This Hospital Prescribes Fresh Food From Its Own Organic Farm
By Liza Bayless
Five years ago, when Lankenau Medical Center was confronted with evidence that it was serving the unhealthiest county in Pennsylvania, the hospital decided to embrace the findings with an unconventional approach: building a half-acre organic farm on its campus to provide fresh produce to patients.
The Deaver Wellness Farm at Lankenau Medical Center. Lankenau Medical Center
The teaching and research hospital just outside Philadelphia was in the midst of its own patient health needs assessment in 2011 when the Robert Wood Johnson Foundation released findings about health outcomes in Pennsylvania counties. Lankenau is officially located within Montgomery County, one of the state's healthiest, taking into account factors including obesity rates and access to reliable sources of food. But the campus is adjacent to and receives many patients from Philadelphia County, ranked the least healthy of all 67 counties.
"That was really telling because it showed that we were serving a really diverse patient population," said Chinwe Onyekere, associate administrator at Lankenau, of the study's revelations. The findings showed that the hospital's patients had widely varying access to healthy food and nutritional knowledge.
With more than 1.5 million people, Philadelphia is one of the largest cities in the country and consistently named one of the unhealthiest. In 2010, 32 percent of its adults and about 25 percent of its children were obese. The same year, 13 percent of the city's adults had diabetes, and Philadelphia County ranked highest among the country's largest counties for chronic illnesses like cardiovascular disease and hypertension.
Across the nation, about half of Americans are estimated to have some kind of chronic disease stemming from health risks including lack of exercise, obesity, smoking and unhealthy eating. Treatment for these illnesses, which include asthma, heart disease or diabetes, has accounted for more than 75 percent of hospital admissions and physician visits in recent years.
This has caused some hospitals to look for ways to address health needs before a patient's condition has deteriorated so much that a hospital visit is necessary. At Lankenau, that meant providing its patients with a source of healthy food.
Students learn about fresh produce at the Deaver Wellness Farm. Lankenau Medical Center
Because the doctors, nurses and other staff were not farming experts, the hospital paired with Greener Partners, a nonprofit advocate for local food systems in Pennsylvania, to build and maintain what would become the Deaver Wellness Farm. Onyekere, who heads community needs programs for the hospital, oversees the project.
Since the farm's launch in 2015, it has provided more than 4,000 pounds of organic food to hospital patients at no cost. The produce is used for educational demonstrations and served in the hospital cafeteria. From its community needs assessment, Lankenau's staff learned that many of its patients, especially from West Philadelphia, lacked access to and nutritional knowledge of fruits and vegetables. So Lankenau now facilitates pop-up markets in internal medicine and the OBGYN practice wards.
While patients wait for appointments, medical assistants bring in fresh kale, broccoli, tomatoes, eggplant, arugula and other produce for them to select. The hospital also provides recipes, and, during an appointment, physicians use the produce to show how a patient can make healthier lifestyle choices.
In the Lankenau waiting rooms, hospital employees lead nutrition courses and food demonstrations. An employee might bring in the materials for a carrot salad, discuss the nutritional significance of each of its ingredients and then chop and assemble the salad in front of patients. Afterward, patients are given the ingredients and a recipe to try at home.
A young visitor gets a taste of what we do at the #DeaverWellnessFarm at #LankenauMedicalCenter. https://t.co/jTSbIAs4B3— ilana_grubin (@ilana_grubin)1480014835.0
For years before the farm, health educators employed by the hospital ran roughly 14 programs in a health education center with two classrooms in the middle of Lankenau's facilities. Seven thousand to 10,000 students from kindergarten through 12th grade took courses each year in physical health, like nutrition, as well as social health issues, like bullying and harassment.
Now, part of the mission of the farm is to serve as what Onyekere calls a "learning laboratory" for classes about healthy eating, and to create a hands-on experience for students to learn about nutrition, gardening and building healthy behaviors.
Outside the hospital, Lankenau—in partnership with The Food Trust and the Philadelphia Department of Public Health—incentivizes healthy food buying by providing coupons called Philly Food Bucks. These coupons for fresh fruits and vegetables are valid at more than 30 farmers markets and are given to patients who express the desire for better access to healthy foods.
"From the moment the patient walks into the door to the moment they leave the office, that whole experience is focused on improving their health," Onyekere said.
