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Nourish 2050: Regenerative Food and Health Systems that Reconnect People with Land, Culture, and Each Other

Regenerative food and health systems work together upstream to build wellbeing for people and planet.

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Lead Applicant Organization Name

Nourish: The Future of Food in Health Care / Nourrir la santé: L’avenir de l’alimentation dans les soins de santé

Lead Applicant Organization Type

  • Small NGO (under 50 employees)

If part of a multi-stakeholder entity (i.e. team), provide the names of other organizations and types of stakeholders collaborating with you.

Nourish is an initiative incubated by the McConnell Foundation with many partners. Nourish will spin-off to be a new organization in fall 2020. We hope to leverage our initial core funding to triple the investment by funders, governments and other partners over the next five years to achieve our goals. Partner organizations in the past three years of work include: Academy for Systems Change, Canadian Coalition for Green Health Care, Food Secure Canada, HealthCareCAN, Health Care WIthout Harm, Sustainable Food Lab. Our work has been guided by a team of advisors and we have also built, and continue to strengthen, relationships with: senior health and agriculture officials in provincial/territorial/federal governments; Indigenous organizations, communities and Elders; health care professional organizations (physicians, nurses, dietitians); and business and organizations along the value chain - food service management; group purchasing organizations, food distributors, producer groups.

Website of Legally Registered Entity

www.nourishhealthcare.ca

How long have you / your team been working on this Vision?

  • 3-10 years

Lead Applicant: In what city or town are you located?

Montreal

Lead Applicant: In what country are you located?

Canada

Your Selected Place: what’s the name of the Place you’re developing a Vision for?

Our place is Canada - a large country made up of diverse regional food systems

What country is your selected Place located in?

Canada

Describe your relationship to the place you’ve selected.

Nourish’s work focuses on the healthcare sector’s relationship to the place in which they are embedded, and the opportunity to unleash the potential for health care institutions to become anchors for health and wealth within their communities. We are fortunate to have a health care system that is publicly funded, but we believe the 4 billion public dollars that health care annually spends on food service should be leveraged for public good. A recruitment process is under way for identifying in 2020 the first cohort of anchor collaboratives. We aspire to reflect the geographical diversity of regional food systems across Canada in our cohort - the prairies, northern, central, coastal - as well as varying population density - urban, peri-urban, rural, remote.

A fundamental part of Nourish’s work is that we hold a bold vision but are not prescriptive about how to achieve it; instead we support the development of systems-leadership in health care institutions, to be mobilized in a place-based way that starts from a deepened awareness of community needs and connection to the land. We do not believe in one-size-fit-all solutions, but aspire to create a learning network guided by the concept of “cosmopolitan localism”, where we connect cohorts of healthcare-institution-led local regions across Canada in reciprocal relationships of learning and sharing. Through support and sharing of successes, failures and learnings from local experiments and innovations, the objective is to inspire and scale ecologies of interventions across the nation that are place-based and unique. 

Most importantly, the foundation of Nourish’s work is to learn from and listen to the deep wisdom of Indigenous peoples, especially in the interconnectedness between health, food and land. Nourish works on Turtle Island, and as part of a colonial system that is on a long journey of reconciling its relationships with Indigenous peoples.

Miichim: https://bit.ly/2RM6eWh

Describe the People and Place: Provide information that would be helpful for an outsider who has never been there and may have no context about this Place to better understand the area.

Canada is one of the most ethnically and culturally diverse countries in the world but it has a dominant European food culture and has systemically dismantled pre-existing Indigenous food systems, causing great harm. When food is a source of comfort and healing for a lot of people, cultural competency expressed in through the food served to patients should be a priority in patient-centred care. When hospitals do not offer patients their preferred culturally relevant foods for healing, hospital staff often expect their patients’ family visitors to supplement food to improve patients’ appetite. 

First Nation, Metis, and Inuit people in Canada are disproportionately food insecure, experience high rates of diet-related diseases like diabetes, and have poor access to clean water. Indigenous people have a life expectancy a full ten years shorter than non-Indigenous Canadians. Canada is a nation that is on a journey of reconciliation with its Indigenous peoples and land. Food is a pathway to reconciliation and justice with Indigenous peoples, but it’s also one that builds health for Indigenous and non-Indigenous peoples alike. The Truth and Reconciliation Commission calls the health sector to address the ongoing impacts of colonization and to close the health gap. Reconnecting with Indigenous foodways and traditional knowledge is a way for Indigenous people to chart a path back to health - and finding ways to braid Indigenous and Western paradigms on food and land, offering the potential for learning to tackle the loss of biodiversity and climate change that binds our collective fate. 

Dominant food paradigms across the geography we have chosen are ones that view food as ancillary, commodity, nutrition but not culture, and put importance on the fact that food be cheap. Cheap, fast, and convenient food culture prevails - making people and planet sick -  undermining the richness of the diverse food traditions across the country. Poor food literacy, intergenerational knowledge loss, low income, and food insecurity are drivers of diet-related chronic disease with well-known impacts on our health care system.

Canada is a large country spanning from coast to coast to coast with significant differences in climate and resulting food systems -- from the sprawling wheat and legume fields of the prairies to seashore abundance and abundant produce of the west coast, to the fisheries of the east coast. Big and diverse as is our chosen geography, the common history of colonialism and development of a cheap food culture is one that binds our fates - we must tackle these paradigms, learning locally and working collectively from coast to coast to coast to reconcile our relationships with land, food, and each other, to build wellbeing through food for people and planet. 

Challenges: Describe the current (2020) and the future (2050) challenges that your food system faces.

The dominance of colonial food paradigms -- which disassociate the health of people and place, and which externalize the costs of food -- drive a short-sighted, cheap/convenient food culture that we see across the following themes:

Environment

Unsustainable farming and fishing practices in Canada put a huge strain on our land, waterways, and oceans, threatening the viability of our food-production systems. Our current food system is a leading contributor to climate change and contributes to water and air pollution, soil contamination, and loss of biodiversity. The Canadian health care sector generates 5.2% of the national carbon footprint of which 9% is attributed to food and agriculture.

Diet

Unhealthy eating and food insecurity are drivers of diet-related chronic disease with well-known impacts on our health care system and climate. Animal-protein heavy Western diets also drive demand for an unsustainable industrial meat industry that has a big climate footprint.

Economics

The economic costs of unhealthy eating are $13.8 billion annually in Canada. Four millions Canadians experience food insecurity, and health care costs are 121% higher for those living with severely food insecurity. Canadians waste 40% of the food we produce and typically 40% of hospital trays are wasted. Food waste along the value change needs to be addressed not only for climate but also financial imperatives.

Culture

Disconnected from their traditional food systems by colonial policies, First Nation, Metis, and Inuit people in Canada are disproportionately food insecure, experience high rates of diet-related diseases like diabetes, and have poor access to clean water. Indigenous people have a life expectancy a full ten years shorter than non-Indigenous Canadians. The Truth and Reconciliation Commission (TRC) calls the health sector to address the ongoing impacts of colonization and to close the health gap. It calls health providers “to recognize the value of Aboriginal healing practices and use them in the treatment of Aboriginal patients in collaboration with Aboriginal healers and Elders”.

Technology

An important factor underlying many of the pressures on our health care system, is our current food system. In place of increasingly “technical” fixes of providing more sickness care there is a huge opportunity to shift to a greater emphasis on more preventative health strategies. Without a change in direction our current health care system will not be financially sustainable.

Policy

The Federal Government recently adopted a national food policy framework. In order to tackle the root issues of why we do not currently have a sustainable food system for all, systems thinking and coordinated action amongst all diverse actors and stakeholders is required. Government policies and programs which for the most part remain in “silos” will importantly need to instead cut across ministries in order to leverage the interdependent social, health, environmental and economic components of food systems.

