A daily dose of greens

Could urban farming change the way hospitals feed patients – and improve the health of our cities in the process?

By Hassell Principal Catherine Loker

Ask anyone to describe a typical hospital dining experience and you’re likely to get a similar answer. Bland. Colourless. Institutional.

But those impressions don’t reflect the changing picture in health care. In recent years, the sector has done lots of detailed work on patient nutrition, and hospitals have improved their food choices, freshness and supply chains.

Menus are now better aligned with what research tell us about the vital role nutrition plays in our physical and emotional wellbeing – and our need for daily access to fresh fruit and vegetables either to heal or to maintain our health.

At the same time, there’s potential for the sector to take bigger, bolder steps – toward new solutions like rooftop vegetable gardens or vertical farming within integrated precincts.

As large, central hubs in our cities and communities, hospitals that generate their own produce could make a significant impact on so many fronts – offering greater sustenance and better health outcomes to patients and staff while also addressing major societal issues like equity and climate change. 

But what could propel us into action – and what would potential solutions look like?

A PATCH OF EARTH: THE RISE & FALL OF COMMUNITY GARDENS

Historically, community gardens have provided the most immediate access to fresh produce for many populations. For example, the ​‘Dig for Victory’ campaign in WWII Britain yielded 1.4 million allotments (with only 300,000 now remaining after continuous decline).

Australia went down a similar path with its communal garden movement, which has seen a resurgence since the 1970s. Still, numbers remain low, with under 100 of these spaces left in the Sydney metro area. At the same time, vegetable consumption has decreased per capita in Australia, from 102kg in 2013 to 93kg in 2017. 

What’s the cost of the decline in healthy eating? 

An estimated $978M of government health spending in Australia could be attributed to low consumption of vegetables in 2015-16 alone, according to Deloitte Access Economics.

It stands to reason that increasing the consumption of fresh fruit and vegetables could have a significant impact on health expenditure, health outcomes and – better still – the prevention of illness.

THE BIG ISSUES: FOOD SECURITY & CLIMATE RESILIENCE

The issues go far beyond the local garden patch – and right up to some of the biggest challenges society is facing worldwide.

Today, Australia has a secure food supply. But the agricultural sector may be vulnerable up to 2050 when we factor in the effects of climate change and an increasingly urban population, according to research institute Future Directions International. 

Governments all over the world are grappling with the same issue – how to make food production more resilient to climate change and also more readily and sustainably integrated into urban environments. 

We’re increasingly hearing the confronting term ​‘food desert’ used to describe populated areas where fresh produce is not easily or readily available. This challenging scenario can exacerbate the cycle of poor nutrition that leads to poor health. It may also be an indicator of social dislocation and isolation, which contributes to the ever-widening socio-economic gaps in communities.

The most recent assessment report from the Intergovernmental Panel on Climate Change (IPCC) is a sobering reminder of global warming’s impact. It outlines the effects it’s already having on food security, but it also shines a light on opportunities to mitigate the damage.

“Policies that operate across the food system, including those that reduce food loss and waste and influence dietary choices, enable more sustainable land-use management, enhanced food security and low emissions trajectories …Such policies can contribute to climate change adaptation and mitigation, reduce land degradation, desertification and poverty and also improve public health.”

HIGHER GROUND: ROOFTOP GARDENS & VERTICAL FARMS

The seeds of a revolution have already been planted in the US.

Boston Medical Centre established a rooftop farm in 2017, and the success of its innovation has been a game changer.

The fresh organic produce not only goes to patients and cafeterias, it’s also supplied to community groups via the hospital’s Preventative Food Pantry. 

“Food is medicine. That’s why we’re doing what we’re doing,” says David Maffeo, Senior Director of Support Services at Boston Medical Centre.

On a total rooftop area of around 2,100sqm, one full-time farmer and one assistant tend to around 800sqm of growing space, with volunteers assisting as needed. The space features more than 25 types of crops – and two beehives – with an annual yield of up to around 2,700kg.

The farm also reduces the hospital’s energy use, the impact of transportation and its carbon footprint.

Similar projects have taken hold in Australia. In the Sydney suburb of South Eveleigh, a 500sqm native farm covers the rooftop of the Yerrabingin House office building. With 2,000 edible and medicinal plants, it’s the first indigenous rooftop farm for urban food production. 

Rooftop landscapes are fertile ground for research too. Launched in 2013, the Burnley Living Roofs initiative – a University of Melbourne project designed by Hassell – was Australia’s first dedicated green roof demonstration, training and research facility. With three green roofs built for Australian conditions, it’s set up for teaching, community activities, and continuing professional and industry development.

Hospital sites in Australia offer even more possibilities, whether they’re new or existing. For example, imagine if all or part of the 5,000sqm, native rooftop gardens at Perth’s Fiona Stanley Hospital were also productive? The Hassell-designed space could serve dual purposes, supporting both biodiversity and a sustainable approach to fresh food supply.

SCALING UP: FARMS & GARDENS IN A HEALTH CARE SETTING

Today there are many successful examples of community and rooftop gardens with relatively modest – but still very worthwhile – goals focused on integrated fresh food production that benefits both community and environment. 

But can these concepts and benefits be translated to scale in an urban context, including in our hospitals?

In 2013 the Macrothink Institute published the outcomes of their research on this subject in ​‘Up, Up and Away! The Economics of Vertical Farming’. The institute designed and simulated a 37-storey building in Berlin to estimate the market potential of such an enterprise – and the yield was 516 times more than expected. It may be theoretical, but it still illustrates the potential for ​‘super-charging’ the vertical farming concept.

In practical and commercial terms, we can look to Europe for vertical farming success stories in recent years. Companies across the continent and in the UK – such as Infarm, Let Us Grow and Square Mile Farms – are part of an industry expected to be worth $22 billion by 2026. 

Whether we’re talking about Nordic Harvest, one of the largest vertical farming enterprises in Europe, or an Australian start-up like Sprout Stack, which is already supplying to commercial and independent grocers in Sydney, there are great opportunities to leverage this technology and apply it within a health precinct context. 

Though it’s an industry still in its infancy and offers a relatively limited range of fresh produce, vertical farming has significant backing and predicted growth. If the health sector follows their lead it could have major benefits for all urban communities. This is not an either/​or scenario, but another possible tool in our kit for creating a healthier, more sustainable future.

Like any innovation, there’s more work to do – significant investment, more research and further assessment of sustainable energy sources. 

But there are strong drivers for the health care sector, including improving food security and accessibility, reaping the health benefits of fresher food and better nutrition, and reducing the carbon footprint associated with delivery.

If we take the first steps, we could see truly holistic health precincts take hold – and spread. 

Imagine the outcome: hospitals that not only offer clinical excellence, training and research but demonstrate real, visible commitment to long-term health and wellness by providing locally-grown fresh food to patients, staff and community – and maybe even selling excess yield to nearby supermarkets. 

It’s an innovation with great physical, social, environmental and economic benefits that could completely transform the way we think about hospital food.