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Presentation at Jane Addams Hull House Association April 8, 2010
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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