If you knew me at Wabash you might be surprised to learn that I’ve become an advocate for local, sustainable, and healthy food.
I certainly am.
As a student I was a regular patron of the Taco Bell on U.S. 231 and, unless microwaved Fiji nachos qualify, never cooked a single meal. My primary involvement with food preparation back then was shuttling the used frying oil to the grease trap as a freshman.
The most powerful food lesson I learned at Wabash was how to eat a full meal in five minutes. That was the amount of time between the blessing and some freshman gathering up the dishes so he could get back to his homework. To this day, I still find it difficult to eat slowly.
The irony of my affiliation with the Slow Food movement is not lost on me.
But Wabash taught me another powerful lesson: how to think. This has served me well in my work, because to comprehend our food system—to “make sense” of “our daily bread,” as the theme of this magazine suggests—one must think like a Wabash man.
The liberal arts train us to ask good questions and to see a problem from multiple angles. Economics, medicine, history, anthropology, politics, business—all of these disciplines help us to understand important dimensions of food. Taken alone, each can be too narrow and cause us to miss the forest for the trees. The relationships between these different ways of looking at food—the ways in which they overlap, interrelate, and contradict—are where the real action is.
That’s how I make my living today. My consulting firm, GCF Group, tackles food-related issues from multiple angles. When we unravel these relationships, we help organizations use food as a lever to accomplish their missions. Food problems become opportunities.
For example:
? Public health experts tell us that 49 million Americans
are food insecure (16%), meaning they don’t always
know where they will find their next meal.
? Supply chain experts tell us that around 40% of food
produced in the U.S. is never eaten—including more
than half of all fruits and vegetables!
? Historians tell us that small-scale farmers who grow
healthy, local food are a dying breed, which accelerates
the loss of traditional farming knowledge, hollows out
rural communities, lengthens the supply chain, and
concentrates the production of food.
? Healthcare experts tell us that three-quarters of medical
spending goes to preventable chronic diseases, most of
which are diet-related, such as obesity and diabetes.
? Environmental experts tell us that food production is the largest user of land in the world and a major contributor
to greenhouse gas, soil depletion, water shortages, and
collapsing biodiversity.
These problems have solutions. Creative, socially minded entrepreneurs and organizations are working to find them. In my career I have had the privilege of working with several of them.
Why should we allow nearly 49 million Americans to go hungry, when there is enough food going to waste to feed them multiple times over? That’s the question that inspired the founders of City Harvest, in New York City, over 30 years ago to begin “rescuing” food that was unused at restaurants and delivering it to friends and neighbors in need.
As the director of strategy at City Harvest, I helped the organization find new sources of food and expand the infrastructure required to distribute it. In just three years, we grew from $18 to $32 million in revenue and nearly doubled the amount of food distributed.
Today, City Harvest rescues and delivers more than 50 million pounds of food each year, serving more than 200,000 hungry New Yorkers each week. Their approach is elegantly simple and highly efficient—it costs less than 25 cents to rescue and deliver a pound of food. Similar groups, such as Second Helpings in Indianapolis, have emerged to exploit this opportunity in other cities where good food is wasted and people are hungry. A national network of food banks and food rescue organizations now delivers nearly 4 billion pounds of food each year.
Food and health are deeply connected. Hippocrates, the father of Western medicine, said, “Let food be thy medicine.” So why do health-care organizations serve foods that are known to contribute to the very health problems they exist to eradicate?
That’s a question that hundreds of hospitals around the country are beginning to ask, including Eskenazi Health in Indianapolis. Eskenazi Health eliminated deep fat fryers in their foodservice operation. They are one of fewer than a dozen hospitals that also operate a farm, which happens to be on the hospital roof. They host a weekly farmers market and a healthy (and delicious) locally owned restaurant, called Duos, among other initiatives.
Recently, Eskenazi Health hired GCF Group to help them further integrate food and health by identifying ways the one million meals they make each year can better reflect their health-promoting mission. Through our work together, Eskenazi Health has adopted additional criteria for the food they purchase—criteria that incorporate more than a narrow nutritional lens.
Recognizing that where food is grown can contribute to its healthfulness, strengthen the local economy, and reduce environmental impact, Eskenazi committed to greatly increasing its local food purchasing, including from small Indiana farmers. Learning that farming practices can influence the healthfulness of food, Eskenazi Health committed to avoiding meat products raised with antibiotics, which contribute to antibiotic resistant bacteria in humans. And knowing that eating a more plant-based diet can greatly improve human health while significantly reducing environmental footprint, the leadership is committing to a significant reduction in the amount of meat it purchases and serves.
That’s a far cry from the “hospital food” most of us are familiar with, and light years ahead of the many U.S. hospitals that still host fastfood brands on their campuses.
If food and health are so closely connected, then a lack of food is even more closely tied to health. Food-insecure families routinely have to reduce the quality, the portion size, or even the number of meals that they eat, because they don’t have the resources to do otherwise. Two-thirds of families accessing emergency food nationwide say they have to decide between spending on food and spending on medical care.
Of course, eating poorly or having to decide between food and medicine creates a significant health problems. Many of those are long-term—obesity, diabetes, cardiovascular disease, and other diet-related disease. But some are more immediate. One recent study of hypoglycemic hospitalizations found a 27% increase in hospitalizations for low-income patients at the end of the month, when food stamps are often exhausted. Researchers are beginning to identify and quantify similar relationships between food insecurity and short-term health outcomes in maternal health, treatment adherence, and mental health.
What can be done?
The field of healthcare interventions for food insecurity is still quite young, but several promising approaches are emerging. Some hospitals and health centers are co-locating health and hunger infrastructure, by opening food pantries within their facilities. Others are screening incoming patients for food security, and connecting them to outside emergency food or SNAP (food stamp) resources.
Some doctors, instead of prescribing pills for diabetes and heart disease, are prescribing fruits and vegetables and cooking classes, and offering families cash to make healthier food more affordable. Still others—hoping to lower readmissions rates and ensure better outcomes—are sending patients home from the hospital with the food they need for a full recovery.
Anyone who has ever managed a business will notice one critical connection missing from this picture: money. Each of those short-term health problems has an associated cost—money that most hospitals don’t have.
And yet addressing hunger problems has an enormous potential payoff. Food insecurity interventions cost relatively little compared to the cost of not doing them. Each time a patient is hospitalized for hypoglycemia, or has a complicated pregnancy, or is readmitted within 30 days, the healthcare bills add up to far more than a bag of groceries.
With nearly 50 million people at increased helath risk due to food insecurity, those numbers are hard to ignore. One study estimated the costs of hospitalizations due to food insecurity alone at $16 billion per year. Someone is paying for all that. Most likely, it’s you, through Medicaid and Medicare.
Which brings us to our final liberal arts question: Why are we paying more to treat the symptoms of food insecurity than it would cost to prevent it?
This won’t always be the case if my work in the coming years—and that of many other more experienced people in the field—can have even a fraction of the impact we believe it can. I am working with Eskenazi Health and others to identify the most effective food-insecurity interventions, develop a scalable model for delivering them in healthcare settings, and capture the potential cost savings for the healthcare system, while working to eliminate food insecurity.
With any luck, we can connect the dots to eliminate hunger, improve health outcomes, and make at least this one area of food make sense.