Posts Tagged ‘health care’

Listening, Learning

In last week’s New Yorker, an article entitled Testing, Testing, written by Atul Gawande, details the author’s optimistic perspective on the Senate’s new health care bill.  Gawande highlights and applauds the bill’s inclusion of pilot programs reminiscent of those responsible for transforming American agriculture in the early 20th century.  “While we crave sweeping transformation,” he writes initially, “all the bill offers is [these] pilot programs, a battery of small-scale experiments.  The strategy seems hopelessly inadequate to solve a problem of [such] magnitude [as that of our health care system].  And yet…history suggests otherwise.” 

Gawande goes on to explain that agriculture was, like health care, a ridiculously expensive and yet crucial sector in the early 1900s, when “more than forty per cent of a family’s income went to paying for food…and farming was hugely labor-intensive, tying up almost half the American work-force.”  The author credits former “agricultural explorer” Seaman Knapp, hired by the USDA in 1903, with getting farmers to farm differently through efforts that started with a pilot program.  Knapp’s work began in Texas, where he encouraged a single farmer to test out a list of simple innovations, including “deeper plowing and better soil preparation, the use of only the best seed, the liberal application of fertilizer, and thorough cultivation to remove weeds and aerate the soil around the plants.”  The success of this initial program led other farmers to follow Knapp’s guidance, leading to similar “demonstration farms” across the country and to the establishment of the USDA Cooperative Extension Service, employing seven thousand extension agents nationwide by 1930.  Other USDA pilot programs led to comparative-effectiveness research, investment in providing farmers with weather forecasts, seasonal statistics, and tremendously helpful information broadcasting.  Gawande claims that the “hodgepodge” of pilot programs led to ultimately successful change, in that agricultural productivity increased dramatically, food prices fell by over fifty per cent, and farming came to employ only twenty per cent of the workforce by 1930.  “Today,” he goes on, “food accounts for just eight per cent of household income and two per cent of the labor force.  It is produced on no more land than was devoted to it a century ago, and with far greater variety and abundance than ever before in history.”

Testing, Testing makes several worthwhile, take-home points.   The author characterizes the reformation of the health care system (like the transformation of the agricultural system) as a problem which is not “amenable to a technical solution,” or a “one-time fix,” but rather one that requires a process of change.  He recognizes farming and medicine as both involving “hundreds of thousands of local entities across the country.”    And he encourages his readers to resist their cynical reaction to the government, writing that his solution is one in which the government “has a crucial role to play,” to guide the system, rather than running it.  He rather shockingly fails to mention, however, the failure of the agricultural transformation that is his model for modern day health care reform. 

The failure of the 20th century agricultural transformation is made manifest in the one product that (appropriately enough) both farming and health care would ideally generate: human health.

Over the past century, food prices have indeed gone down, agricultural production has indeed gone up, and America has, on paper, been relieved of devoting to agriculture the significant force of labor formerly required by farming.  This was all considered a success for several decades, until obesity, diabetes, early sexual maturity, and E. coli food poisoning (along with dozens of other health problems) were recently recognized as the effects of industrial agriculture.  The modern American diet – of highly processed foods made with high fructose corn syrup, meat from animals injected with antibiotics and hormones, and genetically modified foods not quite approved for human consumption – is one of the main causes of our deteriorating health.  Not to mention that industrial agriculture has irreparably damaged our nation’s environmental health, has dangerously demolished biodiversity, and still employs a fantastically under-paid, under-represented workforce of undocumented immigrants.

Gawande perhaps deserves the benefit of the doubt, for his article is optimistic, and encourages the American people to see more in the new health care bill than 2,074 pages that do not “even meet the basic goal that [we] had in mind: to lower costs.”  But his comparison begs for the recognition of what went wrong in the transformation of agriculture, because of a lack of holistic thinking, of preventative solutions, of respect for resources.  This time around, unless we are careful, the price drop and the productivity increase will still not provide the one thing we all want more than a smaller bill.  It will not provide us with health.

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Over the last several months, I have conducted a research project with my friend Sam Lipschultz, who recently graduated from Sarah Lawrence College.  Our research focused upon farm to institution collaboration in the United States, and particularly upon Farm to Hospital programs.  Below is a brief introduction to our final report, and you can download a full PDF file of the report by clicking here, or on the link that follows the introduction.  We hope our work might serve as an inspiration and as a resource for hospitals in the United States.  Your attention and feedback is appreciated!     

