Food, Social Policy and the Environment: Towards a New Model
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© Blackwell Publishers Ltd. , Cowley Road, Oxford, OX JF, UK and Main Street, Malden, MA , USA. S P A – V. , N. , S , . – Address for correspondence: Prefessor Tim Lang, Centre for Food Policy, Thames Valley Univer- sity, St Mary’s Road, Ealing, London, W RF. Email: [email protected]. Food, Social Policy and the Environment: Towards a New Model Tim Lang, David Barling and Martin Caraher Abstract Food policy is high on the public policy agenda, but still suffers from a lack of overview and integration. The paper reviews examples of policy limitations where tighter and more explicit links could usefully be made between environmental, social and public health considerations. The paper proposes a new ecological health approach to public policy. This offers marked advantages over the present “productionist” approach to food policy. With this old policy regime in crisis, the paper reviews current moves towards adoption of the ecological health model in Britain, Europe and globally. Keywords Food policy; Food system; Food poverty; Food safety; Public health; Ecology; Governance Introduction: Food Crises and the Pressure for a New Food Policy By the turn of the new millennium, the fact that UK food and agriculture policy was in some difficulties had become increasingly apparent. For the two previous decades, a series of health scandals and problems had questioned the seeming impregnability of the postwar food and agricultural framework. A catalogue of food scandals or “scares” dented the productionist food and agricultural policy put in place by the Attlee Labour government in the Agriculture Act (Lang a). The list of crises since the s is long: additives, pesticide residues, nitrate residues, BST (bovine somatotrophin), Alar (a plant growth inhibitor used on apples), food irradiation, patulin in apple juice, BSE, Salmonella in eggs (not to mention rising Campylobacter, E coli and other food poisoning), genetically modified (GM) foods, variant Creutzfeld-Jakob Disease (CJD), SPA35.5C06 8/31/01, 9:27 AM 538
Transcript of Food, Social Policy and the Environment: Towards a New Model
© Blackwell Publishers Ltd. © Blackwell Publishers Ltd. , Cowley Road, Oxford, OX JF, UK and Main Street, Malden, MA , USA.
S P A –
V. , N. , S , . –
Address for correspondence: Prefessor Tim Lang, Centre for Food Policy, Thames Valley Univer-sity, St Mary’s Road, Ealing, London, W RF. Email: [email protected].
Food, Social Policy and the Environment:
Towards a New Model
Tim Lang, David Barling and Martin Caraher
Abstract
Food policy is high on the public policy agenda, but still suffers from a lack of overview and
integration. The paper reviews examples of policy limitations where tighter and more explicit
links could usefully be made between environmental, social and public health considerations. The
paper proposes a new ecological health approach to public policy. This offers marked advantages
over the present “productionist” approach to food policy. With this old policy regime in crisis, the
paper reviews current moves towards adoption of the ecological health model in Britain, Europe
and globally.
Keywords
Food policy; Food system; Food poverty; Food safety; Public health; Ecology; Governance
Introduction: Food Crises and the Pressure for aNew Food Policy
By the turn of the new millennium, the fact that UK food and agriculturepolicy was in some difficulties had become increasingly apparent. For thetwo previous decades, a series of health scandals and problems had questionedthe seeming impregnability of the postwar food and agricultural framework.A catalogue of food scandals or “scares” dented the productionist food andagricultural policy put in place by the Attlee Labour government in the Agriculture Act (Lang a).
The list of crises since the s is long: additives, pesticide residues,nitrate residues, BST (bovine somatotrophin), Alar (a plant growth inhibitorused on apples), food irradiation, patulin in apple juice, BSE, Salmonella ineggs (not to mention rising Campylobacter, E coli and other food poisoning),genetically modified (GM) foods, variant Creutzfeld-Jakob Disease (CJD),
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swine vesicular disease, and in foot and mouth disease (FMD). The lastis an exception to the more general rule that such crises have centred onpossible direct effects on human safety. FMD may have engendered a crisisbut it was not primarily for human health.
This litany of safety concerns has dominated the public agenda and helpedframe the public policy debate but it tended to shroud other equally orarguably more serious food-related problems. For the purpose of this paper,such issues may be grouped as stemming from four policy areas: health,environment, social and economic policy.
With regard to health, evidence mounted from the s, with the work ofpioneers such as Ancel Keys (Keys ), of the link between diet and the riseof degenerative diseases. These include coronary heart disease, some cancers(breast, colon, etc.), diabetes and dental decay. Despite hostility from thepowerful food industry—particularly the fats and sugar trades—this evidencewas almost impossible to refute (Cannon ). By the s, the UK wasemulating the USA’s pattern of obesity (which is itself a risk factor for heartdisease). If the evidence suggested poor or inappropriate diets, the policychoice was to stop promoting them or accept the consequences.
