National Study of Community Benefit Practices to Promote Healthy Food Access

Health Care Without Harm’s (HCWH) three-year project, Catalyzing Health Care Investment in Healthier Food Systems, funded by the Robert Wood Johnson Foundation, includes a national study of nonprofit hospitals’ community benefit practices to promote healthy food access and healthier community food environments. The national research informs the development of tools and resources to help facilities address healthy food access and risk of diet-related health conditions in their community health needs assessments (CHNAs) and community benefit implementation strategies.

A national survey of not-for-profit general hospitals throughout the United States assessed the landscape of community benefit programming to increase healthy food access, promote healthy and sustainable food systems, and reduce risk of diet-related health conditions.

Researchers discovered that obesity and diet-related health conditions were among the most common health needs identified in CHNAs. A key finding was that the majority of interventions centered around diet and nutrition education and exercise promotion– and that fewer interventions focused on increasing access to  healthy foods.

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“Alongside the nutrition and exercise information, a lot more can be done to address healthy food access in our communities,” Susan Bridle-Fitzpatrick, PhD, Health Care Without Harm Senior Researcher, said. “Health professionals may educate overweight or diabetic community members to eat five servings of fruit and vegetables per day, but if there are no places to buy affordable fresh produce in the neighborhood, or families are struggling with food insecurity, then these folks will have a difficult time adhering to the recommendations. It is critical to understand the environmental context and how the choices people make depend on the choices they have. People know to eat broccoli and apples–what are the other obstacles keeping people from eating healthier foods? We need to make access to healthy foods both convenient and affordable in our communities.”

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The study involves a national survey of not-for-profit hospitals, analysis of survey respondents’ Community Health Needs Assessments (CHNAs) and implementation strategies, in-depth interviews with key informants, case studies, and a literature review. This report is the first in a series of research reports and other resources that will be released in 2017 and early 2018. These will include a comprehensive research report that will discuss in depth the findings from the survey and other research methods and present recommendations. Also upcoming is a toolkit of guidance resources that will support hospital community benefit professionals and community partners in developing initiatives to promote healthy food access and healthier food environments.

While this project takes a broad look at how hospitals are assessing healthy food access, obesity, and diet-related health needs in their CHNAs and how facilities are addressing these needs in their implementation strategies, the forthcoming resources particularly recommend certain kinds of “win-win-win” opportunities. The toolkit will highlight innovative examples where hospitals employ their community benefit resources to:

  1. improve access to healthy, affordable food and at the same time
  2. support economic and workforce development in low-income communities
  3. strengthen local and sustainable food systems

The project promotes “promising practices” initiatives that include local food producers and processors as part of a multi-pronged effort to increase access to fresh, affordable, and sustainably produced food; promote health equity; and stimulate the local economy—particularly through creating well-paid jobs in low-income communities. These “win-win-win” initiatives support the local food system while working to eliminate health disparities and empower and improve the lives of community residents.

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