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Unravelling the Food–Health Nexus Addressing Practices, Political Economy, and Power Relations to Build Healthier Food Systems

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Unravelling the Food–Health Nexus Addressing Practices, Political Economy, and Power Relations to Build Healthier Food Systems UNRAVELLING THE FOOD–HEALTH NEXUS ADDRESSING PRACTICES, POLITICAL ECONOMY, AND POWER RELATIONS TO BUILD HEALTHIER FOOD SYSTEMS OCTOBER 2017 DISCLAIMER This report was commissioned from IPES-Food by the Global Alliance for the Future of Food for use by Global Alliance members to stimulate an understanding of critical issues related to food system reform, inform individual member foundations, and guide Global Alliance collective action. The Global Alliance has chosen to make it available to the broader community to contribute to thinking and discussion about sustainable food systems reform. It constitutes the work of independent authors. Any views expressed in this report do not necessarily represent the views of the Global Alliance or of any of our members. Date of publication: October 2017 © IPES-Food. This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. SUGGESTION FOR REFERENCING IPES-Food. 2017. Unravelling the Food–Health Nexus: Addressing practices, political economy, and power relations to build healthier food systems. The Global Alliance for the Future of Food and IPES-Food. REPORT AUTHORS Lead Coordinating Author: Cecilia Rocha Editorial Lead: Nick Jacobs IPES-FOOD WORKING GROUP Molly Anderson; Olivier De Schutter; Emile Frison; Corinna Hawkes; Desmond McNeill; Olivia Yambi. REVIEWERS Jessica Fanzo; Claire Fitch; Michael Hamm; James Hughes; Carolyn Hricko; Shiriki Kumanyika; Robert Martin; Maria Oria; Nadia Scialabba; Boyd Swinburn. ACKNOWLEDGEMENTS The Global Alliance for the Future of Food and IPES-Food would like to gratefully acknowledge the many people involved in the preparation of this report. First and foremost, the Global Alliance thanks IPES-Food for sharing the breadth and depth of their collective expertise throughout the development of the report, and for partnering with us to grapple with the complexity of the Food–Heath Nexus. In particular, we would like to thank Cecilia Rocha, lead coordinating author, and Nick Jacobs, editorial lead and IPES-Food Coordinator, for their extensive research, expertise, experience, and time. We would also like to thank the IPES-Food working group members for their tireless and valuable contributions throughout the process. We join the authors in thanking Janina Grabs for her valuable and extensive research contributions to all parts of the report, and in thanking Roni Neff for her expert insights through the process; thanks also go to Anna Savelyeva for research support, to students in the 2015–2016 Masters program in Food Security at the Roma Tre University, and research assistants at Ryerson University. We would also like to thank the reviewers who provided valuable perspectives and insights at early stages of the report’s development. The Global Alliance’s Advancing Well-being Working Group must be acknowl- edged for its guidance in the development of this report. Its commitment to realizing a health-focused food system is impressive and critical — a commitment felt and appreciated throughout the process. We extend deep gratitude to Global Alliance consultants: Lauren Baker for providing project management and editorial oversight; Zanele Sibanda for operational support; and, Alex Kollo for communications and distri- bution. Studio:Blackwell provided the design and layout of the final publication, and Hypenotic designed the graphic elements and accompanying infographic. This report is all the stronger due to their professional hands in helping to shape its form and content from beginning to end. UNRAVELLING THE FOOD–HEALTH NEXUS i i ABOUT IPES-FOOD The International Panel of Experts on Sustainable Food Systems (IPES-Food), established in 2014, seeks to inform debates on food systems reform through policy-oriented research and direct engagement with policy processes around the world. The expert panel brings together environmental scientists, develop- ment economists, nutritionists, agronomists, and sociologists, as well as experienced practitioners from civil society and social movements. The panel is co-chaired by Olivier De Schutter, former UN Special Rapporteur on the Right to Food, and Olivia Yambi, nutritionist and former UNICEF representative to Kenya. IPES-Food employs a holistic food systems lens and focuses on the political economy of food systems, i.e., the differential power of actors to influence priority-setting and decision-making. www.ipes-food.org @IPESfood ABOUT THE GLOBAL ALLIANCE FOR THE FUTURE OF FOOD The Global Alliance for the Future of Food cultivates healthy, equitable, renewable, resilient, and culturally diverse food and agriculture systems shaped by