LINDA WERTHEIMER, HOST:
One of the places you'd expect to find healthy food is in hospitals - boring, but healthy. But in recent decades, fast food restaurants have worked their way into hospitals around the country. That's despite growing evidence linking fast food menus to high rates of obesity, diabetes and other chronic diseases. Elana Gordon from member station KCUR in Kansas City takes us to one place that has been wrestling with that situation.
ELANA GORDON, BYLINE: It's lunchtime at Truman Medical Center, Kansas City's main hospital for low-income people. Thousands of hungry employees, plus patients and visitors, pass by the eating area every day. You've got two options here.
UNIDENTIFIED WOMAN: Can I help someone, please?
GORDON: The first place when you walk in is a McDonald's, where Lamyia Emmanuel, Jason Davis, Wylla Johnson and Chrystal Shand are having lunch.
LAMYIA EMMANUEL: I'm having two McChickens and a medium fry.
JASON DAVIS: Quarter pounder.
WYLLA JOHNSON: Fish sandwich and a Diet Coke. I've been craving it.
CHRYSTAL SHAND: Fries.
KAMEO BURG: I'm having a double quarter pounder.
GORDON: For Kameo Burg, whose mom is in surgery, eating that Double Quarter Pounder hits the spot.
BURG: If you have a McDonald's or something, you know what there is, so you can get what you're used to. It makes it easy. It's more convenient.
GORDON: Truman's CEO John Bluford has been trying to make nutritious food more widely available. He chooses the hospital cafeteria next door to the McDonald's for lunch.
JOHN BLUFORD: I think I'm going to have some green beans, please. And I'd like to try the roasted chicken today.
GORDON: Bluford says promoting junk food in the hospital is a contradiction. Truman now posts nutrition and fitness tips everywhere, and the cafeteria's started using less sugar and fat in a lot of the foods it prepares.
BLUFORD: It's interesting how we've done what looks like hamburgers - black bean burgers and veggie burgers, and so forth. It's quite a difference.
GORDON: Bluford now thinks having any fast food inside the hospital is problematic, too.
BLUFORD: When you come in, you could be - very well be on the way to your diabetic clinic appointment or going to see the bariatric surgeon for your weight problem, and you're passing a McDonald's on the way. That's an inconsistent message.
GORDON: Bluford says McDonald's has served an important role. Until recently, it was the only place open late. And he says 20 years ago, signing long-term agreements with fast food restaurants was a popular thing to do.
BLUFORD: One, because there wasn't the kind of emphasis on healthy eating. And those franchises used to pay a nice penny to lease the space.
GORDON: But Bluford says the economic benefit from the deal is waning. The lease is up in the next few years, and he says he's looking into replacing the restaurant.
The McDonald's franchise at Truman is one of 26 in hospitals around the country.
Susan Levin, a dietician with the Physician's Committee for Responsible Medicine, says Truman's changing attitude is a step in the right direction. Levin led a review last year of food options at 110 hospitals.
SUSAN LEVIN: We were very surprised to see that some of these major reputable hospitals also have as many as five fast food outlets on their campuses.
GORDON: McDonald's says it's proud of its menu and its evolving choices, choices that can be made into balanced meals and include items like salads. It's not about where you eat, the company said in a statement, but what and how much you choose to consume.
Levin says the problem isn't just with the fast food chains. Hospitals' own food options aren't necessarily better.
LEVIN: We've seen a trend of a lot of fried foods in cafeterias at hospitals, like fried chicken bars and country fried steak.
GORDON: Back at Truman, the cafeteria got rid of its fried chicken bar, but it still serves fried food on certain days.
CEO John Bluford says hospitals nationwide are doing more to prepare for changes in the health system that will soon reward places for keeping patients healthy. But within its doors, at least for now, you can still get a Big Mac, fries and a Coke.
For NPR News, I'm Elana Gordon.
WERTHEIMER: This story is part of a partnership with NPR, KCUR and Kaiser Health News.
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