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.
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By Kate Whiting
Bernice Dapaah calls bamboo "a miracle plant," because it grows so fast and absorbs carbon. But it can also work wonders for children's education and women's employment – as she's discovered.
These are the world's most bicycle-friendly cities. Statista<p>"The reason we use bamboo to manufacture bicycles is because it's found abundantly in Ghana and this is not a material we're going to import," says Dapaah, one of the World Economic Forum's Young Global Leaders.</p><p>"It's a new innovation. There were no existing bamboo bike builders in our country, so we were the first people trying to see how best we could utilize the abundant bamboo in Ghana."</p>
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Supporting Students<p>Besides encouraging Ghanaians to swap vehicles for affordable bikes, Ghana Bamboo Bikes Initiative is helping students save time on walking to school so they have more time to learn.</p><p>Each time they sell a bike, they donate a bike to a schoolchild in a rural community, who might otherwise have to walk for hours to get to school.</p><p>Dapaah knows how transformative a shorter journey to school can be to academic performance. She grew up living with her <a href="https://www.youtube.com/watch?v=sb3joGYmx9A&feature=emb_logo" target="_blank">grandpa, a forester in a rural part of the country</a>.</p><p>"We had to walk three and a half hours every day before I could go to school. He later bought me a bike, so I finished senior high and wanted to go to university."</p><p>The experience inspired her to launch Ghana Bamboo Bikes Initiative with two other students at college.</p><p>"When we started this initiative, I looked back and said, when I was young, I had to walk miles before I could get to school, and sometimes if I was late, I was punished.</p><p>"Why don't we donate bikes for students to encourage them to study and so they can have enough time to be on books."</p><p>To date, they have sold more than 3,000 road, mountain and children's bikes – and Dapaah says they plan to donate <a href="https://www.entrepreneur.com/video/350343" target="_blank">10,000 bikes to schoolchildren over five years</a>.</p>
Empowering Women<p>The enterprise is also providing local jobs. It teaches young people to build bikes, particularly women and those in rural communities, where jobs can be scarce. More than 50% of people they have trained are women.</p><p>Dapaah says they want to boost the number of people they employ to 250 over the next five years and they are looking to partner with NGOs to build a childcare facility so mothers can continue to work.</p>
Reducing Emissions<p>By promoting a cycling culture in Ghana, Dapaah says they're also committed to reducing emissions in the transport sector and contributing to the UN's Sustainable Development Goals.</p><p>"I love the idea of reusing bamboo to promote sustainable cycling. People want to go green, low-carbon, lean-energy efficient," she says.</p>
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By Kristen Pope
Melting and crumbling glaciers are largely responsible for rising sea levels, so learning more about how glaciers shrink is vital to those who hope to save coastal cities and preserve wildlife.
Groans, Creaks, Icebergs’ Calving Splashes<p>Oskar Glowacki already knew that melting glacial ice sounds like frying bacon. As ice bubbles burst, anyone nearby can hear crackling and popping, said Glowacki, a postdoctoral scholar at the Scripps Institution of Oceanography. Using hydrophones, he and other scientists now can make more nuanced measurements of how a changing climate sounds underwater, from the groans, creaks and splashes of a calving iceberg to the changes in whale songs as the ocean warms.</p><p>Glowacki recently used a pair of hydrophones to study the underwater world of glaciers, publishing his findings in <a href="https://www.the-cryosphere.net/14/1025/2020/" target="_blank">The Cryosphere</a>. He and co-author Grant B. Deane measured glacier retreat by <a href="https://yaleclimateconnections.org/2020/07/melting-glaciers-sound-like-frying-bacon/" target="_blank">recording the sounds of ice</a> – from small chunks to enormous slabs – falling off the glacier and splashing into the water.</p><p>During the summer of 2016, Glowacki's team placed two hydrophones near Hansbreen Glacier in Hornsund Fjord, Svalbard. For a month and a half, they recorded sounds, also using three time-lapse cameras to collect images – including the "drop height" (how far the ice fell into the water) – so they could compare photos to the recordings. The team created a formula to represent the relationship between the size of a piece of ice falling from a glacier and the sound it makes underwater, also accounting for the pieces of ice falling from varying heights. (Hear an example of the sound an iceberg makes while calving <a href="https://soundcloud.com/user-248456662/iceberg-calving-hansbreen-glacier" target="_blank">here</a>.)</p>
