WHEN has influenced the way hospitals in the Philadelphia region are purchasing, serving and disposing of food in a more sustainable manner. We know that current food production and distribution practices in the US have profound environmental and public health implications:

1. On average, a hospital in the US will serve one million meals a year.
2. Food is transported an average of 1500 miles to reach its destination, contributing to global warming.
3. 70% of antibiotics are given to healthy animals to promote growth and compensate for stressful growing conditions. This use promotes antibiotic resistant bacteria making existing antibiotics ineffective. Over 60,000 Americans die each year from resistant infections.
4. 70% of all broiler chickens are fed arsenic.
5. The American Public Health Association called for a moratorium in 2003 on the construction of all confined animal feedlots operations, or factory farms, because of health concerns.
6. Researchers from the University of Washington have demonstrated that switching to an organic diet eliminates pesticide metabolites in the urine of children.

WHEN works with Philadelphia area hospitals through direct assistance with individual facilities and healthcare systems, educational roundtables, and partnering with local organizations which complement WHEN's objectives. WHEN provides a holistic approach to sustainable, healthy food in healthcare, from purchasing policies and procurement to food disposal and composting.

In 2007, WHEN provided two roundtables for healthcare on sustainable food in Philadelphia, bringing together over 50 hospital representatives from 17 facilities to the table. WHEN also offered a food program in Pittsburgh to influence the largest healthcare system in Western PA, with over 30 attendees from 12 hospitals. These three programs brought expert speakers to talk about the health and environmental impacts from industrial food production and offered examples from throughout the country on hospitals making changes to procurement, policies, and how they serve and dispose of food. Local facilities highlighted their growing efforts. Additionally, WHEN helped to coordinate FoodMed, the conference on food in healthcare in Boston, bringing representatives from three area hospitals and White Dog Community Enterprises as well as a speaker on composting.

Over the past year, by WHEN engaging hospitals on key issues, local facilities have initiated composting, serve milk without synthetic hormones, offer fair trade coffee, recycle kitchen grease into biofuels, and three have signed the Healthy Food in Healthcare Pledge. WHEN has also forged partnerships with food-related organizations, such as White Dog Community Enterprises, The Food Trust, Farm to City, and PA Association for Sustainable Agriculture, to further link hospitals with community resources and opportunities. We forward articles of food interest and encourage hospitals to participate in national listserves on food.

WHEN is a local non-profit championing the health of women and children by reducing environmental exposures through education, research and direct action since 1997. For the past eight years, WHEN has worked with the healthcare sector on pollution prevention, toxins reduction, waste minimization, recycling, and green building. Along with the Healthy Food in Health Care initiative, WHEN also coordinates the Mercury-Free Philly Campaign, Children's Environmental Health, and Environmentally Responsible Healthcare.

WHEN is a member organization of Health Care Without Harm (HCWH), which has been funded by the Claneil Foundation to support sustainable food in healthcare in the Philadelphia region. WHEN serves as the regional organizers for the HCWH campaign. HCWH is an international campaign to transform the healthcare sector so that it is not a source of harm to people or the environment. Dianne Moore, MS, MSW, leads the Healthy Food in Healthcare initiative for the Philadelphia region and Teresa Mendez-Quigley, MSW, supports efforts in Pittsburgh.

WHEN has helped to change markets, influencing buyers (hospitals and healthcare systems), distributors, and sellers/producers, thus making it more sustainable in the long term. Initially, both hospitals and suppliers were hesitant to institute any changes in food purchasing and practices. Over the past 1.5 years, we have experienced dramatic changes locally.

Dairies: Outreach to local dairies and milk distributors initially identified only one dairy that provided milk without synthetic hormones (rBGH- or rBST-free) with the capacity to provide the volume that hospitals need. In Fall 2007, Rosenbergers and WaWa Dairies in the Philly region have gone rBGH-free. Turner Dairies in Western PA has moved to rBST-free milk in May, 2007. Currently, WHEN is taking a leadership role in opposing the PA Dairy Association's ruling to ban the labeling of milk in an effort toward maintaining accurate consumer labeling.