Drew Harris, director of health policy and population health at Thomas Jefferson University's College of Population Health, said that only recently have health providers begun to take accountability for addressing food insecurity among their patients. A former practicing doctor with a specialty in diabetes, he remembers having a very different philosophy about chronic diseases and overall patient health.
"Like many doctors, I probably blamed the patients for not getting well," he said. "I didn't really ask the question: Did they have the ability to follow the diet they were supposed to follow as a diabetic?"
Harris eventually became interested in the wider issues that led to chronic illness. While some patients are never taught health literacy, he said, for others "challenges in life can intervene."
"Not having food security—not knowing where your next meal is going to come from or whether you can purchase everything you need to purchase when you need to—is a major challenge," he said.
What's more, the tools for patient treatment taught in the medical profession have been so focused on prescriptions and procedures, Harris said, that doctors do not always learn the importance of stressing to their patients things like how to create a balanced diet and where to access those foods—knowledge that could keep people out of the hospital in the first place.
Though food insecurity is not a new issue, he thinks medical education is just starting to take a more holistic approach.
"There's a much stronger incentive to worry about why patients are not getting better and what we can do to avoid them getting sick in the first place, and a lot of it has to do with their social environment, their access to healthy food," he said.
Still, Harris stresses the need to pressure health providers. "Holding the medical profession more accountable for results—the quality of the care they provide—is going to make a difference," he said.
Onyekere estimates that Lankenau has provided farm produce to about 400 patients so far, and the hospital is about to launch a survey of patients to better understand the program's impact. Although she said patients have expressed that the farm is making a difference and raising awareness of how to incorporate healthy choices into daily life, the research survey will be a valuable resource for other health providers considering similar initiatives.
Going forward, Lankenau plans to grow the farm with four additional raised beds. Though this year's yield far exceeded initial expectations, staff took that as a sign that it can further increase production. Onyekere said Lankenau is also looking to donate its food to additional community partners, like local food banks.
Lankenau is not the nation's only hospital-run farm. Others include St. Joseph Mercy Ann Arbor and Henry Ford West Bloomfield Hospital, both in Michigan; and St. Luke's University Health Network in Pennsylvania. But Onyekere is aware of none that have so extensively incorporated their own organic food into hospital life.
If America is to confront its growing chronic health epidemic, that integration is key, and, as these hospitals show, is already happening. "We're beginning to move from the patient outward to look more at the neighborhood and the larger environment in which that patient lives," Harris said.
Reposted with permission from our media associate YES! Magazine.
By Kang-Chun Cheng
Modoc County lies in the far northeast corner of California, and most of its 10,000 residents rely on cattle herding, logging, or government jobs for employment. Rodeos and 4-H programs fill most families' calendars; massive belt buckles, blue jeans, and cowboy hats are common attire. Modoc's niche brand of American individualism stems from a free-spirited cowboy culture that imbues the local ranching conflict with wild horses.
The History of Horse Management<p>Before the 1950s, feral horses were largely unregulated in the U.S. They were released, grazed, captured, killed, sold, and otherwise <a href="http://www.blm.gov/sites/blm.gov/files/WHB-Report-2020-NewCover-051920-508.pdf" target="_blank" rel="noopener noreferrer">managed by local inhabitants</a> as they saw fit. Around that time, Velma Bronn Johnston, aka "Wild Horse Annie," started raising public awareness of the "perceived inhumane capture and treatment of free-ranging herds."</p><p>Thanks in part to Johnston's efforts, the Wild Free-Roaming Horses and Burros Act was signed into law by President Nixon in 1971. It declared that the animals "shall be protected from capture, branding, harassment, or death; and to accomplish this, they are to be considered in the area where presently found, as an integral part of the natural system of the public lands."</p><p><a href="http://science.sciencemag.org/content/341/6148/847.full" target="_blank" rel="noopener noreferrer">This act</a> has been amended four times since its conception to accommodate the fluctuating opinions and conditions around maintaining a "thriving natural ecological balance on the public lands"—an admirable although highly subjective goal. Achieving it involves juggling competing interests: those of local residents, permanent grazers, hunters and fishers, advocacy groups, conservationists, and Indigenous tribes.