2016 Hospital Food Report

The Physicians Committee
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2016 Hospital Food Report

Highlighting Hazardous and Healthy Hospital Food Environments - Winter 2016

 

The Physicians Committee’s 2016 Hospital Food Report ranks 24 U.S. hospitals based on whether patient menus offer healthful fruits, vegetables, whole grains, cholesterol-free entrées, and soy milk. Hospitals also earned points for Meatless Mondays, gardens, and farmers markets. Points were deducted for hospitals that have contracts with fast-food restaurants such as Chick-fil-A, McDonald’s, and Wendy’s, which serve disease-inducing items including chicken and cheeseburgers. The Physicians Committee obtained most patient menus and fast-food contracts through state public records laws.

hospital-food

Two hospitals scored 90 points and tied for first place in this year’s report: Aspen Valley Hospital, in Aspen, Colo., which participates in Meatless Mondays and offers healthful entrées each day, and Stony Brook University Hospital, in Stony Brook, N.Y., which has a 2,242-square-foot organic rooftop garden that supplies vegetables and herbs for patient meals. University of Mississippi Medical Center, in Jackson, Miss., comes in last place with a score of 62 percent. The medical center hosts both a Chick-fil-A and McDonald’s.

These and the other hospitals in the report represent public and private hospitals ranging in size from dozens of beds to more than 1,000 beds. The final selection of hospitals was drawn from a list of 262 hospitals surveyed, including the 50 largest public hospitals and at least one hospital in every state.

 

Hospital

Hospital Location

Patient Food Score

State Prevalence of Obesity Among Adults

State Prevalence of Diabetes Among Adults

1. Aspen Valley Hospital

Aspen, Colo.

90%

21.3%

6.3%

1. Stony Brook University Hospital

Stony Brook, N.Y.

90%

27.0%

9.7%

2. C.S. Mott Children's Hospital at the University of Michigan

Ann Arbor, Mich.

86%

30.7%

9.3%

2. Westchester Medical Center

Valhalla, N.Y.

86%

27.0%

9.7%

3. Wexner Medical Center

Columbus, Ohio

83%

32.6%

9.2%

4. St. Luke's Boise Medical Center

Boise, Idaho

82%

28.9%

7.8%

5. EvergreenHealth Monroe

Monroe, Wash.

78%

27.3%

8.0%

5. Memorial University Medical Center

Savannah, Ga.

78%

30.5%

10.4%

5. Sibley Memorial Hospital

Washington, D.C.

78%

21.7%

8.4%

6. Eskenazi Hospital

Indianapolis, Ind.

76%

32.7%

10.0%

6. Lexington Regional Health Center

Lexington, Neb.

76%

30.2%

8.4%

6. Central Vermont Medical Center

Berlin, Vt.

76%

24.8%

6.7%

7. Children's Hospital of Georgia/Georgia Regents Medical Center

Augusta, Ga.

75%

30.5%

10.4%

8. University of Iowa Hospitals and Clinics

Iowa City, Iowa

74%

30.9%

8.3%

9. Greenville Memorial Hospital

Greenville, S.C.

73%

32.1%

11.3%

10. Grady Memorial Hospital

Atlanta, Ga.

71%

30.5%

10.4%

11. Broward General Medical Center

Fort Lauderdale, Fla.

69%

26.2%

9.4%

12. Virginia Commonwealth University Hospital

Richmond, Va.

68%

28.5%

9.2%

13. Parkland Memorial Hospital

Dallas, Texas

67%

31.9%

10.9%

13. Ben Taub General Hospital

Houston, Texas

67%

31.9%

10.9%

14. Brookings Hospital

Brookings, S.D.

66%

29.8%

8.2%

15. University Hospital

Augusta, Ga.

65%

30.5%

10.4%

16. University of Mississippi Medical Center (including menu from Batson Children's Hospital)

Jackson, Miss.

62%

35.5%

12.0%

Fighting Fast Food

This year, the Physicians Committee obtained three new contracts between hospitals and fast-food restaurants: Broward General Medical Center’s contract with McDonald’s, Ohio State University’s Wexner Medical Center’s with Wendy’s, and University of Mississippi Medical Center’s with Chick-fil-A.