Farm Fresh Products: Hospitals are increasingly interested in the concept of buying fresh products from local farmers. This is challenging because many local local farmers do not have the high volume of products that hospitals need with the consistency that is required for menu planning. We are partnering with various local groups - White Dog Community Enterprises, Farm to City, Food Trust, and PASA - to help with this limitation. We are also asking hospitals to request local produce from their distributors which have the capacity to purchase from numerous farmers. ,

Food Waste: Methane gas from decomposition of food waste in landfills increases greenhouse gases. We are encouraging and linking hospitals with composting haulers to take food waste to DEP permitted farms which compost the waste and significantly reduce the amount of food into the waste stream. Hospitals in Philadelphia and Pittsburgh are beginning to participate and there is strong interest in the Lehigh Valley and New Jersey hospitals.

Biofuels: Trap grease and fryer grease can be collected and used to make biodiesel, a cleaner form of fuel for vehicles. WHEN linked one hospital with Fry-O-Diesel to recycle its grease. Another is expected to come on board in 2008.

Green Building: As hospitals are always remodeling or building, we encourage them to use the Green Guide for Health Care (modeled after the LEED accreditation program) for credits on kitchen design and construction, food purchasing and packaging, and waste disposal.

By working with hospitals where their interests lie, WHEN is effective at helping to guide them along the path to sustainability. We identify a champion within the institution, whether in food services, nutrition, environmental services or administration, and provide them with resources and tools to make easy change - targeting low hanging fruits. These efforts benefit patients and patient care, staff and visitors, and the larger community (farmers, workers, local economy). Fair trade products that cannot be grown locally, such as coffee, tea, bananas, spices, and rice, also address workers rights and environmental justice issues.

WHEN's efforts have resulted in the following outcomes over the past year:

1. Five hospitals and one long term care facilities in the Philly region are buying rBST-free milk, creating market change. All UPMC facilities in western PA purchase rBST-free milk. All milk is locally sourced. Additionally, health risks associated with synthetic hormones (breast cancer and autism concerns) are reduced to patients and staff/visitors
2. Four hospitals purchase produce from local farms, and two are scheduled to do so in 2008. A pediatric facility offers 25 employees CSA shares from Lancaster County. This increases demand for locally sourced farm products and reduces diesel pollution from transporting.
3. Two hospitals and two long term care facilities compost about 5 tons a month of food waste on PA DEP approved farms in the Philly region since March 2007. Composting avoids methane and absorbs carbon dioxide, greenhouse gases associated with climate change. 
4. WHEN linked one hospital with Fry-O-Diesel to recycle its grease into biofuels. Another facility that is currently sending its grease to Texas for recycling into animal food will join in 2008. We will support other hospitals joining Fry-O-Diesel's Kitchen Coalition when it becomes operational.
5. Three area hospitals have become the first in Pennsylvania to commit to serving nutritious, locally sourced and sustainably grown food by signing the Healthy Food in Healthcare Pledge (a voluntary program of HCWH which outlines steps hospitals can take to support healthy food). Publicly signing the Pledge illustrates to other hospitals the critical role of healthcare in sustainable agriculture, purchasing and food preparation practices. (See the attached WHEN press release.)
6. Healthcare facilities in Delaware, New Jersey and the Lehigh Valley are being influenced by Philadelphia region hospitals' movement towards sustainability in healthcare food.
7. WHEN nominated Thomas Jefferson University Hospital which received the US Environmental Protection Agency Trailblazer award for its food sustainability efforts (see the attached EPA Press Release).
8. The Philadelphia Inquirer highlighted composting efforts, mentioning two hospitals that WHEN had linked to the composting hauler and farm.

The Philadelphia Sustainability Award would generate great interest by hospitals to join sustainability efforts around food, looking beyond the bottom line (i.e., costs/budgets). WHEN's efforts reflect other communities in California, Oregon and Massachusetts here sustainability efforts have been longstanding. To recognize this region for healthcare's influence on the food industry could send a strong message to agribusinesses that we demand healthier and more sustainably produced foods within healing institutions.