Address the Challenges: Describe how your Vision will address the challenges described in the previous question.

Ode to the Hospital Tray: https://bit.ly/2GGozO6

Institutional leadership through food on climate, equity, and reconciliation is not a noble cause, it is a health imperative for the future. Nourish will support healthcare to leverage the power of food in three interconnected impact areas: 1) Climate; 2) Equity, and 3) Community Wellness. 

Rethinking food will be an important way to shrink health care’s carbon footprint. Reducing food waste and shifting to more plant-rich diets are amongst the top four strategies for reducing carbon emissions in the Drawdown research led by Paul Hawken. Indigenous foodways, including connection to land, respectful harvesting, and tracking ecosystem changes, are a source of wisdom to help navigate out of the climate crisis, and build health for people and planet.

Changing hospital menus, food service operations and procurement can help to decarbonize supply chains. Hospitals can use their significant purchasing power to ‘bring to life’ Canada’s Food Guide including serving less meat overall and sourcing more sustainable meat and plant-based protein. In this work it will be vital to support Indigenous communities access to traditional/country foods essential to their cultures. 

Modeling of sustainable diets by health care facilities will contribute to population dietary shifts which can generate co-benefits from reduced risk of disease, health care costs and greenhouse gas emissions. 

Cultural competency is a priority in patient-centred care, and must be expressed through the food served to patients. When hospitals do not offer patients their preferred culturally relevant foods for healing, hospital staff often expect their patients’ family visitors to supplement food to improve patients’ appetite. However, individuals of lower socioeconomic status are already at a higher risk of food insecurity and may lack access to social networks that can support them while in hospital. Redesigning health care food services and food environments so they meet the needs of culturally diverse communities will be impactful 

The Interrelated issues of diet, affordability and accessibility to healthy food are dealt with downstream by our health system which is oriented more to sickness care than preventative health upstream approaches. We have the power to leverage health care institution resources to invest in upstream approaches to improve nutrition, food environments, health care menus and access to fresh, healthy, cultural, local, sustainable food towards redesigning our food and health systems to be resilient and nourishing for people and the planet.

Health care institutions collaborating with their communities can address both the social and ecological determinants of health by reimagining food along the continuum of care out into the community and the broader food system. Sources of resiliency are community-connectedness and connection to nature. Social prescribing and food programs are powerful ways to build community.  

High Level Vision: With these challenges addressed, now provide a high level description of how the Place and the lives of its People will be different than they are now.

From “food as commodity” to “food as medicine”: Rather a paradigm that sees food simply as a commodity to be traded, food is fully valued for its healing impacts for people, communities, place, culture, and the planet. 

From fragmented to interconnected systems: People, communities and sectors will be connected through finding transition pathways that find synergy across health, agriculture, environment that are currently siloed. Communities will share more resources and power with their institutions in a way that deepens the quality and seamlessness of their health and their health care.

From mechanical to organic: The current system has a high degree of path dependency (e.g. capital invested in current operating systems) in a paradigm of efficiency that is mechanical, but paradoxically produces a lot of undesirable outcomes, like food waste and an inability for hospitals to support local food producers. This rigid system could evolve to mimic more natural, organic forms of self-organizing that seek greater balance between people and planetary ecosystems.

From competing goals to shared mission: The physical separation of the actors in the current system is reinforced by capitalism, that gives rise to a scarcity-driven competitive dynamic for limited resourcing. Within alignment around a common mission–the health and well-being of people and planet–we can move with speed and intuition towards a new future. Conditions will be created for power-sharing and collaboration that draw out the wisdom of all stakeholders in a system,

From disenfranchisement to empowerment: Many actors in the system, from food buyers, to community activists to medical students to hospital employees, feel stuck, undervalued, overwhelmed and burnt out within their roles. We envision a transition toward a system that values everyone’s agency and location in the system, creating meaningful work and meaningful outcomes for all.

Full Vision: How do you describe your Vision for a regenerative and nourishing food future for your Place and People for 2050?

Our vision is a future where the health of people and the planet are supported by sustainable food and health systems, that work together for preventative and equitable health for all. Working at the paradigm-level, we integrate different ways of knowing - Western, newcomer and Indigenous alike - to collectively tackle the mindsets that hold our cheap-food, sickness-care systems in place. Through the catalytic power of food, we’ll collectively carve out transition pathways to regenerative food futures that recognize the interdependent health of people and planet. 

Our vision and work is the result of dialogue farmers, physicians, elders, hospital CEOs and patients, designers, policy-makers, food service companies, community organizers, and health care innovators. 

There is a powerful opportunity to unlock the full potential of health care as a leader in nourishing health for people and planet. Health care organizations have significant purchasing power and influence, have real opportunities for climate change action, and are often the largest employers in their communities. If they take action around food, it will matter. 

Nourish will support health care in leveraging the power of food to achieve impact in three cross-cutting areas: 

Climate: Climate Leadership through Food 

Equity: Address Upstream Determinants of Health through Food

Community Well-Being: Resilient Communities through Food 

We have a powerful opportunity to use food to connect people and planetary health through the $4 billion spend on health care food services every year of which currently little is directed towards local, regenerative and cultural food. Typically, 40% of the patient tray is uneaten and thrown out -- and with roughly 275,000 meals being served in Canadian hospitals daily, this adds up. Also wasted is the opportunity to see the food served in hospitals, to patients and in cafeterias, as a teachable moment for patients and staff in modelling healthy diets. Focusing more on food as medicine will pay quick dividends as patients who do not eat in hospital cost the health system $2 billion every year in extended stays- and this is just looking at the role of food within the hospital walls. Aligning health care food environments with the highest aspiration of their health-promoting mission will be a critical way to support shifts to healthy eating across the population.

In achieving a more regenerative and nourishing food future for people and the planet by 2050, Nourish sees a shift towards more hyperlocal and distributed communities with resilient economies and food systems. In this future, more preventative, equitable and regenerative food and health systems are one that: 

Sees the health of people and the planet as interdependent: The ecological determinants of health are prioritized, with upstream efforts to support the health of our soil, biodiversity, water and air, as a way to promote and serve human health.  

Prioritizes the preventative well-being of people: Preventative health and well-being is holistically fostered through development of regenerative food systems and healthy eating and addressing other social determinants of health, is advocated for and invested in.

Connects health care to community: There is a strong belief that the health of people is not the responsibility of individuals, but of the community.

Aligns home values with institutional values: Many of the personal values around eating, such as the cultural, social and spiritual dimensions of food, are reflected within the public institutions as well.

All of these health care priorities ultimately point to the support and development of more healthy and resilient food systems, communities and planetary system across the interconnected themes: 

Environment

By 2050, the healthcare sector has influenced and leveraged its purchasing power to support a resilient network of farms, food processors, distributors and food service operations to work together in bringing fresh, delicious foods to patient trays and hospital cafeterias. Health care staff regularly visit their farmers, fishers, and foragers to learn about their food traditions. All of the food served to patients has already contributed to their health as it was grown in ways that supports biodiversity in plants, animals, insects and microbes and builds soil health. All health care facilities have maximized their capacity for growing food, flowers and therapeutic gardens ecologically, including composting food waste onsite to cycle nutrients.

Diets

By 2050, the healthcare sector has influenced and modelled healthy eating to move towards fully sustainable diets. There has been a revival of Indigenous food systems alongside development of regenerative Western ones. Canadians have shifted from a meat-centric western diet to one that is focussed on delicious, nourishing and culturally relevant plant-protein forward choices. Everyone has access to fresh and affordable vegetables and fruits through community-based food centres that are integrated with other social and health services, and sourced from local farmers and suppliers. Or, folks have reconnected with Indigenous land-based food systems that centre hunting and harvesting, their stewardship, for example, helping to revive previously dwindling caribou herds. The increasing demand for and accessibility of fresh, whole foods leads to a decline of processed food products. In a 2028 census survey, three in five Canadians eat a climate-friendly diet.

