a sustainable referral and tracking process for the produce prescription program. In addition, collaborators increased their knowledge, skills, and capacity to design, implement, and sustain produce prescriptions. Together, these efforts strengthened local infrastructure and organizational capacity, and positioned the community to launch and grow produce prescriptions for Tribal members.

Sustaining Success

A key factor supporting the sustainability of this effort was the strong collaboration established among the BRHWC, Bad River Food Sovereignty, Extension, and Wisconsin Department of Health Services. This collaborative approach helped sustain the Food Box Program during periods of uncertain funding and strengthened infrastructure to support produce prescription. Rather than creating a new stand-alone program, collaborators connected and integrated efforts across organizations and increased the likelihood that high-quality services can continue beyond any single funding source. The collaboration is creating a model that can grow over time while improving access to healthy and culturally meaningful foods for the Bad River community.

“I am convinced that this effort is not only changing lives, it is going to save lives, and I mean that wholeheartedly.” 

– Robert Houle, BRHWC Director

For more information

Contact Amber Canto (Principal investigator), University of Wisconsin-Madison Division of Extension, amber.canto@wisc.edu, 1-608-262-0384 

This effort is made possible by cooperative agreement CDC-RFA-DP-23-0013 entitled High Obesity Program (HOP) from the Centers for Disease Control and Prevention.

Contact Information

Cooperative agreement: CDC-RFA-DP-23-0013 entitled High Obesity Program (HOP)

Recipient: University of Wisconsin-Madison, Division of Extension

Strategy focus: Produce Prescription

Story author name and email: Macarena Urrets-Zavalia, urretszavali@wisc.edu

¹ Wisconsin Department of Public Instruction. Bad River Band of Lake Superior Chippewa. https://dpi.wi.gov/amind/tribalnationswi/badriver 

²Wisconsin Food Security Project. University of Wisconsin-Madison. 2019-2023 American Community Survey. https://foodsecurity.wisc.edu/mapping