</p><p>The Bureau of Land Management must manage these many conflicting interests. Modoc County's <a href="https://www.fs.fed.us/wild-horse-burro/territories/DevilsGardenPlateau.shtml" target="_blank">Devil's Garden Plateau Wild Horse Territory</a> epitomizes the challenges of this task. Officially deemed wild horse territory, the garden consists of 258,000 acres and is wholly within permitted livestock allotments. It is also home to wildlife such as cougar, antelope, migratory birds, and aquatic species dependent on delicate high-desert riparian areas.</p><p>The presence of wild horses has been shown to <a href="https://www.sciencedirect.com/science/article/pii/S014019631530094X" target="_blank">decrease native wildlife species diversity</a> for both birds and mammals. Pronghorn antelope are an icon in Western grasslands, known for their annual 350-mile migration along historic routes estimated to be 5,800 years old. This awe-inspiring trek is one of the longest large-mammal migration corridors remaining in North America, but 75% of <a href="http://conbio.onlinelibrary.wiley.com/doi/abs/10.1111/j.1523-1739.2004.00548.x" target="_blank" rel="noopener noreferrer">pronghorn migration routes</a> have already been lost because of disturbances from the accelerated leasing of public lands and energy development. Horses also affect the pronghorn's yearly migrations by <a href="http://www.sciencedirect.com/science/article/pii/S014019631630218X" target="_blank" rel="noopener noreferrer">monopolizing watering holes</a>, thus preventing native species from drinking.</p>
Indigenous Support for Ecological Balance<p>Ken Sandusky, a public information officer who has worked for the Forest Service in Modoc County for 13 years, lives by his station's mission statement: "Caring for the Land and Serving People." In his work, Sandusky aims to include the broad range of stakeholders and often acts as a tribal liaison. Sandusky himself is a member of the Choctaw tribe of Oklahoma, but as a Modoc native, is more culturally in touch with the local Klamath tribe.</p><p>When it comes to rangeland health, he says, there's a tangible split in what that actually means. "It depends on what you are measuring the outcome against," Sandusky explains. Range managers may perceive progress from a year-to-year basis, but to many Indigenous tribes, the baseline for "progress" goes back generations, to pre-contact times. "They have long memories," he says. "Tribes see damage that is a hundred-plus years in the making."</p>
A Willingness to Try New Things<p>"Americans don't know what's happening on these lands," says Suzanne Roy, the executive director of the American Wild Horse Campaign, an advocacy organization. The Bureau of Land Management, she says, "is run by and for the livestock industry. They come from a ranching background. The term 'rangeland' management itself illustrates how livestock management is the dominant perspective."</p><p>Roy is particularly concerned about how resources are being allocated: "Policies of land management agencies don't reflect the desires and interests of the public." To illustrate, most Americans associate public lands with national parks and environmental conservation; only 29% of respondents to a recent poll considered livestock grazing an acceptable use of those lands.</p><p>Grazing on public lands certainly aligns with the financial interests of cattle ranchers and helps explain why they insist on increased wild horse management. Cattle can <a href="http://fas.org/sgp/crs/misc/RS21232.pdf" target="_blank">graze on public lands</a> for $1.35 per animal per month, while grazing on comparable private land costs ranchers $23 per animal per month (American taxpayer dollars make up the difference). To be fair, though, small-scale ranching would not be viable without public lands.</p><p>The campaign hopes to work toward more equitable resource allocation and improvements to overall habitats for horses and wildlife generally. "There are workable solutions to this issue," Roy says. "Common pushback from rangers is that new conservation strategies will 'destroy our way of life,' but change doesn't have to be bad."</p><p>The <a href="https://www.sciencedirect.com/science/article/abs/pii/0362331994900264" target="_blank">social conservatism</a> intrinsic to human cultures makes change seem daunting and people reluctant to try new tactics even in the face of suboptimal systems. Roy uses a case in adjacent Marin County to illustrate: Until 2001, the county ran a USDA program focused on killing apex predators (e.g. coyotes, mountain lions, and cougars) in defense of livestock. Unfortunately, this strategy fails to take into account the science of predators. Killing one mountain lion, for example, creates a vacuum and will eventually lead to increased competition for this newly available territory. In 2001, Marin introduced a country-run program that promoted nonlethal methods such as fox lights, guard dogs, and fladry to deal with predator incidents while compensating ranchers for sheep and lambs lost to predation.</p><p>Ranchers were initially livid, concerned that bans on shooting and trapping hindered their rights, making them defenseless against livestock predation. But 15 years later, a majority agreed that this form of humane <a href="http://www.projectcoyote.org/wp-content/uploads/2016/10/Camilla-Fox-Thesis-FINAL-January-2008.pdf" target="_blank" rel="noopener noreferrer">adaptive management </a>has successfully reduced both livestock losses and the total number of predators. Ensuring its continued success, the program requires active participation on behalf of all stakeholders and long-term commitment from the local government for support.</p><p>As one fifth-generation sheepherder, Gowan Batiste, explained in an interview to the <a href="https://www.msn.com/en-us/news/us/mendocino-county-rancher-and-others-calling-for-non-lethal-wildlife-management/ar-BB16CJ8g" target="_blank" rel="noopener noreferrer">Ukiah Daily Journal,</a> "Livestock is a food of desperation for predators; the more you harass them and make life difficult for them, the more likely they are going to come into conflict with humans."</p>