Economics 

Hyperlocal food system that interfaces with a global food system rooted in robust principles of sustainability.  Both individual and corporate big emitters have been incentivized into redesign programs to adapt their lifestyles and operations within planetary boundaries. The social and ecological determinants of health guide decision-making by policy makers based on a robust well-being accounting framework. 

Culture

One of the biggest popular impacts has been the rise of backyard and community gardens, and the shift towards plant-based diets. A cultural narrative seeing “food as medicine’ is mainstreamed in relationship with Indigenous wisdom. Reconnecting with traditional foodways has become a way for Indigenous peoples, who experience disproportionately high rates of diabetes and food insecurity, to chart a path back to health. Indigenous leadership is on the rise in all sectors, with Indigenous wisdom at the foundation of efforts to reconnect with land and develop regenerative practices to restore national habitats, animal migration patterns, and right relationships with the earth.

Technology/ Health Technology

In the health care sector, Health care happens increasingly in community.  With increased access to their health data, people are digitally empowered to monitor their own health.  Communities of seniors in urban centres live increasingly in congregate living facilities, co-located with daycares. Only the sickest are in hospital; but the health system itself wraps around the population, from digital doctors and in-app nutrition counselling, to doctor-prescribed healthy home meal delivery. In the food system, the development of blockchain technology enables contracts between a greater number of small and medium scale -producers with local institutions and retailers. Inexpensive handheld food safety scanners have also helped to bust food safety myths that previously incentivized institutions to exclusively buy from transnational food services companies. 

Policy

Due to the government making bold investments to support a transition to renewable energy and sustainable agriculture, emissions have nearly halved in the decade, and fears of runaway climate change are easing. The Federal Ministry of Agriculture has been renamed the Ministry of Food, which works closely with the Ministry of Environment and Climate Change and the Ministry of Health to co-develop policy that protects both people and planetary health. 

The two core guiding principles that Nourish will not compromise on are that: 

1. There are no trade offs between equity and sustainability. 

2. The health of people and the planet are interdependent.

Nourish starts from the understanding that the only constant is change, and that all systems are dynamic. We aspire to shape the present and ongoing transition in the health system toward better outcomes for people and planet.

Nourish takes a principles-led approach to identifying and supporting transition pathways for health care. To do so, we work at multiple scales in the system: policy, organizational, and community. By supporting anchor leadership in healthcare and encouraging collaboration with communities, we will build evidence for other adopters to follow, and credibility for new practices and policies that position hospitals as drivers of health for people and planet. 

Transition pathways are interconnected ecologies of strategies and actions that support the on-going evolution of systemic transformation toward healthy, sustainable and equitable futures.  To Nourish, change through these transition pathways must be anchored in four core ideas: 

1. Systems-based : We embrace the complexity of all of the interconnected actors and overlapping contexts of health care, social, food and planetary systems to find impactful interventions happening at multiple scales.

2. Place-based: There is no one-size-fits-all solution. We need to address the unique needs and relationships of people and communities in ways that are rooted in culture, land and place. 

2. Awareness-based : We believe systems don’t change unless we also work at the level of the mindsets and beliefs that shape the people working inside them. 

4. Historically-informed: Where we’ve been shapes where we go; we consciously bring history into our understanding of the problems we tackle.  

How did you hear about the Food System Vision Prize?

  • Website

Describe how your Vision developed over the course of the Refinement Phase.

Visioning deepened our confidence to intervene at the overlap of the food and health systems for people and planetary health. A learning that emerged was how important health informatics will be to support policy and co-investments around food to address upstream determinants of health. We can achieve profound health outcomes when we bound our well-being systems by place: communities, land, and foodsheds. 

When futurecasting, we were struck by the abundance of signals and trends  (90+ citations in our refined vision) confirming there are many pockets of the future in our present that we can support and scale. Even before COVID-19, growing health care needs related to food insecurity, unhealthy diets, unsustainable food systems and climate change were pressing. We see an unprecedented opportunity in Canada’s pandemic response to transition towards more resilient, equitable and sustainable futures.

Reconciling our relationship to land emerged as a significant theme through our process. 

Please provide the names of all organizations you meaningfully partnered with to develop this latest version of your Vision (they contributed at least 10 hours of time to the Vision development during the Refinement Phase).

Healthcare stakeholders: 

- Canadian Coalition for Green Health Care
- Centre for Sustainable Health Care (University of Toronto)
- Patient Advisors Network
- Canadian Medical Association
- SSE Synergie Santé Environmentale
- Nourish Innovator network from 25 hospitals and health authorities across Canada including: Haida Gwaii Hospital and Health Centre, CIUSSS Centre-Sud-de-l’ile-de-Montréal, City of Thunder Bay, Horizon Health Network, CHU Sainte-Justine, Oakville Trafalgar Memorial Hospital, Health Sciences North, Covenant Health, Grove Park Home


Food system stakeholders: 

- Food Secure Canada
- Dietitians of Canada
- MEALSource
- MealExchange
- Black Creek Community Farm


Indigenous thought leaders: 

- Three Elders and Knowledge Keepers from the Haida Nation and Saskatchewan
- Nourish Indigenous and Allies Advisory 

Describe the specific steps you took during the Refinement phase to include different stakeholders to develop your Vision, including a description (age, profile, and total number) of the stakeholders engaged, and how you engaged with each.

Co-Designing the Vision: 

Our team identified 25+ key food and health system stakeholder organizations and thought leaders and invited them to co-create our refined vision through a survey, visioning workshops and feedback on our vision summary.

The online survey crowdsourced signals and stakeholder inputs on their ideal 2050 vision for the food and healthcare system (10 completed), which was summarized for online workshop feedback. 

Our 2-hour visioning workshop invited food and health system stakeholders (13 participants including a chef, two dietitians, food security experts, a professor of health policy, an institutional food buyer, sustainable health care organizations, patient advocate, nursing professor) to discuss futurecasting patterns, survey vision themes, and a deep-dive into exploring the Day in the Life of four key system actors in 2050: 

- Suresh, a second generation farmer in Saskatchewan 

- Ellen, an Indigenous physician in Vancouver

- Amélie, an executive chef at a hospital in Montreal

- Don, a retired senior living in Ontario

A second workshop was hosted with Nourish innovators, a cohort of health care food leaders (including Food Service Directors, Procurement Directors, Dietitians) (8 participants),

We shared a draft of our 2050 vision with stakeholders and partners for feedback before submission, which they provided by email and over phone calls

Indigenous Engagement: We spoke with three Elders involved with Nourish, the co-leads of a National Working Group on Indigenous Food Sovereignty, and the McConnell Foundation Reconciliation Program Office 

FSVP Engagement: We connected with three vision semi-finalists to trade notes: KitcheNet, Chicago; Institute for Sustainable Food System, Kwantlen Polytechnic University, British Columbia; University of Guelph, Ontario.

Communications: We shared the announcement of our semi-finalist selection through our Nourish newsletter (1100+ subscribers), and tweeted our progress (700+ Twitter followers). 

What signals and trends did you draw from to inform your Vision? Please provide data or examples that back up each signal or trend.

Environment

Farmers for Climate Solutions(1) accelerate uptake of on-farm practices and regulatory changes, like pesticide bans(2), as part of a just transition. 

The global health care sector recognizes it is the fifth-largest greenhouse gas emitter on the planet(3). Health ministries(4) & medical students(5) call for climate change action for human health.