Hospital fast-food contracts like these often encourage the hospital—which can profit from the fast-food sales—to promote unhealthful greasy meat and dairy products to patients, employees, and visitors.

Harvard research presented at an American Heart Association meeting last year found that study participants who ate fried foods up to three times a week saw an 18 percent increased risk for heart disease. The risk increased with the frequency of fried food consumption, with about a 25 percent increased risk if eaten four to six times a week and up to 68 percent if eaten seven times or more a week.

Once the McDonald’s at Broward General generates $980,000, it must pay the hospital 5 percent of its gross sales (in addition to the base rent). UMMC’s contract with Chick-fil-A encourages the university to “make every reasonable effort to increase the sales and business and maximize the Gross Receipts of each Unit.” Most details in Wexner Medical Center’s contract with Wendy’s were redacted. Last year’s report also revealed contracts between hospitals and Chick-fil-A, McDonald’s, and Tim Hortons.

The Cleveland Clinic, Children's Hospital Los Angeles, Driscoll Children's Hospital in Texas, and Memorial Regional Hospital in Hollywood, Fla.—all featured in last year’s report—ended contracts with McDonald’s recently. Abbott Northwestern Hospital in Minneapolis, Minn., also featured in the 2015 report, will end its lease by this May.

Kosair Children’s Hospital in Louisville, Ky., told NPR it will close its McDonald’s in 2016.

Chick-fil-A still has at least 20 hospital locations, McDonald’s at least 13, Tim Hortons at least four, and Wendy’s at least five. The Physicians Committee is placing billboards and other outdoor ads in 10 states near 20 hospitals with Chick-fil-As. The ads urge people to contact their local hospital to ask that it go #FastFoodFree!

Chick-fil-As in Hospitals

Florida

  • Baptist Medical Center Jacksonville in Jacksonville.
  • UF Health Shands Hospital in Gainesville

Georgia

 

  • Northeast Georgia Medical Center in Gainesville
  • Piedmont Fayette Hospital in Fayetteville
  • University Hospital in Augusta

Maryland

  • Saint Agnes Hospital in Baltimore

Mississippi

  • North Mississippi Medical Center in Tupelo
  • University of Mississippi Medical Center in Jackson

North Carolina

 

  • Carolinas Medical Center in Charlotte
  • Duke University Medical Center in Durham

Oklahoma

  • Duncan Regional Hospital in Duncan

South Carolina

  • Greenville Memorial Hospital in Greenville
  • Medical University of South Carolina in Charleston

Tennessee

  • Jackson-Madison County General Hospital in Jackson

Texas

  • Cook Children’s Medical Center in Fort Worth
  • M.D. Anderson Cancer Center in Houston
  • Texas Children’s Hospital in Houston
  • Texas Health Presbyterian Hospital in Dallas

Virginia

  • Virginia Commonwealth University Medical Center in Richmond

Hospital Food Environment Part of the Problem?

This year’s report reveals an occasional correlation between a hospital’s ranking and its state’s obesity and diabetes prevalence. Those that scored better often have a lower prevalence; those that scored worse often have a higher prevalence. Stony Brook University Hospital in Stony Brook, N.Y., tied for No. 1 with a score of 90. New York State’s prevalence of obesity and diabetes among adults is 27 percent and 9.7 percent, respectively. University of Mississippi Medical Center in Jackson, Miss., ranked last with a score of 62. Mississippi’s prevalence of obesity and diabetes among adults is 35.5 percent and 12.0 percent, respectively.

Stony Brook and several other top scoring hospitals have gardens, a step that can improve patient health, as well as the health of the surrounding community. A 2015 study published in Preventive Medicine Reports found that hospital gardens are not only associated with lower rates of obesity in communities they serve, “they may hold potential to complement other strategies to reduce public health disparities through providing nutrition education, promoting lifestyle physical activity among patients and hospital employees, accelerating healing from injury and disease, and growing food for medically underserved populations.”

