On the Ground With the Farms Feeding Hospitals and Their Patients

In 2022, the White House Conference on Hunger, Nutrition and Health drew a link between good health and good food. Building on the momentum generated by the conference, the Department of Health and Human Services (HHS) developed a Food is Medicine (FIM) initiative geared at reducing nutrition-related chronic diseases and improving food security for populations that historically have not had access to nutritional food.

That’s a tall order. In 2021, approximately 33.8 million Americans were living in food-insecure households and approximately 600,000 Americans died annually from diet-related disease.

But across North America is a growing cohort of hospitals taking on the challenge and turning hospital food from a blob of green Jell-O to a fresh and tasty meal. Working with FIM, hospitals are filling doctor referrals for farm-share boxes of fresh produce and supplying hospital kitchens with organically grown crops. 

These farms are not simply growing kale. They are producing medicine. 

BMC’s Power Plant Farm

At Boston Medical Center (BMC), sustainability matters. On the roof of BMC’s natural gas-powered heat and electrical power plant, there is a 2,658-square-foot outdoor container farm, aptly named Power Plant Farm. Growing more than 30 varieties of crops, including cucumbers, peppers, tomatoes, squash, herbs and leafy greens, the farm harvested 4,000 pounds of organically grown produce last year.

“[This] represents a more holistic approach to care,” says Sarah Hastings, farm manager. “We are starting from square one, making the message clear that fresh foods help us heal and maintain our well-being.” 

The Preventive Food Pantry is the anchor of BMC’s FIM initiative. “We have more than 1,600 families, who receive about four days worth of food with each visit,” says Hastings. Used by cancer patients, those with heart disease, diabetes or other chronic health conditions, they are referred to the food pantry by their primary caregivers, who write prescriptions for foods promoting physical health, recovery from illness or as a preventative for future health issues. 

Throughout the hospital, patients and families are continually connected to the farm, reinforcing the message that healthy food matters. A large glass window in the waiting area of one of BMC’s buildings allows patients and their families to see the farm. “There is an especially heartwarming connection when patients or their families make it down to the farmer’s market in the foyer after observing the crops from the waiting area,” says Hastings. The farmer’s market operates once a week, with the produce sold at subsidized prices to staff, patients and their families. 

BMC’s Teaching Kitchen also incorporates farm produce into recipe tutorials for patients and their families to help them learn healthy ways of preparing food. For example, patients can attend a class at the Teaching Kitchen before bariatric surgery to help them learn simple ways to prepare food that will help their stomachs heal post-surgery and prevent nutritional deficiencies. 

“The farm brings a lot of excitement to the hospital,” says Hastings. 

The Farm at Trinity Health Ann Arbor. Photography courtesy of Trinity Health Ann Arbor.

The Farm at Trinity Health Ann Arbor

Established in 2010, the Farm at Trinity Health Ann Arbor in Ypsilanti, MI is one of the oldest hospital farms in the US. Leaders of Ann Arbor hospital, according to farm manager Jae Gerhart, started to see an increased rate of diet-related chronic diseases such as cardiovascular disease, cancer and diabetes. They decided to use a small portion of the hospital campus to grow nutritional food and act as a community and educational resource geared towards disease prevention. The farm sits on five acres, four of which are used as community gardens or for events. One acre produces food that is designated for FIM’s programs. 

During the growing season, the farm hosts school field trips and summer camps for children aged four to 10. There is a farm-share box program that runs for 36 weeks over the growing season, for which anyone can sign up. For those struggling to afford fresh food, there is the option to sign up for the Farm Share Assistance Program or the Produce Prescription program at no cost. 

“Doctors love the program,” says Gerhart. “More and more, they are asking those social needs questions at a patient’s appointment.”

Gerhart says FIM and farm programs can reduce overall health-care costs associated with diet-related health conditions. “More and more data supports that,” she says.

Researchers at the FIM Institute at Tufts University concur. A 2023 report suggests that FIM interventions, such as medically tailored meals, could eliminate 1.6 million hospitalizations in the US annually and save $13.6 billion in health-care costs per year. Traditionally, individuals experiencing food insecurity spend an extra $1,800 per year in health-care expenditures. Farm share assistance programs could help reduce those costs. 

The Salish Sea regenerative urban farm. Photography by Dave Ryan.

Salish Sea Regenerative Urban Farm

Changing the paradigm that hospital food has to be mushed peas and frozen carrots, the seven-acre Salish Sea Regenerative Urban Farm (SSRUF) sold organically grown cucumbers, tomatoes and 1,000 pounds of potatoes to British Columbia’s Sechelt Regional Hospital in 2023.

The American Medical Association has long advocated for adding a variety of healthy food choices, including plant-based meals and foods low in fat, sodium and added sugars to hospital menus to assist in better outcomes for patients.

But providing better hospital meals is not as simple as it sounds. The cost of local, sustainably grown foods can be more expensive than tins of marinara sauce or bags of frozen peas, especially for small hospitals with limited budgets. Large hospitals prepare food for hundreds of patients daily, with little turnaround time between breakfast, lunch and dinner. It takes time to chop, wash and cook fresh produce as opposed to opening and plating a bag of prepared salad mix. Many hospitals also have contracts with outside vendors, which makes it hard to incorporate other sources.

The SSRUF was aware of all of these concerns when it approached the small 38-bed hospital with its offer to sell its organically grown food from a farm 30 yards away from the hospital’s kitchen. But, according to Dave Ryan, a board member for the farm society, both the hospital and the regional health authority were very receptive. 

Surveys of the kitchen and care staff at the hospital were done to gauge the response of having local produce available to patients. “The kitchen staff were really excited,” says Barbara Seed, another board member of the farm society. 

The head of hospital food services also did a waste audit with preliminary results indicating that, when the fresh produce was added to meal trays, less food was thrown away. More audits will be needed to provide reliable data, but SSRUF is positive that it will concur with them about the benefits of farm to hospital food.

“It’s obvious,” says Ryan, “where nutrient-dense quality food should be—in a hospital where people have metabolic issues and should be served nutritious food to help recover.”