What’s on the Menu Matters in Healthcare for Various Patients


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(THE CONVERSATION) Food is a powerful part of community and medicine. It has the potential to bond, spark nostalgia, spark joy, mark celebration, and promote healing.

It also plays a role in determining whether the health care system is inclusive and equitable.

I study the challenges that older adults and their family caregivers face in the U.S. healthcare system, particularly for people from racial or ethnic minority communities. Health disparities, such as unequal access to care based on race and ethnicity, affect many communities in the United States

Sociocultural characteristics such as language, skin color, religious beliefs and immigrant status can present barriers to accessing high quality health care. I have discovered that food can also be a source of alienation and exclusion in the American health care system. For many patients, this is an important reminder that the system was not designed for them.

Food standards in effect in health establishments

Current food regulations in healthcare environments such as hospitals and long-term care facilities emphasize occupational and food safety. Food quality standards are based on clinical needs, and specialty foods are intended for patients who have difficulty chewing or swallowing, for example. Healthcare facilities and organizations that provide them with menu recommendations routinely advertise alignment with taste preferences, allergy-related needs, and nutritional quality.

While some establishments offer kosher and halal options, culturally inclusive options are often overlooked. For example, some establishment menus highlight sandwiches and salads that reflect only American cuisine. Without culturally inclusive menus, patients might be given foods that do not match their cultural or religious preferences. As a caregiver that I interviewed as part of my ongoing study of older Asian immigrants from multiple ethnic communities, described it: “My mother-in-law was going to the nursing home and my beau -father hadn’t eaten all day before 5:00 p.m. clock. He likes to eat roti and curry for lunch and dinner, but they would just give him a sandwich.

Another participant had to help her mother come to terms with a new diet in an assisted living facility. “So she’s in this new place and one day they served kielbasa and sauerkraut, and she looks at him like, ‘What is this? And I was like ‘Oh, sausage, you’re not gonna like that, and [sauerkraut] … You’re not going to like it either. ‘”

Subsequently, these patients may lack important nutrients to manage their condition and maintain their weight. Undernourishment can have negative effects on physical and mental health, including frailty, or increased vulnerability to health problems and illnesses, and depression. Functional decline due to undernourishment can also lead to an increased risk of falls, hospitalization and death.

The caregivers I interviewed believed the health care system would not be able to meet the needs of their loved ones and resigned themselves to the idea that it would not change. As one caregiver put it, “I would say hospitals need a lot more work. My mother is quite religious and also has dietary restrictions. When she went to the hospital every day, most of the time, she wasn’t eating at all.

Improve the health and well-being of patients

Providing culturally inclusive foods in healthcare settings has the potential to promote mental well-being and even promote joy in older people. It can foster a sense of belonging and community in a place where it can be difficult to form relationships. It could also help patients and their families understand the types of treatment-aligned meals they can prepare and eat at home.

Culturally inclusive diets can also be essential in helping patients feel respected and treated with dignity. This is especially the case when they can adapt to language differences or unfamiliar healing traditions. This could strengthen their confidence in their clinicians and the healthcare system by demonstrating their commitment to supporting diverse patients.

Support caregivers and the local community

A health care system that offers inclusive food doesn’t just support patients.

Caregivers have a myriad of responsibilities, including helping loved ones get around and get dressed. The caregivers in my study also often have to prepare and transport food to ensure that their loved ones eat. One participant estimated that “it takes about half an hour to an extra hour every day to prepare the food and then bring it … straight from my workplace to the hospital.”

The local community could also benefit. Health care organizations could work with local vendors who provide ingredients from different ethnic traditions, economically supporting the community. Health care facilities could also employ chefs and dietitians from a variety of backgrounds to ensure the quality of meals.

Finally, America’s health workforce is becoming increasingly diverse and multicultural. But healthcare workers in racial and ethnic minority communities still struggle with hiding their cultural identity to belong in the workplace. Having access to country foods can help healthcare workers feel more included in their workplace, or at least ease some of the burden of “fitting in” by starting to build an organization that embraces diversity.

Emerging approaches to cultural inclusion

Implementing culturally inclusive meals throughout the country’s health system requires a concerted, long-term effort. In a healthcare environment where every penny is pinched, it can be difficult for facilities to offer multiple choices at mealtime. This requires reviewing regulations regarding the quality of food in health facilities and ensuring cultural sensitivity among health care providers and staff. Facilities also need to have the human resources, funding, knowledge and support to ensure these efforts are sustainable.

Some healthcare facilities have already devoted considerable effort to providing culturally inclusive meals to patients and residents. Holy Name Medical Center in Teaneck, New Jersey offers its Asian American patients a bowl of rice instead of a sandwich, and hot water instead of cold water to drink according to cultural preferences. Rather than relying solely on individual workers to change their practices, they emphasize a system-level commitment to inclusion and educate clinicians and other healthcare workers on different aspects of Asian cultures.

Likewise, one of Bria Health Services-owned assisted living facilities near Chicago has a special unit catering to the dietary, language and cultural preferences of South Asian adults. It’s not clear whether separate units are necessarily the ideal answer – ideally anyone in any facility would be served mouth-watering and culturally appropriate food. But it is a starting point.

To achieve a strong and inclusive health system, we must ensure that it is designed for all. And food is a fundamental way to do it.

This work was developed in collaboration with Merin Oleschuk, Emma Willoughby and Sudha Raj.

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This article is republished from The Conversation under a Creative Commons license. Read the original article here: https://theconversation.com/whats-on-the-menu-matters-in-health-care-for-diverse-patients-166931.

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