Better community health grows in a garden.
Hospitals and communities are uniquely interconnected. Traditionally, the focus of a hospital was caring for patients within the walls of their institutions, but recent research and a rapidly changing reimbursement environment have shifted that focus. Recent public health research has more strongly linked the health of an individual with their behavior and environment, not to the quality of healthcare available. In fact a recent survey on behalf of the American Hospital Association found that 98% of hospital CEOs agree, “at least at some level, that hospitals should investigate and implement population health management strategies.”[i] One way that many institutions are looking at broad public health issues is through a fundamental shift in behavior and attitudes that include healthy food and eating habits.
Gundersen Health System is an integrated tertiary teaching health system headquartered in La Crosse, Wisconsin, where it is the largest employer and as a not-for-profit, has always been committed to the health of its communities. Recently, the organization has focused on the relationship between food and health and they have promoted this through a number of different community based venues. In 2012, Gundersen partnered with the city of La Crosse, Wisconsin to develop a joint neighborhood campus plan to re-envision a more vibrant and healthier community for the neighborhood surrounding its primary medical campus.
One outcome of this plan is Gundersen’s participation in a coalition to construct and participate in new community gardens in this neighborhood. The neighborhood has been identified by the USDA as a “food desert” which is defined as, “a census tract with a substantial share of residents who live in low-income areas that have low levels of access to a grocery store or healthy, affordable food retail outlet”. [ii] This particular neighborhood also has an unusually high percentage of people without access to a vehicle needed to shop at grocery stores in the area. A community garden is an opportunity to directly affect the availability of fresh healthy food in the community. The community gardens will also be used by Gundersen’s executive chef Thomas Sacksteder in teaching elementary school children about the importance of healthy eating. The exuberant Gundersen chef partners with local schools in the Farm2School program getting young children excited about vegetables and teaching them how to prepare easy healthy meals.
Gundersen had already been working on healthy eating campaigns in the community through their free healthy eating program called the 500 Club. Recognizing the need to help people quickly and easily make appropriate food choices when they are on the go, Gundersen registered dieticians work with almost 600 local restaurants and grocery stores to identify and clearly label healthy food choices for customers. Gundersen’s commitment to sustainability also plays a part in its healthy food campaign as they have set a goal of purchasing at least 20% of their foods locally. The health system has used food and healthy eating as a vehicle for collaborating with and committing to their communities.
The Amherst H. Wilder Foundation’s Community Center for Aging in St. Paul, Minnesota has also committed to the health of its community. In the renovation and addition to an existing building, the Center for Healthy Aging consolidated all of the organizations adult day health programs. A key feature of the new center is the landscaped backyard which provides a comfortable environment for outdoor activities. This new inviting space includes raised bed gardening, space for outdoor cooking and dining, and a focus on landscaping that is not only beautiful, but also edible. In addition to the raised beds for growing annual vegetables, the courtyard has apple trees under-planted with thorn-less raspberries and a ground cover of strawberries. At the edges are planted rows of serviceberries, which the residents can use to make excellent jam. By utilizing the landscaping in this way, the organization has already found that there is increased interaction and a stronger sense of community for clients in their programs. The residents can help with planting, caring for, harvesting, cleaning and preparing the produce for their daily meals. Research has shown a wide range of health and well-being benefits including, “direct benefits from the physical activity involved in gardening and having access to fresh, cheap produce on a daily basis.”[iii]
This edible landscaping approach earned the Center for Aging project a LEED innovation credit for Permaculture-based Edible Landscaping. Permaculture is a sustainable way of working with our environment to provide People Care, Earth Care, and Fair Share. Healthy, organic food production and the sharing of resources with the broader community are key hallmarks of permaculture.
Increased interest in community gardens, edible landscaping, and systems for distributing healthy food throughout the community are important tools healthcare institutions can employ as they expand their outreach to patient populations. Additional examples of this can be seen at venues around the country. For example, more than 50 Kaiser Permanente medical centers and clinics host weekly on-site farmers markets to encourage their staff and patients to eat healthier, fresh produce. In the fall of 2012, Henry Ford West Bloomfield Hospital in Michigan opened a 1,500 SF hydroponics greenhouse and associated Education Center with a demonstration kitchen and cafe. The hospital predicts that produce from the greenhouse will reduce their food costs by more than $20,000 a year. A variety of cooking classes geared toward specific health concerns, use of food as a preventive and corrective medicine, and gardening as behavioral therapy are open to patients and the community.
The challenge that healthcare organizations face today in attacking population health issues is big, broad and far reaching. Answers no longer lie within the boundary of the hospital but reach far out into our communities. Answers may lie in the growth of shared partnerships around food and gardening.
[i] Managing Population Health: The Role of the Hospital, Health Research and Educational Trust, Chicago, IL: April 2012, 8. For full report, see: www.hpoe.org/Reports-HPOE/managing_population_health.pdf
[ii] United States Department of Agriculture Food Desert maps can be found at www.ers.usda.gov/data-products/food-access-research-atlas.aspx#.UZIrS7WyCB4 The definition of a food desert can be found at http://apps.ams.usda.gov/fooddeserts/foodDeserts.aspx
[iii] Dr. Richard Jackson. “The Role of Community Gardens in Sustaining Healthy Communities”, Designing Healthy Communities. http://designinghealthycommunities.org/role-community-gardens-sustainaing-healthy-communities/
Meredith Hayes Gordon, AIA, LEED AP BD+C is an Associate and Sandy Christie, LEED AP BD+C is a Senior Associate in the Minneapolis office of Perkins+Will. Both are focused on sustainable healthcare architecture and planning. Meredith can be reached at firstname.lastname@example.org and Sandy can be reached at email@example.com