The health sector is one of the largest purchasers and providers of food, according to the World Health Organization (WHO). And with that purchasing power comes enormous potential for supporting more localized and sustainable food systems.
There is increasing consensus public health professionals that hospitals should serve meals modeled on healthier diets. And as the food as medicine movement grows, there is a deepening understanding that nutrition and disease treatment and prevention are closely linked.
The cost of procuring healthy, locally-sourced and sustainably-grown foods is often the greatest barrier for hospitals with limited budgets. But leaders across the healthcare system are pushing for reform in the quality and procurement of hospital foods, and finding innovative ways to make these foods more accessible.
“I think the reason is that we’ve gotten to a tipping point,” Stacia Clinton, Chief Program Officer of Health Care Without Harm, tells Food Tank. Clinton believes that hospitals are seeing a shift in “value culture” with the food they serve, investing in the long-term health of patients, the wealth of the local community, and contributing to food systems transformation.
While some individual hospitals, such as St. Lukes in Pennsylvania, are building on-site farms to supply their plant-forward menus, there are also initiatives connecting hospitals to local farmers and producers through procurement practices.
Here are 14 initiatives highlighting the root cause of health risks and pushing for local and regional food on hospital menus.
1. Community Alliance with Family Farmers, United States
Community Alliance with Family Farmers (CAFF) works on building sustainable food and farming systems in California through advocacy and programming. Their Farm to Cafeteria program helps schools, hospitals, and universities throughout the state provide more local food to consumers. They do so by providing technical assistance and marketing support for farmers, vendors, and food service buyers. CAFF believes that institutional food service purchasing can provide an anchor for farmers and local communities.
2. Farm to Institution New York State, United States
Farm to Institution New York State (FINYS) is empowering New York institutions, such as hospitals, to spend 25 percent of their food budget on locally grown produce. The initiative, led by American Farmland Trust, makes recommendations to stakeholders across the food and healthcare system to scale up the public purchase of food from New York farms. FINYS also trains and supports institutions increasing their local food purchasing, while campaigning for institutions to receive public funding to purchase New York-grown food.
3. Farm to Institution New England, United States
Farm to Institution New England is a network of nonprofit, public, and private stakeholders working to increase the amount of fresh, local food served in the region’s public institutions. Their New England Healthy Food in Health Care (HFHC) Program works to improve food in health care facilities while supporting New England farmers and protecting the environment. The program draws from resources provided by the national Health HFHC program and since its start, it has expanded to seven active state workgroups around the region.
4. Food for Life Served Here, United Kingdom
The Food for Life Served Here (FFLSH) initiative awards caterers who use healthy ingredients and local produce in institutional settings, like hospitals. FFLSH gives accreditation to institutions whose meals meet the criteria developed by the Soil Association and food industry experts. The Soil Association also works with institutions to improve sourcing practices, offering training and support to help achieve their bronze, silver, or gold awards. Their end goal is to ensure that food served is traceable to local farms and keeps the UN’s Sustainable Development Goals (SDGs) in mind.
5. Food to Overcome Outcome Disparities, United States
The Food to Overcome Outcome Disparities (FOOD) Program works to alleviate food insecurity among cancer patients. Since 2011, the program has distributed more than 300,000 meals to 4,000 patients and their families. The FOOD Program operates 13 pantries located in clinics across New York City’s five boroughs. They partner with a number of organizations to secure fresh fruits and vegetables, including Green Bronx Machine and GrowNYC.
6. Healthy Food in Health Care, United States
Healthy Food in Health Care (HFHC) is helping more than 1,000 hospitals across North America to implement an environmental nutrition framework for the food they procure and serve in their catering. Established by Healthcare Without Harm (HCWH), HFHC promotes an environmentally sustainable food system, prioritizing local foods, reducing and improving the quality of meat, and supporting human dignity and justice. Hospitals can also sign the HFHC Pledge to demonstrate their commitment to food sustainability in the healthcare sector and promote the consumption of healthy food as preventive medicine.
