Why does this work need to happen now?
With a global pandemic, growing health care needs and inequality, and the climate emergency, the Canadian health care system is pressed to find ways to support people’s health in their communities – and to keep them out of the hospital. The pandemic highlights the opportunity for health care to be proactive in addressing the broader systemic issues that overlap with and impact the health of people and planet.
It’s time to tackle the interconnected challenges of health inequity felt by Black, Indigenous, and other communities of colour, and also of the elderly; of food insecurity; of ever-climbing rates of diet-related chronic disease; and of climate change. Canada’s COVID-19 response, rebuilding, and reimagining towards a more equitable and sustainable future can powerfully co-solve for these wicked problems facing our food and health systems.
“We’re in a triple crisis: a health crisis, an environmental crisis, and an economic crisis. In such a complex situation it is important to start somewhere, building pathways to possibility as we move forward. Nourish is a bright light illuminating ways to advance equitable personal and planetary wellbeing through our healthcare system.”
Inequity is a growing burden on the health system.
The growing burden of food insecurity and chronic disease on the health system intersect with issues of health equity and social determinants of health. A complex array of social factors, from food access and housing, to intergenerational loss of culture, and social isolation and loneliness, play a powerful role in how healthy a person is. Extreme differences in food access and income exacerbate the negative health consequences of living in poverty, leading to the most socio-economically vulnerable to be the most frequent users of the health system.
Climate change have profound impacts on human health and lead to further inequities.
We are in an era of a climate emergency, which has powerful health implications, requiring the health care sector to proactively integrate upstream approaches and climate action to their mission and mandate. As the medical journal the Lancet states: “climate change is the biggest global health threat of the 21st century, and tackling it could be our greatest health opportunity.” Impacts of the rapidly changing climate with severe health implications for people include: “extremes of weather, altering patterns of infectious disease, and compromising food security, safe drinking water and clean air.”
“If the global health care sector was a country, it would be the world’s fifth largest emitter on the planet.”
Health Care Without Harm has calculated Health Care’s Climate Footprint globally and found that if the sector was a country, it would be the world’s fifth largest emitter on the planet. A number of recommendations call on the health sector to “respond to the growing climate emergency not only by treating those made ill, injured, or dying from the climate crisis and its causes, but also by practicing primary prevention and radically reducing its own emissions.”
Ecosystem and human health are interdependent
These issues of inequity and climate change are in deep relationship with the deteriorating health of the planet and our ecosystems, with disastrous implications in our lifetime and for future generations without action. Our food systems are threatened by accelerating biodiversity loss and resource depletion that will not only impact the most vulnerable, but us all.
While these issues are both alarming and complex, there are pathways forward that health care can take proactive action on now.
Nourish embraces a systems approach to understanding problems across the social, healthcare, food and environmental systems as interdependent and stemming from similar root causes. We don’t look for a silver bullet, but instead seek interventions that understand the complex nature of problems and solve for root causes along with the symptoms. Interventions like this have stack benefits and can create cascading effects across systems.
Why can and should health care do this through food?
Food is medicine for the people and the planet. What we put on our plates impacts our health and our climate.
Food is one of the key social determinants of health along with income, housing and education. However, food currently isn’t a priority for our treatment-focused health system, where addressing food security is not a top priority. And hospital food services are often managed as an ancillary service disconnected from the provision of care beyond ensuring a patient tray is delivered at a budget price. The economic cost of unhealthy eating is $13.8 billion, put in context of the federal health transfer of $40 billion (2019-2020) and a new study finding that being food insecure took nine years off a person’s lifespan the imperative for rethinking food as central to health is clear .
We have a powerful opportunity to use food to connect people and planetary health through the $4 billion spend on health care food services every year of which currently little is directed towards local, sustainable and cultural food. Typically, 40% of the patient tray is uneaten and thrown out -- and with roughly 275,000 meals being served in Canadian hospitals daily, this adds up. Also wasted is the opportunity to see the food served in hospitals, to patients and in cafeterias, as a teachable moment for patients and staff in modelling healthy diets. Focusing more on food as medicine will pay quick dividends as patients who do not eat in hospital cost the health system $2 billion every year in extended stays -- and this is just looking at the role of food within the hospital walls. Aligning health care food environments with the highest aspiration of their health-promoting mission will be a critical way to support shifts to healthy eating across the population.
Working on food can bring cascading returns on investment
Food is a powerful leverage point for health care with cascading benefits across the system for patient, organizational, community and planetary health. This is proven with early evidence and promising pathways carved out through the first Innovator program of Nourish, where health care leaders saw the impacts of bringing food to a more central role in healthcare in their own organizations and in collaborative projects.