Food Procurement Policy as a Potentially Promising Strategy for Addressing Overweight/Obesity in Hospital Cafeteria Environments Located in Low-Income Communities

Background: Implementation of food procurement policies in County of Los Angeles hospital and medical facility cafeterias may have salutary impact on low-income individuals' access to healthier food options. Cafeteria patrons may include residents of nearby low-income communities, where the percentage of the population with household incomes less than 100% of the FPL is approximately 26%1 as compared to 16%1 for the entire Los Angeles County. Methods: Using a two-stage approach we: 1) describe the policy rationale and development process of an upcoming hospital food and vending services contract that will require the adoption of more rigorous food nutrition guidelines in County hospitals and medical facilities; and 2) qualitatively assess the feasibility (e.g., facilitators and barriers) of implementing such a policy in the public sector healthcare setting via key informant interviews. A pending pre- and post- evaluation of policy impact is planned based on the findings of this initial assessment. Results: A procurement policy at county hospitals may improve the nutritional content of approximately 6,000 meals per day. Factors which may influence policy adoption include food costs, variation in nutrition and cooking standards among the various facilities, customary food procurement practices, contract negotiations with food manufacturers and vendors, and taste preference of cafeteria patrons. Evaluation later this year will further elucidate the impact of such a policy. Conclusions: Food procurement policies may augment other public health and community interventions for combating the obesity epidemic in Los Angeles County, and nationally in the U.S.