By DAVID WAHLBERG - Journal-Constitution
Tuesday, March 11, 2003
As the nation's girth continues to supersize, the institutions that heal us are increasingly offering what some say is a major contributor to obesity: fast food. In Atlanta, patients, visitors and employees can take in Pizza Hut at St. Joseph's Hospital, Chick-fil-A at Atlanta Medical Center and McDonald's at Northside Hospital and just outside Grady Memorial Hospital.
Is it hypocritical for hospitals -- which today often market themselves as "health systems," teaching wellness along with treating disease -- to entice the hungry with fatty french fries and sizzling slices of pepperoni? Or is it a welcome comfort for the weary?
Dr. Mark Fendrick of the University of Michigan surveyed the country's top 16 hospitals last year and found that six, including his own, hawk fast food. Many of those same hospitals were instrumental in getting the hospital industry to ban indoor smoking years ago, so Fendrick and his colleagues wanted to see where they stood on greasy hamburgers.
More than one in every three American adults is overweight, according to the Atlanta-based Centers for Disease Control and Prevention. The sugar, fat and calories in many soft drinks and fast-food meals are associated with weight gain, the CDC says, and obesity is a major risk factor for diabetes and heart disease.
Fendrick says hospitals — which frequently must treat the consequences of alcohol and drug abuse, domestic violence and other societal ills — may be aiding and abetting the obesity epidemic. "In the places where we see the most illness, we're also seeing something that may well contribute to illness down the road," he said.
The American Hospital Association doesn't track how many facilities offer fast food, but the trend is on the rise, said spokesman Rick Wade. It is fueled by consumer demand in a marketplace that is becoming more competitive, he said.
"In a way it probably is contradictory," Wade acknowledged. "But hospitals are trying to be realistic about people's lifestyles and accommodate choices."
The battle against the bulge could be leading to a backlash in some areas. New York officials, spurred by the city's new campaign targeting overweight children, are talking about doing away with McDonald's franchises in three municipal hospitals.
Atlanta's St. Joseph's Hospital opened its Pizza Hut in 1998, in the same food service area as a cafeteria, salad bar and delicatessen. A Krispy Kreme doughnut counter was added more than a year ago.
"People here are going through hard times, and it's not up to us to change their diets," said St. Joseph's spokeswoman Diana Lewis. "If they're upset, they don't want a salad bar. They want pizza."
Lewis said the Pizza Hut and Krispy Kreme brought in $72,000 last year, helping defray the hospital's food services budget, which includes nutritionists who make sure patients are getting their dietary needs.
Northside Hospital has had a McDonald's since 1990, said hospital spokesman Russ Davis, which stays open later than the cafeteria next door.
"A lot of people are hungry at odd hours when they are visiting patients," Davis said. "The lines stay extremely busy and long. The demand for their product is very high."
Sean Goodlett, a Northside radiology technician who was recently eating a McDonald's burger and fries while on break, said shift workers like himself appreciate the convenience of the McDonald's. "Until you're stuck working here until 5 in the morning, you don't understand," he said.
Frank Hummel of Woodstock, at the hospital for the birth of his daughter, sat with her 4-year-old sister, who was enjoying a Happy Meal.
"With McDonald's, you know what you're getting wherever you are," Hummel said.
The McDonald's just outside Grady opened in 1991, and Atlanta Medical Center opened its Chick-fil-A in 1993 and a Blimpie sandwich shop two years later.
Emory University Hospital doesn't have fast food, although some fast-food outlets line a nearby campus food court. Emory considered putting a Chick-fil-A in its recently renovated Crawford Long Hospital but decided against it, partly because of the negative nutritional message, said Emory administrator Debra Bloom.
"The core of our business is making people healthy," Bloom said.
Dietitians point out that fast-food chains have started carrying more healthy options, from salads to soups to lower-fat sandwiches. A McDonald's grilled chicken sandwich and salad with fat-free dressing, for example, contains 550 calories and 25 grams of fat, less than half of what's in a double Quarter Pounder with cheese and fries, which packs 1,300 calories and 74 grams of fat -- 9 grams more than the recommended allotment of fat for an entire day.
The key for hospitals, said Jenn Burnell of the Georgia Dietetic Association, is to offer healthy snacks along with fast food. "Yogurt and turkey sandwiches are just as easy to grab as pizza," she said.
But Burnell noted that hospitals are in a bind.
"They're trying to promote health, but they are also businesses that need to make money."