people, communities, and their institutions. We are a unique collaboration of philanthropic foundations that have come together to strategically leverage resources and knowledge, develop frameworks and pathways for change, and push the agenda for more sustainable food and agriculture systems globally. Representing countries across the globe — with diverse interests and expertise spanning health, agriculture, food, conservation, cultural diversity, and community well-being — the Global Alliance shares a belief in the urgency of advancing sustainable global agriculture and food systems, and in the power of working together and with others to effect positive change. www.futureoffood.org [email protected] @futureoffoodorg TABLE OF CONTENTS 1 FOREWORD 3 KEY MESSAGES 4 EXECUTIVE SUMMARY 8 SECTION 1. INTRODUCTION: UNDERSTANDING HEALTH IMPACTS IN A FOOD SYSTEMS CONTEXT 15 SECTION 2. HOW HEALTH IMPACTS OCCUR IN FOOD SYSTEMS AND HOW MUCH WE KNOW ABOUT THEM: FIVE KEY CHANNELS OF IMPACT 16 IMPACT CHANNEL 1: Occupational Hazards 24 IMPACT CHANNEL 2: Environmental Contamination 34 IMPACT CHANNEL 3: Contaminated, Unsafe, and Altered Foods 40 IMPACT CHANNEL 4: Unhealthy Dietary Patterns 49 IMPACT CHANNEL 5: Food Insecurity 54 SECTION 3. WHAT HOLDS BACK OUR UNDERSTANDING OF HEALTH IMPACTS AND OUR ABILITY TO ADDRESS THEM: KEY CHALLENGES 56 CHALLENGE 1: Overcoming blind spots in the evidence base: Populations without power; problems without visibility 58 CHALLENGE 2: Reclaiming research for the public good 61 CHALLENGE 3: Bridging the divide between food and agriculture 63 CHALLENGE 4: Broadening the frame of the nutrition problem 66 CHALLENGE 5: Addressing the food–health–climate nexus: Reconnecting health risks to ecological drivers 69 CHALLENGE 6: Addressing the food–health–poverty nexus: Seeing health impacts in their socio-economic context 72 CHALLENGE 7: Communicating complexity and building a healthier debate at the science-policy interface 76 SECTION 4. IDENTIFYING LEVERAGE POINTS FOR BUILDING HEALTHIER FOOD SYSTEMS 78 LEVERAGE POINT 1: Promoting food systems thinking 80 LEVERAGE POINT 2: Reasserting scientific integrity and research as a public good 82 LEVERAGE POINT 3: Bringing the alternatives to light 83 LEVERAGE POINT 4: Adopting the precautionary principle 85 LEVERAGE POINT 5: Building integrated food policies under participatory governance 87 THE WAY FORWARD 88 ENDNOTES 90 BIBLIOGRAPHY 114 IPES-FOOD PANEL MEMBERS LIST OF FIGURES AND TEXT BOXES FIGURES 6 Figure 1. The ballooning costs of health impacts 13 Figure 2. How food systems affect human health: five channels of impact 21 Figure 3. Blind spots in the evidence base: under-reported and under-estimated occupational hazards in food systems 25 Figure 4. Environmental contamination pathways 65 Figure 5. Broadening the frames of the debate on diets and nutrition 67 Figure 6. The Food-Health-Climate nexus 71 Figure 7. The Food-Health-Poverty nexus TEXT BOXES 20 Box 1. Counting the human and economic costs of occupational hazards in food systems: Select estimates 30 Box 2. Counting the human and economic costs of environmental contamination in food systems: Select estimates 37 Box 3. Counting the human and economic costs of food contamination: Select estimates 47 Box 4. Counting the human and economic costs of unhealthy diets: Select estimates 51 Box 5. Counting the human and economic costs of food insecurity: Select estimates 81 Box 6. Reforming editorial standards to counter industry bias 84 Box 7. The precautionary principle | FOREWORD FOREWORD Good food is a cornerstone of good health, and this fundamental relationship is widely understood. Yet profound changes in global food systems over the last decades have resulted in significant negative impacts on health and well-being that range from food insecurity to chronic disease, and from environmental degradation to diminished economic opportunity and the erosion of culture. These impacts are experienced unequally across the globe and between differ- ent groups of people in different places. Transformational change is needed. At the Global Alliance for the Future of Food we believe that health and well-being are central to sustainable food systems that are renewable, resilient, equitable, healthy, diverse, and interconnected. We are a strategic alliance of mostly private foundations working together and with others to transform global food systems now and for future generations. As such, we have the privilege, the responsibility, and the opportunity to make the impact of food systems on health and well- being more visible to decision makers, and to strengthen the fundamental role that food systems play in creating and sustaining health and well-being in all communities and populations. We commissioned this report from the International Panel of Experts on Sustainable Food Systems (IPES-Food) as one contribution to this shared goal. In the report,
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