In the realm of environmental policy, evidence also mounted of damage tosoil structure, biodiversity, water systems and wildlife, as well as of environ-mental implications associated with changed lifestyle and shopping patterns.With the food revolution of the post-World War II period, the distance foodtravels between primary producer and end consumer rises, the so-called“food miles” problem. The bill for these environmental costs is externalized,i.e. not included in the price the consumer pays at the checkout. These costsare borne either by the taxpayer (the consumer with another hat) or, in thecase of global climate change, by no one, a legacy for which future genera-tions might not be grateful.
In social policy, evidence mounted again from the s that problems offood poverty—assumed to have been abolished by post-World War II pros-perity—had not departed but merely altered (Leather ). Research showedthat access to shops was not just a matter of income but also of geospatialrestructuring of the retail sector (Lang ). What the Department of Health’sLow Income Project Team, in a much quoted phrase, called “food deserts”,was alleged to be associated with, if not due to, the collapse of local shopsand the rise of supermarkets (DoH ).
In economic policy, even as the New Right celebrated the triumph of neo-liberalism and the renewed emphasis on trade-oriented deregulation in thes and s, concerns were re-emerging about remarkable levels of mar-ket concentration in the food sector (e.g. Feder ; Wrigley ). Studiesof the impact of transnational corporations (TNCs) and of their control ofsupply chains suggested that while the nation state was being used to pro-mote a new freedom for business, those most likely to benefit were the largerand better capitalized companies. The global reach of TNCs created a newgeospatial politics in which the face of the earth could literally be shrunk(Barnet and Cavanagh ).
How has this situation developed? How can a situation where fromdiverse sources, outside the main citadels of food and agricultural policy, a
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consensus has emerged that public policy is delivering huge quantities offood without meeting other public policy goods? In this paper, we argue thata proper understanding of the relationship between social and environ-mental policy has to centre on the complexity which the post-World War IIfood revolution has unleashed. From the s it was clear to enoughpeople within the British state that the previous century’s experiment withmercantilism—preferential “free” trade within the Empire—was over. First,there was no longer an Empire which could feed the UK, but more import-antly, second, the experience of two world wars had shown that food securitycould not be guaranteed under blockade conditions. Third, there was, astoday, mounting political pressure to end the indignity of food poverty—thehungry s (e.g. Boyd Orr ).
From the s on, a food revolution unfolded which within half a centuryhad transformed not just what primary food is grown and how, but how it isprocessed, distributed and even cooked (Goodman and Redclift ). Publicpolicy nurtured and supported this transformation, yet now this revolution isseen to pose a huge challenge. Corporate concentration, at the manufactur-ing and retail ends, is facilitating private systems of regulation along the foodsupply chain (Marsden et al. ). Agrochemical and food manufacturinginterests are introducing new technologies into the food system, as for exam-ple with biotechnology and the new wave of functional foods. Such develop-ments have stimulated further unrest from consumers, engendering businessand regulatory concern about consumer confidence and societal responses tofood issues. A new architecture of food governance is emerging with thecreation of new national food agencies and new trade bodies changing worldfood trade rules. In short, the context in which food policy has to be formedis rapidly changing.
Food is an illustration of how and where social policy and environmentalpolicy meet. Our argument is that current public policy lacks any adequateholistic perspective with which to analyse this complex relationship. Theanalysis of the dynamics of the food system has tended to be partial, nar-rowly confined to particular policy areas (agriculture or health, environmentor industry, trade or development), or specific disciplines (agricultural eco-nomics, nutrition, environmental science, medicine, nutrition, etc.).
In this article we contend that in order to address food policy adequatelyit is necessary to produce an integrated, long-term strategy that links boththe social and the environmental dimensions. Such a strategy needs a freshconceptual framework for food policy, rooted in what we have termed a newmodel of ecological public health (Lang and Caraher ). Table givessome comparisons of the current production-oriented food policy with thatoutlined for the new ecological health model. We follow this with a discus-sion of different levels of governance at which public policy is manifest. Thearticle then explores some key features of food in both social and environ-mental policy.
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Table
Some features of the old productionist and new ecological health models of food policy
Key policy feature,by area
Economic policy
Health policy
Environment policy
Social policy
Morality
Price policy
Policy coordination
“New” ecological health model
Reducing inequality by stateaction provides health safety net.Citizenship requires both skills andprotection.
