On February 28, 2023, The New York Times published a front-page article entitled “Alone and Exploited - Migrant Children Toil in Hazardous Jobs Across the U.S.1 If you think child labor is just a problem in other countries, think again.  Look no further than Grand Rapids, Michigan, though it is occurring in every state according to the article.

If you thought the working conditions described in Upton Sinclair’s 1906 book The Jungle, describing working conditions in meatpacking plants in the U.S. was a thing of the past, they’re not. Exploitation of young, unaccompanied migrant workers is going on every day here in the U.S.  

Back about 20 years ago, group purchasing organizations and large healthcare providers began taking a more careful look at who they were purchasing goods and services from, as well as who was producing them.  To illustrate the point, language such as this was inserted in many contracts which were signed by suppliers:

13.14   Child Labor
Seller represents and warrants that it complies with applicable labor and employment laws and prohibits any form of child labor or other exploitation of children in the manufacturing and delivery of Products, consistent with provisions of the International Labor Organization’s Minimum Age Convention, 1973.  A child is any person who is less than fourteen (14) years of age or who is younger than the compulsory age to be in school in the country in which Seller’s business is being conducted if that age is higher than fourteen (14)2

It is shocking to see global brands identified in the article, using contractors to produce food products commonly found in healthcare facilities. Household names like Frito-Lay, General Mills and Quaker Oats.  Cheerios® are ubiquitous in hospitals because of their nutritional profile. Nature Valley® bars are everywhere in many healthcare facilities. Should they be manufactured on the backs of underage migrant children, desperate for income here in the U.S.?  Apparently General Mills “realizes the seriousness of the situation” according to the article.  Do they realize that likely they are in breach of your contracts with them?  At least they were willing to comment.

These and other suppliers will undoubtedly blame their contract manufacturers, employment recruiters and others for these problems.  In most contracts, you cannot assign the responsibility away for these types of provisions.

Look at the website of the contractor used by these brands, Hearthside Food Solutions, and it says all the right things.  Their “values” include: “People-first, people-forward.”  Ironically, the site goes on to say, “We’re here to do the behind-the-scenes work that lets our customers and their brands shine.”

As an industry, we have gotten in the habit of writing long (40 to almost 100 page) contracts.  If we don’t start enforcing those terms and tell ourselves we are willing to enforce them, nothing will change.

National and Regional GPOs: Enforce your contracts by calling out suppliers who are in breach of your terms and conditions.  Serve notice on suppliers, ask for remediation plans and follow-up on the corrective actions taken.

Health Systems and IDNs: You work daily to improve the health of your communities, and care deeply about the well-being of the patients you see.  If you care about “population health” and the social determinants of health, then why support suppliers who abuse those principles?  Should you support brands that ignore your own--and their own--basic ethics and principles?  

Supply Chain Leaders: Ensure your purchasing department writes child labor and other basic principles into your own purchase contracts—and enforce those provisions.

Read the article. You know the answer.  Act now.  

1 Dreier, Hannah. “Alone and Exploited - Migrant Children Toil in Hazardous Jobs Across the U.S.” The New York Times, February 28, 2023.
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