Innovators like Josée Lavoie from Ste Justine are demonstrating that it’s win-win for hospitals to design for the wellbeing of people and the planet.
A decade is coming to a close this year. Soon we’ll turn the calendar to 2020, a number associated with perfect vision and the power of hindsight. The new year is calling for perspective - a cue to look backward even as we move forward. For our team at Nourish, this has been the work of the last few months: to hurry up and stand still. To take stock of three active years of programming, from the selection of twenty-five Nourish Innovators in 2016 to a Spring symposium of two-hundred in 2019. In the summer we published our Developmental Evaluation Report and since then we’ve been doing a lot of listening - to friends, partners, and to community and health leaders across the system - to process what is needed to scale Nourish’s work.
One thing is clear to us: Institutional leadership through food on climate, equity, and reconciliation is not a noble cause, it is a health imperative for the future. Between the eleven-year climate window forecasted by the International Panel on Climate Change and the growing burden of food insecurity and chronic disease on the health system is an opportunity to unlock the power of food to build health.
“One thing is clear to us: institutional leadership through food on climate, equity, and reconciliation is not a noble cause, it’s a health imperative for the future.”
Haida Elder Margaret Edgards, Métis Elder May Henderson, Hodenesaunee knowledge keeper Kitty Lynne Lickers, and Haida knowledge keeper Sue Gladstone share traditional teachings at the Nourish Symposium, May 2019.
Over the last three years, the movement for health care leadership through food has taken root and found powerful voices in intrapreneurial food service directors, hospital CEOs, and First Nation, Metis and Inuit elders who have understood the connections between land, food, and health long before Nourish ever came on the scene.
The Innovators have pointed us to emerging pathways that will unlock the power of food to support wellbeing for people and planet. They do so through efforts to understand and enhance the patient food experience; to design more climate-friendly and culturally competent menus; and to source food that creates social and ecological value rather than drain it. More work is needed to reveal these pathways and to transition to a system whose incentives reflect the fundamental connection between people and planetary health.
What is good enough for the kiddos inheriting our health system? Aiden weighs in about what he likes.
This work is bigger than a network of the Innovators and other health care intrapreneurs like them. It is the work of whole hospitals and health authorities with the communities they serve. And it’s the bigger work of policy change, or what Montreal-based Nourish Innovator Josee Lavoie calls influencing “the people upstairs.” Because when you’re in the basement of a hospital and it takes a small miracle of sweat to bring sustainably grown food in for your patients, you know the rules of the game need to change to enable hospitals to leverage their budgets and credibility to build health, not just treat sickness.
Going forward, the work continues to be about food, but about so much more than what’s on the patient tray. It isn’t enough for the patient to be satisfied with their food if it comes from ecosystems that are dying and a planet that is becoming uninhabitable. We are calling hospitals more explicitly into their missions to support wellbeing in their communities, supporting health beyond the bricks and mortar of their own walls, out in the environments that are making us sick in the first place.
“Going forward, the work continues to be about food, but about so much more than what’s on the patient tray. It isn’t enough for the patient to be satisfied with their food if it comes from ecosystems that are dying and a planet that is becoming uninhabitable.”
Harnessing health care’s assets
Capital. Procurement. Human resources. Reputational credibility. Data and evidence. Beyond just the food they buy, health organizations have tremendous assets that can be harnessed more intentionally to build health - and in fact, wealth - in their communities. Hospitals can be places to model healthy eating on a budget - for patients, families, and the nearly 2 million Canadians who go to work every day in the health care and social sector. Hospitals are influencing the behaviours of patients, staff, and markets, whether they intend to or not. My own grand-parents left the hospital with a diabetes diagnosis and the belief that Fruit Loops were good medicine, because that’s what they were served in care.
At the Children’s Hospital of Eastern Ontario in Ottawa, Chef Simon Wiseman has transformed the cafeteria into a delicious hub of health for staff, patients, and families, who are drawn by the undeniable aromas of his creations, which are available as take-home dinners. Residents of Grove Park Home actually make money from the bee hives they keep - an initiative that sweetens their quality of life along with their morning coffees… not to mention winning them a handful of awards for their innovation.
Chef Simon Wiseman shares his vision of hospital food, backed up by his colleague Bernice Wolf, Director of Food and Marketed Services at CHEO.
Climate health is human health
Food-climate connections are poorly understood, my MP told me over lunch a few months back. It’s hardly mentioned in the House of Commons. But food represents two of the top five solutions to mitigate climate change as described in Drawdown, scientist Paul Hawken’s work that lays out the top one-hundred interventions. Reducing food waste is ranked as the third most impactful solution, and is significant for hospitals, who toss up to 50% of a patient tray. Shifting toward more plant-rich diets is the fourth ranked intervention, one with benefits for a health system that spends 67% of its budget on treating diet-related chronic disease. New York state just made it the law for hospitals to offer plant-based options at every meal.
Food represents two of the top five most viable global climate solutions modelled by the Project Drawdown scientific team.
Culture as a pathway to health
Reconnecting with traditional foodways is a way for Indigenous peoples, who experience disproportionately high rates of diabetes and food insecurity, to chart a path back to health. Colonial paradigms on food safety that judge Indigenous foods “unsafe” are one expression of the unconscious bias against Indigenous peoples that produce staggering health gaps, like a ten year difference in life expectancy compared to non-Indigenous Canadians. But as understanding grows, there is an emerging trend to increase access to Indigenous foodways in health care. Most recently, the Thunder Bay District Health Unit’s CEO and Chief Medical Officer of Health, Dr. Janet DeMille acknowledged that her organization had been an agent of ongoing colonization in its food safety program, and announced a new principles-based approach to enable better access to wild game.
The tide is changing as we roll toward a new decade, and it’s changing because visionary leaders are using hindsight and foresight to connect the dots on complex issues. Along with the twenty-five Nourish Innovator organizations, the company is growing as more leaders emerge nationally with proofs of concept, calls-for-action, and policies that unlock the power of food to address these complex and interconnected problems. Fundamentally, this will be the work of Nourish 2.0: to support Canadian health care and policy leaders to carve out transition pathways to futures where stewardship around the upstream social and ecological determinants of health leads to better health outcomes - for people and for the planet. We’re actively building partnerships and seeking input on our draft strategy.
Food is the opportunity to bring the health of people and the planet into alignment. But it’s possible that we will miss it, because the health sector is so used to viewing food as ancillary to care. Our friend Dr. Andrew Boozary recently wrote in the Toronto Star, “If there was a drug that could save lives and improve the health of millions of Canadians, you might expect policy-makers to be all in. Or for our health care system to get the medicine to as many people as possible. In fact, such a compelling treatment already exists — access to nutritious food.”
“ It’s time to replace “How much will it cost?” with “What’s the cost of not acting?” and better still, “What is there to gain? Because the answer is, everything. ”
As we turn the page on the last decade, I’d like to lay to rest the perennial question that has the power to keep old systems in place, even as they are dying. It’s time to replace “How much will it cost?” with “What’s the cost of not acting?” and better still, “What is there to gain?”
Because the answer is, everything.
— Hayley Lapalme, Nourish Co-Director
We want to invite you to learn more about Nourish’s strategy to support the next decade of leaders to carve out transition pathways that unlock the power of food in healthcare, join us on January 30th at 12pm noon ET for a preview of our 2020-2025 programming. Register here.