Healthy Hospital Food Movement

Many experts agree that hospitals need to do a better job providing patients foods that promote good health. At last year’s International Conference on Nutrition in Medicine, Kim Williams, M.D., president of the American College of Cardiology, who began a vegan diet in 2003 to improve his own heart health, told the story of a patient of his who was vegetarian when he went into the hospital, but came out eating unhealthful meat and dairy products. His patient said, “the hospital fed it to me, so I figured it was OK.”

Meat and dairy products are linked to obesity, heart disease, diabetes, cancer, and many other diseases. Just last year, the World Health Organization placed processed meats—such as bacon and hot dogs, common in hospitals—in the same carcinogenic category as tobacco products and asbestos.

The newly released 2015 Dietary Guidelines for Americans recommend that “individuals should eat as little dietary cholesterol as possible,” limit saturated fat intake, and eat more fruits, vegetables, grains, and legumes. And a recent Centers for Disease Control and Prevention report found that “most adults consumed too few fruits and vegetables,” but that “increased attention to food environments in multiple settings … might help improve fruit and vegetable intake, and thus help prevent chronic disease.”

Hospitals are one of those settings. A 2015 study in the journal Nutrients evaluated 84 patient menus and found that none met the Dietary Reference Intakes (DRI) for fiber and only 57 percent met vitamin C recommendations. The authors concluded that “appropriate nutritional targets for energy, macronutrient, and vitamin and mineral levels are needed to ensure that menus are of high nutritional quality in order to … optimize patient outcomes.”

Report Methodology

The Physicians Committee obtained most patient menus and fast-food contracts through state public records laws. Hospitals were then ranked on the following criteria:

  1. Does the hospital offer daily at least one vegetable, rice, or bean side dish? If so, award 20 points.
  2. Does the hospital offer daily at least one piece of fruit or fruit side dish (such as applesauce)? If so, award 20 points.
  3. Does the hospital offer daily at least one whole grain or potato, nonsugary breakfast item? If so, award 20 points.
  4. How many healthful, cholesterol-free, entrées or soups does the hospital offer? Award two points each entrée.
  5. Award two points if the hospital offers soy milk.
  6. If listed as Meatless Monday participating hospital, add two points.
  7. If the hospital provided patient menus as required by the state open records law, award two points.
  8. Does the hospital have a farm, kitchen garden, or community garden on hospital grounds? If yes, award four points.
  9. Does the hospital host a farmer’s market? If so, add two points.
  10. How many fast-food outlets does the hospital host? Subtract three points for each major fast-food outlet.

1. Aspen Valley Hospital Aspen | 90 percent

Aspen Valley Hospital, located in Aspen, Colo., earns a high Patient Food Score. In addition to participating in Meatless Mondays, patient menus obtained through the Colorado Open Records Act reveal that the hospital serves cholesterol-free, healthful entrées each day, as well as a selection of vegetables and fruits including baked yams, steamed brown rice, steamed vegetables, and a fresh fruit cup. The hospital also scores points for offering soy milk.

1. Stony Brook University Hospital | 90 percent

Stony Brook University Hospital in Stony Brook, N.Y., earns a high score thanks in part to “Stony Brook Heights,” its 2,242-square-foot organic rooftop garden that supplies vegetables and herbs for patient meals. The hospital also scores points for its patient menu, publically available on its website, which features healthful entrées including pasta with olive oil and vegetables; crudités and hummus; create-your-own-salad with tofu, vegetables, and chickpeas; tofu fajitas; and a black bean burger. The New York Times reports that its head chef has banished bacon, soda, and hot dogs.

2. C.S. Mott Children’s Hospital at the University of Michigan | 86 percent

C.S. Mott Children’s Hospital, part of the University of Michigan Health System, located in Ann Arbor, Mich., is one of the country’s largest children’s hospitals. Patient menus for C.S. Mott and Von Voigtlander Women’s Hospital (in the same complex), obtained through the state’s Freedom of Information Act, show that healthful entrées include fruit compote with quinoa crumble (breakfast entrée); pasta with marinara sauce; vegetarian chili; hummus, fresh vegetables, and pita bread; and a veggie burger. Soy milk is also available.