Diets

Plants are bred for flavour, not commodification(6). Making an impact on soil and taste drives hospital menus based on behavioural insights to shift towards more plant-based diets(7).

Indigenous cuisine is being re-claimed and re-invented by a new guard of chefs (8), and they are integral in the movement to Take Back the Tray (9) in hospitals, schools and other institutions.

Processed foods are a much bigger health problem than we thought (10) on our gut microbiome. Unhealthy food in hospitals (11) is eliminated to better align with their health promoting missions.

Culture

Mutual aid networks flourish during the pandemic (12) and inequities come more clearly to light for marginalized communities (13). Screening for food insecurity (14) becomes the new norm, and society comes together not only to fix things in the moment, but also to push for systemic change.

Along with medications, doctors make social prescriptions (15) for forest bathing, food boxes and volunteering to address isolation (16) and social determinants of health. This new way of seeing a patient as a whole person radically transforms healthcare.

Spending time in nature (17), being on the land (18), and collective gardening (19) become part of everyone’s mental health regimen.

Economics

Perverse calls to action for Canadians during COVID-19 around unhealthy diets (20), shifts mindsets towards wanting a food system focused on health, not just profit.

The largest academic hospital in Canada invests in upstream health with affordable housing (21), and social medicine is a key pillar of healthcare’s redesign (22) post-pandemic.

US commodity farmers planting small plots of cover crop mixes designed for community harvest (23), leading to greater interest in land-sharing (24).

Technology

Canadian health care goes digital, archaic paper record systems which hold up real-time COVID-19 data (25) finally lead to #AxetheFax (26) and virtual house calls (27) cut down trips to doctor’s offices and tests.

A carbon-backed digital social currency(28) utilizes blockchain technology for trade at the city level, rewards sustainable food choices, and is adopted by municipalities to meet net zero targets.

Policy

A Canadian Food Policy Advisory Council (29) breaks down silos and uses tools like the Food Systems Dashboard (30) to bring together data on food production, environments and diets.

Charitable food cannot adequately address food insecurity during COVID-19, opening policy windows for a universal basic income (31). Gaps in regional food self-sufficiency (32) spur bi-partisan action to measure and boost food production per resident.

Describe a “Day in the Life” of a key food system actor within your food system in 2050 (e.g., farmer, chef, supply chain actor, food policy actor, etc.).

Niloufar is a former GP, now Co-Director of the Don Well-Being Centre, a hub that provides care for the whole person.

This morning she wakes up on hard ground after the Centre’s annual Solstice Feast. She and her colleagues camped with community members, listening to Elder Ted’s stories about how this land came to be known as the Dish With One Spoon.

Niloufar climbs her way up the rewilded ravine, toward the wafting smell of roasting onions coming from the Centre’s community restaurant. Crossing the gardens where apprentices are experimenting with plant breeding, she finds her Co-Director Abena, a skilled farmer and community organizer in the clinic atrium. 

Abena is watching the Well-Being dashboard update on the wall. Both have been closely monitoring loneliness with a recent wave of climate refugees into their foodshed. Engagement with the world kitchens program has been high, and the numbers are looking good. 

Niloufar swipes to get the view of one of hundreds of Indigenous-governed sister Centres, Margaret’s Place, in a converted tourist fishing lodge. A band of pink light shows that Wild Sockeye stocks are up. She wishes her old teacher, honored in that Centre’s name, was still here for this.

Niloufar joins the Wheels to Meals breakfast program. Then she works with Jean, the Foodshed Facilitator, on the Centre’s forward buying goals with local farmers. 

After a lentil confetti bowl, she meets with the Mississaugas of the Credit River, who are working up a business plan for a land-based teaching centre on 50 acres bequeathed as reparations. With the resurgence of Indigenous foodways, the life expectancy gap with settlers has been eliminated.

Before riding home, Niloufar helps staff with pick-up of the week’s seasonal Planetary Food Boxes, set up by the vertical garden that’s reclaimed the old Don Jail. She straps her box to her electric bike, and takes off to her co-op to make dinner for friends and to digest the abundance of the Equinox. 

Environment | How will your food system of 2050 adapt to climate change and remain resilient?

The health care sector has reorganized around the ecological and social determinants of health, leading to structural changes in the public sector under the “People and Planetary Well-Being Mandate.” Investments into planetary health interventions are financed by savings in reduced health care costs from a healthier population.

Well-Being Regions are connected to the health of their Foodshed.

By 2050, the Well-Being sector has leveraged its purchasing power to support a resilient network of farms, food processors, distributors and food service operations. Hospitals repurpose their parking lots, rooftop spaces and underutilized land to greenhouses and gardens. Tray waste shrunk from 40% to 2%. In acute care settings, all of the food served to patients has already contributed to their health as it was grown in ways that supports biodiversity in plants, animals, insects and microbes and builds soil health. By using food as preventative medicine, the sector has dramatically reduced use of carbon-intensive pharmaceuticals. 

Community Well-Being Centres, an evolution of existing community food centres (1) and aboriginal and community health centres (2) focused on preventative care, maximize their capacity for growing food, flowers and therapeutic gardens ecologically, including composting food waste onsite to cycle nutrients. Well-being centres are also food hubs, building local food access and knowledge about ecological agriculture.


Foodsheds embody a cosmopolitan localism (3) approach of fostering a reciprocal relationship between the local and the global 

Foodsheds are locally focused, maximizing their production within ecological boundaries and trading whatever is not needed for self-sufficiency with other foodsheds. With a small population compared to its food production capacity, Canada is still a net food exporter but redundant trade has been reduced

Care and well-being is delivered at a local scale, where citizens are committed to their sense of place, social connection with their community, and stewardship of their land and ecosystem. However, the distributed place-based hubs are cosmopolitan - being globally networked, sharing information and learnings to inform larger-scale decision-making by national and international bodies. This shift is enabled by a new national accounts system, the National Well-Being Index (see Economics).


Agriculture has adapted to warming with a significant shift to agroecology

Global warming changes growing seasons and zones in Canada: some aspects impact farming positively with longer frost-free growing days enabling different crops to be grown (4). This is balanced by an increase in high temperature events and changes in precipitation patterns which has required adaptation and a focus on soil health.


Indigenous jurisdiction and stewardship of land helps restore ecological balance

As reparations, there is a return of significant parcels of Crown and other lands to Indigenous stewardship. Some land returns to Indigenous jurisdiction and some is designated as “land trusts” for the purpose of cross-stakeholder stewardship around regenerative practices. The integration of Indigenous wisdom, for example in herd management and permaculture has led to the revival of caribou herds and other threatened wild populations along with the design of “food forests.”


Land-based education to build ecological literacy around the interdependence between people and planetary health is a key part of lifelong learning.

There are opportunities across the journey in both formal (within a school-setting) and informal education opportunities. Children are taught ecological literacy and Indigenous history at an early age, building the understanding that human health is interdependent with the health of the planet. The curriculum includes daily food and garden courses from K-12 where students learn how to grow food and prepare meals together at lunchtime.

Circular food economy approaches reduce waste along the value chain and find efficient ways for repurposing byproducts. Green hospital buildings are designed to efficiently use resources, e.g. composting food waste for fertilizing gardens, greenhouses to recover excess heat from buildings. Investments in solar panels and energy build resilience.


Canada has transitioned to a net-zero carbon economy with energy efficient public transportation options (bike paths, light rail) providing the backbone.

With the purchase of a car heavily taxed and cost-prohibitive, people choose to walk and bicycle and seniors adopt electric tricycles as a mode of transport. Domestically produced and out-of-season foods are heavily tariffed. Specialties like coffee and chocolate are transported by the most energy efficient means. Massive investments are made into fully transitioning all public transportation to renewable sources of energy electric buses and trains. 

