We are in an era of incredible pressure on the Canadian healthcare system. The silver tsunami and a growing burden of chronic disease are forcing a conversation around the next big innovation since medicare. From systems that are centralized and hierarchical, the MaRS Market Insights’ Transforming Health report finds a shift to new models of care that are decentralized and integrated, providing a continuum of care that puts patients at the centre. We can see pockets of the future in innovations like telemedicine, community-based care, physician prescriptions and wearables that support lifestyle-based prevention strategies, and the application of new technologies to empower patients at the centre of complex webs of care.
How will food fit into this future?
Nourish recently completed selection of twenty-five innovators in food and health care for a two-year leadership program. The interview process confirmed a talented pool of people in health care who recognize the need for a shift in our approach to food. With the growing burden of chronic illness, evidence of patient malnutrition extending hospital stays and the likelihood of patient readmission, healthcare providers are at a crossroads regarding the role of food - and food education - in the system.
From Haida Gwaii to Gander, the twenty-five innovators are wayfinders, navigating the complex questions of the present and pointing to ways that their organizations can bring new approaches to food that recognize its impact across the patient journey, on economic vibrancy, and on environmental well-being. Could food play a transformative role in a preventative and sustainable strategy that relieves pressure on an overburdened healthcare system? Could institutions play a more preventative and proactive approach to care with food, as they have did with their leadership in smoking-cessation in the past, meeting tobacco’s advertising claims with evidence and an active role for healthcare professionals? These are some of the big questions the cohort is bringing to invigorate a national conversation around food and health.
Historically, the disconnection of food from care highlights the short-term perspective of acute care, which pits food against other elements of clinical care when it comes to budgeting, suggesting it’s “Food or the new MRI.” However, this emphasis on short-term strategies reinforces a feedback loop that ignores the fundamental problem behind an inefficient, overburdened system. Mitigating disease with nutrition and lifestyle is less costly than treating chronic illness, which costs Canada $68 billion in direct healthcare costs and $122 billion in productivity losses annually. Yet we continue to disconnect and deprioritize food in care, even as rates of complex, chronic, diet-related illness continue to rise.
So long as the narratives of the past dominate, seeing food as ancillary and separate from care, the opportunity to capture the full value of food in care will be missed. The winners of the future, from both a patient and institutional perspective, will be those who pursue a better understanding of the connections between food, culture, health, and care - and who integrate food as a strategy for health across the continuum of care.
There are early health leaders making these connections.
Kaiser Permanente, an American provider of both healthcare and insurance, understand the opportunities around food in care, and have adopted an anchor institution mentality to steward better community food environments. They are leaders in research and practice, studying the relationship between drug resistance and the use of antibiotics on livestock. They have taken action in their supply chains, and made commitments to source local, sustainable produce and antibiotic-free meat.
The Nourish cohort will take this work further, making its own connections through two years of dialogue, mentorship, and projects. The English, French, and Indigenous innovators are supported by an ecosystem of partners, advisors, coaches, and mentors, and their experiments, insights, and failures will be featured on this blog. You will hear from acute, long-term, and complex continuing care institutions that are embracing a collaborative, networked approach to learning and innovation, including: the Children’s Hospital of Eastern Ontario in Ottawa and St. Justine in Montreal, two of Canada’s earliest adopters of room service foodservice models; MenoYaWin Health Centre in Sioux Lookout, who have redefined care to include traditional foods and cultural practices; and Alberta Health Services, leaders in protected meal time. Like their peers in the cohort, each of these organizations is represented by a committed and influential individual, who believes that the culture of food in their institutions can be enhanced through a collaborative, networked approach to learning and innovation.
Perhaps the moment that my colleagues and I are most looking forward to now will be the moment the twenty-five innovators arrive to our February retreat to meet for the first time. It is among the first dedicated convenings of healthcare foodservice practitioners in Canada; one that invites us all beyond the “do more with less” mindset to bring our diverse talents to reimagine the potential of food in our institutions - and for the cohort to find in their peers and mentors the people who are already starting to blaze those trails.
Poet and farmer Wendell Berry famously wrote that “eating is an agricultural act,” describing the impact of individual choice on food and farming. When we consider the scale and scope of impact these innovative wayfinders could have, representing a sector that serves thirty-five million people and spends well over $200 billion annually, we can see a parallel with institutional food: feeding people is a cultural act. It is a driver of agricultural, educational, and economic outcomes that will shape the norms and values of the future of food and health in Canada for generations to come.
We invite you to join our cohort on this journey to shape the future of food - if their vision is any indication of it, it is a promising one.