Population approach; ill healthstems from entire supply chain;degenerative diseases suggest howfood is grown and delivered isimportant.
Has to be built into food practices;short supply chains where possible;bioregionalism for all?
Population approach; state aspotential corrective to imbalancebetween individual and socialforces.
Societal responsibility should bebased on citizenship.
It is false accounting if costs areexternalized to other budgetheadings; costs should beinternalized where possible.
Social goals as significant as otherpolicy goals; new mechanisms forintegration.
Towards a New Model of Food and Public Policy
Although food policy is in crisis in the UK, there were two levels of response:national and regional.
At the national level, many European countries began to set up foodagencies from the late s. These included the UK, France, Finland andGreece, with the Netherlands debating whether to do so (Lang et al. ).Agencies were presented as the way both to win consumer confidence infood governance and to take food safety standards out of political influence.The UK Food Standards Agency (FSA) began work in April and was
“Old” productionist model
Increase production and supplyby application of science andcapital. Consumers have rightto choose.
Health stems from prosperity,availability and some equity ofdistribution; rising prosperitymakes health services affordable.
Should not dislocate marketforces; long supply chain; globalreach for affluent consumers.
Family responsibility; pluswelfare safety net.
Individuals should be responsiblefor food within market rules.
Cheapness of food mayexternalize costs.
Primacy of economics;fragmented specialist decisionmaking.
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committed to ensuring a per cent drop in food poisoning within five years,an ambitious target (FSA ).
At the European regional level, there were positive moves to reform foodpolicy from two sources: the EU itself and the World Health OrganizationEuropean Region, a much larger area of member states (including theEU). In the late s, a number of initiatives at the European level came tofruition that might balance Europe’s currently warped food and agriculturalpolicies, which are heavily oriented to promote the agricultural sector. Thefirst was through the World Health Organization European Region whose member states conducted a four-year consultation process, culminating ina Food and Nutrition Action Plan (WHO-E a) endorsed by all memberstates at the Regional Committee in September (WHO-E b). Thisproposed a five-year process of upgrading food policies to give equal weightto nutrition, food safety and sustainable food supply. The latter is to includesocial policy objectives such as reducing health inequalities. This process is tobe reviewed politically at a ministerial meeting to be held in .
These moves were paralleled within the European Union. In order toaddress a loss of public confidence in the public process after BSE, on January the European Commission produced a White Paper on FoodSafety which announced a process for introducing a new General Food Lawor regulation, a new European Food Authority (EFA), and proposals(including one on nutrition) mostly targeted at improving food safety withinthe EU (CEC a; Trichopoulou et al. ). The proposed EFA is in-tended to start work in with a budget of . million euros. Under theFrench Presidency of the EU ( July–December ), an -month processfor modernizing EU policy on food and health produced a new audit ofelements for European action (SFSP ). The new health and consumerprotection Directorate General, DG SANCO, was asked to prepare newinitiatives to strengthen and broaden EU food policy. This was agreed on December by social and employment ministers (CEC b). At the sametime, a three-year process of setting new pan-EU nutrition guidelines wascompleted at Crete in May . This Eurodiet Project produced a con-sensus from specialists from every member state on the need for new EUdata-gathering, health-promotion and public policy initiatives (Kafartos andCodrington ).
These moves are significant, because within EU circles they represent ashift away from the Common Agricultural Policy’s pre-eminence in Brusselsand because they represent a willingness to accept that the older productionistpolicies are inappropriate. The possibility of a broader, more integratedpolicy is at least on the agenda. The WHO European Region now representsthis conceptually in figure . This shows health as a roof under which we allcan shelter as having to stand on three pillars: nutrition, food safety, sustain-able food supply. Informally, WHO Geneva HQ is already adding a fourthpillar to this list: healthy lifestyles. We might prefer this to be called some-thing like culture. In a sense, the rather vague notion of “sustainable foodsupply” ought to include the notion of lifestyle and culture. But if we takesupply as distinct from consumption, there is an argument for having a
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fourth pillar. Perhaps “sustainable consumption” would be better. Waltner-Toews and Lang () have argued that in fact, if the pillars approachis to be adopted, it ought to acknowledge that there are many more thanthree pillars. They argue that many factors sustain health. They have arguedthat the pedestal on which the pillars rest is also very important for health.Figure —the impact of food on health in the twenty-first century—represents this. While this may be more complex and accurate, it loses thesimplicity and elegance of the WHO-E’s three-pillars approach.
