Farm to Hospital: For Health
Promotion and Sustainable Food
System
Please do not cite without permission
Mustafa Koc
Department of Sociology &
Centre for Studies in Food Security
Ryerson University
mkoc@ryerson.ca
Food system problems are interrelated
• Hunger, obesity, farm crisis, global warming
are interrelated symptoms of broader
problems and require short, mid and long
term solutions
• Effective response require our ability to see
interrelationships among these seemingly
unrelated issues and seeking solutions.
HUNGER, OBESITY & CHRONIC
HEALTH PROBLEMS
OBESITY: THE NEW EPIDEMIC
Center for Disease Control http://www.cdc.gov/obesity/data/trends.html#state
Fig. 1: Prevalence of obesity among Canadian adults in 1985, 1990, 1994, 1996 and 1998
Katzmarzyk, P. T. CMAJ 2002;166:1039-1040
Copyright ©2002 CMA Media Inc. or its licensors
http
://www.hc-sc.gc.ca/fn-an/surveill/atlas/map-carte/mass_adult_obes_fem_e.html
WHERE THERE IS OBESITY THERE IS
DIABETES?
• Obesity
• Diabetes
2010 HEART AND STROKE FOUNDATION
ANNUAL REPORT ON CANADIANS’ HEALTH
• Between 1994 and 2005, rates of high blood pressure
among Canadians young and old skyrocketed by 77%,
diabetes by 45% and obesity by 18% - all major risk
factors for heart disease. For example, among those
35 to 49 years of age, the prevalence of high blood
pressure increased 127%, diabetes by 64% and
obesity by 20%.
• The new at-risk populations include:
–
–
–
–
–
Young Canadian adults in their 20s and 30s
Women between the ages of 35 and 45
Boomers (50-64)
Some of Canada's growing ethno-cultural communities
Aboriginal Peoples,
(2004) Health Impacts:
Katzmarzyk and Janssen
• Coronary artery disease, stroke, hypertension, colon
cancer, postmenopausal breast cancer,
Type 2 diabetes, gallbladder disease and osteoarthritis
• $4.3 billion (2001$).
• $1.6 billion in direct costs.
• $2.7 billion in indirect costs.
• Could Obesity Cost Canadians $95 Billion in 2008?
Arya Sharma, Scientific Director of the Canadian
Obesity Network, University of Alberta
MARKET VOLATILITY AND FOOD
PRICE CRISIS
Volatility in the global markets:
Food crisis 2008-2011
Price hikes spreading as inflation hits 3.3 per cent
Globe and Mail, Apr. 19, 2011
• Gasoline prices are 18.9 per cent above yearago levels, and forecast to head higher still.
Prices for food bought from stores jumped 3.7
per cent in March, the biggest annual increase
in 19 months, as bad weather in Mexico and
the southern United States drove up vegetable
prices.
•
http://www.theglobeandmail.com/report-on-business/economy/price-hikes-spreading-asinflation-hits-33-per-cent/article1990859/
FARM CRISIS AND RURAL DECLINE
Source: The Farm Crisis: Its Causes and Solutions, NFU (2005)
ENVIRONMENTAL CONSEQUENCES
Food miles
“Food miles" refers to the distance food travels from the time
of its production until it reaches the consumer.
The food system causes 15% of global greenhouse gas
emissions (Pirog 2001).
In North America,
food travels on
average over 2,000
km from source of
production to
place of
consumption
(Roseland 2005).
Cooking up a Storm (Garnett, 2008)
Contribution of food groups to Greenhouse gas
emissions kg/CO²eq
Source: Kramer K.J., Moll, H.C., Nonhebel, S. and Wilting, H.C. (1999) Greenhouse gas emissions-related
to Dutch food consumption, Energy Policy 27 (1999) 203–216.
Weber and Matthews:
Environ. Sci. Technol. 2008, 42, 3508–3513
• of all the greenhouse gases emitted by the
food industry, only 4% comes from
transporting the food from producers to
retailers.