Keeping Wild Horses in Check<p>When it comes to wild horses, many solutions are already in the works. Through annual autumn wild horse roundups, known as gathers, the Double Devil Wild Horse Corrals has become one of the U.S.'s most successful adoption sites. The California Cattlemen's Association, a nonprofit trade association and organization popular among ranchers in Modoc, urges its members to support the wild horse gathers in Devils Garden, saying they are humane, good for the horses themselves (since competition for scarce water and forage resources may instigate aggression and <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1111/j.1439-0310.1981.tb01930.x" target="_blank" rel="noopener noreferrer">herd violence</a>), and necessary to support local ranchers and Modoc's agriculture-reliant economy.</p><p>Another popular solution for controlling wild horse populations is a fertility-control vaccine called PZP, given to female horses on the range <a href="https://www.youtube.com/watch?v=Ur7w3UPTCsk" target="_blank" rel="noopener noreferrer">using dart guns</a>. Mares are tracked on foot or with game cameras while drones are used to locate more elusive herds. The PZP vaccine has been endorsed by the American Wild Horse Campaign as the "<a href="https://americanwildhorsecampaign.org/fertility-control" target="_blank" rel="noopener noreferrer">most promising strategy</a>" for managing wild horses in their habitats and is also recommended by the National Academy of Sciences. Importantly, a dose of the vaccine only costs $30.</p><p>Lastly, land acquisition and <a href="https://americanwildhorsecampaign.org/equitable-share-resources" target="_blank">grazing lease buyouts</a> can promote equitable sharing of public lands and available forage. Acquiring key pieces of land adjacent to or within federally designated wild horse habitat areas can reduce conflicts over resource allocation.</p>
A Global Search for Solutions<p>Pastoralists all over the world face similar land-use conflicts, despite huge variations in climate and culture. The ongoing situation across rural California resonates with that of Fulani cattle herders in Niger and Sami reindeer herders in the Arctic.</p><p>Herders everywhere are accused of having too many animals or are perceived as selfish and irresponsible by their own communities. Overgrazing is certainly an issue, but it's not simply the number of animals that matters: The <a href="https://savory.global/holistic-management/" target="_blank">amount of time</a> animals spend in a certain area is critical to rangeland health. And in the context of such allegations, the ecological value of grazing is frequently omitted. Grazers, both wild and domestic, <a href="https://www.yesmagazine.org/issue/food-everyone/2019/02/04/restoring-the-range-can-beef-be-earth-friendly/" target="_blank" rel="noopener noreferrer">are key to regulating soil health and allowing for species diversity and coverage, </a>as well as efficient carbon sequestration.</p><p>Part of the problem in these heated grazing debates is that moderate viewpoints are drowned out by extremist agendas—those who prioritize wild horse populations at all costs and those who want all of the horses gone, period. "The majority of people don't really have strong views about the horses," Sandusky says. "But the ones who do can get really into it." These unwavering views make it difficult to find compromises that account for all stakeholders.</p><p>"There is no biological problem, merely a social one," says professor Nicholas Tyler, a pastoralism expert at the University of Tromsø in northern Norway. Tyler maintains that in the case of horses and cattle in the West, as with so many others, the so-called equilibria argument is specious and quasi-biological. "Certainly a lot of horses will influence the species composition," he says. "Remove the horses, things change. Add horses, things change again. There is nothing magical about that."</p><p>But Tyler takes it one step further: "There never was, is, or will be a balance. There are shifting equilibria, which is something quite different," he says. "It is up to the community to decide which state of that equilibrium it prefers."</p>
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EcoWatch Daily Newsletter
By Anne-Sophie Brändlin
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By Victoria Masterson
Using one of the world's problems to solve another is the philosophy behind a Norwegian start-up's mission to develop affordable housing from 100% recycled plastic.
