Food is a multidimensional topic, Alan Weil, editor in chief of Health Affairs, stated in the opening remarks of Health Affairs Food and Health briefing in Washington, where speakers came to together to tackle how food and health systems relate to each other.
As the speakers largely noted, the intersection of food and health is largely a public health topic. For example, it was shared by speakers that two-thirds to three-fourths of calories in America are consumed from ready-to-eat processed food. Thus, engagement from industry to providers is important to shape the conversation on how food effects health.
Craig Gundersen, a professor of agricultural strategy at the University of Illinois, noted that food insecurity, defined by the USDA as “consistent access to adequate food limited by a lack of money and other resources at times during the year,” has gone up 30% since 2009. He noted if food insecurity can be reduced, healthcare costs may follow suit.
Obesity and healthcare costs
There might be merit into this idea as Y. Claire Wang, associate professor of health policy and management at Columbia University, shared her findings from a recently published study, including a finding that severe obesity drastically increases medical costs. In her study, she noted that an individual with severe obesity paid an average of $1,980 more in healthcare costs in 2013 than a non-obese individual. A moderately obese individual spent $941 more than a non-obese individual, she said. That adds up as she noted that 14% of Americans are considered severely obese.
In addition, the study found severe obesity cost state Medicaid programs nearly $8 billion annually. A shared infographic from the latest Health Affairs demonstrated obesity throughout the country:
Dong D. Wang, a doctorate candidate at Harvard's T.H. Chan School of Public Health, shared his study finding that analyzed the diets of Americans to document the change in disease burden attributed to change overall dietary quality over time. Wong shared results that from 1999 through 2012, healthier quality of diet culmulatively prevented 1.1 million deaths. During the same time period, the difference in dietary quality resulted in a 12.6% decrease in type 2 diabetes, an 8.6% decrease in cardiovascular disease, and a 1.3% drop in cancer cases.
However, "Giving giving food to people doesn’t get to the root causes of food insecurity,” stated Dr. Hilary Seligman, associate professor in residence at the University of California, San Francisco. That said, she noted food banks have emerged as a potential partner in providing diabetes interventions, as food insecurity is an important risk factor for diabetes control and few diabetes interventions address this risk factor.
The role of executives
During the “Systems” session, Healthcare Dive asked where hospitals and healthcare executives fit into food and health industry integration.
Importance of community benefit work is a “great opportunity to make meaningful community health needs assessments that can be translated into action within the community,” said Julie Willems Van Dijk, associate scientist and co-director of the county health rankings and roadmaps program at the University of Wisconsin Population Health Institute. She added as payment reform continues toward value-based reimbursement that the economic incentive for hospitals and healthcare leaders to be invested a community’s food and health communities will grow.
Vivica Kraak, an associate scientist of food and nutrition policy at Virginia Tech, noted one tricky area for health systems is transactional partnerships. For example, when a food company that may specialize in doughnuts contributes money to a healthcare center. “I would first advise to think carefully about corporate sponsorship and whether and how they’re going to engage and whether it’s appropriate for them not to engage.”
She also mentioned in Michigan, there are commitments of 20% to 30% from some hospital centers to purchase locally produced food. The action helps support a sustainable food system across the hospitals in the state. “I think other states can replicate that,” she said.
Roni Neff director of food system sustainability and public health, at Johns Hopkins University's Center for a Livable Future, stated hospitals nood to concentrate more reducing on the food waste they create, which can be “staggering.”
However, Dr. David Wallinga, senior health officer at the Natural Resources Defense Council, stated he wasn’t sure the current health infrastructure is the best place to address food issues. “I don’t know in if 40 to 50 years, hospitals that are now constructed are going to look like the best place to have a farmers market.” He said that bravery is needed and to start with the question ,“How do we create a community environment that serves the needs of the people?”