The Disconnect Between Food Policy and the Public’s Health

Jim Bloyd, MPHCook County Department

of Public HealthApril 8, 2010

“Currently there is a great disconnect between public health diet-related diseases and agriculture policy issues, but they are intimately connected. A systematic strategy that simultaneously focuses on developing the sustainability of food systems, community food justice, and pubic health success would have multiple benefits and allow for rich partnerships.”

Story, Hamm, Wallinga (2009) Journal of Hunger and Env Nutrition

In 2007 it was estimated that 8.3% of adults over the age of 20 in Cook County (including the City ) had diabetes.

Nationally 24 million people have diabetes.

National direct medical costs are estimated at $116 Billion

National total costs are $174 Billion

Diabetes in Cook County

US Life expectancy

Increasing mortality inequality between 1983-1999

Decrease 1.3 yrs Men 11 counties Women 180

countiesSource: Ezzati et al (2008) PLoS Med

Retail food-price increases, 1985 to 2000 Source: Muller (2004) cited by Wallinga (2009)

Without a food system approach dietary guidelines will not be met. Where does food come from? How is it produced? What is produced? How is it priced? Is it subsidized? How is it distributed? How is labor treated?Story et al (2009)

Sustainable Food System:

Healthy food to meet current food needs Healthy ecosystems Minimal impact on the environment Promotes local production and

distribution infrastructures Nutritious food available for all Humane and just

APHA and AMA resolutions

Source: www.ecocenter.org

Sustainable Food System

“ A sustainable and resilient food system conserves and renews natural resources, advances social justice and animal welfare, builds community wealth, and fulfills the food and nutrition needs of all eaters now and in the future.”

Harmon, A. & Tagtow, A. 2008 Dieticians Cultivating Sustainable Food Systems

Sustainable Food Systems Model

Source: 2007 ADA Primer on Sustainable Food: Healthy Land, Healthy People

Why the Farm Bill

Renewed every 5-6 years Impact on

Ag production Rural development Food assistance Conservation Research

Farm Bill Critical because..

USDA-Very Low Food Security: 14.6%

Food Research and Action Center-Food Hardship:19% in the US

Production, industrial agriculture is not producing better nutrition

Farmers net income is decreasing, often below cost of production

About 94 Billion Dollars(Five Distinct Appropriations 2000-2006; Cong Res Svc in Imhoff (2007))

How the USDA Spends a Tax Dollar

Food stamps, nutritionComodity & Foreign AgConservationRural DevelopmentFood SafetyAdministration

Proposed Principles on Fed Ag and Food policies

US food system should serve population health, environmental health, and economic health of food and ag sector

Ag policies need to align with healthy eating recommendations and support public health goals

Appendices Follow

Cook County Data Retail Food Prices Chronic Care Model

Thank you

Jim Bloyd, MPHCook County Department of Public

Health708-492-2019jbloyd@cookcountygov.comwww.cookcountypublichealth.org1010 Lake StreetOak Park, IL 60301

Diabetes in Suburban Cook

The South District had the highest rates of hospital discharges for diabetes. The Southwest District had the highest rates for the youngest and oldest age group.Source: Cook County DPH, wePLAN

Quality, Nutrient-Dense Food Costs More (Townsend et al Am J Clin Nutr (2009))

Diet quality and cost (Townsend 2009, Am J Clinical Nutr)

More money spent = more nutrients/ calorie

Low income women purchasing more calories-no ‘full’ signal from hi-fat food

SNAP Education reaches few but… Need to change the environment

InformedActivated

Patient

ProductiveInteractions

PreparedProactive

Practice Team

Functional and Clinical OutcomesFunctional and Clinical Outcomes

DeliverySystemDesign

DecisionSupport

ClinicalInformation

Systems

Self-Management

Support

Health System

Resources & Policies

Community

Health Care Organization

Chronic Care Model

WHO Model