PFPP
• Our food system consumes the energy-equivalent of
9¼ barrels of oil per person per year—that’s 1¼
tonnes of oil for each.
• If the world adopted our system—if all 6.87 billion
people tried to eat like Canadians—global oil use
would increase 50%, use of other energy sources
would increase similarly, and emissions would
increase accordingly.
NOAA Trends in Atmospheric Carbon Dioxide. (National Oceanic and Atmospheric Administration (NOAA),
Earth System Research Laboratory, Global Monitoring Division: 2010).at
<http://www.esrl.noaa.gov/gmd/ccgg/trends/#mlo>
http://www.esrl.noaa.gov/gmd/aggi/
Water
• “Water use has been growing at more than the
rate twice of population increase in the last
century.” UN-Water Statistics - Water Resources
.
http://www.unwater.org/statistics_use.html
• Irrigated agriculture accounts for 70% of global
water withdrawals.
Distribution of Earth’s Water
http://www.global.ucsb.edu/climateproject/papers/pdf/Morrigan_2010_PECC2.pdf
Aral Sea Story
Water withdrawal as percentage of total available water
Source: UNEP Vital Water Graphics - An Overview of the State of the World’s Fresh and Marine Waters. (United
Nations Environment Programme (UNEP): Nairobi, Kenya, 2008).
Loss of biodiversity
Reduction of Diversity in Fruits and Vegetables, 1903 to 1983 (Varieties in NSSL Collection)
Taxonomic
Name
Vegetable
Asparagus
Number
in 1903
Number
in 1983
Loss
(Percent)
Asparagus officinalis
46
1
97.8
Bean
Phaseolus vulgaris
578
32
94.5
Beet
Beta vulgaris
288
17
94.1
Daucus carota
287
21
92.7
Allium ampeloprasum
39
5
87.2
Lactuca sativa
487
36
92.8
Allium cepa
357
21
94.1
Pastinaca sativa
75
5
93.3
Pisum sativum
408
25
93.9
Radish
Raphanus sativus
463
27
94.2
Spinach
Spinacia oleracea
109
7
93.6
Squash
Cucurbita spp.
341
40
88.3
Turnip
Brassica rapa
237
24
89.9
Carrot
Leek
Lettuce
Onion
Parsnip
Pea
Source: Carry Flower, and Pat Mooney. 1990. The Threatened Gene -- Food, Politics, and the Loss of Genetic
Diversity.Cambridge: The Luthworth Press.
PROBLEM
• “At the core of the problem is an outdated system
designed for the export market that is no longer
producing local food for local markets:
• Farmers are in a financial crisis;
• Agricultural land is fast disappearing;
• Food bank use is increasing and;
• Health is declining due to lack of access to
nutritional food.” (Metcalf Food Solutions, 2010)
3 key priorities
Sustainability:
ability to avoid
crisis in the
long-term
Resilience:
capacity to
cope with
volatilities
Food security:
stability of food
provisioning for
all, at all times
GOING BEYOND THE BINARY THINKING
•
•
•
•
large scale or small scale
private or public
technology or tradition
global or local
Why Support Local Food Economy
• For strengthening local economy and
community
• For better environmental stewardship
• For building resilience
• For food security and national security
• For health promotion
FARM TO HOSPITAL: FOR HEALTH
PROMOTION AND SUSTAINABLE FOOD
SYSTEM
Farm to Hospital: Promoting Health and Supporting
Local Agriculture, Beery & Valianatos (2004)
• “The nation’s hospitals have a mission to promote
both the health of their patients and the communities
in which they are located. To meet this goal, they
employ skilled staff and utilize the world’s most
advanced medical technologies. “
• However, in the hospital cafeterias and kitchens the
health mission seems less clearly reflected.
• Many hospitals, searching for ways to cut costs, are
offering fast food meals and vending machines.
•
http://scholar.oxy.edu/cgi/viewcontent.cgi?article=1380&context=uep_faculty&seiredir=1#search=%22Farm+to+Hospital:+Promoting+Health+and+Supporting+Local+Agriculture%22
Farm to Hospital: Promoting Health
and Supporting Local Agriculture
• Partnering with local farms can help bring food services
in tune with the institution’s overall health mission.