Multi-level Food Governance
Part of the complexity of the modern food system is that no one level ofgovernance can even pretend to have control over food supply. Initiativessuch as those at the European level are reminders that although crises placehuge political and policy challenges to national politicians, they are in factincreasingly matters for international negotiation. Conceptually, the new food
Figure
World Health Organization European Region Policy Model,
Source: WHO-E (a).
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Figure
A more complex model of food policy
Source: Waltner-Toews and Lang ().
policy has to address public policy challenges at four interacting levels: theglobal, regional, national and subnational or local levels. Some features ofthese are given in table .
One of the advantages of conceiving of food policy in terms of these levelsis that it helps explicate tensions within public policy, over and above tensionsover policy direction. These structural features are central to any appreciationof whether food policy is capable of yielding outcomes that are more or lessintegrated. The concept of multi-level governance recognizes, also, theinterconnectedness of the different levels, as policy outcomes at each levelare impacted by, and part of, the dynamics at the other levels. Hence, pol-icy making in the EU is a confluence of national, subnational, intergovern-mental, European polity, and wider international institutional and policynetwork dynamics (Marks et al. ).
Inequalities and Food Poverty: the Pressure fromSocial Policy
Traditionally public health concern has rightly focused upon absoluteunderconsumption as a source of malnutrition. More recently, evidence has
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Tab
le
Som
e fe
atur
es o
f m
ulti-
leve
l foo
d go
vern
ance
Lev
el
Glo
bal—
trad
e
Glo
bal—
econ
omic
Glo
bal—
food
regu
latio
n
Glo
bal—
Uni
ted
Nat
ions
(UN
)
Reg
iona
l—U
Nsy
stem
Reg
iona
l—E
urop
eU
nion
(EU
)
Inst
itutio
n
Wor
ld T
rade
Org
aniz
atio
n (fo
rmer
lyG
ener
al A
gree
men
t on
Tar
iffs
and
Tra
de)
Wor
ld B
ank;
Int
erna
tiona
l Mon
etar
yFu
nd, e
tc.
Cod
ex A
limen
tari
us C
omm
issi
on
Food
and
Agr
icul
ture
Org
aniz
atio
n;W
orld
Hea
lth O
rgan
izat
ion;
UN
ICE
F;U
N D
evel
opm
ent
Prog
ram
me;
UN
Env
iron
men
t Pr
ogra
mm
e
Uni
ted
Nat
ions
Reg
iona
l bod
ies,
e.g
. for
WH
O, F
AO
Eur
opea
n C
ounc
il; E
U P
resi
denc
y;C
ounc
il of
Min
iste
rs; E
urop
ean
Com
mis
sion
, e.g
. DG
SA
NC
O, D
GA
gric
ultu
re, D
G E
nvir
onm
ent,
etc.
;E
urop
ean
Parl
iam
ent
Com
men
t
Tra
de li
bera
lizat
ion
focu
s; f
ood
and
agri
cultu
re u
nder
GA
TT
rul
es p
ost-
Incr
easi
ngly
pow
erfu
l in
food
, soc
ial a
ndno
w e
nvir
onm
ent;
tens
ions
with
UN
sys
tem
Join
t W
HO
-FA
O s
ecre
tari
at (
s
ff.)
; new
influ
ence
and
pow
ers
with
G
AT
T;
criti
cize
d fo
r hi
gh T
NC
inpu
t
Set
up in
s a
s pa
rt o
f ne
w U
N; o
pera
tes
regi
onal
ly, t
hrou
gh m
embe
r st
ates
.Pr
ogra
mm
es s
uch
as U
ND
P, U
NE
P, e
tc.
bolte
d on
.
Eur
opea
n R
egio
n no
w t
akin
g le
ad in
new
WH
O f
ood
thin
king
ff.
Com
mon
Agr
icul
tura
l Pol
icy
is p
ower
hous
eof
EU
foo
d pr
actic
e; m
arke
t ha
rmon
izat
ion
of f
ood
sta
ndar
ds h
as b
een
cont
entio
us b
utsu
cces
sful
; new
thi
nkin
g in
s?
Rat
iona
le
GA
TT
(
f
f.); A
gree
men
t on
Agr
icul
ture
(
, r
evie
w
ff.)
