Instead, it subsidizes the production of cheap fats, sugars, and oils that fuel obesity; creates profit for food processors and corporate farmers; and supports agricultural practices that damage the environment, with long-term consequences for our health. The upcoming Farm Bill reauthorization requires that those concerned about health and well-being become involved in this issue and demand not only good economic policy but also sound health policy. In this article, we outline 3 major public health issues influenced by American farm policy. These are rising obesity; food safety; and environmental health impacts, especially exposure to toxics and pesticides.Two thirds of American adults are overweight and one third are obese.Though the prevalence of obesity remained stable through the 1960s and 1970s, America experienced an increase of more than 50% per decade in the 1980s and 1990s. These trends have significant long-term implications for our health and quality of life. The three leading causes of death in the United States are all associated with poor diet and overweight. Diabetes—America’s 6th leading cause of death—is also dramatically rising. The term adult-onset diabetes has become Type II diabetes as more young people develop the disease.If obesity trends continue, the lifetime risk of developing diabetes will be 1 in 3 for children born in 2000.There is increasing likelihood that for the first time in American history this generationof children will live shorter lives than their parents.The young and poor are most affected by rising obesity, but these trends hold for both sexes, all major racial and ethnic categories, geographic regions,growing raspberries in pots and socioeconomic strata.As Americans loosen their belts, they must also open their pocketbooks, because poor diets create additional costs to society.

Not only is poor diet linked to the major causes of death and increased medical spending, but it also carries other costs: overweight persons retire earlier, go into nursing homes at younger ages, have higher absenteeism rates, and are more likely to be disabled.The costs of obesity are borne not just by obese individuals but also by the public who supports their care: half of obesity-related medical costs are borne by public systems funded by taxpayers—Medicare and Medicaid.Public health professionals have achieved limited success in reversing obesity trends. Their main efforts focus on educating the public about the importance of individual behaviors and by supporting legislation to alter food and physical activity environments, especially in schools. But an unavoidable obstacle to success is the American food supply, which continues to provide an overabundance of cheap fats, oils, and sugars.Typical supermarkets and convenience stores contain an abundance of cheap, unhealthy food items. If tomorrow every American woke up and refused to consume anything but the foods recommended by the US Department of Agriculture Dietary Guidelines for Americans, there would be a catastrophic food shortage. Although the USDA guidelines recommend the consumption of fruits and vegetables as part of a balanced diet, the food system falls drastically short of providing enough fresh fruits and vegetables to meet their recommendations.The public health community has been slow to examine the link between food policy and public health. Until now, most attempts to reverse the American obesity epidemic have focused on changing consumer behaviors, but the results are depressingly inadequate. Little attention has been focused on examining the “upstream determinants”; namely, the food supply. Just as Americans have failed to ask why there is not enough healthy and affordable food, the public health community has failed to adequately consider what policies are driving the obesity epidemic. By following the pathway of public funds to what and how Americans choose to eat, one finds that American farm and food policies are major vectors of diet-related disease.

Fruits and vegetables are good for us. They lower the incidence and mortality of the most common chronic diseases in America.Yet less than 4% of totalUS cropland in 2004 was planted with fruits and vegetables.What is happening on the rest of our farmland? These acres are dominated by the 8 main “commodity” crops . Why is this the case? Government agricultural policies extend from the 1930s when federal policy-makers passed laws to create price stability and ensure the long-term economic viability of farming, particularly for family farmers. But in the 1970s, farm policy shifted away from maintaining stable prices to maintaining low prices and maximizing production of certain commodity crops that could be bought and sold on the international market. Direct payments were established to encourage competition and increase production, thereby lowering the price of these commodities. Farmers rely on government payments for economic stability, so they plant the crops that farm policy encourages them to grow. Seventy to 80% of all farm subsidies are directed toward the 8 commodity crops, which together cover 74% of US cropland. Farmers growing “specialty crops” such as fruits and vegetables are not eligible for direct subsidies and are penalized if they have received federal farm payments for other crops. In addition, large farms, which make up only 7% of the total, receive 45% of all federal payments. Meanwhile, small farms, which are 76% of the total, receive just 14% of the payments.The end result is a government-structured food supply that heavily favors just a few crops, grown by large-scale farming operations that fail to satisfy the healthy dietary needs of Americans .Certain subsidies provide a critical safety net to family farmers, but food processors are among those who gain the most from government payments. Processors have profited from the conversion of these subsidized commodities into processed foods sold at ever higher prices despite lower nutritional content. Between 1980 and 2000, consumer food expenditures in the United States increased two and a half times to $661 million, while the farm value of these foods increased only one and a half times. During this period, the proportion of each food dollar that went to farmers dropped from 31% to 19%, meaning that 81 cents of each dollar spent on food in 2000 went to non-farm-related activities, including labor, packaging, transportation, and marketing .

