← Advancing Health
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- [00:01]
A
Welcome to Advancing health. Food insecurity doesn't always mean not having enough to eat. It can also describe lack of access to healthy food. Coming up on this podcast, we learn more about Cleveland Clinic's broad strategy to provide opportunities for healthy eating to all of the communities it serves. As today's guest says, we look at food as medicine.
- [00:26]
B
Hi, I'm Nancy Meyers from the American Hospital Association. Thank you for joining us today as we have a great conversation planned with Vicki Johnson, who's the Executive Vice President and Chief Community Officer for the Cleveland Clinic, based out of Cleveland, Ohio, but with operations worldwide. Today we'll be talking a little bit about how they're understanding and meeting the needs of both their patients and their communities as they seek to drive better health for all. So, Vicki, thanks so much for joining us today. Appreciate you being here.
- [00:57]
C
You are welcome and thank you for the invitation. It's an honor to be here.
- [01:01]
B
Tell me a little bit about the work that you and your team lead at the Cleveland Clinic. Just to ground us.
- [01:07]
C
Sure. So in 2023, Cleveland Clinic established the Community Health Office and I'm blessed to be the leader. As you said in the introduction, we are an enterprise with a global footprint. So it's my job to lead an awesome team and at developing a strategy to care for every community in which we're located. And our objective is to build healthy communities together. We have a strategy that we'll talk about a little later to make sure that we use the same approach to engage with every community so that the outcomes and the strategies that we have are locally relevant. So we're happy to do this work. We are a service line to every institute and department at Cleveland Clinic. So when we discover the needs of our local communities, we work as a partner, a non physician partner. So we have a diet partnership to work together to leave the walls of the hospital and go into the community where patients and community members are to address those needs together.
- [02:13]
B
So I know that one area that you've been focusing on through the work of your team and over the last few years has been what some people would refer to as food insecurity. But your lens is a lot broader than that or broader than just simply access to food. Can you tell us about the work to address nutrition that the Cleveland Clinic has undertaken?
- [02:33]
C
Yes, I'm happy to do that. So you're correct. So we look at food as medicine and we look at food as something that we can engage communities around. It's easy to understand that at the foundational level, everyone needs Access to food, but it needs to be good food. So in the urban communities in which we're located, sometimes it's not access to food, it's access to good food. We have patients and neighbors who shop at gas stations and convenience stores, and so they have something to eat, but it's not necessarily nutritious. So we've worked in partnership with the communities in which we're located, with local health departments, with the business community, all stakeholders, to figure out how we can leverage the economic impact that we have in each community to address nutrition, which then includes how do we leverage who we are to attract retailers who will provide nutritious food, so access to better food options. And then also how do we educate and work in collaboration with our community to understand how nutrition is a really big part of health and children in particular, how they perform at school. And everything really is based on that foundational need that we all have. But we do not all have access to the same quality of food.
- [04:06]
B
So it sounds like you're really taking a multi pronged approach in terms of the strategies as you go from community to community that you serve. And I heard you mention retail partnerships and education. Can you maybe talk a little bit more about what some of your foundational strategies are in different communities that you're most proud of?
- [04:27]
C
Absolutely. So let me start even broader. First to say that when we think about food, we looked at food from an enterprise perspective and as a healthcare provider. So food at the bedside, food that we sell on our campuses, so the types of retailers and restaurants that we allow to have a presence on our campus, that we sell to patients, families and caregivers, and then food in the community, which is the space that I lead, We've leveraged relationships that we have with food vendors, those that we do business with at the bedside and on campus, to see how can we partner together. The whole thing, the whole approach that we use is how do we leave the hospital. We want to go where people are so that we have the greater opportunity to have an impact on the health outcome. So how do we leverage partnerships? So we have great partnerships with Morrison Health, for example, the relationship started inside the hospital, but we both care for the same community, so how do we go together to provide education? So how do we leverage the chef, and that is preparing great meals for our patients in the community as well. And how do we bring that to communities where people are? So how do we use cooking demonstrations and education and recipes in libraries and community centers combined with other partners like the American Heart Association? So we leverage those relationships. We have also we've been so fortunate in our main campus area, which is in the city of Cleveland, in the Fairfax neighborhood, where we've been over 100 years. And we've been in a community where the people who are our neighbors had not had a quality grocery store for over 30 years. And in 2018, they told us the best thing that we could do for them as a partner, as an anchor institution, is to leverage our employee base and the amount of dollars that we spend to attract a retailer to a community, quite frankly, that they could not do this on their own. So the population was declining, the number of households, the educational attainment, all the things that retailers look for to make a good business decision. This community did not have it. But what they did have is a committed partner and in Cleveland Clinic. So we leverage the number of caregivers on main campus, the number of patients that visit every day, the number of construction workers that park cars. We use all of this data to have conversations. And we're successful in attracting a high quality retailer. And now we're working together. It's Meijer. And they're using the urban format to work with us in the community. So 40,000 square feet of fresh groceries that did not exist before for our community. We're really pleased and so happy about that, because when we went back to the community in 2023 to have the same kind of conversation, to ask on a regular basis, how do you define health? How can we be a good partner? And we collect data. And once that was looked at, we found no one described a food desert anymore. No one said, can you help us with access to food anymore? And we also had an economic impact with the 50 jobs that were created as well as a result of that. So that's what we've been doing, is talking with the community on a regular basis. How can we be helpful and really be really transparent about what we can and what we cannot do and then work together to make that happen? So in other communities, we do not have 20,000 caregivers. You know, we do not have that type of impact, but how can we leverage, again, our vendors to make those opportunities and to increase the healthiness of every community that we serve?
