“You are what you eat.” Usually taken as an individual diet mantra, the old saying is gaining new relevance on the community scale as a rubric to transform healthcare.
It’s hard to stay healthy if you lack access to fresh, healthy food—or if you are unable to consistently afford an adequate amount to eat. Research shows that food insecurity is not only associated with a higher risk of obesity and diet-related chronic diseases such as diabetes and hypertension, but also with the poorer management of diet-sensitive health conditions and with greater healthcare costs, including avoidable emergency department visits.
Historically, hospitals have mostly been in the business of treating conditions, but many are rethinking the role they can play in preventing as well as managing health problems. Hospitals, health systems, and government are increasingly investing time and resources in identifying and addressing social determinants of patients’ health, especially food access.
While powerful, a systemic approach to root causes in public health requires major shifts for many hospitals. The Ecology Center is making change easier. This spring marked the culmination of a three-year national project in the release of Health Care Without Harm’s “Delivering Community Benefit: Healthy Food Playbook,” an extensive and free online resource to help healthcare professionals integrate a healthy food orientation in a comprehensive approach to community well-being.
With support from the Robert Wood Johnson Foundation, HCWH began examining hospital landscape in 2015 to pinpoint and understand promising practices to promote healthy food access, healthy eating, and healthier food environments to address the risk of diet-related health conditions. The Ecology Center was part of a national team conducting research, interviewing community benefit professionals at hospitals, contributing to numerous implementation strategy briefs, and producing two forthcoming Michigan case studies.
Sustainable Food Program Director Lindsey Scalera comments: “We are thrilled to share this new resource with our network of healthcare professionals and community-based food systems partners. The Healthy Food Playbook will help healthcare leaders identify and incorporate food into their community health assessments and strategies. We believe Michigan hospitals can inspire the next generation of creative solutions addressing diet-related health needs and advance the development of healthy, equitable and sustainable food systems.”
The Healthy Food Playbook will help hospital professionals more thoroughly consider the role of food systems as they assess the health needs of their surrounding community, implement effective programs that harness local partnerships, and follow up with evaluation and reporting to continually improve the ways they serve their patients and communities. It synthesizes research findings, offers strategies to identify community needs, presents program models, and shares hospital case studies to make the processes and benefits tangible.
TaShara Coakley, Community Health Lead at Ascension St. John Providence, describes the influence the Playbook will have in Detroit: “Here at Ascension St. John Providence we recognize that food insecurity is an issue in the populations we serve, but we needed guidance on how to approach the issue. The Health Care Without Harm Healthy food playbook provides valuable resources and recommendations for addressing food insecurity.”
The Playbook arrives at a timely moment for impact. Since the early 1950s, private nonprofit hospitals have been required by law to provide “community benefit” public services that justify their tax-exempt status. These include programs to expand access to health services, to improve public health, to advance knowledge through education or research, and to reduce healthcare costs borne by the government. Most hospitals fulfilled community benefit requirements by providing free and reduced-cost care to patients who were unable to pay. Though charity care remains a critical and primary form of community benefit, recently revised IRS guidelines and the Affordable Care Act require hospitals to do more.
The Healthy Food Playbook leverages these recent changes to community benefit legal requirements, which include mandatory Community Health Needs Assessments (CHNAs) every three years and increased focus on disease prevention. This resource will increase the prevalence and effectiveness of now-incentivized healthy food programs, both new and old. The Playbook takes a broad, environmental nutrition approach to answering the question “what is healthy food?”—one that can influence the social as well as the physical health of communities. Looking beyond calories and vitamins, the Playbook considers healthy food as the product of a sustainable system that that fulfills the nutritional needs of all eaters, that conserves and renews natural resources, that advances social justice and animal welfare, and that builds community wealth.
Our upcoming work is to ensure both hospital community benefit professionals and community food system partners know about the playbook and create opportunities for them to connect with each other around common goals for community health. On June 25, the Ecology Center and the Detroit Food Policy Council, in partnership with Health Care Without Harm, will host a networking event in Detroit to highlight examples and opportunities for healthcare and food systems partnerships in our region, to connect hospital community benefit health professionals with community food system organizations, and to engage participants in strategizing to bring these ideas into their work.
We are excited about this milestone in the Ecology Center’s long history of promoting sustainable food for healthy communities. The Ecology Center is a founding member of Health Care Without Harm (HCWH), and we have partnered with them since 1996 to reach out hospitals in Michigan on a host of sustainability initiatives. As regional organizers for the HCWH Healthy Food in Health Care program, we have collaborated with institutional and supply chain partners throughout Michigan to bring healthy, local and sustainable food to healthcare facilities, and we’ve worked closely with partners throughout the state to cultivate opportunities for the healthcare sector to address food insecurity and provide healthier food environments.
Published on May 30, 2018