2. Westchester Medical Center | 86 percent

Westchester Medical Center, located in Valhalla, N.Y., is on Becker’s list of the largest public hospitals in the country. Patient menus provided voluntarily show that healthful entrées include a black bean burger, tofu stir-fry, pasta with marinara sauce, and portobello rustic on a multigrain roll. Soy milk is also available.

3. Wexner Medical Center | 83 percent

Ohio State University’s Wexner Medical Center, which includes the Ross Heart Hospital and University Hospital, is located in Columbus, Ohio. Wexner’s score is boosted by the Ross Plant Based Diet menu, obtained through the Ohio Open Records Law, which includes healthful entrées such as sweet potato hash browns with kale, caramelized onion and pepper quesadilla (no cheese), and an enchilada casserole (no cheese). The Dining on Demand House Menu includes Tuscan pasta salad and a veggie burger. Soy milk is also available. Wexner loses points for a Wendy’s located in University Hospital on the ground floor between the 12th Avenue parking garage and Doan Hall.

4. St. Luke’s Boise Medical Center | 82 percent

St. Luke’s Boise Medical Center in Boise, Idaho, earns points for hosting a farmers market, which is provided through a partnership between the Capital City Public Market, Idaho’s largest farmers market, and Global Gardens, an Idaho Office for Refugees agricultural training program. The hospital’s patient menu, provided voluntarily, includes healthful entrées such as Luke’s veggie burger, tofu stir-fry with brown rice, and pasta with primavera vegetables and marinara sauce. Soy and rice milk are available.

5. EvergreenHealth Monroe | 78 percent

EvergreenHealth Monroe in Monroe, Wash., earns points for participating Meatless Mondays. The patient menu, obtained through the Washington Public Records Act, includes healthful entrées such as a garden burger and vegetarian soup of the day. Soy milk is also available.

5. Memorial University Medical Center | 78 percent

Memorial University Medical Center in Savannah, Ga., earns points for participating in the Meatless Monday campaign. Its patient menu, obtained through the Georgia Open Records Act, features healthful entrées including hearty vegetable soup, a black bean burger, a three-vegetable plate, and a black-eyed pea salad.

5. Sibley Memorial Hospital | 78 percent

Sibley Memorial Hospital in Washington, D.C., has a patient menu with healthful entrées including a veggie burger, vegetable stir-fry, pasta with marinara sauce, and vegan seven-bean soup. Soy milk is available.

6. Eskenazi Hospital | 76 percent

Sidney and Lois Eskenazi Hospital in Indianapolis, Ind., earns extra points for its Sky Farm and Eskenazi Health Farmers' Market. Sky Farm is a 5,000-square-foot rooftop garden, which is open to patients, staff, and the community and provides produce—including kale, beets, and broccoli—for the hospital’s Ingram Micro Mobility Marketplace and Café Soleil. The farmers market provides fresh and local produce to the public during the summer. The hospital’s patient menu, obtained through the Indiana Access to Public Records, features healthful entrées including pasta with marinara sauce, vegetarian pasta, and a veggie burger.

6. Lexington Regional Health Center | 76 percent

Lexington Regional Health Center in Lexington, Neb., earns extra points for adopting plant boxes in a community garden. Hospital staff cares for the garden, which provides underserved members of the community with fresh vegetables such as squash, zucchini, beans, peas, and tomatoes. The hospital’s patient menu, obtained through the Nebraska Public Records Law, features healthful entrées including corn casserole, a vegetable collage salad, and Spanish rice.

6. Central Vermont Medical Center | 76 percent

Central Vermont Medical Center, which includes Central Vermont Hospital, in Berlin, Vt., earns points for its participation in the Two Rivers Farm-to-Table program.
The medical center also purchases produce wholesale from the Vermont Youth Conservation Corps to resell at a weekly farmers market or use in the patient and cafeteria menus. Healthful entrées include rice pilaf, and pasta salad.

7. Children’s Hospital of Georgia/Georgia Regents Medical Center | 75 percent

Georgia Regents Medical Center in Augusta, Ga., which was featured in last year’s report, loses points for hosting a McDonald’s, which is located on the first floor of the Children's Medical Center. But the patient menu, obtained through the Georgia Open Records Act, features healthful entrées including grilled vegetable hummus on flatbread, whole-wheat penne, and barley rice pilaf.