Bre
tton
Woo
ds (
)
GA
TT
(
) S
anita
ry a
ndPh
ytos
anita
ry M
easu
res
Agr
eem
ent
UN
Dec
lara
tion
of H
uman
Rig
hts
(
)
Man
ager
ial;
clos
er li
nks
with
gove
rnm
ents
Tre
aty
of R
ome
(
); S
ingl
eE
urop
ean
Act
(
); A
gend
a
re
form
and
mid
-ter
m r
evie
w
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Rat
iona
le
Com
mis
sion
pro
posa
l (C
OM
(
)
fi
nal)
Food
Sta
ndar
ds A
ct
Var
ious
—pr
oduc
tion
and
food
sup
ply,
env
iron
men
tal
prot
ectio
n, r
ural
life
, hea
lth
Dev
olut
ion
Act
(
);
Food
Sta
ndar
ds A
ct (
)
LA
s: E
nvir
onm
enta
l Hea
lth a
ndT
radi
ng S
tand
ards
offi
cers
; DH
As :
Publ
ic H
ealth
, Pub
lic H
ealth
Lab
orat
orie
s, e
tc.
Com
men
t
Safe
ty f
ocus
; som
e ac
know
ledg
emen
t of
nutr
ition
but
litt
le o
f so
cial
or
envi
ronm
enta
lin
tegr
atio
n
Beg
an in
Apr
il
; s
afet
y fo
cus
but
has
som
e nu
triti
on r
espo
nsib
ilitie
s e.
g. s
urve
ys
Dep
artm
enta
lism
unt
il cr
isis
per
iods
Rel
atio
nshi
p w
ith n
atio
nal b
odie
s, e
.g.
Parl
iam
ent,
FSA
is e
volv
ing
Enf
orce
men
t is
cen
turi
es-o
ld; n
ew p
aral
lel
priv
ate
sect
or r
egul
atio
n vi
a su
pply
cha
inco
ntra
cts
Reg
iona
l—ne
wE
U in
itiat
ives
Nat
iona
l—U
K
Sub
nation
al—
UK
Loc
al—
UK
Tab
le 2
(cont
’d)
Lev
elIn
stitu
tion
Eur
opea
n Fo
od A
utho
rity
Food
Sta
ndar
ds A
genc
y
Gov
ernm
ent
Dep
ts: M
AFF
, DoH
, DE
TR
,D
iFID
Wal
es, S
cotla
nd a
nd N
Ire
land
Ass
embl
ies/
Parl
iam
ents
and
Foo
dSt
anda
rds
Age
ncy
Com
mitt
ees
Tw
o m
ain
invo
lvem
ents
: Loc
al A
utho
ritie
s(L
As),
Dis
tric
t H
ealth
Aut
hori
ties
(DH
As)
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grown of the importance of relative poor consumption as well as of foodinsufficiency (Acheson ; James et al. ; Leather ). The less incomepeople have, the narrower the range of foods they consume, the higher theproportion of their household expenditure is on food, and the worse theirdiet-related ill health is. This is not a natural but a human-created state ofaffairs. At its most extreme, poverty locks people into a cycle of hunger andpremature death, a cycle that is known to be preventable. An equitable foodsupply would have major public health benefits. History shows us that foodpoverty is not inevitable. In both war and peace, equitable public policy candecrease infant mortality and increase overall human health. This applies toaffluent countries as much as lower-income countries. For example, whenthe UK introduced a system of food rationing in World War II, healthimproved because poorer social groups at least ate better and the healthinequality gap was reduced (Boyd Orr ).
The global picture on food and poverty is sobering. UNICEF and UNDPcalculate million children globally are undernourished, and billionpeople exhibit effects of poor diet (UNICEF ). This is the result both ofmacronutrient—protein, carbohydrates and fats—and micronutrient defi-ciencies. One key issue is the policy choice between a strategy giving morepriority to local produce for otherwise marginalized populations and onegiving priority to providing food security by earning enough currency toimport food sufficient for nutritional needs. The latter is currently in thepolicy ascendancy with neo-liberal trade policies favouring reduction of sub-sidies and import-substitution strategies. Like all models, this has certainassumptions. The food import–export approach to food security can workwell in nutrition terms as long as the national currency is strong, but this israrely the case for less developed countries (LDCs).
