Despite the mountain of evidence that links poor diet choices with chronic diseases, hospital patients and visitors have a smorgasbord of fast food options — including McDonald’s, Chic-fil-A, and Wendy’s — only feet away from their rooms.
But just like the cigarettes that used to be sold in hospital gift shops, fast food in treatment center cafeterias may soon be a thing of the past, if the Physicians Committee for Responsible Medicine (PCRM), a nonprofit group comprised of medical professionals, gets its way.
In its fifth report on hospital food, PCRM exposes the profit-driven relationship between fast food enterprises and hospitals that helps maintain the restaurants’ presence in medical centers across the United States, particularly the South, a region affected by disproportionately high obesity rates.
PCRM’s report, published in the journal Public Health Nutrition, examined more than 200 public health hospitals, many of which receive government funding to treat underserved populations. An infographic included in the report showed that Chic-Fil-A, Wendy’s, and McDonald’s had a presence in at least a dozen restaurants combined.
“The previous generation dealt with cigarettes. Now it’s time to tackle meat, cheese, and all the fat and cholesterol they are packing into patients’ arteries,” PCRM president Neal Barnard, M.D wrote in the report. “Hospitals need to end contracts with fast-food chains selling Big Macs, chicken nuggets, and double bacon cheese burgers.”
Upon examination of contracts obtained through state records requests, researchers learned that the rent paid to the hospital positively correlated with monthly sales. Hospitals also had the option of cancelling leases if restaurants didn’t meet a quota. According to the report, some fast food restaurants had exclusive control over medical centers. By no means was this relationship one-sided: Hospitals remained complicit in connecting patients and guests to fast food, often placing fast food offerings next elevators, emergency entrances, pharmacies, clinics, and parking garages.
At the end of its report, PCRM calls for a ban on fast food in hospitals, concluding that health centers that have contracts with fast-food companies “encourage patients, employees, and visitors to eat the very foods that hospitalize millions of Americans every year.”
An estimated 75 percent of Americans consume high calorie, high-sodium fast food monthly, with half of that group saying they eat it at least weekly. These diet choices, in tandem with lack of physical activity, have helped fuel a dramatic rise in the U.S. obesity rate, which has more than doubled since the 1970s. Last year, the American Society of Clinical Oncology predicted that obesity will surpass tobacco as the leading cause of cancer within a couple of years.
Coronary artery disease, stroke, and diabetes — all of which develop out of a high-sugar, high-salt diet — count among the deadliest ailments that hospitalize Americans. While medical institutions have the potential to serve as a respite from unhealthy food options, that vision has not necessarily come to fruition. For example, nearly 90 percent of hospitals in California have at least one fast food outlet on their campuses and high-sugar drinks in their vending machines, according to a report from the Centers for Disease Control and Prevention (CDC).
That’s why hospitals have recently become a new frontier for advocates who want to raise the public consciousness around healthy eating. In 2011, in a campaign that mirrors PCRM’s current efforts, the American Hospital Association (AHA) urged hospitals to eliminate unhealthy food options from their cafeterias, saying that serving fast food “sends an inconsistent message” that doesn’t promote a culture of wellness. And in 2010, an expert panel convened by the CDC argued that hospitals have a unique opportunity to promote healthy food environments.
“The mission, influence and reach of hospitals make them natural leaders for worksite wellness and community-wide health promotion,” the panel report, titled “Healthy Hospital Choices,” read. “As major employers and flagship health organizations within communities, hospitals can influence community norms by adopting model policies and practices that promote the health of employees and patrons of their own organization. Supporting health-promoting environments in hospitals provides an ideal opportunity to advance health and prevent chronic diseases for patients, employees and visitors.”
Some hospitals have already heeded these calls to change. Riley Hospital for Children in Indiana, for example, didn’t renew its contract with McDonalds at the end of 2013. St. Louis Children’s Hospital followed suit later on, removing Dairy Queen products from its facility. Other treatment centers have gone a step further, introducing healthy food alternatives to patients, visitors, employees, and caregivers. St. Luke’s Hospital Anderson Campus in Easton, PA, for example, announced the launch of a community farm program that would produce 44,000 pounds of fresh produce.
More broadly, PCRM’s appeal comes amid evolving attitudes about diet and nutrition in the United States. In a 2012 poll conducted by the International Food Information Council Foundation, nearly 80 percent of consumers admitted that while their diets didn’t meet national guidelines, they wanted to eat healthier. A Gallup poll two years later found that nearly 45 percent of Americans seek organic products.