Hospitals Challenge

By Sapna E. Thottathil, Michelle Gottlieb, Lucia Sayre on April 24, 2012

Three benchmarks toward building a healthier, more sustainable food system.

The way food is produced, processed, packaged, distributed and consumed in the United States has significant impacts on human health, climate change, air and water pollution, and the viability of future agricultural production. Our industrialized food system encourages quantity over quality, abundant use of dangerous pesticides, overuse of non-therapeutic antibiotics, and highly processed foods over fresh and whole foods, all of which negatively impact not only the environment but also individual health. Nationally, the United States spends billions of dollars to treat diet-related, chronic diseases—$147 billion to treat obesity alone, another $116 billion to treat diabetes, and hundreds of billions to treat cardiovascular disease and cancers.

Hospitals have significant buying power as institutions. By prioritizing sustainably produced food, hospitals have the ability to improve the health of their food systems, improve the health of their patients, staff, and visitors, and invest in the well-being of communities and the environment. Hospitals also have the opportunity to educate and model for the public healthy eating habits and the importance of fresh, nutritious foods. And indeed, they are doing just that, from coast to coast. Health care organizations are writing healthier menus, working with local farmers to purchase locally, sustainably-grown products, reducing the amount of meat they purchase and serve, and purchasing more fair trade and certified organic products than ever before. There are many different strategies a facility can implement to make this goal a reality, and the new HHI Healthier Food in Hospitals Challenge is an excellent roadmap.

The Healthier Food in Hospitals Challenge is one of the six Challenges that are included in the HHI sustainability agenda and is made up of three benchmarks for sustainable food procurement, with a baseline commitment of signing the Healthy Food in Health Care Pledge (see or formally adopting a sustainable food policy:

  1. Take the Balanced Menus Challenge Decrease the amount of meat purchased by 20 percent over baseline year, within three years.
  2. Increase Purchases of Healthy Beverages Increase the percentage of healthy beverage purchases by 20 percent of total beverage purchases annually over baseline year or achieve healthy beverage purchases of 80 percent of total beverage purchases, for use throughout the hospital (patient, retail, vending, and catering) within three years. (Include promotion of tap water over bottled water where possible.)
  3. Increase Procurement of Local and/or Sustainable Foods Increase the percentage of local and/or sustainable food dollar purchases by 20 percent annually over baseline year or achieve local and/or sustainable food dollar purchases of 15 percent of total food purchases within three years.

When health care facilities enroll in HHI, they must choose at least one of the six Challenges. If they choose the Healthier Food Challenge, they can then choose a minimum of one of the three benchmarks listed above. What does “local food” mean? What is a “healthy beverage?” What’s the definition of “sustainable?” All of these terms are fully defined in the how-to guide that facilities will receive if they choose to work on the Healthier Food Challenge in the next three years as part of the HHI. The how-to guide not only provides definitions of these terms, but also provides step-by-step guidance on how to achieve these goals, interesting strategies, marketing ideas and comprehensive resources to meet these benchmarks. The Healthy Food in Health Care program also has regional organizers across the country that can help to provide technical assistance and organizing support for facilities that take on this Challenge.

To date, over 370 health care facilities have signed on to the Healthy Food in Health Care Pledge and are working toward creating more sustainable and healthy food service operations internally as well as a healthier food system for us all. As one of the six challenges of the new HHI, participating hospitals will now be able to track their data and progress in this area and measure the environmental and public health impacts of their collective efforts in ways that have not been possible before.

For more information and to take the HHI Healthier Food in Hospitals Challenge, visit

Making a Difference

Health Care Without Harm (WCWH) congratulates the San Francisco Bay Area Hospital Leadership Team for its work to secure a contract for certified-humane, cage-free eggs from Wilcox Farms through U.S. Foods, one of the major food distributors serving the health care sector.

The University of California San Francisco Medical Center and John Muir Health are now purchasing 100 percent of their liquid eggs from Wilcox Farms. (Liquid eggs, which are pre-separated from their shells, are commonly used in institution and restaurant kitchens and constitute the majority of hospital egg purchases.) “At UCSF Medical Center, we use over 66,000 pounds of liquid eggs annually. As a result of switching from conventionally-raised eggs to cage free-eggs, UCSF is saving over 2,000 chickens from living in battery cages every year. This is part of our larger goals in sustainable purchasing,” says Jack Henderson, associate director of Nutrition and Food Services.

UCSF Medical Center and John Muir Health achieved this result through their participation on the Bay Area Hospital Leadership Team, organized by HCWH’s California team at the San Francisco Bay Area Physicians for Social Responsibility (SF PSR). The Bay Area Hospital Leadership Team has been working together for the past four years on the procurement of sustainably grown, healthy food products for their facilities. All seven constituent systems participating on the Team have signed the Healthy Food in Health Care Pledge that states healthy food must come from a food system that is economically viable, ecologically sustainable, and socially just. The hospitals share knowledge and pool their purchasing power in order to shift the marketplace toward healthier, sustainably-produced food.

The U.S. Foods contract with Wilcox Farms is a significant decision, making cage-free eggs more accessible to other hospitals in California and the Pacific Northwest. Wilcox Farms is a fourth generation family farm in Washington state. It is committed to converting their operation to 100 percent organic and cage-free in response to growing demand as well as the company’s desire to sustain the land, community and company for the future. Its cage-free hens are free to run and preen with access to the outdoors and are certified humane by Humane Farm Animal Care.

“In 2006 our family made the decision to convert our hen houses from conventional to cage free and organic. Although we knew it was the right thing to do, it has not always been easy—the process has been extremely intense both with financial and management resources. So when customers like UCSF and John Muir Health choose our products, it validates our decision to transition to cage-free and organic. This is a really positive motivator for our family,” says co-owner Andy Wilcox.

Cage-free eggs are just one part of a larger sustainability agenda for the Bay Area Hospital Leadership Team. Congratulations to the group for its good work! To learn more about this group or other hospital leadership teams that HCWH helps to coordinate around the country, please visit

Come visit us at CleanMed 2012!

The Healthy Food in Health Care Program will be presenting several dynamic sessions on building sustainable food service operations and understanding healthy food issues. We’ll also have a booth in the exhibit hall with a plethora of resources and information. See you in Denver!


Sapna E. Thottathil, Program Associate
Physicians for Social Responsibility

Michelle Gottlieb, Co-Coordinator
Healthy Food in Health Care Program
Health Care Without Harm

Lucia Sayre, Co-Executive Director
San Francisco Bay Area Physicians for Social Responsibility
Co-Coordinator, Healthy Food in Health Care and Food Matters Programs
Health Care Without Harm