8. University of Iowa Hospitals and Clinics | 74 percent

University of Iowa Hospitals and Clinics in Iowa City, Iowa, is on Becker’s list of 50 largest public hospitals in the United States. The patient menu, obtained through the Iowa Open Records Law, features healthful entrées such as a vegetarian Malibu burger, low-sodium tomato soup; pasta salad with balsamic dressing, vegetables, and black beans; and a build-your-own sandwich with hummus, lettuce, and tomato. Soy milk is available.

9. Greenville Memorial Hospital | 73 percent

Greenville Memorial Hospital in Greenville, S.C., loses points for hosting a Chick-fil-A, located on the first floor of the hospital.  The hospital’s contract with Chick-fil-A automatically expires and renews on Dec. 31 each year, unless one of the parties provides notice before mid-November. Greenville’s patient menu, obtained through the Freedom of Information Act, features a few healthful entrées, including couscous pilaf and barley pilaf.

10. Grady Memorial Hospital | 71 percent

Grady Memorial Hospital in Atlanta, Ga., which was featured in last year’s report, loses points for a McDonald’s in its parking garage. Its contract with the restaurant expires on June 28, 2016. Grady’s patient menu, obtained through the Georgia Open Records Act, features healthful entrées including minestrone soup and vegetable soup.

11. Broward General Medical Center | 69 percent

Broward General Medical Center in Fort Lauderdale, Fla., which was featured in the 2014 report, earns points for hosting a farmers market with a “vast variety of vegan products.” The patient menu, obtained through Florida’s open records law, includes healthful entrées such as vegetable rice soup and rice pilaf.

Broward General loses points for hosting a McDonald’s, located near the hospital’s main entrance. The more fast food the restaurant sells to patients, employees, and visitors, the greater likelihood the medical center will turn a profit: Once McDonald’s generates $980,000, it must pay the hospital 5 percent of its gross sales (in addition to the base rent). However, the lease does encourage McDonald’s to add new items with “positive nutritional qualities” and items with “lower fat and calories.”

12. Virginia Commonwealth University Medical Center | 68 percent

Virginia Commonwealth University Medical Center in Richmond, Va., which is on Becker’s list of the 50 largest public hospitals, was featured in the Physicians Committee’s 2014 report on the five worst heart hospital food environments. Virginia Commonwealth loses points for hosting a Chick-fil-A, on the first floor of Main Hospital,  and Wendy’s, located on ground floor of the Gateway Building. The patient menu, obtained through the Virginia Public Records Act, features a few healthful entrées, including lentil soup, hearty vegetable soup, and a meatless breakfast sausage patty.

13. Parkland Memorial Hospital | 67 percent

Parkland Memorial Hospital in Dallas, Texas—which recently closed its old facility and moved to a new one—is featured on Becker’s list of the 50 largest public hospitals in the United States. Parkland earns points for closing its McDonald’s in 2009 and for keeping fast food out of the new location.

13. Ben Taub General Hospital | 67 percent

Ben Taub General Hospital in Houston, Texas, which was featured in last year’s report, loses points for hosting a McDonald’s on its basement level. The hospital’s patient menu, obtained through the Texas Public Information Act, lists healthful entrées including garlic pasta, seasoned pasta, and confetti rice.

14. Brookings Hospital | 66 percent

Brookings Hospital in Brookings, S.D., features an online patient menu with healthful entrées including spaghetti with marinara sauce.

15. University Hospital | 65 percent

University Hospital in Augusta, Ga., loses points for hosting a Chick-fil-A located on the first floor in the food court.  A patient menu obtained through the Georgia Open Records Act includes a healthful veggie burger.

16. University of Mississippi Medical Center (including menu from Batson Children’s Hospital) | 62 percent

University of Mississippi Medical Center in Jackson, Miss., which is on Becker’s list of 50 largest public hospitals, hosts both a McDonald’s (next to the Batson Children’s Hospital) and a Chick-fil-A on campus (not inside the hospitals).