Real Food, Real Health: Reasons and Resources for Starting Farm to Hospital Programs in the United States

U.S. hospitals spend over $5 billion each year on food.  The average hospital serves over a million meals each year.   If shifted to support the healthiest, freshest food, this buying power would help hospitals meet their most basic goal, of nourishing human health, while supporting the food system infrastructure required to increase and maintain access to healthy food for years to come. 

Connecting farms with nearby hospitals has positive implications far beyond environmental and human health.  Farm to hospital programs create a niche market for the types of farms that are often left out of both the conventional food system, and alternative local food systems.   Small farms, often farming with some variation on certified organic practices, tend to gravitate toward direct retail markets, such as farmers markets and Community Supported Agriculture groups.  Large farms, often practicing chemical intensive farming, tend to produce for export to other regions or countries.  It is the mid-size farms that are disappearing fast.  And it is those mid-sized farms that are perfect for the wholesale market of farm to hospital programs.  Farm to hospital programs provide an increase in nutritional value and taste of food; a heightened capacity for accountability over food safety and worker conditions; increased food access and food security by offering fresh, healthy food to the entire spectrum of community residents; and key contributions to the much needed infrastructure for thriving local food systems.

For healthy food in hospitals to become the norm, hospital stakeholders must begin to act on their awareness of the pitfalls of producing and consuming conventional food, and on their knowledge of the advantages of purchasing locally grown and sustainably produced food.  The following study considers the unique and strategic location of farm to hospital  programs on the frontier of local, equitable and sustainable food systems.

FULL REPORT: Real Food, Real Health, by Annie Myers and Sam Lipschultz

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Americans are beginning to understand that buying and eating locally grown food is better for our health, the environment, and our local communities and economies than consuming the monocropped or factory-raised processed foods that we find cheaper, faster, and more readily available..

Local communities support farmers markets across the country. Through outlets known as Comnunity Supported Agriculture (CSAs), small farmers sell shares of their harvests to season-long customers. And after-school gardening programs teach elementary school children how to avoid diabetes and obesity by eating, and often growing their own, fresh vegetables. 

In New York, the Manhattan Borough President has called for the promotion of urban agriculture to help solve issues of hunger, food distribution, and nutrition education.  Michelle Obama has announced plans to use the White House Garden to educate children about healthful, locally grown fruit and vegetables.

As farmers markets and CSAs, community gardens and urban farms, tiny delivery companies and small locally-minded businesses gain ground, they are creating the potential for service to larger institutions.  Forty-one states have operational Farm to School programs, providing children in nearly 9,000 schools across the country with healthy lunches.  Students from nearly 300 colleges and universities report to the Real Food Challenge, and are working to increase the procurement of “real food” on their campuses.

Despite this progress, there remain two major dots we haven’t quite connected: the institutions that are in the business of serving our health, and healthy food.

Fresh, local vegetables are healthier than processed foods.  We should have them in our hospitals.  Access to nutritious food should be factored into policy as preventative care.

There are several significant reasons why this hasn’t happened yet.  First, four companies control 80 percent of America’s beef production.  Two companies process 75 percent of the precut salads in the country.  The voices of such companies are powerful in Washington.  Second, pharmaceutical companies aren’t big on preventative health care.  Hospitals and pharmaceutical companies are in cahoots.  Third, the industrialization of America’s food system destroyed much of the infrastructure that would have allowed large institutions to source locally.  In almost any region of the country (except perhaps California), it is difficult to coordinate the arrival of enough locally grown food at a hospital kitchen.  Fourth, our policymakers aren’t prone to holistic thinking, and so we are left struggling to find something other than band-aids to help heal our environment, our economy, and our health.  We don’t usually consider the complex options that might help cure, all at once, these ailing elements of our society.  And finally, we need a leader.  We need someone in Washington who will commit to introducing healthy food into hospitals, and who will integrate nutritious food into our health care plans.

Undeterred by these obstacles, little groups of ambitious individuals have begun creating models, hard-earned examples, of Farm to Hospital coordination.  One is in New Milford, Connecticut. 