- [08:40]
B
And I love how you talked about bringing your workforce in your caregivers because they are one of our first communities. Right. And so being able to put in this market as you have in Cleveland serves the people who live in the neighborhood. And it also is a nice benefit and service to your team members, who I assume use it Every day or on a regular basis as well.
- [09:04]
C
That is so true. And I would be remiss if I didn't say where we do not have those same opportunities because we don't have the same level of economic impact. We're working with local communities around food pantries and nourish pantries, where it's not just food, it's also the education and talking with a health care provider and almost issuing and we have food prescriptions to make sure that we're making the connection. And again, food is health. And we have wonderful initiatives where we focus primarily on populations that need us the most. It's a place based strategy. We've decided to focus on pregnant women and children around food and nutrition, infant and maternal health, all women in the community. So we've been able to really connect everything together. Food insecurity, access to care, exercise, all of that to get to the outcomes that we hope to see in years to come.
- [10:02]
B
Let's talk about what the outcomes are that you're measuring now as well as those that you're looking to measure over time to see how you're making an impact through these programs and other community programs that you have in place.
- [10:18]
C
Well, time is the first thing we want to focus on. It will take time. And I think in healthcare we're sometimes looking for instant results because that's what you see with healthcare in terms of surgery or medicine. And so in this case, we all know this will take time. So we look for indicators that evidence has shown us will have a difference. So for example, we are looking for pre and post test. And so at the end of a 12 week or 16 week or 90 day initiative, whatever the timeframe is, have we been able to increase one's awareness and knowledge and a change in behavior? For example, we have an initiative called Healthy Moms and Healthy Babies where we've eliminated barriers like transportation, where a pregnant moment, she's pregnant and she has children and so she's able to shop with $200 a month and shop for healthy food using her cell phone, using the computer, and having food either picked up or delivered at the doorside. So through that experience, we're able to stay with that mom throughout the first year of the baby's birth. And then we can measure and it's self reported. And because we have community health workers that are really closely building relationships with these mothers, we know the change in behavior. We can believe it because we see it, we're closely aligned with them. So when we change our behavior and when we recognize, okay, we know better. I accept that. And I'm actually going to change how I eat and what I purchase, how I prepare it. Then we can expect, based on evidence, that we will see an increase, for example, in the birth weight of the newborn. We can see a change in the need for certain medications because we're eating better. So we're hoping and we expect to see a healthier community at the end of this work. And when it's not perfect, we do it again. We continually form and keep these relationships with folks. And when you don't exercise as much as you used to, we'll start all over again because we're going to be in the community forever and we're there as a partner to institute these behaviors that we know will produce the outcome that we're looking for. On the access to food piece again, when we've removed the necessity of a person to buy their dinner at the gas station because they now can purchase it at a market, we know people will become healthier and the outcome and their future is brighter because we've been a part of bringing that to the community.
- [13:15]
B
Thanks so much. And one last question. Kind of as a wrap up, we'll play Monday morning quarterback. You've had several years of experience in this world and you've had some successes and likely you've had some things that didn't go as planned. What are key pieces of advice? Maybe one or two things that you would give to another organization that was either just starting out, addressing some of these same things, or was interested in expanding the work that maybe they've already started.
- [13:45]
C
I think we have to give ourselves grace at the very beginning and celebrate every success. Sometimes we get caught up in huge numbers, but every success is huge to that individual. It's huge for every child that we are a partner with to really care for people for life. And if we start well, then we can end well, you know, celebrate 10 people completing an initiative, celebrate 30, and then those 10 or 20 or 30 are going to share that experience with their neighbors. And then you'll get to the place where you're seeing 3, 4, 500 as we are today. We have a fitness center also on main campus with world class equipment. And now we're up to thousands of people that come in every day, unique individuals that are using our fitness facilities with physicians on staff, you know, present with dietitians present in the same building where you can have yoga and you can soon teach and each other teach your neighbors how to eat better. So be in this for the long term. Is what I would say. And in community it's also hard to measure impact. Again, healthcare is different. We have 400 surgeries scheduled for today and we know the outcome within minutes. This is very different but it has a greater impact in one sustaining their health in the community in which they're living. So partner with the physicians and know that we are just as important and in some cases more important in partnering with patients when they go home and community members to live a healthy life.
- [15:35]
B
Well, on behalf of aha, I'd like to say thank you Vicki to you and your team and the Cleveland Clinic for the work that you are doing to make a difference one person at a time, one community at a time. It sounds like you've had amazing success and have many more successes to come.
- [15:53]
C
Thank you.
- [15:55]
A
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