Healthcare Food and Environmental Health

1. Healthcare Food and Environmental Health An H2E presentation Jamie Harvie, Institute for a Sustainable Future

3. Is it just personal choice?

4. “ It is unreasonable to expect that people will change their behavior easily when so many forces in the social, cultural, and physical environment conspire against such change. ” Institute of Medicine

7. The Food System

8. Food System - Contributors to Poor Health • Over Production of Unhealthy Food Products • Use of and Exposure to Pesticides • Antibiotic Resistance • Food borne Illness • Impaired Drinking Water • Respiratory Illness and Poor Air Quality • Socioeconomic Concerns

10. Nutrition and Health • High-sugar or high-fat foods including soft drinks, salty snacks sweets and desserts, comprise almost 30 percent of all calories consumed by Americans. • Research suggests soda and fast food consumption linked to increased risk of weight gain and diabetes.

12. Top Ten Agricultural Crop Subsidies ~ $1 billion; 1985 - 2002 $ 34,552,627,460 $ 17,247,966,489 $ 13,018,173,430 $ 10,967,530,537 $ 10,663,566,847 $ 7,795,799,116 $ 3,193,985,171 $ 2,256,567,708 $ 2,018,407,457 $ 1,411,386,147 1. Corn subsidies . . . . . . . . . . . . . . . . 2. Wheat subsidies . . . . . . . . . . . . . . . 3. Conservation Reserve Program . . . 4. Soybean subsidies . . . . . . . . . . . . . 5. Cotton subsidies . . . . . . . . . . . . . . . 6. Rice subsidies . . . . . . . . . . . . . . . . . 7. Sorghum subsidies . . . . . . . . . . . . . 8. Livestock subsidies . . . . . . . . . . . . 9. Dairy Program subsidies . . . . . . . 10. Barley subsidies . . . . . . . . . . . . . .

13. Access to supermarkets increases fruit and vegetable intake • Black Americans reported an average 32% increase in their fruit and vegetable intake for each supermarket in their census tract. • Consumption for White Americans increased by 11%. (Morland et al., AJPH, 2002) (

14. Shifting to a More Sustainable Food System ENV1007_SW Marketing CCG 03/08/05

15. Looking at things in their whole context, while seeking to also understand the interconnections between parts. Nothing exists in isolation; everything is part of a larger system. Ecological Thinking

16. Food Industry Consolidation • Tyson Food responsible for 25% or all US chicken sales • The average broiler chicken farm sells nearly one million birds annually. • 54 percent of U.S. livestock are now concentrated on 5 percent of livestock farms. • 5 Seed companies control 75% of global seed sales

17. Food Industry Consolidation • Cargill and Archer Daniels Midland control 75% of global market for cereal grains. • 6 cents of every dollar spent on a loaf of bread goes to the wheat farmer – about as much as is spent on the plastic, petroleum-based wrapper • Four companies control over 80% of beef packing

18. Use of and Exposure to Pesticides

19. Pesticides • Use of agricultural chemicals known to cause cancer in CA increased 127% from 1991 to 1998. • In CA 90% of pesticides used are prone to drift. • In CA farmworkers are 59-70% more likely to develop various forms of cancer that the rest of the population. • Atrazine, a widely used herbicide is found regularly in rain and drinking water in the USA. • EPA estimates over 1 million Americans drink water from agricultural pesticides. • “Average” person has 13 pesticides in their body

20. Pesticides • Potential impacts of fetal exposure include reduced infant birth weight, low sperm counts and other fertility problems later in life, disruption of neurological development infancy, other neurobehavioral problems.

21. Combined Animal Feedlot Operations (CAFOS) • Generate an estimated 575 billion pounds of animal manure yearly • Manure uneconomical to transport distance, typically stored in open or covered pits or lagoons • Public health problems, including the overuse of antibiotics and food borne illness. 

22. CAFO’s Water Quality • Human pathogens from manure applied fields • Manure land application can lead to excess nitrogen and phosphorus in soil

23. CAFO’s and Air Quality • Dust, molds, bacterial endotoxins and manure generated gases ammonia and hydrogen sulfide, known airway irritants, allergens or respiratory hazards • CAFO Communities - eye and respiratory symptoms “similar to more prevalent and severe symptoms experienced by CAFO workers who are exposed at much higher concentrations of mixed emissions,”

24. CAFOs and Community Health • Since 1986 independent hog operations declined by 72% - a loss of 247,500 farms. • CAFOs associated with declines in local economic and social indicators which undermine the socioeconomic and social foundations of community health (APHA)

25. Community and Economic Health • A hospital’s long-term vitality depends in large part on the economic health of the broader community. Every step of the food chain where ownership falls outside the community is a potential drain on the health and vitality of the local community. • US Family Farmers typically lose money every year. In 2001 alone, income declined by 60%. • Suicide is a leading cause of death among farmers.

26. U.S. Institute of Medicine /National Academy of Science: “Clearly, a decrease in antimicrobial use in human medicine alone will have little effect on the current [antibiotic-resistant] situation. Substantial efforts must be made to decrease inappropriate overuse in animals and agriculture as well.” Antibiotic Resistance

28. ABX

29. ABX • Used for growth promotion and disease prevention • Medically important and non-medically important • Floroquinolone use • AMA and AAP “Contribute to resistance and create a danger to humans”.

30. Recombinant Bovine Growth Hormone (rBGH) • Banned in Canada, Western Europe, Japan, and Australia • Cancer risks • Antibiotic resistance concerns • Animal welfare concerns • Economic impacts

31. Food Miles • Trucks moving food freight account for 40% of road freight in UK • Head of CA lettuce shipped to Washington D.C.require 36x fuel energy to transport than food energy it provides. • Typical food item now travels from 1,500 to 2,400 miles from farm • Resultant air pollution

32. Ecolabels Meaningful and Verifiable • verifiable by the certifier or another independent inspection organization. Consistent and Clear • same meaning if used on other products. • can be verified. Transparent • organizational structure, funding, etc pulic No Conflict of Interest Opportunities for Public Comment • Input from stakeholders • Examples • Food Alliance • Transfair • USDA Organic

33. Healthcare Explores… • Creating weekly farmers’ markets on hospital grounds • Creating hospital gardens to grow fresh produce as well as provide patient exercise opportunities • Instituting policies to buy only meat raised without non-therapeutic antibiotics or hormones. • Setting goals and exploring new relationships designed to increase the purchase of locally-produced, fresh produce • Buying more certified food products • Making hospital campuses “fast food-free zones” • Purchasing foods providing fair prices, and a living wage, to the people who produce them • Buying milk produced without use of synthetic hormones, like rBGH • Buying coffee certified as Fair Trade