In 2007, three women — a chef, a pediatrician, and a lawyer — came together to bring local, fresh vegetables into the kitchens of New Milford Hospital.  They found a powerful ally in the hospital’s CEO, a specialist in preventative cardiology.  Their hospital signed the Healthy Food in Health Care Pledge, agreeing to adopt food procurement policies that “provide nutritionally improved food for patients, staff, visitors, and the general public,” and “create food systems which are ecologically sound, economically viable, and socially responsible.” They launched their Plow to Plate program with cooking classes for the community and meetings between farmers, community members, and hospital representatives.  They changed their hospital’s contract to include local procurement policies, and made a request for proposals for a new food service provider.  Eighteen long months later, the Plow to Plate program is serving fresh, wholesome foods to their patients; supporting regional farmers through institutional accounts as well as the Plow to Plate farmers markets; and teaching local middle and high school students how to farm sustainably, cook safely, and eat healthfully.

Many institutions are, in fact, working to create similar systems.  A total of 122 health care facilities across the country have signed the Healthy Food in Health Care Pledge.  The majority of these institutions are in California, Oregon, and Washington, but others are in Nevada, Illinois, Iowa, Ohio, Arizona, Wisconsin, Michigan, Delaware, Maryland, Pennsylvania, New Jersey, New York, Connecticut, Massachusetts, Vermont, New Hampshire, and Maine.

Hospitals making the transition to serving healthy food have embarked upon a marathon thick with hurdles.  They face the difficulties of finding a food service provider willing to work specifically with regional sources; of identifying regional farmers who can reliably produce enough product to service a large institution; of competing with the growing strength of direct marketing at retail farmers markets and the higher prices farmers receive selling retail.  They have to find the right farmers, distribution centers, and distributors; to retrain their kitchen staff and perhaps renovate their kitchen facilities; and they have to teach their community of patients why healthy food is important.  They face their most daunting challenge in increasingly tight hospital budgets.

Policy could do a lot to eliminate obstacles.  Washington could require hospitals to source fresh, locally grown vegetables.  The immediate force of hospitals’ enormous purchasing power would find farmers ready to cater to their needs, distribution centers built overnight, processing centers and canneries springing up in every region, and food service providers overhauling their systems in response. 

Until Washington sees the light, locally elected officials can connect some dots on their own.  A representative of the New York State Department of Agriculture and Markets made clear to me this February that the mental and political divide between urban and rural areas is the largest barrier against developing a regional food system in New York City.  Farmers don’t know what hospitals need or how they could propose to service them.  Hospitals don’t know how many farms are nearby or what sort of demand local farmers could meet.  The rural and urban political representatives don’t even realize they have something to talk about.

Hospitals have got to start serving healthy food.  The change will be a challenge, but well worth the effort.  People walk or jog dozens of miles for Breast Cancer, MS, Heart Disease, and HIV/AIDS.  This is a marathon for Diabetes and Obesity, for Soil, for Community, for Local Economy.  We have to run it, for our health, and for the health and future of our kids.

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This is one in a series of essays related to an ongoing research project. The research is focused upon developing a Farm-To-Institution distribution program in New York State. A more detailed description of this work can be found under Ongoing Research, in the Research section of this site.

The latest two interviews conducted for this project presented a rather revealing story.  The first was with the organizer of a small delivery company that links farmers to restaurants in New York City.  The second was with a representative of a Brooklyn District Public Health Office (DPHO), who is involved in the Brooklyn Coalition of the NYC Food and Fitness Partnership.

Representing the small delivery service, the first interviewee eagerly told me about how her company works.  She gave me the nuts and bolts, the logistics, the schedule.  The farmers post their products on Fridays, the restaurants order on Mondays, the farmers harvest to order on Tuesdays and deliver to a drop-off site that night.  The truck is loaded that same (Tuesaday) night, the driver departs early Wednesday morning, the city driver takes over by sunrise, and the restaurants receive all their deliveries before Wednesday evening.  The company works with farms in a single county.  They deliver to about twenty restaurants.  They charge their farmers a fee that leaves them (the farmers) with a higher percentage of the price of their produce than they would ever receive from a wholesaler or mainstream distributor.  The interviewee herself is essentially a vibrant link, on the phone, answering farmers’ questions, dealing with chefs’ neurosis, solving the little crises that occur when the truck breaks down or the traffic is bad or the frost lingers longer than is ideal.  She told me about the possibilities for the company’s growth, who might be served, how service could be expanded and made more efficient, what additional farmers she might work with, what additional clients she might seek.  We spoke for nearly two hours about the potential and possibilities of the model her company has pioneered. 

