How to make big changes for public health and the future of life on this planet

We cannot overstate the urgency of this moment. There is a pandemic wreaking havoc on people’s lives, and this month the CDC reported new strains of swine flu that have “the essential hallmarks of being highly adapted to infect humans”. And let’s not forget the climate crisis and rampant deforestation that may soon reach a tipping point with the Amazon rainforest.

If you have not already, please read about the pandemic risk associated with factory farms as well as the urgency of addressing our food system's contribution to the climate crisis.

This page was written in response to what department heads at SF public hospitals perceive as the biggest barriers to change. With a creative, solutions-focused approach, the Board of Supervisors and the Department of Public Health can demonstrate to other cities how to use public funds to protect public health, animals, and the future of life on this planet.

address dietary racism

promote public health

One concern about replacing animal products at hospitals was patient nutrition.

What you may not know is that people of color already face nutritional deficiencies in institutions that have a heavy focus on dairy. Nearly 66% of Laguna Honda and 74% of SF General patients come from communities of color, with high rates of lactose intolerance. A volunteer at Laguna Honda reported that dairy milk is almost always given on a meal tray whether or not patients ask for it, so a ton of milk is thrown away unopened. The same thing happens in public schools, and this results in an enormous volume of waste and nutritionally deficient meals for people of color who avoid drinking dairy milk if it makes them sick. Seed the Commons, Switch4Good, and other organizations rightfully call this “dietary racism”.

The hospitals must plan meals that don’t have dairy as a nutritional component. They could change the default beverage to water (Canada’s latest food guide) or something plant-based and accessible to people of color. This change alone could make bigger commitments possible, since dairy makes up an estimated 35%-45% of the public hospitals’ spending on animal products.

100 local physicians and nurses signed onto a letter explaining how a shift to healthier, plant-forward offerings promotes public health both by lifting the burden of chronic, diet-related diseases for some patients (saving money for hospitals in the long term) and by addressing pandemic risk coming from factory farms. Here’s testimony from two of them:

educate patients

Another challenge named at SF public hospitals was getting cultural shifts away from the standard American diet, especially among older patients. We agree that patient education is important, and patients can be nudged over time. We have testimony from people in the Bay Area who learned new information and made significant changes in their 50’s and 60’s. Many of them were also battling diseases like diabetes, heart disease, and high blood pressure.

There are creative ways to implement changes that are so subtle that some won’t even be noticeable. In aggregate and over time, they can be very impactful.

  • Change portion sizes: Increase the portions of the plant-based portion of the meal

  • Gradually introduce new plant-forward meals into the rotation and improve the marketing language used to describe the new meals

  • Start with substitutions of products that are already indistinguishable (Just Mayo, chickenless nuggets, non-dairy ingredients in recipes, etc.)

create systemic change

Every institution has barriers to change. Some onerous city requirements have already been eliminated at the Department of Public Health via this ordinance. Compassionate Bay talked to the Department of Public Health about key bottlenecks in onboarding new vendors. What we need is for department heads, nonprofits, and legislators to all come together, really look at the bottlenecks, and coordinate on a plan to address them and make systemic change possible.