Diets | How will your food system of 2050 address malnutrition in all its forms (undernutrition, micronutrient deficiency, metabolic disease) for the people living there?

Canadians have shifted from eating carbon intensive ingredients and processed foods to focusing on delicious, nourishing and culturally relevant Planetary Diets, with direction from EAT-Lancet describing the Planetary Diet as meals consisting of “half fruits and vegetables, complemented by whole grains, plant proteins, unsaturated plant oils, modest amounts of meat and dairy” (1). The diet and taste shift is credited heavily to the healthcare sector’s promotion of the planetary diet as a way to improve both individual and planetary health to address climate change. Canadians still can access tropical fruits, coffee, tea, chocolate and sugar but its higher pricing reflects fair labour and sustainable transportation used.

Universal access to fresh local food is provided through a Universal Planetary Food Box (PFB) featuring fresh, seasonal and sustainable fruits and vegetables sourced from the foodshed. Each box varies and reflects the unique growing capacities and traditional knowledge of each region, and is universally provided as a minimum shelf of food for individuals and households to build upon. This committed market volume provides a stable source of demand for small and medium size producers locally, and builds social cohesion in the foodshed. Boxes are available for pick-up at a Well-Being Centre, or is delivered for those with mobility challenges. 


Sovereign Indigenous food systems exist alongside regenerative farming practices. 

Indigenous peoples have championed a return to sovereign traditional foodways. Indigenous-stewarded food systems lead to a drastic decrease in diet-related diseases and chronic illness, like diabetes, in Indigenous communities across Canada.


Social eating is a fundamental part of well-being, offered through Community Restaurants

Everyone has access to affordable, delicious and nutritious meals, and a social gathering place, at their community restaurant based at a Well-being Centre in Canada. Community restaurants menus are designed by reputable chefs who source from local farmers and suppliers. “Wheels to meals” becomes the main meal support for seniors so they can gather here, with home delivery and take-out options also available. 


Health provider knowledge of food as medicine.

Food is seen as a key part of health and all health care providers are trained in cultural humility and planetary diets. Care teams integrate the prescription of cultural foods and diets as a way to support patients' health and well-being in physical, mental, spiritual, and emotional dimensions. Healthcare providers are pivotal in advocating for affordable access to fresh, whole foods. 


There is an overall decline in processed food and plant-based meals. Labelling on food includes information about nutrition, sustainability, and provenance 

Protein alternatives like lab-grown meats and plant-based proteins is the starting point of a shift away from the consumption of carbon-intensive meat products. However, this peaks in 2030 and falls due to a cultural tide away from this  highly financialized, centralized, energy-intensive food-like product. Palates and norms turn to simpler options, like deliciously prepared legumes. Caramelized confetti lentils is the new surf and turf. 


Food becomes a bigger part of household spend and time

The average household spending on food rises from approximately 10% in 2017 (2) to 20% in 2050 to support more sustainable food production practices and reflecting the cultural importance of food in daily life. This is complemented by a widespread practice of households growing some of their own food. In rural areas, food forests are increasingly popular and in densely populated cities, rooftops, parking lots, backyards and sections of public parks are maximized for beautiful food gardens, SPIN-farm and aquaponic installations. 


Growing and preparing food is part of the new curriculum for kids
Children are supported to grow food, such as herbs and vegetable gardens, and wild craft in a responsible and regenerative manner. All schools have a lunch period where children are taught how to prepare meals and share them with each other (3). They learn life skills and the importance of healthy eating for themselves and their communities.. 


Foodshed tourism becomes the new “travel” experience :

With carbon pricing international travel is more of a luxury, but the appetite for experiencing other food cultures has not waned - it simply takes place closer to home. Restaurants, seasonal food festivals, hide tanning camps, and community events are destinations to celebrate food cultures and histories.


Through all of these programs and interventions diet-related chronic disease declines dramatically from its peak in 2020, when it was costing the Canadian healthcare system an estimated $13.8B every year (direct health care: CAD$5.1 billion, indirect: CAD$8.7 billion) (4).

Economics | Where and what will the jobs be that support living wages in your future food system of 2050, and how will these jobs impact gender equality?

Healthcare spending shifts from acute care to preventative care, delivered through Well-Being Centres and fewer hospitals.

With healthcare being the largest budget line in provincial/territorial budgets, forecasted health data showed that diet-related chronic disease had to be addressed at scale. Additionally, COVID-19 made clear that food insecurity was a significant issue and health disparities related to income and racism could no longer be ignored.

Canada followed the lead of Denmark, dramatically reducing its number of hospitals (2) and significantly invested in primary care (3). This upstream preventative health investment would build health and equity and generate savings to the health system. 

Food access and healthy eating were addressed through pilots of Food Rx (4), farmers market coupons, and capacity-building in Indigenous communities that led to a revival of traditional foodways. Scaling these programs nationally targeted the prevention of 6 million pre-diabetics in 2020 from developing the disease, with a return on the investment 10 years later.  In 30 years time these policy successes evolved into universal Planetary Food Boxes and cemented the possibility for nation-to-nation collaboration between the federal government and the more than 600 nations across Canada. 


A National Well-being Index (NWI) reorients national priorities from economic growth to social and ecological well-being. 

The National Well-Being Index (NWI) (an evolution of the Gross Domestic Product (GDP) measures value creation through indicators of well-being across human and ecological well-being, reflecting the true cost accounting of food-health systems. Canada follows New Zealand (5) migrating to the NWI approach, tracking indicators for both community health (e.g. blood pressure, cancer rates, respiratory issues, exercise, cultural connectedness) and ecological health (e.g. soil health, clean air and water, biodiversity, pollinators).

Universal basic income

To ensure a healthy and thriving population, a basic income is established. A range of tax rebates, income transfers, housing subsidies and the Universal Food Box contribute to a “Basic Income Guarantee ensures everyone an income sufficient to meet basic needs and live with dignity, regardless of work status” (6). 


Indigenous economic reconciliation is a driver of well-being, and is based on reparations through the return of land  (see Policy theme)


True cost-accounting of food production shifts the system towards sustainability. 

Carbon pricing (7) for fossil fuels was implemented with the Greenhouse Gas Pollution Pricing Act (8), and a true cost accounting (8) of food started with the planetary diet at the city level. A carbon-backed digital social currency (10) rewarding sustainable food choices was adopted by municipalities to meet their net zero targets. Hospitals and other large public institutions were the first adopters tracking their food purchasing and its carbon footprint. 

Food prices go up to reflect production practices that protect and enhance water, air, soil, and biodiversity. Focus on doubling farmer share of the food dollar and government support for widespread transition akin to the EU targets for 2030 (11) to halve pesticide use, have 25% land in organic production and 10% “high diversity” landscapes, such as ponds and hedges.

The implementation of Inheritance and Wealth taxes helps to fund these transitions, and a 10-year study of the wealthiest 1% of Canadians most impacted by these policies report no decreases to their well-being or life satisfaction. 


Jobs change to value roles in the food system and community care delivery:


Fair labour along the food value chain is established and workforce in agriculture grows - both urban and rural. Foodshed facilitators emerge as important regional coordinators leading the Planetary Food Box, attracting employees from shrunken national distribution companies. Migrant farm workers are offered a pathway to citizenship and along with temporary workers, are guaranteed basic worker rights (e.g. sick leave, unemployment insurance). Consolidation in the meat processing sector is broken up, with smaller more distributed facilities built to the highest standards for both animals and workers. Living wage standards (12) are established for fast food and grocery store sectors through union negotiations, following Denmark’s lead. 

Healthcare sector restructures around new roles in well-being. Post-pandemic care work takes on a higher value which has a significant impact on women, many of whom previously provided for low-pay or unpaid. Long-term care facilities are overhauled and personal care workers are more fairly compensated. Unpaid caregiving by families and friends assessed at $26B (13) is supported by the health care system. Two key new roles emerge: data systems specialists to track well-being and ecological health; environmental stewardship and educators. 