Of course, the small delivery company serves relatively high-end restaurants that are committed to buying fresh, local products, and of sourcing through a short, transparent supply chain.  Such restaurants are willing to pay a premium for the high quality (and marketability) of these products, as are their customers.

The bodegas of Central Brooklyn are a different story altogether.  They are no more able to pay a premium for perishable produce than they are to charge their customers $4/lb for tomatoes.  But they’re still a part of the same food system.

As a result of the Kellogg Foundation’s Food and Fitness Partnership, the second interviewee participates in many meetings and conferences regarding the regional food system, and in particular, related to the high rates of diabetes and obesity in the neighborhoods within her district of Brooklyn.  Her DPHO, along with the one in Harlem, recently conducted research that shows a correlation between a lack of access to healthy foods and health risks.  The research found that most community members buy their food from bodegas that rarely offer fruits, vegetables, or milk, but instead primarily provide the residents with cigarettes, alcohol and soda.  This research led the NYC Department of Health’s Physical Activity and Nutrition Program to partner with local bodega owners to expand the availability of healthier food choices in target neighborhoods the highest rates of obesity and diabetes in the city (Harlem, South Bronx, and Central Brooklyn).

As the second interviewee explained the Healthy Bodegas Initiative, she did not lose her eagerness to share her experience, but her words were not hopeful.  “The distribution network does not exist,” she said, “to make it feasible for local, small grocery stores to source foods from local farmers, even if fresh produce were financially accessible.  It would be great if the farmers who sell at markets in nearby [more wealthy] neighborhoods,” she continued, “could just come here at the end of their day, and sell their leftover produce at a discounted price to a distributor at a central drop-off/storage location, rather than trucking it back home.  Storeowners could then purchase the produce from the distributor, at a lower price than is possible at the moment.  But this system is not set up, and at the moment, the farmers don’t have the incentive to come here!”

So the story goes: When enough high-end restaurants begin to demand fresh, local produce, a delivery company emerges to cater to their demand, trucking quality products straight to their door from upstate New York.  When community residents demand fresh, local produce, they work to change policy.  But their bodega-owners can’t “demand local produce” because there isn’t an efficient distribution system in place to make fresh produce convenient and affordable enough for their business.  The community demands may change policy – in some ways, they already have.  But only purchasing power can inspire the creation of a distribution system.

The second interviewee had never considered the effect it would have to encourage the purchasing of fresh, local produce in the hospitals of Central Brooklyn.  Yet the main tool she has to work with, besides policy, is purchasing power.  Bodegas may provide many people with “food,” but they are small and unorganized, and have no set choreography for collaboration.   Their purchasing power, as individual entities, is negligible.  Meanwhile, several local hospitals serve thousands of meals a day.  The patients in these hospitals are the same mothers and fathers and children who so are so gravely affected by obesity and diabetes as the customers at the local corner stores.  If anything, hospitals are deeply invested in their patients’ health, and the correlation between human health and consumption of fresh produce has been proven!  The latest draft of the New York City Council’s “Global Warming ‘Foodprint’ Resolution” sets a goal for 20% of food served in city-run institutions to be local and preferably organic produce within ten years, and provided a budget allocation to make this possible.  As policies like these develop, centers of demand for fresh produce are powerful tools for inspiring the development of a stronger local food system.  Hospitals are hubs of such demand.  We who understand (and are so eager to learn!) how we might connect our nearby farmers with the city….we have to talk to the hospitals.

Some other cities and regions at work…

Plow to Plate: New Milford, CT

Center for Food and Justice: Los Angeles, CA

Local Food Plus: Toronto, Ontario

Grow Montana: Montana State  

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This is the first in a series of essays related to an ongoing research project. The research is focused upon developing a Farm-To-Institution distribution program in New York State. A more detailed description of this work can be found under Ongoing Research, in the Research section of this site.

