June 2014: Healthy Food in Health Care Newsletter


June 2014
General HFHC newsletter header
Healthy Food in Health Care at CleanMed 2014


This year's CleanMed conference provided a showcase for the Healthy Food in Health Care (HFHC) work of hospitals across the country and advanced collaboration for a healthier food system. Here are just a few of the highlights: 

Kicking off the event, the HFHC program convened a meeting the hospital leaders of the Healthier Hospitals Initiative (HHI) to discuss what they can do to use their collective purchasing power to support the production of meat and poultry produced without the routine use of antibiotics. We know how critical it is that we protect the efficacy of our vital reservoir of antibiotics, and the impact that non-therapeutic use in animal agriculture is having on the rise in antibiotic resistant bacteria, causing hard to treat (and expensive to treat) human illnesses. These hospitals brought to this meeting their suppliers and management companies, all pledging to work together to better understand the issue, identify the challenges and create solutions.

Breakout sessions at the conference engaged attendees in learning about best practices and strategies for building healthier food environments and systems in their facilities and communities. Read more about the food sessions and CleanMed through a blog written by Emma Sirois, National Co-Leader of HFHC. And mark your calendars now for CleanMed 2015, May 12-15, in Portland, Oregon! 

Take Action: Antibiotics in Animal Agriculture & Policy

Consider signing Health Care Without Harm's letter to the Food and Drug Administration's Commissioner Hamburg, encouraging the agency to reduce the overuse and misuse of antibiotics in food animal production by requiring meaningful veterinary oversight on farms and by addressing disease prevention.

Join hospitals across the country and take action to protect antibiotics by passing a resolution to phase out the purchases of meat raised with non-therapeutic antibiotics within your hospital, medical center, or medical school. Download resources on how to develop a resolution online.

Interested in reading more about the issue? The Abstinence Method is a new piece out from Food & Environment Reporting Network that explains why and how Dutch farmers are eliminating the routine use of antibiotics, and it also discusses lessons for the U.S.
News from the Field: Palomar Health System, CA

Palomar Health is an 800 bed, three hospital health system located in San Diego County, California that has been reducing the amount of meat on its menus and tracking its progress for the past three years. To date, Palomar Health's downtown campus has reduced the pounds of meat it serves per meal by 19 percent.

"But what we found was that even though we had reduced the amount of meat we were buying and preparing, rising prices - especially for beef at a 17 percent cost increase in this three year period - had eliminated the savings we had planned to use to purchase more sustainably-raised meats," shares Barbara Hamilton, Sustainability Manager at Palomar Health.

Given that the system prepares over two million meals annually, Palomar Health has to employ several creative strategies to find cost savings. These include plant-based and seasonal menu planning that are changed according to the availability of fresh vegetables and fruits, along with more appropriate portion sizes. Says Hamilton, "weekly menus are planned with the flexibility to use seasonal produce for best flavor and price...Pomerado Hospital café increased sales by 39 percent from September to December 2013....Some staff [are ordering] an extra serving to take home
Kitchen staff serving customers at Palomar Health
for dinner!"

Marketing has been an additional strategy Palomar Health System has pursued to increase sales, and it sends out emails and newsletters, and puts up signs around the cafeterias to advertise its sustainable food offerings. "Marketing is so important; it could make or break your programs," comments Hamilton. It is also important to engage food service staff, Hamilton points out: "It gives them greater buy-in to see good sales data." Palomar Health also provides tastings so that staff can see the food and then talk about the meals being served and ingredients to customers.

Ultimately, "these [meat] issues are too big for us to roll out on our own," admits Hamilton. As such, through Health Care Without Harm, Palomar Health is working with hospital teams in the San Diego area and throughout California to aggregate demand for sustainable meat and is now scheduled to purchase grass-fed, Animal Welfare Approved beef from Estancia at a reduced cost over the summer. To learn more about hospitals buying Estancia beef in California, read our recent blog from Health Care Without Harm (One Year Later: Hospitals move from ideals to action on "antibiotic-free" meat).
Clinician Champion: Aparna Bole, MD
Aparna Bole, MD, FAAP is the systemwide Sustainability Manager for University Hospitals (UH) and a pediatrician at UH Rainbow Babies & Children's Hospital. She originated the Sustainability Manager role in 2010, and has been charged with building a multidisciplinary sustainability program at UH that engages leaders across the system and focuses on waste reduction, energy management, green building, sustainable procurement, and education & outreach. As a practicing pediatrician at Rainbow, she continues to be active in patient care and pediatric resident and medical student education. In her dual roles, she is particularly interested in the relationship between sustainability and pediatric public health. Healthy Food in Health Care caught up with Dr. Bole to talk about her environmental health advocacy efforts.

Q. Could you describe your advocacy efforts surrounding environmental health and food?
At University Hospitals, we have assembled a multidisciplinary Nutrition Committee that includes dietitians, Supply Chain & Operations leaders, Nutrition Services professionals, and physicians. We advocate with our food suppliers to increase the availability of locally and sustainably produced foods, and work to integrate our health and wellness goals with sustainable procurement goals in menu planning and food purchasing. Our priorities include decreasing our total meat purchasing, investing in sustainably sourced meat products, and increasing our purchase of locally grown items. I represent UH in the City of Cleveland's sustainability initiatives, including efforts to establish a local foods business cluster. For our pediatric and women's clinic patients, we have begun a produce delivery and nutrition education program (called Healthy Harvest) that features fresh, locally grown, direct-from-farmers produce as well as practical shopping and preparation tips. Finally, I have developed content related to sustainability and public health, with a special focus on sustainable food systems, for our pediatric resident advocacy rotation at UH Rainbow Babies & Children's Hospital. On a national level, I participate in advocacy with the American Academy of Pediatrics related to regulating the use of antibiotics in animal agriculture.