Our food system provides greater rewards to those who process, market, and distribute food than to those who actually grow it. Food processors, with proportionally more of their funds available for marketing, have been successful at creating new foods with desirable characteristics: low cost, convenience, high energy density, and appealing taste .13 With the additional support of government-sponsored product and processing research at land grant universities, these innovations use cheap agricultural inputs to make tastier and longer lasting foods with higher profit margins. Processed grocery foods dominate supermarket sales , and simultaneously the consumption of added fats and sugars has increased . Americans are eating more food, most of which is unhealthy. Between 1970 and 2000 the average consumption per person of added fats increased38% and average consumption of added sugars increased 20% . Researchers estimate that if we acted rationally and in our best interest, the average person over age 4 would consume about 2350 calories each day.Yet our food supply makes available 3800 calories per person each day. The price of fresh fruits and vegetables increased 118% from 1985 to 2000, and the price of fats and oils increased only 35%. Consumers are price sensitive, such that even small changes in the price of healthy foods affect their consumption.Not surprisingly,plant pot with drainage when ingredients are cheap, producers also compete by increasing portion sizes .The cost of the food itself is small relative to the price of preparing, packaging, shipping, and advertising, so the cost of increasing portion size is small relative to the perceived value of larger sizes. Cheap food inputs make it possible for food retailers to double the calories in an item while selling it for only cents more. This profitable strategy offers consumers short-term bargains but staggering long-term costs.While $21 billion dollars were spent under the Farm Bill to support commodity crop production in 2005,Americans are spending $147 billion a year on obesity-related illnesses, not to mention the costs of time, productivity, and quality of life lost.Agricultural policy subsidies come at a cost to public health. The system provides all consumers with excess fats and sugars, but especially vulnerable are children and the poor. Lifetime dietary patterns—healthful or not—are generally set early in life. Unhealthful patterns are important; obese children are likely to remain obese into adulthood. Poor families who live in low-income communities often find themselves living in food deserts, where healthy food options are unavailable but fast food abounds. Many older citizens who live on fixed incomes must choose between medicine and vegetables. Freedom of choice for consumers is desirable, yet we have a food system that increasingly limits healthy choices for large segments of the population, making unhealthy eating the default option.Foodborne pathogens cause approximately 76 million illnesses, 325,000 hospitalizations, and 5000 deaths in the United States each year.This too is related to the Farm Bill. Current US farm policies encourage a system that is both highly centralized and relies on large amounts of imported foods. American food travels through several stages and many miles as it journeys from farm to table—each link presents an opportunity for food contamination. Poorly monitored food imports, the threat of agro-terrorism, and our system of highly centralized food production put the safety of our food system at risk.Though foodborne pathogens most often affect raw foods of animal origin, the 2006 Escherischia coli spinach outbreak demonstrates the vulnerability of our entire food system to contamination.

Despite comprehensive food safety regulations and consistent food sanitation surveillance nationwide, a batch of contaminated fresh spinach from a single farm in Monterey County, California, infected 205 persons across at least 26 states in a 2-month period.This outbreak resulted in 102 hospitalizations and 3 deaths. How does contaminated spinach from one farm infect people all over the country? Spinach from California travels the country as a result of the large-scale centralized production and distribution of our food. When American farm policy changed in the 1970s to encourage low prices and competition between farmers, many went out of business. The farmers who survived were the ones who successfully increased their overall size and their investment in technology. Since 1900, the number of farms has fallen 63% and the size of farms has increased 67% .To reduce costs, large-scale farmers typically use highly centralized and mechanized production practices, including confined animal feedlot operations and monocultures. Though these methods are efficient, they create conditions that put plants and animals at risk of disease and microbial contamination and harm the environment. Monoculture techniques increase the risk of crop disease and deplete nutrients in soil, requiring the use of artificial fertilizers which evaporate, descend as acid rain, contaminate the water supply, and contribute to global warming.To promote rapid growth, cattle are frequently fattened with large quantities of grains that change the acidity of their digestive systems making them more vulnerableto pathogenic strains of E. coli. Increased shedding of such pathogens in animal waste occurs with the decline in the state of an animal’s health and an increase in its stress levels,both of which are exacerbated in CAFOs.Inadequate manure treatment, contamination of nearby fields and water, and contamination of slaughtered livestock are a frequently suspected sources of contaminated foods.To maintain the animals’ health, many producers dose the animals with antibiotics,a practice that poses its own set of problems . Centralization also creates large distribution channels through which contaminated foods may easily spread without aggressive vigilance. Though centralization may make detection of contaminated foods easier, potentially more individuals are at risk if contamination goes undetected. The consequences of a breach in food safety are much greater in this type of system. This is illustrated by the recent salmonella-tainted peanut butter scare, which sickened hundreds of people, caused several deaths, and put the Peanut Corporation of America out of business. Smaller, more isolated food systems are inherently less vulnerable to large-scale contamination.A highly centralized structure also increases the risks of harm from deliberate attacks. Biological agents introduced undetected into the system could result in a major disruption of our food supply. Additionally, high-speed, automated methods of slaughtering and food processing may make contamination both more likely and more difficult to detect.New threats to food safety have also arisen from global food trade.