UMMC’s contract with Chick-fil-A, which the Physicians Committee obtained through the Mississippi Public Records Act, requires the medical center to “make every reasonable effort to increase the sales and business and maximize the Gross Receipts of each Unit.” The menu includes “Chick-fil-A Chicken Sandwich,” “Chargrilled Chicken Sandwich,” “Nuggets,” and “Biscuit w/bacon/sausage/egg/cheese,” among other unhealthful items. The contract also states that the university must “at its own cost, use diligent efforts to advance the reputation of CFA and the Products and to enhance consumer awareness of the Products and” CFA’s logos.

Patient menus, obtained through the Mississippi Public Records Act, reveal that Batson Children’s Hospital offers few healthful entrees.

Conclusion

Hospitals across the nation are taking strides toward improving patient health and the health of surrounding communities by providing healthful plant-based patient meals, ending contracts with fast-food restaurants, and promoting community gardens and farmers markets.

But there is still room for improvement. Disease-promoting meat and dairy products are the norm on most patient menus, and at least 42 hospitals still have Chick-fil-A, McDonald’s, Tim Hortons, and Wendy’s fast-food restaurants.

Doctors and the general public are calling for continued improvement. Nearly 10,000 people have signed the Physicians Committee’s “Make Hospital Patient Rooms Fast Food–Free” petition.

Hospitals that continue to feature fast food and unhealthful patient menus put patients and the community at risk for obesity, diabetes, and heart disease, while those hospitals that provide patients more fruits, vegetables, whole grains, and legumes at every meal are leaders in the healthy hospital foods movement.

 

Appendix

 

Chick-fil-A McDonald's Tim Hortons Wendy's

Florida
1. Baptist Medical Center | Jacksonville

2. UF Health Shands Hospital at the University of Florida | Gainesville

Georgia
3. Northeast Georgia Medical Center | Gainesville

4. Piedmont Fayette Hospital | Fayetteville

5. University Hospital | Augusta

Maryland
6. Saint Agnes Hospital | Baltimore

Mississippi
7. North Mississippi Medical Center | Tupelo

8.University of Mississippi Medical Center | Jackson

North Carolina
9. Carolinas Medical Center | Charlotte

10. Duke University Hospital Complex | Durham

Oklahoma
11. Duncan Regional Hospitals | Duncan

South Carolina
12. Greenville Memorial Hospital | Greenville

13. Medical University of South Carolina University Hospital Complex | Charleston

Tennessee
14. Jackson-Madison County General Hospital | Jackson

Texas
15. St. Luke's Medical Center/Texas Children's Hospital Complex | Houston

16. Cook Children's Medical Center | Fort Worth

17. Texas Health Presbyterian Hospital | Dallas

18. University of Texas M.D. Anderson Cancer Center | Houston

Virginia
19. Virginia Commonwealth University Medical Center | Richmond

California
1. Naval Medical Center San Diego | San Diego

2. Rady Children's Hospital San Diego | San Diego

Florida
3.  Broward General Medical Center |  Fort Lauderdale

4. Jackson Memorial Hospital | Miami

5. Tampa General Hospital | Tampa

Georgia
6. Georgia Regents Medical Center/ Children's Hospital of Georgia | Augusta

7. Grady Hospital | Atlanta

8. Northside Hospital | Atlanta

Iowa
9. Mercy Medical Center | Des Moines

Mississippi
10. University of Mississippi Medical Center | Jackson

Texas
11. Ben Taub General Hospital | Houston

12. John Peter Smith Hospital | Fort Worth

13. Texas Children’s Hospital | Houston

Note: Kosair Children’s Hospital in Louisville, Ky., told NPR it will close its McDonald’s in 2016.

New York
1. Buffalo General Hospital |Buffalo

2. Erie County Medical Center | Buffalo

3. Upstate University Hospital | Syracuse

Ohio
4. Riverside Methodist Hospital | Columbus

 

 


 

 

 

 

 

 

 

 

 

Michigan
1. DMC Harper University Hospital I Detroit

Ohio
2. Ohio State University Wexner Medical Center | Columbus

Florida
3. Sacred Heart Health System | Pensacola

4. UF Health Shands Hospital at the University of Florida | Gainesville

Virginia
5. Virginia Commonwealth University Medical Center | Richmond