Sustainable Food in Healthcare

1. Sustainable Food in Healthcare Wendi Shafir EPA Pacific Southwest Region

2. Overview • Why Sustainable Food ? • Sustainable Food in Healthcare • Health Issues • Environmental Issues • Strategies • Food policies, Healthy Food Pledge • Procurement • Operations • Tools • GGHC • HCWH Pledge • PGH • EDF Best Practices Guide

3. Why Sustainable Food ? • Support Human and Environmental Health • Educate patients, community • Provide healthier food (Farmer’s Markets) to community • Combat Antibiotic Resistance • Reduce food production’s environmental footprint • Energy, water, pesticides, soil conservation, fishery depletion

4. Sustainable Food in Healthcare • Average US hospital serves over 1 million meals per year • Patients, Staff, Visitors plus vending • Education of patients and visitors • Improved health of patients, visitors, community • Positive publicity - differentiation

5. Health Issues • Poor nutrition – risk factor in 4 out of 6 leading causes of death • Obesity, diabetes, heart disease, stroke • Increase in antibiotic resistance • Lack of Education on good nutrition • Often no source of fresh food in underserved communities • Respiratory Illness in neighbors (CAFOs) • Pesticide exposure to workers and their families, neighbors

6. Environmental Issues • Energy/Carbon – food production methods, transportation • Water conservation • Water quality - CAFOs, Pesticide, Fertilizer • Antibiotic resistant organisms, endocrine disruptor released into environment • Adequate Food Supply

7. Medical Professionals Call for end to Non-Therapeutic Use of Antibiotics in Food Production: • American Medical Association • American Public Health Association • American Academy of Pediatrics • American Academy of Family Physicians • American Nurses Association • American Academy of Neurology

8. How To Start • Form Green teams • Commitment at all levels • Develop goals, policies • SIGN: Healthy Food in Healthcare Pledge

9. Healthy Food in Healthcare Pledge • From Healthcare Without Harm • Sample Language provided • Over 240 hospitals have signed up • Healthcare without Harm – provides resources • AMA approved a policy resolution in support of practices and policies to promote sustainable food health care systems

10. Involve suppliers • Food service providers: ex. Sysco • GPOs: ex. Novation • Food service contracts: ex. Sodexho, Aramark • Many have Sustainability Policies and Practices – But you may not get what you don’t ask for • Strategy - Avoid signing a contract with a prime vendor, get more flexibility in sourcing • Insist on what you want, put into next contract

11. Food Policies • Locally sourced foods • Hormone/antibiotic free animal products,rBGH Free Dairy • Sustainably harvested foods, fair trade • Organic and other certified food

12. What else can you do? • Healthier vending machines • Serve meals lower on the food chain less meat, vegetarian options • Farmers Markets • Onsite Gardens • Healthy Cooking Classes and demonstrations

13. Marketing and Education • Table tents • Special of the day feature • Patient tray inserts • Menu’s, recipes

14. Sustainable Food Purchasing: • Meat, Dairy and Eggs • Produce • Seafood • Coffee and Tea • Bottled Beverages

15. Sustainable Dining Operation: • Cleaning Chemicals and Pest Control • Cooking and Refrigeration Equipment • Dishwashing and Water Use • Facilities Construction and Design • Serviceware • Recycling and Waste Disposal

16. Some Examples • Meat, Dairy and Eggs • Produce • Cleaning Chemicals and Pest Control • Cooking and Refrigeration Equipment • Waste Practices • Water

17. Meat, Dairy and Eggs • Serve meals that are lower on the food chain • Go Antibiotic Free • Consider Cage Free, Hormone Free, Grass fed, • Reduce Transport GHGs

18. Produce • Go organic or at least IPM- take the time to learn more about your source farms • Go seasonal and local • Reduce transport GHGs • Support local farms, communities • Freshest • Buy imported produce with credentials • Such as fair trade, Rainforest Alliance

19. Cleaning Chemicals and Pest Control • Use certified cleaners • Such as Green Seal, those on San Francisco’s list • Get informed • Ask for Materials Safety Data Sheet • Prevent pests • Integrated Pest Management - Non-chemical preventative measures • Dry-clean responsibly • Avoid Dry cleaners who use perchloroethylene (PCEs) • Reusable laundry bags -eliminate need for plastic disposables

20. Cooking and Refrigeration Equipment • Reduce appliance “on” time • Use energy efficient appliances • Energy Star Program for Commercial Food Service • Center for Energy Efficiency Commercial Kitchens Initiative • Focus on refrigeration.

21. Example: Waste Practices Reduce food waste by: • Tracking and planning (Join EPA’s Wastewise) • “room service” model for patients • Reduced packaging • Reduce bottled beverages • Use re-usable china, serving ware, linens • Biobased service ware • Recycle, compost

22. Water • Rinse smarter - Low-flow spray valves, Regulation devices • Buy water and energy-efficient equipment. • Energy Star or Consortium for Energy Efficiency’ • Don’t overheat • Tankless water heater • Insulate • Programmable thermostat, recirculation-pump timer • Regular preventative maintenance • Serve water upon request -Bottleless water service • Spot and fix leaks

23. Discussion • Kaiser Permanente Sustainable Food Programs • What are YOU doing • Ideas?

24. Resources • EDF Sustainable food practices • http://innovation.edf.org/page.cfm?tagID=34864 • Healthcare without Harm • http://www.noharm.org/us/food/pledge • Practice Greenhealth • http://cms.h2e-online.org/ee/waste-reduction/epp/psguide/food/ • Foodmed • http://www.foodmed.org/ • Green Guide for Healthcare • www.gghc.org

25. Contact Info • shafir.wendi@epa.gov • 415-972-3422 • http://www.epa.gov/region09/waste/p2/hospart.html