“Farm to School” and
“Healthy Hospitals Initiative”: Change Agents in
Food System Reform
Marydale DeBor JD, Lecturer, Yale School of Medicine, Department
of PsychiatryManaging Director, Fresh Advantage™ LLC
New Haven, CT
Farm to Cafeteria ConferenceAugust 2-5, 2012
Overview• Solving “Weight of the Nation” NEJM, August
2, 2012• Health Care Sector- Where are We?• One Model: Plow to Plate• National Hospital Initiative: HHI.org• Partnership with Farm to School Movement• Key points of possible collaboration identified
at this conference
We all know what the problem is……………starting with those ubiquitous sugary beverages .
1 out of 3 children born in 2000 or after will develop Type 2 Diabetes
The Moral Dilemma
• Given the evidence of harm done by consumption of food and beverages that contribute to obesity and related disease,
How do we, as health care professionals….reconcile our mission, the oath that physicians take, with this:
“Food served in children's hospitals rated largely unhealthy”
UCLA News December 1, 2001
Two Interdependent Systems: Food and Health Care are Broken• Illness (physical and mental), hunger,
malnourishment, comprising ability to learn and function
• Require leadership to be fixed
• Health care sector should be leading, not absent..BUT
• Farm to School is the true Pioneer
One Hospital’s ExperienceSee: “Plow to Plate: The Hospital as Change AgentSustainability: The Journal of Record, April, 2012
Caveat:
• Plow to Plate is far from the norm. The model is premised upon the notion that hospitals (and physicians) must become public health practitioners---foreign to how system works now, but will be compelled by the economics of current situation and the implementation of reform policy and regulation. It will take generations of hard work and advocacy.
• Fletcher Allen is the goal, but it is exceptional
Start with the Basics: Think…
“[Local] Food is Primary Care™”
Use the resources available: Local, Regional Farms.. Supporting local economy
Community Coalition
Hospital as
LEADER
Physicians & APRNs
Local/State Policymakers
Media
FarmersFIRST!
Farmers’ Markets
Restaurants / Chefs
Schools
Social Service
Agencies (Youth & Seniors)
Department of Agriculture
Churches
Local Department of Health Farmland
Preservation Advocates
Parks and Recreation
Copyright 2012 Marydale DeBor 11
RFP process, new vendor, community and hospital programs with health objectives
• Make it a “food movement”• Make it fun, delicious, engaging• Don’t preach, don’t use the “N” word• Ingredient, calorie count and weight watcher data
on all menus (nobody cared, or read them)• Make it taste good, and look beautiful, above all
• Engage the media
FACULTY: Doctor, Chef and Fisherman
New Milford Youth Agency Program: after
schoolwww.youthagency.org
Consumer Supported Agriculture- Our
Employees30 Shares Guaranteed by
HospitalSold Out in Less Than 1 Week
Healing/Learning Culinary Garden
Building a Food Learning Hub, Not Just a Food Service
Success Documented Widely
• April, 2012 “Gold Award” Connecticut Quality Improvement Partnership
• In May 2011: CHANGE COMES TO DINNER by Katie Gustafson
• 2011 –Connecticut Magazine; NY Times
• 2010 –Greening Food and Beverage Services, by Cheryl Baldwin, GREEN SEAL Guide to Transforming the Industry
• 2009 Planetree Award for Nurturing Foods
• 2009 Glynwood Center for Sustainability/Good Food for Health Award
Poster Presentation: Institute for Health Care Improvement National Convention-2011
What still needs work
• Supply and Distribution
• Knowledge deficit on part of physicians
• Cardiologist insists we put soda back in cafe…….a matter of individual “choice”See NEJM article re : food industry messaging strategy
• Vending machines; 24/7 healthy food service
Opportunities for Hospital-School Collaboration
• Establish and Foster dialogue with local hospitals and physicians, nursing organizations: The Communication/Relationship Imperative! Saturday plenary
• Tell your story: to physician groups in your states (state and local chapters of American Academy of Pediatrics, Family Medicine, Psychiatry, Internal Medicine….) Friday session
FTS and Health Care Sector:Collaboration Opportunities
• Supply/Distribution/Procurement– Include hospitals in
• your purchasing coops (Friday sessions: Jeremy West, Greely CO)
• Clean, cut, prep processing centers (Doug Davis, Burlington)
• Long term storage facilities
• Training of food service workers
Hospital-School Collaboration: Metrics
• We don’t need (only)high tech interventions to fix this!– But let’s get distributors to adoptllicense Black
River’s tracking methodologies! Saturday plenary
– HHI has data collection system; join forces– Health care has resources: they have to measure
everything! Maybe can help with metrics, esp if academic center
Collaboration Opportunities
• Advocacy, Advocacy, Advocacy !!!!
• Join New England Farmers Union—or your
state chapter of National Farmers Union– Progressive policy platform– advocates at federal level for family farms and
all of the policies and programs upon which Farm to School depends!
www.nfu.org newenglandfarmersunion.org
Our Future: Our Children
Plow to Plate Youth Chef Advocates, 2009
To learn more….• Contact: Marydale DeBor JD, Founder, Managing Director
• [email protected] 203-745-1796 Cell: 860-248-9854