October 23, 2013

By Jack Henderson, recently retired after ten years as the Associate Director of Food Service Operations in the Nutrition and Food Services Department at the University of California, San Francisco (UCSF) Medical Center.

Over the past two and a half decades of my work in hospital food service, I thought a lot about the meat I served to patients and customers. In recent years, I’ve become increasingly concerned with what I like to call “S

TAB,” or the overuse of Sub-Therapeutic Anti-Biotics, in the production of meat and poultry in the USA. Many independent health experts agree that this overuse contributes to a rising wave of bacteria that are resistant to even the newest and most effective antibiotics. This is a problem that threatens all of us.

Jack Henderson

Jack Henderson

Let me tell you about how I came to use my position within hospital food service to address sustainable food issues like the overuse of antibiotics in livestock production. I recently retired after ten years as Associate Director, Food Service Operations in the Nutrition and Food Services Department at the University of California, San Francisco (UCSF) Medical Center. I started as executive chef at UCSF Medical Center in 1990, bringing with me experience working as a chef in London, Hong Kong, India, Israel, and Boston. As Associate Director, I was responsible for most of the food service operations in the Medical Center. Serving 1,500 patient meals a day, with combined retail and catering sales of over $8 million and an annual budget of $6.5 million, it was and remains a big job.

About seven years ago I had a visit from Lucia Sayre, Co-Executive Director of the local chapter of Physicians for Social Responsibility (PSR). Lucia asked me about rBST in milk production, and I was quick to assure her that our milk was absolutely 100% rBST-free. Then she asked me about yogurt, and I thought, “is it not enough that we have milk covered”? With Lucia’s encouragement, I embarked on a two year-long battle with Dannon asking them to remove rBST from their yogurt. In December 2008, the battle ended when we dropped Dannon in favor of a local, rBST-free yogurt maker.

In 2009, the University of California (UC) Office of the President announced a sustainable food procurement goal of 20% by 2020 for all ten universities and five medical centers in the UC system. It seemed like we had a long climb ahead of us when we struggled to get a 6.5 percent sustainable spend that year, but we still had eleven years to go, so not to worry.

To expedite the mission, we assembled a Sustainable Foods Task Force and got to work. With help and encouragement from the Health Care Without Harm (HCWH) Healthy Food in Health Care Program (HFHC), as well as Bay Area Hospital Leadership Team (HLT), organized by San Francisco Bay PSR, we set about the job with our eyes on the prize.

As a result of the hard work of our team members, this year, UCSF Medical Center hit 22% sustainable food purchases seven years ahead of schedule and it was all done under budget!

The next challenge: UCSF Medical Centers Antibiotics Resolution

This year, the gauntlet was cast down when the UCSF Academic Senate passed a resolution that UCSF would begin to phase out the purchase of “STAB” meats and poultry. This is not an easy proposition for two reasons. A sufficient supply of “clean” meat and poultry to cover all a hospital’s needs is hard to find. Then, there’s the elephant in the room, the price – it just costs more to produce, period.

Our department mantra, however, is “baby steps.” Our team decided that, although it may not be feasible to do everything, we could at least do something.

We started by buying a burger patty that was “never, ever” treated with antibiotics. Then we took a page out of the playbook from John Muir Hospital – a partner in our Hospital Leadership Team – and put on a sustainable chicken dish for one patient meal once a week. Food Services also took a leap forward just last week by bringing in the ubiquitous- but this time STAB-free – 4 ounce, boneless, skinless chicken breast at a price we hope to continue to afford!

Stakeholders coming together to discuss challenges and opportunities

We finally had the opportunity to discuss the ongoing challenges and opportunities to scaling up our sustainable meat efforts at Balanced Menus: Meeting Health Cares Demand for Sustainable Meat, a convening hosted in the San Francisco Bay Area by Health Care Without Harm’s Healthy Food in Health Care program and San Francisco Bay Physicians for Social Responsibility on October 7 and 8. On the first day, over eighty experts from across the supply chain gathered at the UCSF campus to tackle the thorny problems surrounding the procurement of STAB-free meat and poultry

There was broad representation from the people who matter most in this vital work. We had meat and poultry suppliers, distributors, end-users like hospitals and schools, researchers, medical professionals, and funders.

The first day began with a panel of professionals from three hospital members of the Bay Area Hospital Leadership Team who described their work and its relationship with the Healthy Food in Health Care Program. Kimberley Alvari, Food Service Director from Washington Hospital in Fremont presented on “hospital food procurement 101” and explained the various pressures she faces every day in trying to bring in sustainable foods for her staff and patients. Then, I detailed a very successful project that used the combined purchasing demand of the HLT to bring in Wilcox Farms cage-free eggs from humanely raised hens through the distributor, US Foods. Lastly, Alison Negrin, Executive Chef at John Muir Hospital in Walnut Creek explained how the HLT had boosted the various hospitals’ use of local produce from Bay Area small family farms through the Farm Fresh Health Care Project coordinated by Community Alliance with Family Farmers and PSR. The morning ended with a presentation by Dr. Tom Newman from UCSF on the deleterious climate change effects of widespread beef production.

The afternoon began with Dr. Michael Martin from UCSF discussing the passage of the Academic Senate resolution to phase out the purchase of meat and poultry produced using STABs and his hope that other institutions will emulate this exciting step. The afternoon ended with a panel of food system experts who presented the argument in favor of STAB-free meat and poultry. Brian J. Kenny from Hearst Ranch in Central California described they raise 1,500 head of prime cattle. He was followed by Charles Thierot whose family raises organic pork on their Llano Seco Ranch near Chico. Lauren Gwin, Research Associate at Oregon State University, and Kathryn Quanbeck, Co-Founder of Food & Farm Consulting, presented the supply chain challenges to sourcing local and sustainable meat and poultry. Finally, Andrew Gunther from Animal Welfare Approved gave an impassioned presentation on the health, social, and environmental benefits of increasing the use of STAB-free, grass-fed meat.

The next day, a select group of forty individuals representing all facets of the industry convened at the David Brower Center in Berkeley to discuss the challenges and potential solutions in relation to the production and availability of STAB-free meat and poultry for institutions. The entire body of attendees was broken down into groups with representatives from all sectors so that all stakeholders could hear and learn from each other. After much lively discussion, the groups came back and the findings were tabulated. When the talks ended, the assembly took on an exciting and interactive life of its own.

The energy level in the room soared as many suggestions came up for discussion and expansion. As the meeting came to a close, each of the hospitals was encouraged to take back with them a concrete plan to boost sustainable meat purchases. The beauty of having all the players in the same room was the understanding that each had a role to play in achieving success.

The primary commitment that emerged from the meeting was to begin to use STAB-free, grass-fed ground beef. This will soon be available to hospitals through mainline distributors. The impressive quantity of ground beef needed by hospital food service ensures that this type of purchasing will make a difference. There will be lots of follow-up work to be done in the coming days and weeks, but the momentum from the meeting will carry this into solid progress. Watch this space! And repeat after me, “Baby Steps, Baby Steps!”

This is the third post in a 3-part series on the health care sectors efforts to protect antibiotics for human medicine by building a more sustainable agricultural system through policy advocacy and procurement strategies. Read the previous posts:

Hospitals Protecting Antibiotics for Human Medicine: From Agricultural Policy to Sustainable Procurement

From Chipotle to Whole Foods, Now Hospitals and Schools: The Power of Large-Scale Sustainable Meat Procurement

A version of this blog first appeared on Health Care Without Harm’s website.