Q. When and how did your interest in the intersection between human and environmental health begin?
I have been interested in environmental issues for much of my life, but began to be interested in the intersection between the environment and health while I was a medical student. I perceived environmental factors impacting my patients' health (for example, poor air quality affecting patients with asthma), and also perceived opportunities within my hospital system to reduce waste, operate more efficiently, use safer cleaning chemicals, and improve food offerings. At that point, I began to reflect about the fact that our hospitals' negative environmental impacts were contrary to our mission to enhance our patients' and communities' health.

Q. In what ways are you able to integrate environmental health education and advocacy into your traditional schedule?
Our Healthy Harvest program occurs while I am in clinic seeing patients, and resident education is part of my job. In regards to advocacy in other arenas, I am in the unusual position of holding both a sustainability title and being a physician, so environmental health education and advocacy are natural ways to combine my roles.

Q. Any recommendations on how other clinicians can become more involved in advocating for a healthy food system?
Any clinician who works in an institution that serves food can and should ask questions about how that food is sourced, and express to their organization's leadership the importance of increasing locally and sustainably sourced food. The purchasing power of our health care institutions can play a significant role in transforming our national food system. In addition, for a typical organization, a significant contribution to the organization's environmental impact is its food purchasing, especially meat (and particularly beef) purchasing - so achieving more sustainable food procurement can dramatically decrease an organization's environmental impact and carbon footprint. Clinicians can also provide advice to their patients about how to shop for healthy and sustainably sourced food on a budget and model healthy and sustainable purchasing practices in their personal lives. There are also opportunities to participate in policy advocacy around, for example, antibiotic use in animal agriculture, through our professional organizations and other national organizations such as Health Care Without Harm and the Pew Charitable Trusts.
About Us

The Healthy Food in Health Care program is a national initiative of Health Care Without Harm that harnesses the purchasing power and expertise of the health care sector to build a sustainable food system. For more information, visit www.healthyfoodinhealthcare.org.  

In This Issue
Healthy Food in Health Care at CleanMed 2014
Take Action: Antibiotics in Animal Agriculture & Policy
News from the Field: Palomar Health System, CA
Clinician Champion: Aparna Bole, MD
Upcoming Events
New Resources
Our Program in the News
Sign up for Our Listserv
Share Your Story
Contact Us
Pledge Update
Total Pledge Signers:
We welcome the following facilities who signed the pledge since March: 

~Multiple Tenet Healthcare facilities across the nation
~Bradley Hospital, RI
~Emerson Hospital, MA
~North Shore-LIJ Stern Family Center for Rehabilitation, NY
~PeaceHealth St. Joseph Medical Center, WA
~Providence Regional Medical Center Everett, WA
Upcoming Events
1. Eastern Massachusetts Workgroup Farm Tour, Sherborn, MA, June 26
Join other health care professionals and food service folks on a tour of Springwood Organic Farm in MA from 9am-1pm. RSVP to sclinton@hcwh.org.

2. Food Forward: Creating healthy, sustainable menu options, Southfield, MI, July 23
The Ecology Center's Healthy Food in Health Care Program is partnering with the Humane Society to host Food Forward-an opportunity for food service professionals to discover new strategies for incorporating healthy menu options. Learn about the health, sustainability, and financial benefits of adding more meat-free meals into your menu from experts in the field. Event includes exciting presentations, panel discussions, a cooking demo and more. It also includes a complimentary lunch. Click here to register today!
New Resources 
1. Expanding Antibiotic Stewardship: The Role of Health Care in Eliminating Antibiotic Overuse in Animal Agriculture
Check out our new white paper, which argues why the health care sector has an important role to play in protecting antibiotics in the agricultural sector.

Magazine Column: Balanced Menus - Health care food service revolutionizing menus with "Less Meat, Better Meat"
Our recent Greenhealth column explores the issue of antibiotics in animal agriculture and meat reduction in hospitals.

3. New England Healthy Food in Health Care Report 2014
This report outlines the activities that New England health care systems, hospitals, and clinicians are currently engaged in through the Healthy Food in Health Care program. It is a sampling of the innovative work underway in these facilities. Download the report to read more.

4. Farm Fresh Healthcare Project How-to Guide
This How-to Guide presents insights from the Farm Fresh Healthcare Project in hopes of providing guidance for other farm-to-institution initiatives. Read more about the lessons learned.

5. Part 1 of our antibiotics webinar series - Foundations: Emerging Science, Farm Practices, and Federal Policy
With the first webinar in this series, learn the foundational issues around antibiotics in animal agriculture - the latest policy and science, as well as how and why antibiotics may or may not need to be used in poultry and livestock production. Listen to the archived recording online.

6. Part 2 of our antibiotics webinar series - Clinical Advocacy around Antibiotics: From Resolutions to Policy Engagement
The second webinar in our series presents tangible suggestions on how health professionals, particularly clinicians, can become involved in being stewards of antibiotics in food production. Listen to the archived recording online.
Our Program in the News 
Sign Up for Our Listserv 
Share Your Story
If you would like to share your story in our next issue, contact Sapna Thottathil, Healthy Food in Health Care: sapna@sfbaypsr.org.
Contact Us 
For more information about the Healthy Food in Health Care program, contact one of our regional organizers.