2021-02SFC  Edible Austin Leaderboard

Healing Health Care

!By Oran B. Hesterman, Ph.D.
President and CEO of the Fair Food Network

Up close and personal. That was my experience with the health-care system when I was 36 years old and lying in a hospital bed with IV lines running into my veins. The doctors warned me that if my ulcerative colitis did not improve, they would need to remove my colon. A few days later they wanted me to try eating something and sent in a tray of food—a plate of roast beef with a mound of mashed potatoes and a big piece of yellow cake with chocolate icing.

I politely declined the offering and called a friend and asked, “Can you save my life today?” She rushed over to the hospital, bringing me a wonderful dinner of tofu, steamed greens and brown rice.

The good news is that I recovered and am today completely healthy with the help of a conscious diet that nourishes my body and soul. That experience made me newly aware of the healing power of food and the lack of choices available to people who don’t have the knowledge and/or opportunity to access the healing food they need, both inside and outside a medical setting. But it is particularly critical for our health-care system to support a healthful and healing diet.


If hospitals are supposed to make us well, why does much of the food found in them seem unhealthful? By one estimate, hospitals account for approximately $12 billion of annual food purchasing power. This figure includes meals for patients and for visitors and health-care workers in cafeterias. Though it represents only a small fraction of our total food system, it offers a huge opportunity to demonstrate the connection between personal health, healthful eating and a healthy food system. By shifting how health-care institutions source food, we can make an immediate difference and demonstrate a more integrated approach to health in the long run.

Consider the efforts of Dr. Preston Maring, who works in California at Kaiser Permanente, one of the largest health-care institutions in the country. I have long respected his leadership efforts to provide more healthful, locally sourced food through the creation of farmers markets on hospital property, as well as his tireless work to use more locally and regionally produced organic foods in hospital meals. Starting with a single farmers market in the hospital parking lot at Kaiser Permanente’s facility in Oakland, the program has now grown to include 40 farmers markets in six states, either at Kaiser Permanente hospitals or at locations it sponsors.

Kaiser Permanente now spends approximately 15 percent of its overall food budget on locally grown sustainable food, nearly two times as much as most other hospital systems of its size. By the end of 2015, that number is expected to grow to 20 percent. This means that locally grown fruits and vegetables are now being served in patient meals at more than 30 hospitals and medical facilities. In 2011, this translated into more than 190 tons of produce!

Another group working in this arena is Health Care Without Harm, an international network of more than 450 public health, nursing, environmental, labor and health-care organizations. It was started by health-care workers and activists who were concerned about the lack of healthful food choices in health-care institutions as well as the life-threatening and environmentally dangerous unintended consequences of current health-care practices.

The organization’s Healthy Food in Health Care program seeks to transform the system of food sourcing to promote sustainable agricultural practices and to encourage changes in institutional and public policy that lead to a healthier food system. More than 300 hospitals in the United States and Canada have already signed the program’s Healthy Food in Health Care Pledge to purchase foods that are both grown in an ecological manner and follow principles of social justice. To accomplish this proposed shift in purchasing priorities, the organization provides model contracts for hospitals. Most of the larger health care systems have signed the pledge, and attention is now turning to third-party certification, such as that of the Food Alliance.


How can you get involved? First, you can advocate for better food from food service directors in health-care institutions, taking a bottom-up approach. If you are a health-care worker, you can choose more nutritious and sustainable foods when you buy catered meals for meetings and maybe even create a farmers market at your local facility—and then patronize it and encourage your colleagues to do the same.

Want to have a broader impact on the area of health care? Write to your local newspaper and galvanize your community into collective action around this issue. Urge your local health-care facility to purchase local, sustainable food and increase the types of healthful choices available in their facilities. Physicians can collectively encourage hospitals to sign the Healthy Food in Health Care Pledge. Patients and families can write letters praising positive food choices and suggesting changes in food options that do not support this healthful approach to eating. Finally, as recommended by Healthy Food in Health Care leaders, administrators and hospital leaders need to call for a national leadership conference focused on changes to the food system, both in public policy and in institutional procurement.


The idea of offering locally sourced food is gaining traction among some health-care providers in Central Texas. Below is a sampling of institutions working to improve the quality of food they make available to their patients and community.



In Austin, Dell Children’s Medical Center of Central Texas, which is part of the Seton Family of Hospitals, has been implementing a number of initiatives to offer more nutritious, sustainably grown food to its patients. Fresh produce is often sourced locally for hospital meals, and quarterly farmers markets are held inside the cafeteria to promote local farms and to encourage people to sign up for their community-supported agriculture (CSA) programs. Menu items are being redesigned to promote and even discount healthier fare. In addition, there are plans for an on-campus vegetable garden. “We’re committed to the health of our patients, both in the clinic and in the communities to which they return,” says Dr. Stephen Pont, the medical director for the Texas Center for the Prevention and Treatment of Childhood Obesity. “Wherever we can try to have a positive impact for them, we work for that.” Last year, the hospital also received donor-funded CSA program shares for produce from Green Gate Farms, which they used as part of a 10-week program featuring cooking classes, food tastings and recipes for families with obese or overweight children.



Last year, dozens of expectant mothers who were patients at the People’s Community Clinic in Austin received a prescription for free local produce from the SFC Farmers’ Market–East in the form of vouchers. The goal of this pilot project, done in partnership with St. David’s Foundation and East Coast-based nonprofit Wholesome Wave, was to prevent childhood obesity, says Bianca Flores, the director of health promotion at the clinic. “Pregnancy often affords a valuable opportunity to encourage women to make behavior changes that improve immediate health outcomes and reduce the risk of future chronic disease in both mother and child,” Flores says. “Also, because mothers play a critical role in influencing a family’s nutrition and health habits, promoting and expanding the availability and consumption of fruits and vegetables through these prescriptions is a worthwhile intervention with the potential to benefit the entire family.”




On Wednesday mornings in the summer, it can be a disorienting scene outside Scott & White Healthcare’s hospital in Temple. Live music and people chatting are likely to be heard as folks connect with area growers to buy fresh honey, cheese from pasture-raised goats and other specialty items at the on-site farmers market. “It’s just a way to skip the supermarket crowds and buy locally grown, farm-fresh produce and products,” says Alex Hainzinger, the hospital’s wellness program specialist. “We really just wanted not only to support our staff and the community in ways to eat healthier, but also to support our farmers.” Scott & White also offers summer farmers markets at their Waco and Round Rock campuses, with a fourth market planned for Killeen.




In San Antonio, Texas Diabetes Institute patients not only get to learn how to prepare recipes using fresh herbs and seasonal produce, they also get to see how they grow at the institute’s on-site vegetable garden. “Sometimes people don’t think growing fruits and vegetables would be associated with a clinic, but they’ve been very successful with it,” said Sandra Jackson, the general manager for nutrition services for University Health System, the umbrella organization of the institute. Through dietician-led cooking classes, patients learn to prepare healthful dishes, such as tangy nopales with habanero peppers and eggplant with whole bay leaf, mint and fresh tomatoes. Even better, the ingredients are grown just steps away in the institute’s 15- by 45-foot garden. “The patients have been very receptive to the program,” Jackson says. “It teaches them healthy eating habits, and they’re more aware of locally grown foods, like fruits, vegetables and herbs—and how to incorporate them into different recipes.” —Nicole Lessin