During a recent conversation with Christina Grace, of the New York State Department of Agriculture and Markets (NYSDAM), my research questions prompted her to mention the common food service providers of hospitals and prisons. In many cases, these institutions are serviced by providers like Aramark, Sodexo, and Chartwells. The usuals. Of course they are, yet it wasn’t something I’d thought about. Christina’s was the first interview Sam and I had done, in our work concerning farm-to-hospital and farm-to-prison distribution.

My first reaction was to want to whip our project clear around and embark again in the opposite direction.

NYU works with Aramark, as do many public and private universities and colleges across the country. In the early stages of our ongoing efforts to change the food sources in our school dining halls, Sam and I and many students, primarily organized by the Real Food Challenge, learned how to read our food service provider’s contracts. We may have primarily looked for the date on which the contracts would end, but many students – particularly those from large schools like NYU – learned how to negotiate, to wade through the bureaucracy, to talk to company representatives about releasing their purchasing data, to discuss whether the company executives might approve sourcing from a small distributor that might feed one ingredient to one college, rather than the entire kitchen to the entire nation. The results were not negligible – NYU now has a pilot local and organic dining hall, fair trade coffee in all seven dining halls, and Aramark may eventually work with the New York farmers markets. But working towards these changes felt mildly like convincing Wal-Mart to sell Organic, or Starbucks to buy Fair Trade. Aramark would certainly strategically adjust, but their heart would never be in it.

Now, in the initial stages of our new project, Sam and I have focused upon learning from alternative Farm-to-Institution distribution programs around the country, with the ultimate goal of writing a proposal (for a policy, or an organization, or a business) that will create a Farm-to-Institution program in New York State, particularly to service hospitals and prisons. I have been excited to think of this as very different from our work with our individual universities – a different constituency, a different structure, a different (more invisible) need, a different sort of potential for change. And so when I heard Aramark, I wasn’t excited. I had wanted to do something more creative than propose the same changes in a different contract.

The other interesting aspect of the conversation with Christina was that although she had a lot to say, she switched her focus early on to her work with public schools. She spoke of the numerous initiatives of the School Food program, of the sliced apples and the carrot coins, the yogurt, and the school gardens. There are certainly scattered projects across the country addressing hospitals, and prisons, and NYSDAM is looking at starting something with hospitals in New York, but there’s nothing on the ground yet. The School Food program, after all, is an ongoing struggle, and it only started in 2002. But it was disappointing to hear that there haven’t been more efforts to serve other institutions.

It took two days for the underlying conversation to rise above my superficial discontent. I’ve never heard much about patients and prisoners getting access to local, organic, fresh, healthy foods in New York. That was part of my motivation for this project. But I hadn’t realized what an integral puzzle piece they were in the food movement; how perfectly, predictably, they are a part of the big picture. New York policy has really only acted upon concern for school children. The 2002 school food legislation demands that, “The State Education Department should collect information from schools and other educational institutions that are interested in purchasing New York farm products and share that information with interested farmers and farm organizations across the State….The schools would then be notified by the State of the availability of the products.”

This bill was and is a wonderful step in the right direction, but it significantly ignores the interconnectedness of all major institutions, considering the vast number of meals they must provide, the few providers they source from, the purchasing power they possess together, and the potential benefit of a policy like that of 2002 for the State Departments of Education, of Health, and of Correctional Services – all together! This sort of demand would no longer clamber up the big bad supply chains, reaching for a chance to make a difference. This sort of demand would be a Giant for those beanstalks. A new distribution system would have to grow to serve it, stronger, and closer to the ground.

The idea that specific institutions can band together to make their demands heard is not a new one. So far, primarily, public schools have come together with public schools, and universities with universities, to demand access to the local products that are available. These focused efforts have not been easy nor yet “successful,” and it may feel as though broadening their focus will only complicate and slow the progress that has already been made. This may be true. But as the force behind a movement that claims a sort of holistic integrity, the community working to create a more sustainable food system cannot neglect the state of our health care system nor ignore the industries that control our prisons. These are the trademarks of an era we have in fact elected to end, but now it is our job to connect ALL the dots.

Department of Agriculture & Markets News. Governor signs bill establishing farm-to-school initiative. Press release (Feb 13, 2002).

