How increasing access to culturally appropriate foods in hospitals can improve health outcomes
By Aubrey Knickerbocker, MSN/DPD student
When you think of hospital food in the United States, you don’t exactly picture an array of diverse cultural dishes. The lack of variety and cultural considerations is not surprising given that, in 2019, there were 9.8 million healthcare technicians and practitioners in the US (this includes surgeons, physicians, and registered nurses), two-thirds of whom identified as non-Hispanic white.1 In addition, a vast majority of registered dietitians in the United States are white.
Barriers to proper nutrition already exist in hospital settings, including unsuitable serving times, inflexible ordering systems, uncomfortable settings, food being out of reach, difficult packaging, unpleasant smells2 — the list goes on. Malnourishment can lead to increased disease susceptibility as well as increased risk of falls, hospitalization, and death. In addition to physical decline, mental health likely suffers as well.2
What if you were presented with these barriers and also didn’t recognize the food? Or the food didn’t align with your beliefs? While focusing on the nutritional content of offerings, it can be easy to forget that providing culturally appropriate foods is an essential component of healthcare. Food can be a source of alienation and exclusion in the US healthcare system.3 Patients confined to a hospital may only have access to the food the hospital offers. When visitors are limited, such as during the COVID-19 pandemic, family members cannot bring alternative options. If the patient is not eating the hospital food, they are likely not eating at all.
Providing culturally appropriate foods at the hospital that meet patients’ current nutritional needs is essential for continued care after the hospital stay; patients and their families can better understand what foods align with their treatment and what they should prepare at home.3 Besides preventing malnutrition, there are other essential benefits to including culturally appropriate foods on hospital menus. Offering increased diversity supports mental well-being. It fosters a sense of belonging and community in a place that can feel very isolating. It plays a vital role in building trust between the healthcare system and those from culturally diverse communities who have language differences or are unfamiliar with US healthcare practices.3
The bottom line is that healthcare exists to meet the patient’s needs. Ignoring the role of food in healing is undermining that commitment. As nutrition professionals, this is something we are all aware of. In the hospital setting, obtaining quality nutrition is not the individual’s responsibility. For the person trying to heal, it should not be challenging to procure nourishing foods that align with their cultural and religious beliefs. This change will take time and considerable effort. Strict regulations outline requirements for meals and budgeting in healthcare settings. Change will require revisiting the regulations around dietary quality in healthcare facilities.3 It will require increased cultural sensitivity and competency among care providers and staff and pushing systems to continue to drive this change.3
What can we do in the meantime? Hospital dietitians can ensure that they provide culturally appropriate dietary education for their patients so that they know what to eat when they return home. Dietitians can also be aware of community resources to give patients upon discharge. Nutrition professionals can work with clients and their families to make a list of quick, portable foods for their loved ones during hospitalization. Compiling a list of meals that can be premade and frozen for later use is another helpful tool.
Access to culturally appropriate foods is a right, not a luxury; it will do much more than heal the body. In the words of Yotam Ottolenghi, “Food can bring people together in a way nothing else could.”
References:
1. Laughlin L. 22 million employed in health care fight against COVID-19. Census.gov. https://www.census.gov/library/stories/2021/04/who-are-our-health-care-workers.html. Published October 8, 2021. Accessed November 15, 2022.
2. Naithani S, Whelan K, Thomas J, Gulliford MC, Morgan M. Hospital inpatients’ experiences of access to food: A qualitative interview and observational study. Health expectations: an international journal of public participation in health care and health policy. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5060454/. Published September 2008. Accessed November 15, 2022.
3. Minakshi R. What’s on the menu matters in health care for diverse patients. The Conversation. https://theconversation.com/whats-on-the-menu-matters-in-health-care-for-diverse-patients-166931. Published September 13, 2022. Accessed November 14, 2022.