Sustainable Homes<p>UN-Habitat says an <a href="https://unhabitat.org/un-habitat-aims-to-use-plastic-waste-to-support-housing-for-all" target="_blank">estimated 60% of people living in urban areas of Africa are in informal settlements</a>. At the same time, between 1990 and 2017, African countries imported around 230 metric tonnes of plastic, "which mostly ended up in dump sites creating a massive environmental challenge," the agency adds.</p><p>UN-Habitat deputy executive director, Victor Kisob, said the aim of the partnership with Othalo was to "promote adequate, sustainable and affordable housing for all."</p>
Artist's impression of an Othalo community, imagined by architect Julien De Smedt. Othalo<p>Othalo's process involves shredding plastic waste and mixing it with other elements, including non-flammable materials. Components are used to build up to four floors, with a home of 60 square metres using eight tons of recycled plastic. A factory with one production line can produce 2,800 housing units annually.</p><p>Following successful laboratory tests, Othalo's factory in Estonia has started producing components to build three demonstration homes for Kenya's capital, Nairobi; Yaoundé, the capital of Cameroon and Dakar, the capital of Senegal.</p><p>Othalo founder Frank Cato Lahti has been developing and testing the technology since 2016 in partnership with <a href="https://www.sintef.no/en/" target="_blank">SINTEF</a>, a 70-year-old independent research organization in Trondheim, Norway, and experts at Norway's <a href="https://en.uit.no/startsida" target="_blank" rel="noopener noreferrer">University of Tromsø</a>.</p>
Othalo founder Frank Cato Lahti. Othalo<p>Almost <a href="https://www.un.org/development/desa/publications/2018-revision-of-world-urbanization-prospects.html" target="_blank">seven out of every 10 people in the world are expected to live in urban areas by 2050</a>. More than 90% of this growth will take place in Africa, Asia, Latin America, and the Caribbean.</p><p>"In the absence of effective urban planning, the consequences of this rapid urbanization will be dramatic," UN-Habitat warns.</p><p>Lack of proper housing and growth of slums, inadequate and outdated infrastructure, escalating poverty and unemployment, and pollution and health issues, are just some of the effects.</p><p>Mindsets, policies, and approaches towards urbanization need to change for the growth of cities and urban areas to be turned into opportunities that will leave nobody behind, UN-Habitat says.</p>
Pioneers of Change<p>Reimagining cities and communities for greater resilience and sustainability was a key topic at the<a href="https://www.weforum.org/events/pioneers-of-change-summit-2020" target="_blank"> World Economic Forum's Pioneers of Change Summit 2020</a>.</p><p>The digital event brought together innovators and stakeholders from around the world to explore solutions to the challenges facing enterprises, governments and society.</p><p>Opening the summit, <a href="https://www.weforum.org/events/pioneers-of-change-summit-2020/sessions/opening-plenary-8f731cbc65" target="_blank">Stephan Mergenthaler, the Forum's Head of Strategic Intelligence and a member of the Executive Committee</a>, said: "We need to change the way we produce, the way we live and interact in our cities to make this transition to net-zero emissions a reality…</p><p>"And as this year has illustrated so dramatically, we need to make every effort that we keep populations healthy, if we want to avoid jeopardizing all this progress."</p><p><em>Reposted with permission from </em><em><a href="https://www.weforum.org/agenda/2020/11/un-africa-recycled-plastic-housing/" target="_blank">World Economic Forum</a>.</em><a href="https://www.ecowatch.com/r/entryeditor/2649069252#/" target="_self"></a></p>
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By Brett Wilkins
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Many people shop online for everything from clothes to appliances. If they do not like the product, they simply return it. But there's an environmental cost to returns.
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