Food trade policy impacts upon and shapes the room for policy man-oeuvre in tackling the links between public health and food poverty. G criticsargue that current trade rules have been unnecessarily biased against thepoor, particularly in LDCs. Under trade liberalization the LDCs have notbeen able to trade out of poverty (Watkins ). A World Bank report foundthat greater openness to trade has had a negative impact on the incomegrowth of the poorest per cent of people in developing countries (Lundbergand Milanovic ). The UN’s Food and Agriculture Organization foundthat the impact of the Agreement on Agriculture (AoA) on developingcountries had been a surge of food imports, not an increase in food exports(FAO ). The Seattle meeting of the World Trade Organization (WTO)put the concerns of the LDCs back on the world trade agenda. These coun-tries have proposed the introduction of a development/food security box,under the current review of the AoA, within which selective domestic tradebarriers would be permitted for LDCs to foster domestic food production(WTO a). Food security for populations in the developing world remainsa policy battleground between advocates of free trade and the self-reliancestandpoint (Madeley ).
In Europe, it should be recognized that poverty is not confined to lessaffluent countries; in situations where absolute poverty is rare, relative depriva-tion becomes more important (Halsted et al. ). Women, children and older
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people are at greatest risk of poverty (Beaglehole and Bonita ). There isstrong evidence that more unequal societies have worse indices of health(Wilkinson ). There are considerable disparities of income within the EU.The top per cent of households shared over a quarter of disposable incomein , while the bottom per cent shared per cent. Some millionindividuals in the EU live in million poor households (Eurostat ).
Food inequalities in developed states suggest that food poverty is not justfinancial but social and emotional (Koehler et al. ). Within the EU,which has an explicit commitment to tackle “social exclusion”, there is nodatabase, although a methodology to enable intra-EU analysis has beendeveloped under the DAFNE programme (Trichopoulou et al. ). TheEuropean Commission’s Communication on Public Health proposed im-proving information on “inequalities in health, covering variations betweenpopulation groups of the determinants of health, morbidity and mortalityand assessment of interventions to reduce them” (CEC ).
The picture in the UK also illustrates the fact that food poverty can havea marked health impact. Food poverty in the s was higher in the UKthan other EU countries (Lang b). Inequalities in income and healthwidened from to and the proportion of people with less than halfthe average income grew. The economic and social costs of this concernedthe last government and it set targets for tackling what it called “variations inhealth”. One initiative it set up was a Low Income Project Team under theDepartment of Health, which reported in (DoH ). In , the newgovernment set up an independent Inquiry into Inequalities in Health chairedby a former Chief Medical Officer. When this reported, it showed that thelowest income decile had experienced a real, not just relative decline inincome (Acheson ). In effect, both reports showed that the health costsof economic policy had thus been “externalized” on to worsening food-related ill health of people on (relatively) low incomes. One issue which hasbeen raised by the government’s Social Exclusion Unit (SEU) is the issue ofimproving access to shops (DoH ), an issue that has received someconsiderable social policy analysis (Ellaway and Macintyre ). From thes the decline in local (small) food shops had accelerated, as supermarketsgrew in both sales and power in the food supply chain. The SEU’s PolicyAction Team (PAT ) concluded that to improve access to shops ingeneral, a complex set of initiatives was needed, ranging from planning tocredit and new community shopping. The PAT report has not beenfollowed up at the time of writing.
The Acheson Inquiry into Inequalities in Health found that lowersocioeconomic groups have a greater incidence of premature and lowbirthweight babies, heart disease, stroke, and some cancers in adults (Acheson). Other studies have shown that risk factors including lack of breast-feeding, smoking, physical inactivity, obesity, hypertension, and poor diet areclustered in the lower socioeconomic groups ( James et al. ). The diet oflower socioeconomic groups in the UK is found to provide cheap energyfrom foods such as meat products, full cream milk, fats, sugars, preserves,potatoes, and cereals but has little intake of vegetables, fruit, and wholemealbread. This type of diet is lower in essential nutrients such as calcium, iron,
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magnesium, folate and vitamin C than that of the higher socioeconomicgroups. The importance of fruit and vegetables and their link with degenerat-ive diseases is one such simple message both policy makers and consumerscan appreciate.
Environmental and Health Impacts of AgriculturalProduction and the Food Supply Chain
The new ecological public health has to give equal policy focus to both whatpeople eat and how their diet is produced and distributed. The environmen-tal impacts of the food system can be linked to the adverse health and socialimpacts. These problems occur from agricultural production right along thefood supply chain. Initiatives are coming forward to address these aspects ofthe impacts, and some are attempting more holistic solutions, but they fallshort of the degree of integration and reach sought by the ecological modelof public health.