Culture | How will your 2050 food system ensure that the cultural, spiritual and community traditions and/or practices in your Place flourish?

Households make space in their daily rhythms for family meals, gardening, and participating in community activities. Ecological living is enabled by innovations in urban planning and architectural design. 

The workforce shifts to a 32-hour work week (1) and mandatory lieu-time. Households now have more time for food - cooking from scratch, growing and preserving food, meals with family and friends, and volunteering in community programs. Household budgets are smaller and international travel is less frequent, encouraging more staycations and local culinary tourism to  restaurants run by Indigenous and both recent and long standing immigrant communities. Fusion abounds.

Ecovillages are rapidly developed that maximize environmental design for self-sufficiency in energy (solar, wind etc) and food production. Orchards and food forests (2) inspired by Indigenous wisdom and permaculture design generate harmonious landscape use and protect natural ecosystems. Physical assets like electric vehicles are shared. 


Aging is radically rethought post-COVID. A small majority of Canadians live in multi-generational households.

After the devastation of COVID-19, long-term care is overhauled in Canada and the aging journey is rethought (3). Home sharing (4) with seniors is on the rise, along with cohousing. Senior services are decentralized and twinned with other community settings like daycares, youth centres and schools. Elders share their knowledge and work with young children and youth on cooking and growing projects.  Overall there is a cultural shift around aging, an emphasis on quality of life rather than quantity of life. Life expectancy stabilizes at 90 years for all genders and cultural groups.


Urban city design is made hyper sustainable, and twinned with a rural flourishing. 

The post-pandemic shift to remote working for many sectors encourages a repopulation of rural areas. In addition to virtual connections, rural and urban areas are more physically connected by significant investment into rapid transit networks that enable eco-friendly commutes into downtowns. 

New affordable housing is co-located with Well-Being Regions and public transit as the evidence base for the return on investment for health from comprehensive community development (5) is expanded. 


Respecting Indigenous land rights and a revival of food sovereignty

Indigenous leadership within and beyond Canadian institutions rises through agreements that return Crown land to Indigenous jurisdiction. Indigenous wisdom is centred as a foundation of efforts for people to reconnect with nature and develop regenerative stewardship practices, including restoration of habitats and historical animal migration patterns. Most First Nation, Métis, and Inuit communities exercise a high degree of food sovereignty; a mix of traditional and modern foodways. 

The food and health systems respond to local cultural differences and respect food traditions from across Turtle Island and around the world. The Universal Food Box and hospital menus reflect and celebrate culturally relevant foods.


Ecological literacy and food are woven more deeply into our education system, and expand beyond formal schooling with the option for a two-year food apprenticeship after high school. Time on the land is part of healthcare professional training.

A universal national healthy school food program (6) ensures all children thrive at school and build food literacy in their region. Nature-based learning becomes part of the curriculum for all schools and participating in a nature solo is a requirement for graduation.

Upon graduation, youth can enter a government-subsidized two year food apprenticeship program that deepens valuable skills publicly determined as “vital work”, these include: permaculture and SPIN farming; Indigenous foodways; Sustainable Engineering; Community Care etc. These are paid apprenticeships where young people are mentored by elders, farmers, chefs, community activists, food artisans and businesses to learn the skills that prepare them for meaningful work to their communities. 

For every role in the healthcare system, training includes time on the land and in community. Medical schools across the country follow the social accountability mandate (7) led by the Northern Ontario School of Medicine. 


Food is medicine - both to protect health and as part of healing

A cultural narrative of seeing “food as medicine” is mainstreamed in relationship with Indigenous wisdom. Ready access to healthy, sustainable, culturally-appropriate food contributes to everyone’s physical, mental, emotional, and spiritual health.

Citizens expect their food and sustainability values at the household level to be replicated at the institutional level. Serving cultural appropriate meals takes on a key role in patient care and experience. Meals are cooked from scratch, valued food artisan roles are reinstated in hospital food services (butcher, baker, etc).

Technology | What technological advances are needed to transform your food system into one that meets your goals and embodies the values of your Vision in 2050?

Integrated health and well-being informatics are tracked by individuals, their data is then anonymized and aggregated for community-owned data-banks. Well-Being Regions are brokers of this rich data to guide policy.

At first, well-being data inputs are around the individual’s health care journey, but expanded later to include inputs around their food and lifestyle choices. People are empowered to digitally monitor their own health through wearable technologies, which enables a low-friction seamless way for individuals to opt into tracking their health and well-being activity - from the food that they consume to their fitness and biometric data. Individuals still own their own information, but with their permission longitudinal data can be aggregated to help Well-Being Regions identify patterns and design programs. 

During implementation, debates around privacy and data ownership led to health data being community-owned through the setting up Well-Being Regions as platform co-operatives (1). Blockchain technology also enables the secure transfer of well-being records that is accessible to the individual who owns it, but is anonymized to other sources. Data is importantly balanced by stories, qualitative evidence and human knowledge. A principle of “Nothing for us without us” is adopted and creates important qualitative data responsibilities for Well-Being centres, Foodsheds, Indigenous governments, and policy-makers. In turn, everything from urban planning to federal budgets for well-being are informed by the rich data carefully collected and held.  


Digital health records and virtual house calls enable more responsive and preventative care being delivered in people’s homes and their community.

There are fewer hospitals that deal with only the sickest of patients, long gone are wasted hours in doctors’ office waiting rooms, and visits to separate specialists as most of the care needed is offered in the neighbourhood Well-Being Centre . 


New research around the way that diet impacts the human gut microbiome becomes a key part of medicine. 

It becomes possible to understand what foods are best for your immune function, metabolism and mental health (2). Gut bacteria imbalance that is associated with diabetes, heart disease and obesity-­related diseases is trackable, and mitigated with dietary shifts to promote the healthiest gut ecosystem possible. A growing evidence base shows correlations between environmental toxins such as pesticides and herbicides on health, and promotes stronger regulation. More is understood about the soil microbiome, and agroecological practices that can replenish nutrients in the soil that were depleted through monocultures, and food ingredient nutrient profiles improve over time.


Taste and nutrition, not performance in commodity agriculture, drives plant breeding.

Plant-breeding based on taste (3) and nutrition is also the norm rather than for high yields, shelf life and shallow attractiveness. An innovative industry of plant breeders, farmers and chefs are at the helm of a nationwide movement to develop richly flavorful varieties for everything from potatoes to peppers. There are also more heritage and heirloom seed banks with farmers rights to seeds enshrined which helps to reverse declines in global biodiversity (4).


Food data and informatics improve food provenance, incentivize shifts to more sustainable food purchasing, reduce waste in food value chains and direct it towards circular economies. 

The development of blockchain technology enables food provenance to be tracked, and ultimately sustainability can be robustly assessed. Provenance data enables contracts between a greater number of small and medium scale -producers with local institutions and retailers. Vendor food bases are maintained and easily accessible to consumers and buyers to help make better informed decisions. For example, an interface would enable local suppliers to inform a hospital procurement manager of exactly what seasonal products are available to them for immediate menu-planning. Analytics of diets in turn help foodsheds plan food production and delivery nutrition supply management. 


Wide-tech as opposed to high-tech

Overall, there is a push towards the driving force of technology to be guided by democratic uses for the common good. Wide-tech (5), the valuing of a wider definition of technology that integrates human technologies and wisdom is prioritized -- as Indigenous wisdoms or permaculture practices inform farming, or traditional medicinal practices lead to clues around a holistic lifestyle of well-being. For example, in spite of all the data generated, it is the Indigenous stewarded cariboo lands that restore ecosystemic balance and population health. It is the integration of both quantitatively grounded data with qualitatively understood wisdom that steward the transition to a robust well-being system. 