7. Katalog živil (The Food Catalog), Slovenia
Katalog živil is a food procurement website for all public institutions in Slovenia, facilitating the purchase of locally-produced foods. Established by The Slovenia Ministry of Public Administration, the aim of the tool is to improve the quality of food served in institutions, like hospitals, through its comprehensive database. The process allows for greater transparency in the procurement of food, allowing hospitals to assess the nutritional value of foods, alongside the producer’s location and certifications such as organic. Likewise, the site has made local food producers more identifiable to institutions, creating easier communication between suppliers and purchasers.
8. Local Food in Health Care Facilities, Canada
The Local Foods to Health Care Facilities initiative aims to increase the amount of Ontario-produced food served in health care facilities. Part of a larger effort to bring local foods into Broader Public Sector catering, its pilot project in 2012 was funded by the Greenbelt Fund and the Ontario Government. The project aimed to help three health care facilities in the initial stages of procurement from local growers. Upon its completion, the participating institutions remained in the project (Cedarwood Village, Norfolk General Hospital and Nursing, and Norview Lodge) and maintained their partnerships with Ontario producers, with the goal of increasing their local purchasing year on year.
Modèle d’Économie Circulaire Alimentaire pour les Hôpitaux Français (MECAHF) is a project demonstrating how a circular economy of food could operate in hospital catering. Running from 2018 to 2021, the project aimed to reduce food waste through the Centre Hospitalier de Niort’s (CH Niort) supply chain (from procurement to disposal) and to reinvest savings from the scheme into the purchase of local and organic produce. Developed by HCWH Europe in collaboration with CH Niort, MECAHF reduced food waste by 20 percent and increased sustainable food procurement by at least 10 percent in three years.
10. Northeast Organic Farming Association, United States
The Northeast Organic Farming Association (NOFA) is a coalition of seven state chapters that advocates for and educates on organic and sustainable agriculture. Some state chapters, including Vermont’s, are working to promote consistent access to affordable, regionally grown foods for institutions. They aim to build relationships with local farmers, share best practices with organizations in the network, and increase demand for local and organic foods.
11. Nourished By New England, United States
Nourished by New England (NNE), which began as a two-year program, connected more than 40 health care facilities to 19 farmers and food businesses, as well as dozens of community partners across New England. Developed by HCWH, the program enabled participating hospitals to spend more than US$5 million on local seasonal foods from New England farmers and fishers. While the program ended in 2020, it laid the groundwork for further partnerships between hospitals and farmers in New England, allowing small and mid-sized producers to serve institutional customers.
12. Nourish Healthcare, Canada
An initiative of the McConnell Foundation and Food Secure Canada, Nourish Healthcare aims to prioritize individual and planetary wellbeing with the food served in hospitals. The organization believes in using hospital food to promote and model healthy diets to patients and staff. They have worked with 26 innovators in hospitals, health centers, and long-term care facilities across Canada to make menus more healthy, local, sustainable, culturally appropriate, and delicious. In the long term, the organization seeks to influence policies that support food for health initiatives, bridging the gap between the food system and the healthcare system.
13. ÖkoKauf Wien (Eco-Buy Vienna), Austria
ÖkoKauf Wien (OKW) is a program created by the City of Vienna ensuring that 30 percent of all food served in the city’s public cafeterias is organic, seasonal, and locally sourced. As Vienna’s green public procurement plan, OKW engages with institutions to achieve the city’s sustainability goals. For example, the Vienna Hospital Association (Wiener Krankenanstaltenverbund, KAV), a group of 11 hospitals, serves meals with predominantly local produce and prioritizes high vitamin-containing foods. The group collectively serves 30,000 meals per day, and, thanks to OKW, 32 percent of foods served are organic.
14. Programa de Aquisição de Alimentos (Food Purchase Program), Brazil
As part of Brazil’s Zero Hunger strategy, Programa de Aquisição de Alimentos (PAA) was established in 2003 to increase food access and support family farmers and rural entrepreneurs. The program aims to boost rural economies with an institutional food procurement program, giving small farmers contracts to supply public institutions, including hospitals. Brazil’s PAA also promotes more nutritious and seasonal diets with fresher ingredients due to the shorter supply chain.
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