The dominant model for agriculture in Western Europe, notably in theUnited Kingdom, after the end of World War II became one driven by thepriorities of the state for economic self-sufficiency in food production. The fur-ther industrialization of agriculture, increasingly capital- and chemical-intensive,led to increase of: farm size, external technological inputs, and yield andfood output. The adverse effects of this process were realized from the sonwards with increasing concern over the environmental, animal welfare,food safety, health and social impacts. The sustainability of the land and theconservation of the landscape, as well as public health, were impacted by:pollution of soil and water media with chemical inputs; biodiversity loss andecological impacts of large monoculture production (as opposed to mixedfarming and rotations); and restricted numbers of technologically enhancedcultivars (Conway and Pretty ; Pretty : –).
Intensive rearing and “factory” farming of animal livestock supplementedby chemically enhanced and industrialized feed, and the subsequent increasedand often cross-border travel from farm to abattoir, heightened concernsover both animal welfare and food safety. The success of this state support,in terms of increased production, resulted in overproduction of certain food-stuffs, adding budgetary pressures to a potential reform agenda. The drive togreater production also led to rationalization within farming, with technicalinputs replacing labour and concentration of farm holdings leading to thesubsequent reduction of numbers of farmers and farm workers and so to thedislocation of rural communities and of social sustainability.
Social theorists of agriculture have conceptualized such developments aspart of an industrial model of agriculture (Goodman et al. ) or, as avariation, the “productivist” model (Clunies-Ross and Cox ). Certainly,policy makers have come to regard this intensive model as the pre-eminentor conventional model of agriculture (House of Commons ). The state ofEuropean agriculture and rural life is heavily influenced by the CAP regime,which has provided a macro policy framework, in a somewhat contradictoryand imperfect manner. The CAP has found itself under pressure to reformfor the past decade. The key pressures have emanated more recently from the
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proposed enlargement of the EU to central and eastern European countries(CEEC) and the need to prepare for, and subsequently conform to, the rulesagreed under the GATT Uruguay round in and administered throughthe WTO, including the AoA.
In response to concerns about the adverse impacts of the conventionalmodel, a variety of different approaches to farming have emerged. On theone hand conventional agriculture has adopted management strategies tomitigate specific problems. Strategies to reduce pesticide use at the farmlevel, for example, have led to the introduction of integrated crop manage-ment and pest control techniques. On the other hand, a range of morealternative agricultural systems has been developed, under a variety of terms,advocating more ecological and post-productionist strategies (Beus and Dunlap). The most developed amongst these alternative approaches is organicfarming which sees “the farm as an organism a coherent, self-regulating andstable whole” rather than seeing farming in terms of external inputs (Lampkinet al. : ). A related theme within both of these differing approaches(conventional and alternative) is an attempt to make agriculture more sus-tainable. Sustainability has proven to be a universally embraced and oftenappropriated concept, and consequently its meaning is highly contested.
Jules Pretty (: –) has identified the key components of sustainableagriculture, as needing to draw upon, and in turn sustain, both naturalcapital and social capital. Natural capital (including soil, water, air, plants,animals and ecosystems) has to be integrated in agricultural systems in theform of regenerative technologies such as: use of nitrogen-fixing plants forsoil conservation, use of natural predators for pest control, integration ofanimals into cropped systems. Social capital entails utilizing farmer and com-munity labour, knowledge and experience, and underpinning communitycohesion. The aim is to achieve enhancement of both the quality and quan-tity of wildlife, water, landscape and other public goods of the countryside.The importance of greater reliance upon natural organic inputs, farmerparticipation and reduction of external and non-renewable inputs, is alsoreflected in the development of agroecology as a model for poor farmers indeveloping world agriculture (Altieri ; Pinstrup-Andersen et al. ).
There are signs that some of the aspects of sustainable agriculture arefinding their way into EU thinking on agricultural policy, but in a piecemealfashion. The EU’s position as put forward to the WTO’s Committee onAgriculture is that further liberalization of trade in agricultural productsmust be underpinned by public support, which can only be garnered if themultifunctional role of agriculture is met. The multifunctional role “coversthe protection of the environment, and the sustained vitality of rural com-munities, food safety and other consumer concerns” (WTO b). Not-withstanding suspicions in the trade policy communities that the model is ascreen for protectionism, the multifunctional model of agriculture is endorsedby more progressive environmental interests and will help shape the nextstage of CAP reform, with the mid-term review of the Agenda reformsin . The multifunctional model shows some complement to sustain-able agriculture, but lacks the latter’s emphasis on alternative productionmethods. The model also fails to provide a comprehensive enough reach to
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fulfil the goals of ecological public health, but may provide a useful platformfor the advocacy of environmental benefits.