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It took a crisis in Cuba for urban agriculture to take over.  The dissolution of the Soviet Union in 1991 cut off nearly all agricultural imports to Cuba, including pesticides, fertilizers, farming equipment, and food.  Not only did organic farming increase, by necessity, but Cubans began cultivating a significant percentage of their food in urban areas.  The government encouraged them to do so.  And in 1998, the city farms in Havana alone produced an estimated 541,000 tons of food for local consumption.  These included 8,000 officially recognized production units cultivated by over 30,000 people.  The population of Havana is 2.2 million.  Today, some neighborhoods in the city produce 30 percent of their own subsistence needs.[1] 


A significant growth in urban agriculture in the US is worth considering for several reasons.  For one thing, such cultivation would be small-scale, and thus would encourage local consumption (the most local, from one’s own garden).  But urban food production would also contribute to community food security, would rescue biodiversity, provide local jobs, create a complete cycle of nutrients and waste, aesthetically improve urban spaces, and increase the freshness and variety of the ingredients in the urban diet.  Increasing a community’s food security would ultimately mean creating a strong, regionally based food system that wouldn’t rely upon imports, or foods that could be prevented from reaching people in times of war or crisis.  Plant biodiversity would thrive as people learned to grow the specific varieties of foods native to their land, varieties that are everywhere disappearing as cities expand and farms consolidate.  Such biodiversity would mean too a greater variety of foods and nutrients, which would contribute immensely to the health of those who ate them.  The complete recycling of nutrients and waste within single households would have an immense, positive environmental impact on food-producing communities.  And, urban spaces could be so much more beautiful!

The next question then is how we in the US might cause a bit of an agricultural revolution in our country akin to that which the end of trade with the Soviet Union caused in Cuba. 

pict5585.jpgWorking at Added Value’s Red Hook Community Farm in Brooklyn has been a personal (tiny) contribution of mine to the growth of urban agriculture in New York.  The hundreds of community gardens throughout the five boroughs are consistently inspirational.  Just Food trains community members to start up “City Farms” throughout the New York area.  And the people working them, and eating the produce they’ve grown themselves, understand the value and joy of providing even a small portion of their own daily sustenance. 

As for California, I’m gradually acquainting myself with the various organizations at work to increase food production in the Bay Area.  Spiral Gardens runs a Community Farm in South Berkeley, producing food for volunteers as well as low-income seniors in a nearby housing complex.  City Slicker Farms helps low-income West Oakland residents build and maintain backyard vegetable gardens.  Beyond supporting and operating four productive gardens in North and West Oakland, People’s Grocery is collaborating with the Sustainable Agriculture Education Center (SAGE) to increase food cultivation in their recently opened 15-acre Agriculture Park in Sunol, which will grow fresh produce for West Oakland residents.  SAGE has developed an “Agricultural Parks Toolkit” as a “comprehensive guide for public and private landowners who want to establish agriculture as a valued urban-edge amenity.”  UC Berkeley’s Institute of Urban and Regional Development has been working with SAGE to develop a policy framework for “New Ruralism,” a concept meant to strengthen the emerging synergy between the new urbanism/smart growth movement and the sustainable agriculture/regional food systems movement.  The Alemany Farm cultivates food on four and a half productive acres, right in the city of San Francisco. 

pict5591.jpgFor a personal take on these efforts…your author here is still a student.  So for the moment, three UC Berkeley courses are contributing to the urban ag vision.  Land Use Controls” is supplying an understanding of the complex laws and organization behind zoning, subdividing, property taxation, and the influences of infrastructure on land use.  Cartographic Representation” is providing skills with which to artistically, persuasively map out what could really happen on urban territory.  And “Urban Forestry” is lending a little more hands-on knowledge about what urban growth actually requires.  Meanwhile, I’ll be eating foods every day that are all grown quite nearby.  Altogether, that’s a personal start.

And this is personal stuff, urbanites.  It’s your property, your garden, your hands in the dirt.  You yourself might never grow enough to supply even an entire meal, but you can contribute to a change in the food system, one that would immensely benefit your community and it’s local health, economy, and security.  Call me crazy, but I believe those are the areas that currently concern our population the most.


Also, my friend Adam Brock recently wrote a (more detailed, less Annie-style-sentimental) four-part series entitled “Why Cityfarming?”  Check it out.