Unlocking Information About Antarctic Ice Shelf<p>Other researchers also are using hydrophones to learn more about crumbling glaciers. Bob Dziak, research oceanographer with the NOAA/Pacific Marine Environmental Laboratory <a href="https://www.pmel.noaa.gov/acoustics" target="_blank">acoustics research group</a>, captured a massive calving event of the Nansen Ice Shelf in Antarctica with a hydrophone. He published the results with colleagues in <a href="https://www.frontiersin.org/articles/10.3389/feart.2019.00183/full" target="_blank">Frontiers in Earth Science</a></p><p>On April 7, 2016, satellite images showed a massive calving event had occurred on the ice shelf. The paper described it as the "first large scale calving event in >30 years."</p><p>However, once Dziak and colleagues delved into the data from three hydrophones deployed 60 kilometers east of the ice shelf, they uncovered a series of "icequakes" from January to early March 2016. He and other researchers believe that much of the ice actually broke free in mid-January to February, but it remained in the same location until an April storm – which their paper described as the "largest low-pressure storm recorded in the previous seven months" – broke the ice free.</p><p>"We suspected that the icebergs broke apart but remained in place – kind of pinned in place – until a major storm with high winds passed through the area and, finally, it was that last push that pushed the icebergs out to sea," Dziak says.</p><p>He and his co-authors wrote that "fortuitous timing and proximity of the hydrophone deployment presented a rare opportunity to study cryogenic signals and ocean ambient sounds of a large-scale ice shelf calving and iceberg formation event."</p>
Listening to Songs of Humpback Whales<p><a href="https://www.mbari.org/" target="_blank">Monterey Bay Aquarium Research Institute</a> studies the ocean, including its acoustics. One of the institute's projects involves examining the soundscape of California's Monterey Bay, including sounds from animals, humans, weather, and geologic processes like earthquakes. The researchers once even recorded an under-sea landslide. They also focus on recording and analyzing the <a href="http://www.mbari.org/humpback-song/" target="_blank">songs of humpback whales</a>. Male humpback whales' songs can be over 15 minutes in length, and they can be repeated for long periods of time – even hours. Listening to these songs and analyzing them can provide unique insights into the lives of these complex animals.</p><p>"Any time we want to study marine mammals, sound gives us a window into their lives because they use sound for all of their essential life activities, really," says institute biological oceanographer John Ryan. "Communication, foraging, reproduction, navigation – depending on the species, of course."</p><p>Previously, scientists had thought singing occurred only during courtship and mating, but now they think whales may also use song while migrating and hunting. They know song has a crucial role in the whales' lives.</p><p>"There's a whole other dimension to humpback whale song," Ryan says. "It is a mode of cultural transmission in this species. They learn songs from each other. They share songs as a population, and when populations mix and mingle, they learn new ideas, they explore with their song, improvise, and it's a real essential part of their culture."</p>
By William S. Lynn, Arian Wallach and Francisco J. Santiago-Ávila
A number of conservationists claim cats are a zombie apocalypse for biodiversity that need to be removed from the outdoors by "any means necessary" – coded language for shooting, trapping and poisoning. Various media outlets have portrayed cats as murderous superpredators. Australia has even declared an official "war" against cats.
Faulty Scientific Reasoning<p>In our <a href="https://doi.org/10.1111/cobi.13527" target="_blank">most recent publication</a> in the journal Conservation Biology, we examine an error of reasoning that props up the moral panic over cats.</p><p>Scientists do not simply collect data and analyze the results. They also establish a logical argument to explain what they observe. Thus, the reasoning behind a factual claim is equally important to the observations used to make that claim. And it is this reasoning about cats where claims about their threat to global biodiversity founder. In our analysis, we found it happens because many scientists take specific, local studies and overgeneralize those findings to the world at large.</p><p>Even when specific studies are good overall, projecting the combined "results" onto the world at large can cause unscientific overgeneralizations, particularly when <a href="https://doi.org/10.1016/j.tree.2015.01.003" target="_blank">ecological context is ignored</a>. It is akin to pulling a quote out of context and then assuming you understand its meaning.</p>
Ways Forward<p>So how might citizens and scientists chart a way forward to a more nuanced understanding of cat ecology and conservation?</p><p>First, those examining this issue on all sides can acknowledge that both the well-being of cats and the survival of threatened species are legitimate concerns.</p><p>Second, cats, like any other predator, affect their ecological communities. Whether that impact is good or bad is a complex value judgment, not a scientific fact.</p><p>Third, there is a need for a more rigorous approach to the study of cats. Such an approach must be mindful of the importance of ecological context and avoid the pitfalls of faulty reasoning. It also means resisting <a href="https://doi.org/10.1111/cobi.13126" target="_blank">the siren call of a silver (lethal) bullet</a>.</p>
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