1. 3 forces driving sustainability in hospitalfood
By Janet Howard
Published March 12, 2014
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Tags: Food & Agriculture, Health Care, More... Food & Agriculture, Health Care, Supply Chain
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 thesake 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 applea 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 theobesity 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,”theproduction 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 pasturecould 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 theU.S. Department of Agriculture. Compostingfood waste
adds nourishment to soil, eliminating the need for chemical fertilizers, and supports drainage.
3. Antibioticresistance
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 thegeneral 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 theCenters for Disease Controland Prevention showed that resistant
microbes kill at least 23,000 peopleeach 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. TheCenters for Disease Control
estimates thecare costs from thesediseases 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 promotefaster 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, theAmerican Academy of Pediatrics and Health Care Without Harm,
have called for an end to this practice.

2. Hospitals and schools lead theeffort to purchase meat raised without thenon-therapeutic use of antibiotics so that we can
preserve their viability as a critical lifesaving toolfor 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 themountain.
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 Hospitalin 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 phaseout the
procurement of meat raised with non-therapeuticantibiotics 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 thetippingpoint, where all hospitals, regardless of sizeor location, could benefit from the
lessons learned from early adopters.
He envisioned an initiative, based on the success of the Institutefor 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 thethree-year
Healthier Hospitals Initiativein 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. Theteam 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 themarketplace. Several hospitalsystems
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 Systemand 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.