Policy | What types of policies are needed to enable your future food system?

Key policies enable the Nourish 2050 vision but some of the power has shifted from governments to a food citizen culture of greater self-reliance, care for others in communities and place-based policy-making. 

There has been a shift from people being food consumers to food citizens (1) as they take greater control over their household food provisioning (including growing their own food), participating in community food programs and democratic governance bodies for food and health systems.

Foodshed Councils (2) are place-based decision-making bodies bringing all local food and health issues to the table for a foodshed (3), a geographical area bringing together cities and the rural. Foodshed councils bring together everyone from farm to fork for multi-stakeholder dialogue and bring priorities to regional, provincial and federal governments through a National Food Policy Council (4). Indigenous governments similarly send representatives to a National Indigenous Advisory Council. 

Community care workers and doctors, particularly women, become a political wave (5) in electoral politics post-COVID bringing medical and public health expertise into their roles as elected officials and decisively shifting political discourse toward more upstream and preventative policy approaches.


Through the Canada Well-being Act, the federal government restructures health care funding to integrate governmental silos and budgets in addressing the social and ecological determinants of health

The Canada Well-being Act (2032) set out the primary objective and conditions for provinces and territories “to protect, promote and restore the interdependent well-being of Canadians and the planet by facilitating access to care services that address the social and ecological determinants of health. This leads to the restructuring of federal government to have a Ministry of Well-Being (previously separately Health and a Public Health Agency), a Ministry of Ecology (previously Environment and Economic Development) and a Ministry of Food (previously Agriculture and Agri-Food) which have a shared “People and Planetary Health Mandate” and are co-invested in the programs of “Well-Being Regions” and “Foodsheds”.   

Well-being has replaced growth (6) as the main aim of government spending with the focus on promoting the health and happiness of Canadians, which also relies on planetary health. These Ministries coordinate other departments on cross-cutting issues- food, well-being, ecology - and liaise with Indigenous governance bodies.

Comprehensive data is gathered to track policy impacts and guide future decision-making, around the National Well-Being Index, with measures inspired by New Zealand for well-being domains (7). 


Food policy focuses on maximizing local food self-sufficiency in foodsheds, then trading the rest. A moonshot goal for soil health and food (8) spurs investment and innovation along the food value chain and enables a Just Transition to a low-carbon economy.

Regulations break-up corporate food concentration (9) and reduce availability of ultra-processed foods. Small and mid-sized food businesses receive marketing and infrastructure supports. Large commodity farms growing corn, soy, and wheat are encouraged to dedicate 1% of their cropland to fruits and vegetables (10) which based on US models, can increase production by 50% and distribute it across the country. 

Urban agriculture is an area of investment for rooftop, backyard, community, and school gardens that grow produce, raise bees and small livestock. They generate “nibbles of food but oodles of social capital” (11).

Regenerative agriculture transition supports include carbon payments for farmers and carbon pricing for food and technical assistance for agroecology. Renewable energy strategies consider externalities (e.g. ethanol declines as it is deemed an inefficient energy source). Net zero carbon targets for all sectors induce health care facilities to reduce their carbon footprint (12) including through planetary diet (13) menus and values-based procurement to decarbonize supply chains.


Indigenous peoples build power in community and build capacity for self-determination 

After generations of dispossession from their land and waters, power building in Indigenous communities leads to a modern cultural resurgence of Indigenous foodways and governance. Action on The Truth and Reconciliation Calls to Action (14), spurred by movements like #IdleNoMore (15), solidarity within and across nations like the Wet'suwet'en (15) and calls from Indigenous health leaders inside institutions to use food as a pathway to reconciliation, work across scales to unravel the systemic racism of the Indian Act. The 2021 case of the Beaver Lake Cree (17) at the Supreme court is the latest in a string of landmark rulings for Indigenous rights, that led to cascading reparations agreements that transfer Crown land back to nations. 

Describe how these 6 Themes connect with and influence one another in your food system.

Technological developments around data significantly impact upstream policy investments into the social and ecological determinants of health

E-health systems at scale enabled a shift to integrated health care, where insights from the monitoring of longitudinal individual and population health patterns have been instrumental in determining how upstream investments (e.g. Universal Basic Income and the Universal Planetary Food Box) leads to the downstream health impact and cost savings to the health system.

The shift towards a National Well-Being Index (NWI) dissolved the silos between government ministries (e.g. Ministries of Well-Being, Food, and Ecology) for full-cost accounting of all government co-investments and returns: for example, providing access to healthy and sustainable food through the Universal Planetary Food Box was justified as a health-based investment that ultimately leads to less people entering the hospital walls, reinforcing the demand for sustainable food that leads to the restructuring of the Canadian food system into local resilient Foodsheds. 

New technologies have led to greater transparency in the value chain through the tracking and sharing of food system data, leading to major cultural shifts around the need for more ethical values-based procurement standards. Purchasers are able to enforce their values-based stipulations in their contracts (e.g. criteria around sustainability, worker safety and welfare) with the traceability of their products through the entire value chain from farm to table. Additionally, the convenience and accessibility of data tracking around quality and safety has enabled smaller supply chain players to enter the market.


Centering planetary well-being through a cultural paradigm shift that has cascading impacts on the economy and the environment

With the critical need for action around climate change, the symbol of Planetary Diets -- which foregrounded sustainable food purchasing and consumption as the primary intervention for people and planetary health -- was significant in connecting individual choices to climate action. People’s tastes and cultural norms around diet voluntarily shifted to local, seasonal eating, and making empowered decisions to purchase and consume things that are aligned with their values -- and people transitioned from being food consumers to food citizens. 

This transition led to the democratization of food policy and the valuing of food sovereignty over a market-driven system --  industrialized agriculture and food processing became less profitable, and was pushed back by citizens that advocated for heavy regulation and taxation of those industries. People’s desire to purchase from local farmers and artisanal businesses (e.g. butchers, bakers) led to a thriving local sector where these roles were valued and well-compensated. Household spending on food doubles as it rises in importance.

Describe any trade-offs you may have to make within your system to attain your Vision by 2050.

True cost accounting of the food system will lead to increased food costs, which may intensify food insecurity without adequate social programs 

Carbon-pricing and true-cost accounting of food and all the social and environmental externalities from its production means that the prices of food items will increase, which may intensify food insecurity. However, food security groups advocating for affordable access to fresh and whole foods argue that the prioritization of sustainability in our food systems should not be a trade off with equity. Debates focus around not the “why”, but the “how” of food access interventions: is it better for the government to lower food prices through subsidies paid by taxes (resulting in little change to food prices for consumers) or through true costs of food reflected in prices? Ultimately, the decision to provide a Universal Planetary Food Box means that the baseline food needs of households are covered in a sustainable manner, but any food purchases that are non-seasonal and imported are significantly more expensive. Home gardens flourish. 


Tension between the mainstreaming of planetary diets while respecting Indigenous food sovereignty and cultural diets

One of the major tensions centre the to shift to more sustainable planetary diets through recommendations to reduce meat-consumption and to consume more local and seasonal foods. In Canada, the over simplicity of this narrative needed to be balanced with the respect for sustainably harvested game and fish central to Indigenous food systems. Furthermore, Canada is a culturally diverse country where diversity is expressed in food choices -- so decisions to increase the costs of carbon-intensive imported food items make it less accessible for cultural groups. 