• Procuring locally grown produce can enhance patient
and cafeteria meals and provide a market for small
farms.
• Hosting a farmers’ market on hospital grounds gives
staff, visitors and community members a chance to buy
fresh, healthy food.
• Hospital gardens can be places of calm and healing.
• A boost to small farmers.
•
http://scholar.oxy.edu/cgi/viewcontent.cgi?article=1380&context=uep_faculty&seiredir=1#search=%22Farm+to+Hospital:+Promoting+Health+and+Supporting+Local+Agriculture%22
Every Bite Counts Climate Justice and BC’s Food System
Marc Lee, Herb Barbolet, Tegan Adams and Matt Thomson
• Hospitals and other care institutions can better
integrate healthy, local food as part of health care
itself.
• Hospitals can also influence communities in terms of
their eating habits, encouraging consumption of local
foods across all age demographics, from pregnant
mothers, to children, to the elderly.
• Malnourished populations who might otherwise lack
access to healthy food can have fresh, locally-grown
fruits and vegetables while they are in a position to
rest, heal and reflect.
POWER OF INSTITUTIONAL
PROCUREMENT
Every Bite Counts Climate Justice and BC’s Food System
Marc Lee, Herb Barbolet, Tegan Adams and Matt Thomson
• Channeling provincial public sector
procurement is an essential means of scaling
up local, sustainable food. A steadily growing
percentage of food budgets should be
allocated to the sourcing of local food, and
these budgets should also be grown over
time.
•
http://www.policyalternatives.ca/sites/default/files/uploads/publications/BC%20Office/2010/11/ccpa_bc_every_
bite_counts_full.pdf
Farm to Hospital: Promoting Health
and Supporting Local Agriculture
• Hospitals should establish procurement goals that prioritize buying
locally to the maximum extent practicable.
• Hospitals should work with farmers, other institutions and
community groups to overcome logistical barriers to a farm to
institution approach. Farmer co-ops, farmer registries (identifying
farmers and their product mix available for direct institutional
purchases), and third party intermediaries can help with
transportation, storage, quality control and other practical aspects
of local food purchasing.
• Hospitals should evaluate opportunities for incorporating locally
sourced fresh foods as part of patient food choices.
•
http://scholar.oxy.edu/cgi/viewcontent.cgi?article=1380&context=uep_faculty&seiredir=1#search=%22Farm+to+Hospital:+Promoting+Health+and+Supporting+Local+Agriculture%22
Every Bite Counts Climate Justice and BC’s Food System
Marc Lee, Herb Barbolet, Tegan Adams and Matt Thomson
• Many opportunities surrounding the
development of linkages between local food
suppliers, distributors and institutions will
require collaborative or collective efforts by
and between farmers, distributors,
institutions, marketing entities and
consumers alike.
•
http://www.policyalternatives.ca/sites/default/files/uploads/publications/BC%20Office/2010/11/ccpa_bc_every_
bite_counts_full.pdf
People’s Food Policy
• “Devote resources to research and development
for a public food system that guarantees universal
access to adequate amounts of healthy, safe, and
appropriate food for all. This may include, for
example, the establishment of local procurement
policies (from urban agriculture and nearby
farms) for institutions such as hospitals, schools,
universities, correctional facilities, care homes,
legislatures, and government offices.”
•
http://peoplesfoodpolicy.ca/files/pfpp-resetting-2011-lowres_1.pdf
LONG TERM THINKING
• Stage 1 – Initial food systems change: Strategies for
creating small but significant changes to existing food
systems and provide immediate and temporary relief to
existing problems
• Stage 2 – Food systems in transition: Strategies for
building capacity through greater involvement from those
experiencing food insecurity and by strengthening current
food systems through partnerships and networks
• Stage 3 – Food systems redesign for sustainability:
Strategies are broader in scope, requiring long-term
commitment from representatives of the entire food
system (Position of Dietitians of Canada Individual and
Household Food Insecurity in Canada, 2005)