A number of commentators have raised concerns recently about the increasing corporate presence in Australian schools. At a time of burgeoning rates of obesity and chronic disease, the increasing presence of fast food franchises within Australian hospitals should be equally troubling.
There’s strong evidence to show that high consumption of fast food increases the risk of obesity and chronic disease, such as heart disease, diabetes and range of cancers. As such, health services invest significant resources encouraging people to eat healthy food and control their weight to reduce their risk of contracting these diseases.
Hospitals are accredited on the nutritional quality of the food they provide to patients and nutrition advice is a key component of their outpatient services. They even offer nutrition counselling to their staff. Yet at the same time, they invite fast-food outlets to set up in prominent places within the hospital foyer.
Of most concern is the rising number of children’s hospitals that now have fast-food outlets on site. Sick children arouse extraordinary protective emotions and children’s hospitals hold a unique position in the psyche of the community.
What’s the harm in one burger?
It’s not surprising then that many people are happy to suspend nutritional concerns in line with the perception that fast food may improve the hospital experience for children.
Why shouldn’t a sick child and harried parents have easy access to some familiar, comforting and fun food? It makes going to hospital a less scary experience and provides the opportunity for parents and children to relax together. After all, a few hamburgers and the occasional cup of hot chips are not going to have a serious impact on the nutrition and health of our children. Right?
This is an understandable but reactive line of reasoning. And its acceptance positions those who object to the presence of fast-food restaurants in children’s hospitals as uncaring zealots.
But despite the issue being presented as a debate around what’s best for children’s health and welfare (nutrition and enjoyment), this is not a primary driver of the relationship between fast-food restaurants and hospitals. Fast-food restaurants are not invited into public hospitals to provide a fun venue for children. And fast-food restaurants don’t push to be sited in children’s hospitals in order to provide a service to sick children. The primary driver is economics.
It’s about the money
Hospitals are short on funds and have realised they have a high-value asset they can trade for much needed financial return. Their public spaces provide access to a regular flow of captive consumers, short of time but in need of food and distraction – making them ideal customers for fast-food restaurants.
These outlets see another opportunity: they can gain longer-term customers by improving attitudes about their products and encouraging people to see them as more nutritious. They create goodwill through association with an institution that promotes wellbeing and provides a caring environment. Being inside a hospital is worth a lot more to a fast food chain than being situated just down the road – this is known as the halo effect.
Many people under-estimate the long term impact of what patients experience in hospitals. Diabetics have been known to maintain for many years the exact meal plan that they were first exposed to in hospital despite receiving updated advice as an outpatient.
Visitors are similarly influenced. A 2006 study published in the prestigious scientific journal Pediatrics compared the fast-food consumption patterns and behaviours of parents visiting paediatric hospitals with or without a fast food restaurant. It found having a McDonald’s restaurant in the hospital was associated with increased consumption of fast food by outpatients on the day of their visit and a perception that McDonald’s food was healthier than it was.
In addition, the respondents from the hospital with an onsite McDonald’s were twice as likely to think of McDonald’s food as healthier than the other fast-food outlets.
Hospital administrators need to accept their obligations to provide appropriate services for both patients and visitors rather than outsourcing this responsibility.
If they want to provide comforting, enjoyable food for children in hospital, they could start by investing in their own food services. If they want to provide a fun environment to make children’s stays in hospital less stressful, then improve facilities by providing games and play areas. And if they want to lighten the mood and relieve the stress on visiting parents, they could improve waiting and visitor amenities.
This is not to say that fast-food corporations should be denied the opportunity to contribute to improved services and facilities of children’s hospitals for children and their parents. But this relationship should be driven by philanthropy rather than marketing interests.