Big data innovation around health tracking may lead to increased surveillance and centralization of power

With the great power afforded by technological advancement comes great responsibility -- for individuals and systems alike. While technological advancements have enabled better accounting/tracking of E-SDOH returns on investment, increased self-surveillance and a dependency on data-driven decision-making may continue to over-optimize metrics that can be tracked. For example, scientific research around diets can continue to steer towards the optimization or elimination of specific foods, microbiomes and/or practices, rather than inviting a bigger-picture principles-based approach.  Lack of foresight and mitigation against the centralization of power around access to data will be problematic for both public and private entities --  data being decentralized and anonymized into Well-Being Regions is a starting point, but there will always be a compromise in the trade off between the convenience of centralized data and services and the empowering but frictionful experience of decentralized services. 

3 Years | Describe 3 key milestones that you would need to achieve within the next three years for your Vision to be on track?

By 2023, Nourish will have successfully run two years of programming with a first Anchor Collaborative Cohort of five health care teams collaborating with place-based community partners to undertake work on food --  within and beyond hospital walls --  that addresses the social and ecological determinants of health. Innovations, like food prescription programs, cultural and Indigenous foodways projects, developing planetary health menus, hosting onsite community gardens, and bringing Elders in residence, will emerge policy-ready for scaling. A second cohort of five additional Anchor Collaboratives will deepen the work of the first to become ten pioneering health organizations of various sizes and demographics paving the transition of the alignment of patient and planetary health.  

During this time, a Planetary Health Campaign will be underway promoting health care leadership around menus and diets that are good for people and the planet. Patient trays and cafeterias will showcase cultural plant-forward or Indigenous food systems based delicious dishes, with the aim to draw down emissions through reductions in food waste, use of less carbon-intensive ingredients, and seasonal menus that draw on the local abundance of a bioregion. By 2023, 20% of hospitals (n=160) across Canada will have signed on. 

Importantly, the movement for reconciliation through food will have taken root in Canadian health care. Health organizations across the country have taken steps to learn about and build relationships with the traditional peoples where they are located, supporting Indigenous-led development of culturally-appropriate menus, gardens, and programming that continues a revitalization of Indigenous knowledge and wellbeing through food. Nourish will contribute to this milestone by providing resources, support, and mentorship, foremost through land-based programming developed with Indigenous community leaders for the Anchor Collaborative cohort. 

10 Years | What progress will you need to make—by 2030—that would set your Vision up to become a reality by 2050?

Paradigms will shift to health-in-all (1) views, recognizing the fundamental role that healthy food systems, from soil to fair work to food culture, plays in the well-being of people and  communities. Households and institutions spend more time and money on food, recognizing its true costs and value. 

Relationships between food and health actors will evolve. Food services will no longer be in the basement of hospitals but at the table with clinical health leaders. Farmers will have direct relationships with hospitals, physicians with community food leaders, Elders with CEOs.  

Routines will shift for food and health workers alike. Distributors will diversify the regional producers -- big and small -- that they source from and hospitals will use values-based procurement standards to guide ethical and sustainable purchasing. Physicians will make food prescriptions, and connecting with nature will be part of everyone’s daily mental health regimen. 

Power will be shared with Indigenous knowledge-keepers, community organizers, support workers, farmers and others who are knowledgeable about the social determinants of health. The gap between the rich and the poor will decrease with new progressive policy programs like universal basic income.

Policy will enable a shift to true-cost accounting for food systems leading to ecological production. Healthcare leadership on food as central to the health of people and planet will transform menus, purchasing and make addressing food insecurity a top priority. 

Funding flows will shift, with a growing number of health regions generating evidence for investment in upstream interventions like treating food insecurity proactively, transitioning away from the fossil fuel economy to regenerative agriculture, and supporting the revival of Indigenous foodways and stewardship of ecological resources.

If awarded the $200,000 prize what would you do with it?

Nourish would apply the prize funds to amplify the Anchor Collaborative programming around two central overlaps between the food and health care systems: 


Land-based learning for health and food system leaders

Disconnection from land and food culture, for both Indigenous peoples and settlers, is a central theme to be reconciled in our vision. In our initial two-year Nourish cohort, we tested the transformative impact of experiential learning on the land to activate leadership on food, health, and reconciliation. We led learning journeys with 200+ health leaders to farms and traditional territories, with time spent with Elders and knowledge keepers for story and ceremony. By taking stakeholders outside of their everyday contexts into new spaces and unreconciled histories, there is an opportunity to reawaken an inherent connection to land, and to shift mindsets and beliefs. Nourish aspires to bring health care system leaders (e.g. hospital executives, physicians) into co-created land-based learning journeys facilitated with local Indigenous leaders, to deepen leadership and understanding at the intersection of food and health care systems. 


Movement-building around Planetary Diets

The Planetary Diet(1) is an exciting opportunity for the health care sector to reconcile the separation between the health of the people it stewards, and the health of the planet impacted by climate change. With health care organizations in the country needing to address climate change as the most pressing issue of our time, the opportunity of the Planetary Diet is a vital intervention - approached with cultural humility - at the intersection of the social impact of food insecurity and the ecological impacts of environmental degradation on human health. The FSVP platform is a pathway to scale a healthcare-led movement around the interdependence of people and plenary health through Planetary Diets, a food-centred pathway that can transform land, food, health and ecological systems alike. 

If you are chosen as a Top Visionary, The Rockefeller Foundation would like to share your Vision widely with a global audience. What would you like the world to learn from your Vision for 2050?

A significant part of Nourish’s work is movement building for reconnection - with land, food, culture, health, and each other. Disconnection from the ecological and social determinants of health has led to a great untethering of our food and health institutions from the abundant natural and cultural systems that give rise to well-being. Our hope is to provide inspiration and evidence for re-anchoring people and institutions to their places and histories - aligning hearts, minds, and hands around creating a more regenerative and just future. Existing interventions and pathways carved by Innovators in Canada and globally show us it's possible.  

Dedicating time and energy to this prize, especially in this uncertain time during the COVID-19 pandemic, has had a profound impact on our team and ecosystem of collaborators. We believe that our vision illuminates the interdependence of human health and planetary health and reveals a pathway out of our silos to transition to a future where we care about our food systems and ecosystems as we would our personal health. 

The Food System Vision Prize is a platform for us to inspire and motivate people around the world. The weaving together of the well-being of our people, community and our planet is rooted in place, in the soil that our hands and feet touch, and the foods that we eat. From this starting point, we can build resilient food and health care systems that reconnect us to each other and to the land and water that nourish us.  

Please share a visual that communicates the structure and operation of your food system in 2050. Describe the visual.

Canada’s Well-Being Regions and Food Sheds illustrates the network of Well-Being Centres providing services to the community. It has a Well-Being Dashboard to track indicators around population well-being, community well-being and ecological well-being. 

The Map of Foodsheds and Well-Being Regions across Canada shows the geographic boundaries of the co-located Food-Health bioregions. The colour-coded climatic regions of the Foodsheds influence food production and local diets. 

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Hi Jennifer and Hayley,

Congratulations on getting through to this stage of the Food Vision Prize! Your entry stood out to us because it reinforced the need for interventions to be placed-based and it emphasized bringing all stakeholders’ needs into the conversation.

We were also intrigued by your approach in targeting hospitals as a lever point in institutionalizing diets centered around healthy and regeneratively grown products. Through the next phase, you might want to elaborate further on:

1) How your solution will encourage patients’ continued dietary choices and behaviors once they’re home.

2) How the conversation between Nourish and institutions will differ when scaling to other organizational structures such as retirement homes, governmental offices, and even college campuses.

Best of Luck!
Chris

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Photo of Jennifer Reynolds
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Hi Chris Monaghan Thanks this is great feedback! I'm looking forward to reading your vision in more detail and hope your team is having as much fun as we are during refinement - it feels good to go bolder and deeper. cheers, jen

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Photo of Hayley Lapalme
Team

Good feedback - thanks for it and for reading the vision Chris!

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