[1] Murphy, Catherine.  Development Report No.12: Cultivating Havana: Urban Agriculture and Food Security in the Years of Crisis.  1999. 

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pollanquote.jpgLast week I attended two events featuring journalist, author, and professor Michael Pollan.  He joined chef and restaurant owner Dan Barber on Tuesday evening in a lecture hall of the 92nd Street Y, and Wednesday he spoke at a Just Food fundraiser, in a beautiful Flatiron District apartment.  Prompted by the queries of Joan Gussow at both events, Pollan had to address the “elitist” question with which he’s become familiar.  Aren’t you (and your ideologies) a little out of touch with the average American eater?  How can the average American afford the foods you recommend we eat?  And she wasn’t talking a meal at Barber’s restaurant Blue Hill.  It’s the farmers markets with $4 tomatoes, and mixed greens at $6 per ¼ pound. 

Barber is finally admitting he’s an elitist.  And, he added, a day at Stone Barns (including enjoyment of the grounds, hiking trails, farm facilities, and food) still costs less than a day at Disney World. 


pollan2.jpg Pollan responded that the prices of local products will go down as demand goes up.  He also pointed out that Americans currently spend 10% of our income on food in America, while “when he was a boy,” we spent 18%.  Meanwhile, while we once spent 5% of our income on health care, we now spend 15%.  According to Pollan, there’s a direct correlation: factory farmed, processed foods lead to diabetes, obesity, and heart problems.  Add the costs together, and we may think (industrial) food today is wonderfully cheap, but our expenditure on food and health care has risen from 15% to 25% in about the last thirty years.

Amidst my Pollan-event-hopping, flush with a Christmas check, and increasingly nervous at the prospect of leaving an apartment in Brooklyn and friends I love (for Berkeley, California), I decided to prepare a farewell feast that would be as local as possible.  Fifteen people, lots of money: it would be a final splurge. After working at Saxelby Cheesemongers for two months, it seemed about time I bought a significant poundage of local cheeses.  Plus, I’d been waiting for a reason to try Karen’s lamb from Three Corner Field Farm. A search for less-than-$12/lb. local honey took me to Marlow & Sons in Williamsburg.  And I bought apples and pears from Migliorelli Farm, to dip in whipped heavy cream from Evan’s Farmhouse Creamery.  I prepared an elitist meal, by all accounts.

As far as I’m concerned, the meal for a party of fifteen cost about the same as one pair of jeans from Seven.  It’s a lot for food, but the evening was worth more than any clothes I’ve ever owned.  Granted, most people can’t afford Seven jeans, and they can’t afford the dinner I served.  The meal essentially spoke to Pollan’s point on the expenditure of our income.  We need to learn to spend more on food.  We will be healthier people.  As Joan Gussow pointed out, we don’t want the prices of local, organic, family-farm products to go down too far with the market demand, because there is a bottom-line cost of production for the types of food we want to support.  For small farmers to stay in business, they must make a profit.  Real food costs something.  What we actually need to work on is the other side of the equation: minimum wage should be enough that people can afford real food.

There is something else to be said, however.  If market demand won’t take care of affordability, and if we agree that minimum wage isn’t anywhere close to paying for $4 tomatoes, we must look elsewhere to defend our local food movement from the damning critique of elitism. 

The connection between health care and what we eat is a pretty good hint at some other solutions.  Medical centers can establish nearby farmers’ markets and source their institutional food locally.  Their patients might get healthier than they do now, eating from nearby falafel and hot dog stands.  The government could increase the allotment of food stamp funding to the Farmers Market Nutrition Programs.  Medicaid costs would go down.  Health insurance programs could support clients who purchase CSAs.  Emergency food organizations, soup kitchens, and homeless shelters can coordinate with local farmers and restaurants that source their food locally, and through donation, receive fresh produce, meats, and dairy products much more healthy for their eaters than the canned and processed surplus foods they are normally given.  Pollan didn’t particularly expand on these possibilities, essential to the movement he has come to represent, even while he spoke for Just Food, a leader of food justice efforts in New York.  But he did say: we need to vote with our votes, not just with our forks.  Those who can afford farmers market prices must learn to accept them.  But we also need to support policies that recognize the correlation between our health and our diet, and that recognize the (financial, and hedonistic) prudence of spending government money to support the production and consumption of real food.  


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