Silicon Valley is a cutting edge place for technology development, New York City for the arts. Toledo, Ohio—not a place we usually think of as cutting edge—certainly qualifies as an avant-garde leader in the anti-hunger movement.
Toledo is the headquarters of ProMedica, the largest health care provider in northwest Ohio and southeast Michigan. The company wants to change the way policymakers in the region look at the problem of hunger in their communities. The idea is to recast hunger as a health care priority, on par with fighting illnesses such as diabetes, heart disease, and cancer. If ProMedica succeeds in doing this in the region, it could inspire other healthcare institutions around the country to do the same. Before long, this concept could change the way many more policymakers view the importance of eliminating hunger in their communities.
ProMedica has considerable influence on policy development in northwest Ohio and southeast Michigan, not only by virtue of being the largest healthcare provider but also because it is the region’s largest employer. When its government relations office talks to the governors of Ohio and Michigan, or to the mayors of cities where it provides services, and says that hunger and nutrition deserve their attention, the elected leaders are inclined to listen in a different way than they do to traditional anti-hunger lobbyists.
Barb Petee, ProMedica’s chief advocacy officer and head of its government relations department, is in charge of developing ProMedica’s anti-hunger strategy. As a not-for-profit healthcare organization, its goals are to provide high quality, affordable care to everyone in the community, including underserved populations at risk of hunger. “Think about how many pill bottles say ‘Take with Food,’” says Petee. “If there is no food in the home, that could slow a patient’s recovery or lead to readmission to the hospital.”
In analyzing readmissions, ProMedica discovered that food security issues affected many of its patients. Under the Affordable Care Act, hospitals will be penalized for readmissions. Healthcare reform has given doctors and healthcare organizations more reason to focus attention on hunger. It means doctors putting far more emphasis on prevention and wellness. As they take another look at the options, they should notice the incredible return on investment offered by federal nutrition programs.
Health care is the fastest growing cost in government budgets at any level—federal, state, or local—and officials are well aware of the challenges they face in trying to control its costs. According to a 2013 report by the U.S. Government Accountability Office (GAO), “The primary driver of fiscal challenges for the state and local government sector in the long term continues to be the projected growth in health-related costs.” Anything that can slow the rise of healthcare costs should be welcome news.
ProMedica’s internal campaign to raise awareness about hunger began by sharing information on the effects of hunger with employees, doctors, and board members. It meant going into healthcare facilities and talking to staff about what they could do at the different touch points in the delivery of care—at admission, in the doctor’s office, over the phone, on a home visit, or during routine procedures like a blood draw. “If I’m a nurse,” says Barb Petee, “It’s probably not on my radar to ask the patient if she’s hungry.” Now it is. ProMedica also trains hospital staff to provide information and encouragement for eligible families to apply for SNAP benefits.
Petee realized that ProMedica needed to develop an external strategy to match its internal one. She has strengthened relations with partners in local and national anti-hunger infrastructure. She works with national partners like Share our Strength and the Alliance to End Hunger. In Toledo, she is working closely with local partners in the schools and groups involved in emergency feeding programs. The sheer gravity of the situation led to an “all hands on deck” attitude. In the aftermath of the Great Recession in 2011, Toledo’s child poverty rate was 44 percent.
The impact that a sizeable institution like ProMedica could have on hunger in Toledo became clear at once when it joined its efforts to increase the number of summer meals served. In 2010, Toledo served only 1,500 summer meals. A year later, the number rose to 45,000. The next year, it climbed to 100,000. A major reason for the program’s fast growth was a public information campaign. Most anti-hunger organizations don’t have a lot of spare money for marketing or people with those skills. Marketing is a core component of ProMedica, so it was able to use its resources in that area to build a successful campaign around summer meals.
Rebranding hunger as a healthcare issue doesn’t change the fact that it is a problem rooted in poverty. Rebranding could, however, move local residents who would be predisposed to make quick judgments about poverty and poor people to consider solutions to hunger in terms of health care rather than “welfare.” If we talk about hunger only as an extension of poverty, it’s much easier to think of it as solely a personal problem, not society’s problem. While many people consider it perfectly acceptable to excoriate “welfare recipients,” it’s almost never okay to make similar derogatory remarks about patients with chronic health problems.
Healthcare professionals are increasingly aware that they must do a better job of addressing the social determinants of disease, which include diet-related chronic health problems. For every dollar spent on health care, 75 cents goes to the treatment of chronic disease. Between 1995 and 2010, the rates of diabetes increased by more than 50 percent in 42 states, according to the Centers for Disease Control. At this rate, by 2050 one in three Americans will have diabetes, and most of it will be Type 2 diabetes, a diet-related condition. Diabetes is associated with obesity, and obesity is not just the result of a preference for unhealthy foods. Often, it’s about not being able to afford healthy foods.