Philadelphia’s Good Food, Healthy Hospitals Initiative Uses Food as Medicine

by Gabrielle Khalife
Part of the Food Policy Snapshot Series

Policy Name: Good Food, Healthy Hospitals

Location:

Philadelphia, PA  

Population: 1,580,863 (U.S. Census Bureau, 2017)

Overview: Good Food, Healthy Hospitals (GFHH) is an initiative to transform Philadelphia’s hospital food environment and promote healthy foods and beverages for patients, staff and visitors. The program’s approach is based on the concept that good food is good health care. Ensuring that staff, patients and visitors have access to fresh, healthy and environmentally sustainable food in hospitals is a reflection of the Philadelphia health system’s commitment to preventative care, and an opportunity to reduce the risk of chronic disease for thousands of citizens.

Progress to date:

In June 2014, GFHH was launched by Get Healthy Philly (an initiative of the Philadelphia Department of Public Health) and Common Market (a non-profit working to improve food access to vulnerable populations), in partnership with the American Heart Association and the Einstein Healthcare Network.

Program/Policy Initiated: June 2014

Food policy category: Preventative Health Care

Program goals: To integrate nutrition standards and promote local and sustainable food procurement in hospitals in an effort to combat preventable chronic diseases.

How it works: GFHH invites hospitals to voluntarily adopt 5 Good Food standards including (1) the food and beverage purchasing standard (outlines purchasing goals for healthy foods and beverages), (2) the standard for food and beverages served in cafeterias, cafes and on-site restaurants (guidelines for healthy meal options, food content and preparation, product placement, pricing, promotion and nutrition information), (3) the standard for food and beverages served in patient meals (guidelines for how food is being prepared and promoted, the sodium and sugar content of foods, the variety of vegetables, fruits and other whole unrefined foods and ingredients that are made available to patients), (4) the standard for food and beverages served in catering (healthy food and beverage guidelines used for meetings and special events held on or off the hospital campus), and (5) the standard for vending machines (promotes healthier beverage choices by moving healthier products to eye level and increasing the amount of water available). Click here to learn more.

In addition to adopting voluntary Good Food standards, GFHH sites also provide innovative programs and services to educate and encourage healthy eating for their patients, staff and visitors, including Farm Stands (sustainable and locally grown farm products for sale on the hospital campus), a Subsidized Farm Share Program (boxes of sustainable and locally grown foods available at discounted prices for communities with support from hospital foundations), a FreshRX Program (Clinicians prescribe fruits and vegetables through vouchers to be used at nearby farmers markets. The redeemed vouchers are tracked through the hospital’s electronic medical records system) and more.

Philadelphia hospitals can sign the Good Food, Healthy Hospitals pledge. Hospitals are considered participants in the initiative if they take the pledge and achieve 1 Good Food standard in 1 year. Further, through a recognition system, GFHH highlights hospital achievements by awarding a bronze medal to hospitals that implement 2 Good Food standards, a silver medal to hospitals that implement 3 Good Food standards and a gold medal to hospitals that implement at least 4 Good Food Standards. GFHH also provides technical assistance, educational resources, marketing materials and general support to participating hospitals.

Why it is important: Preventable chronic diseases are linked to poor diet and lack of access to healthy foods. Healthy foods not only provide adequate nutrition but also promote public health while improving environmental and economic sustainability. Hospitals are well-suited to impact the health and wellness of those who work, heal, visit, and eat within their walls. Offering and promoting fresh, local and healthy food can impact the health of the community as well as reduce health care costs over time. This is particularly important given that, among the ten largest U.S. cities, Philadelphia has some of the highest rates of diet-related chronic diseases including obesity, high blood pressure, diabetes and heart disease. Therefore, by increasing access and availability of healthy food and beverage options on their sites, hospitals can prevent chronic diseases before they begin.

Initiatives like GFHH also help to bridge the gap between public health and medicine. On average, U.S. medical schools offer less than 20 hours of nutrition education over 4 years, and even with this brief education, it is unlikely that students will remember their nutritional knowledge once they begin practicing as licensed physicians. With the top 10 causes of death in the U.S. being attributed, or linked, to nutrition and diet, more attention needs to be given to the fact that the food we eat has a significant effect on our health outcomes. While modern medicine can aid in treating disease, targeting diet and nutrition treats the underlying cause and can prevent disease before it even begins, or even reverse it once it has occurred.

Evaluation:

Baseline data is collected from each hospital during the first year of program implementation and includes interviews with key personnel from the hospitals, environmental assessments of cafeterias and vending operations, patient and cafeteria menus, nutrition information, and customer surveys. 

As of September 2017, 16 hospitals had signed the pledge to adopt GFHH, reaching 27,000+ hospital staff and influencing more than 3.7 million cafeteria meals and 2 million patient meals per year.  

Learn more:

https://www.youtube.com/watch?v=lJgB6AQfqvY

Point of Contact:

Catherine Bartoli

T: (215) 685-5281

E: Catherine.Bartoli@phila.gov

Similar practices:

Fruit and Vegetable (F+V) Prescription Programs are partnerships between health care providers and healthy food retailers that are created to increase access to and affordability of fruits and vegetables. The health care setting provides healthy eating messaging and distributes prescriptions for fruits and vegetables to patients. The produce retailer then reinforces that messaging and redeems the prescriptions in exchange for product or produce incentives. Along with GFHH’s FreshRX program, there is also the Fresh Food Farmacy in Northumberland County, PA, for adult patients with type II diabetes who are food insecure, the FVRx Program in Navajo Nation, AZ, UT, and NM, for pediatric patients who are overweight or obese and pregnant women, and Pharmacy to Farm in New York, NY, for adult patients with hypertension who are enrolled in SNAP. F+V Prescription Programs have several benefits and positive outcomes for patients including (1) reduced body mass index (BMI) (2) increased fruit and vegetable consumption (3) increased access to healthy foods and (4) improved self-reported health status. F+V Prescription Programs also establish links between community organizations and clinical settings, lead to improved patient-provider relationships and result in increased provider awareness of the social determinants of health.

References:

https://foodfitphilly.org/good-food-healthy-hospitals/

https://foodfitphilly.org/wp-content/uploads/2017/02/GFHH-Achievement-Report-2017.pdf

https://foodfitphilly.org/wp-content/uploads/2017/02/Good-Food-Healthy-Hospitals-Descriptor-Print.pdf

https://foodfitphilly.org/wp-content/uploads/2017/12/V2-GFHH_nutritionstandards-web-Updated-for-2017.pdf

https://foodfitphilly.org/wp-content/uploads/2017/02/Good-Food-Healthy-Hospitals_pledge.pdf

https://foodfitphilly.org/healthy-hospitals-faq/

https://www.phila.gov/health/pdfs/GoodFoodHealthyHospitalspresentation_62215.pdf

https://nccd.cdc.gov/nccdsuccessstories/showdoc.aspx?s=14317&dt=0

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