3 forces driving sustainability in hospital food

Earlier this year, GreenBiz reported on the movement toward more healthful food in the State of Green Business Report. More recently, we've seen the growing trend around more sustainable meat procurement with new policies at McDonalds and Chick-Fil-A, among others.

The momentum is building in health care, as well. It’s not an easy task to overhaul the complex health care food system, but it’s a critical move and well worth the heavy lifting for the sake of prevention, climate change, health care spending, the environment and public health.  

The supply chain sometimes can feel like a maze, requiring strength in numbers and perseverance to wend our way through for healthier meat, local and organic foods and healthier beverages. Hospitals traditionally have not been known for tasty food, but in addition to enhanced patient experience, at least three key drivers are behind this national trend in health care.

1. Health

Clinicians' prescribing a pesticide-free apple a day and wellness initiatives’ offering incentives for healthier lifestyles are steps in addressing $190 billion in annual spending on obesity health care costs alone, according to the Journal of Health Economics. The prevention and wellness issue is pretty clear with the obesity epidemic and diet directly linked to cardiac disease, diabetes and cancer.   

2. Climate  

Many health care sustainability leads and green teams are just starting to recognize the role that food plays in both climate and health, and are taking steps to include healthier food in their overall sustainability programming. In the U.N.’s “Livestock’s Long Shadow Report,” the production of meat and dairy products was reported as a serious contributor to global climate change, accounting for 18 percent of the world’s greenhouse gas emissions — more than cars, trains and planes combined. Conversely, the sustainable production of 100 percent grass-fed beef stores carbon in soil, according to Scientific American’s article, “Return to the Roots.” Converting half the U.S. corn and soy acreage to pasture could cut carbon emissions by as much as 144 trillion pounds. Forty percent of U.S.-grown food is wasted, ending up in landfills and giving off methane gas, a greenhouse gas 70 times more potent than carbon dioxide over a 20-year period, according to the U.S. Department of Agriculture. Composting food waste adds nourishment to soil, eliminating the need for chemical fertilizers, and supports drainage.

3. Antibiotic resistance

Methicillin-resistant staphylococcus aureus (MRSA) is one of the frightening resistant organisms that used to be reserved for the immunocompromised and elderly in hospitals, but it’s now found in the general and otherwise healthy population. It’s scary when an antibiotic doesn’t do the trick and clinicians must try a variety until one works. What if the day comes when none does the trick?  

Antibiotic resistance is of real concern. A January study by the Centers for Disease Control and Prevention showed that resistant microbes kill at least 23,000 people each year and complicate treatment and recovery for 2 million more. Health professionals characterize the threat as the largest challenge facing modern medicine, according to the study. The Centers for Disease Control estimates the care costs from these diseases are as high as $20 billion a year and lost productivity as high as $35 billion a year.

So what does all this have to do with food? Up to 80 percent of all antibiotics consumed each year are routinely given to poultry, beef cattle and swine in their feed to promote faster growth and prevent disease outbreaks, not to treat diagnosed disease, according to government estimates. Numerous health organizations, including the American Medical Association, American Nurses Association, American Public Health Association, the American Academy of Pediatrics and Health Care Without Harm, have called for an end to this practice.

Hospitals and schools lead the effort to purchase meat raised without the non-therapeutic use of antibiotics so that we can preserve their viability as a critical lifesaving tool for medicine.

Back in the day

Health Care Without Harm kicked off its Healthy Food in Health Care program with the development of a Healthy Food Pledge in 2006. Since then, regional organizers and a national strategy have developed several areas of focus, including the balanced menus challenge, the Food Matters Clinical Education and Advocacy Project, a series of resources, fact sheets and awards to help move the mountain.

Examples of early adopters include Fletcher Allen Health Care, a 500-bed facility serving Vermont and northern New York, which reported and documented that 30 percent of purchases were sustainable and 37 percent were locally grown or raised in 2012. This facility also tracked combined fresh and frozen beef, pork, turkey and chicken purchases produced with “reduced antibiotic use” at 48 percent.

Lucille Packard Children’s Hospital in Palo Alto, Calif., a 311-bed facility, took the balanced menus challenge, offering at least one protein-balanced vegetarian or vegan option at each meal for both patient and cafeteria food. The cafeteria menu was also meat-free one day per week throughout the year.
 
At UCSF Medical Center, a 600-bed facility, the Academic Senate unanimously approved a resolution to phase out the procurement of meat raised with non-therapeutic antibiotics and urged all 10 University of California campuses to do the same. It started off with antibiotic-free chicken for patients, staff and visitors.
 
But Gary Cohen, founder of Health Care Without Harm, wanted more. While the initiatives successfully had engaged 400 hospitals by signing the food pledge and more than 90 were working on buying more healthful and less meat, he wanted to cast the net further and use data to reach the tipping point, where all hospitals, regardless of size or location, could benefit from the lessons learned from early adopters.  

He envisioned an initiative, based on the success of the Institute for Health Care Improvement’s 100,000 Lives Campaign (PDF), where data would demonstrate value — financially and environmentally. Cohen and the team from Health Care Without Harm, the Center for Health Design and Practice Greenhealth garnered 12 sponsoring health systems and kicked off the three-year Healthier Hospitals Initiative in spring 2012, a no-cost way for hospitals to explore green strategies and benefit from proven strategies. They enrolled and committed to one or more challenges within six areas of focus: engaged leadership, healthier food, leaner energy, less waste, safer chemicals and smarter purchasing. The team identified standardized measures, definitions and a series of how-to guides, case studies and learning platform to ensure success. The team’s goal: engage 2,000 hospitals in the U.S. and Canada and raise awareness around health care’s role in leading communities to a healthier future.  

Setting up these specific, measurable interventions is the only way to use data to drive change. Without clear definitions and standardized language, data can be inconsistent and doesn’t result in any benchmarking potential.
 
The initiative is about strength in numbers with aggregate data and collective power in the marketplace. Several hospital systems signed a letter articulating the goals of the Healthier Food Challenge and a desire for better-quality meat and beverages and the ability to track local and sustainable foods. This letter was sent to the signer’s business partners with a request for a healthful food roundtable meeting that took place Feb. 11 in Washington, D.C.

The vast majority of Health Care Food Service Contract Management Companies, group purchasing organizations and distributors came together to help overcome obstacles to healthful food with their health care customers. Attendees included representatives from Kaiser Permanente, University of California at San Francisco (UCSF), Fletcher Allen, Partners Healthcare, Dignity Health, Lee Memorial Health System and Gundersen Health.

The meeting outcome — a priority on improving meat procurement — has been established and a strategy is under development. Success stories were shared, challenges identified and a follow-up meeting has been set at CleanMed, the conference on environmental sustainability in health care June 2-5 in Cleveland, Ohio.  

We are underway, thanks to some early adopters, sharing best practices and strength in numbers. 

Hospital food image by Goran Bogicevic via Shutterstock.