Federal strategy upholds health care’s integral role in addressing hunger & building a better food system

Health Care Without Harm
5 min readOct 19, 2022


By Emma Sirois & Lucia Sayre

This September, the White House convened the Conference on Hunger, Nutrition, and Health with the aim to “catalyze the public and private sectors around a coordinated strategy to accelerate progress and drive transformative change in the United States to end hunger, improve nutrition and physical activity, and close the disparities surrounding them.”

At the conference, the administration released a new National Strategy on Hunger, Nutrition, and Health which outlines specific actions the federal government will take. Several renowned physicians and health care leaders from the Practice Greenhealth network took the stage to share their experiences at the intersection of heath care and our food system, emphasizing how the health sector can be a critical ally in this work. These echoed comments Health Care Without Harm submitted to contribute to the National Strategy, lifting up the priorities seen within our network and programs.

This convening could not come at a more urgent moment, as our country faces compounding concerns around addressing the growing issues of hunger and nutrition security, given the pandemic, increasing economic inequity, and the persistence of systemic racism.

COVID-19 laid bare the fragile nature of our food system and food supply chains, and preventable diet-related diseases continue to be leading causes of death and disability. The health care sector, with healing as its primary mission, understands all too well the skyrocketing costs of treating the health impacts of chronic, diet-related diseases, which are currently estimated to account for 85% of health care costs. Cardiovascular disease, diabetes, and all obesity-related conditions account for $316 billion, $327 billion, and $1.72 trillion respectively. Increases in the rates of these diseases are simply not sustainable over time.

Chronic, diet-related diseases are estimated to account for 85% of health care costs.

The National Strategy and the conference highlight the health care sector’s opportunity and responsibility to address hunger, build a healthier and more equitable food system, and protect our collective environmental and economic health.

Food is medicine: Health care is a critical partner for food and nutrition security

Integrate Nutrition and Health: Prioritize the role of nutrition and food security in overall health — including disease prevention and management — and ensure that our health care system addresses the nutrition needs of all people. — National Strategy on Hunger, Nutrition, and Health; second pillar

The administration proposes legislation to expand “food is medicine” interventions — such as medically-tailored meals — through pilots with Medicare programs, building on similar efforts with Medicaid services while calling on states to “leverage all available federal authorities to expand coverage of ‘food is medicine’ interventions and states and private entities to expand produce prescription programs.”

Dr. Kofi Essel, director of George Washington University’s Culinary Medicine Program and pediatrician at Children’s National, spoke on a panel about integrating nutrition into health care training, coverage, and delivery called “Food is Medicine: Bringing nutrition out of the health care shadows.” He shared about Children’s National’s efforts, from food insecurity screening to their critical collaboration with community organizations to provide a produce prescription program that is yielding positive health outcomes. (Time: 45:35)

Other pledged efforts will increase access to nutrition-related services through private insurance and federal programs beyond Medicare and Medicaid, including Indian Health Services implementing a National Produce Prescription pilot, and the Veterans Administration implementing produce prescription programs and food pantries.

The National Strategy also lifts up the critical role health care institutions can and should play in screening for food insecurity and other social determinants of health, and providing referral to programs and resources. All federal health care systems will now universally screen for food insecurity, while payors and providers will receive incentives to screen for food insecurity and other social determinants of health.

“If we are really committed to population health and reducing medical costs we need to put the health care system to work for health. Leadership at this moment is about asking if every patient can afford to feed their family and then connecting them to and paying for healthy food.” — Rebecca Onie and Rocco Perla, Health Leads (Time 22:22)

Health Care Without Harm recently made recommendations to the Centers for Medicare and Medicaid Services regarding the importance of integrating screening for social determinants of health as a basic component of primary health care and incentivizing this practice across all health care facilities.

Healthy food environments: Cafeterias have a powerful role to play

Empower all consumers to make and have access to healthy choices: Foster environments that enable all people to easily make informed, healthy choices, increase access to healthy food, encourage healthy workplace and school policies, and invest in public education campaigns that are culturally appropriate and resonate with specific communities. — National Strategy on Hunger, Nutrition, and Health; third pillar

The administration has pledged to expand access to healthier food environments in federal facilities by implementing and updating the Federal Food Service Guidelines to promote fruits, vegetables, whole grains, low-fat dairy, and low-sodium options; increase the availability of healthy beverage choices and plant-based options; and encourage healthy choices through behavioral design. These important guidelines address the nutritional composition of meals served and provide detailed guidance on food purchasing that supports local economies and environmental sustainability.

Health Care Without Harm has been working for the past several years with partner organizations to advocate for this action, which would impact millions of federal employees and those who receive services at federal medical facilities.

We will continue to advocate for critically-needed updates to the guidelines, including stronger criteria and guidance for addressing climate change mitigation through plant-based meal offerings, food purchasing, food waste reduction, and racial equity through food purchasing via food businesses owned by people of color.

These guidelines not only impact federal food service but also serve as model guidance for state and private food service operations.

Dr. Thea James, vice president of mission at Boston Medical Center, spoke on a panel called “Breaking Barriers: Bridging the gap between nutrition and health,” which focused on cultivating community development and advancing health equity to improve nutrition and health. She spoke about the necessity of focusing on upstream causes of ill health including food insecurity and even further upstream to economic security. (Time: 1:21:50)

Long-term solutions start with community health & wealth: The next 50 years

The first White House Conference on Food, Nutrition, and Health in 1969 was a pivotal event that influenced the country’s food policy agenda for the next 50 years, including the creation and expansion of critical nutrition and anti-hunger safety net programs: the Supplemental Nutrition Assistance Program (SNAP); the Special Supplemental Nutrition Program for Women, Infants and Children (WIC); and the National School Breakfast and Lunch Programs. While we continue to benefit from these landmark federal policy and programmatic actions implemented over 50 years ago, the new National Strategy is a pivotal first step to healing the food system.

We cannot settle on solving for acute, short-term health impacts of food insecurity and hunger alone. We must devise long-term solutions for these entrenched challenges that prioritize our collective environmental and economic health, build regenerative systems that protect our natural resources, invest in fair labor practices, and prioritize living wages. When we address food insecurity and hunger through a lens of equity and resilience, we also build strong regional food economies, healthier production practices, a diverse food supply chain, and wage structures that reflect the “true cost of food” and the value contributed by food service workers.

Emma Sirois is Health Care Without Harm’s Healthy Food in Health Care national program director.
Lucia Sayre is Health Care Without Harm’s Healthy Food in Health Care program regional director



Health Care Without Harm

Health Care Without Harm seeks to transform health care worldwide so the sector reduces its environmental footprint and becomes a leader in the global movement.