Environmental impacts occur not only on the farm but along the wholefood supply chain. The notion of “food miles/kilometres” refers to the dis-tance that food travels between primary producer and end consumer. Between and /, while the tonnage of food consumed remained constant,the amount of food transported on UK roads increased by per cent andthe distance it travelled increased by nearly per cent (Paxton ). If thefood travelled further, so do consumers getting to the shops. In the UK, overthe same period, the distance travelled for shopping in general rose by percent and the number of shopping trips taken by car more than doubled(Raven and Lang ). Changes in the food retail sector meant that smaller,local shops fell in numbers while larger supermarkets grew considerably.Environmentally, it would make better policy to encourage people to shoplocally. The distance taken by shopping trips to town-centre food stores isless than half that of trips taken to edge-of-town stores (Whitelegg ). Inpolicy terms, the question is: why should a rich growing country like the UKbe fed by others when it could feed itself and others could feed their own orlocal populations? The net import of “hidden” land, i.e. land used elsewhereto feed the British, was . million hectares in (MacLaren et al. ).Much of this hidden importation was produce fed to animals.
Managerially, there have been astonishing efficiency improvements in thefood supply in recent years, but some food “efficiency” also creates unneces-sary pollution. The UK food, drink and tobacco sector, for instance, emits. million tonnes of carbon annually, compared to the chemical industry’s million and the iron and steel industry’s million. It also creates nearly million tonnes of waste, most of which is dumped in landfill sites (DETR). This is not efficient.
Energy is a key concept linking nutrition and environmental policy. In, for instance, , giga joules of energy (equivalent to millionlitres of fuel) were consumed in transporting , tonnes of dessert applesimported into Britain (Garnett ), yet such apples can grow in the UK.Four out of five pears consumed in the UK are now imported, and two-thirds of its apples (Hoskins and Lobstein a, b). Fruit farmers were“encouraged” out of business by CAP subsidies to destroy trees. The role ofthe CAP upon food supply in the EU is considerable. There is a deficiency inunderstanding CAP’s impact on health within the EU (Lang b; Lobsteinand Longfield ). The budget for the CAP in was approximatelya, million, yet even after the recent Agenda reforms, the subsidylevels for different produce pay no attention to food-related health needs.Hence per cent of CAP support goes to meat, per cent to dairy and just per cent to fruit and vegetables (Lobstein ).
The link between poor production conditions, the supply chain and diet-related human health has featured in many recent public policy crises andconcerns. Although crises may start in one state, their impact has spreadfar partly due to trade liberalization between countries, as “we all swim inthe same microbial sea” (Brundtland ). Since the early s there hasbeen a marked increase in the reports of food-borne diseases, resulting from
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chemical or pathogenic contamination (Brundtland ). The lengtheningand changing nature of the food supply chain has given rise to increases infood-borne pathogens, notably: Salmonella ( reported cases per , inthe EU in ), Campylobacter ( per ,), and E coli (lower incid-ence but high mortality) (Trichopoulou et al. ). The incidence is higheras food-borne illness is seriously under-reported, possibly only in , oreven in . The economic costs can be immense. Between and it has been estimated that food poisoning cost the UK National HealthService £,, for inpatient care alone (Djuretic et al. ). In researchers at Oxford Brookes University estimated the costs of food poison-ing to the UK economy were of the order of £.– billion/year (Roberts). The BSE crisis has already cost UK taxpayers £ billion (c. a billion)in direct costs (Lang ).
There are also considerable political costs. Governments and institutionscan be seriously damaged or fall, as happened in with the dioxin scan-dal in Belgium (McKee ). There can also be serious intergovernmentaltensions, as was shown by the UK–French problems following discov-ery that animals were being fed recycled sewage in animal feed. The incid-ence of food-borne illness can be seen as a breakdown in the food system,that demands a holistic, not a reactive response. Incidence of zoonoses inlivestock has also raised fresh public concern about the nature of the foodsupply chain, as with the foot and mouth outbreak in the UK and on con-tinental Europe in . The political reaction to the food safety crises hasseen the ushering in of a new range of food safety agencies at national andnow at regional (EU) level. The new EFA, for instance, will begin work bythe end of . At the national level, a majority of member states also havetheir own agencies. This is probably set to become a source of future tensionbetween the levels of governance.
The costing of the externalities of the food supply chain is slowly beingaddressed. An estimate of the total external costs of UK agriculture was£. billion for . This assessment included costs of contamination ofdrinking water with: pesticides (£ m/year), nitrate (£ m), Cryptosporidium(£ m), and phosphate and soil (£ m). Costs also included: damage towildlife, habitats, hedgerows and drystone walls (£ m), from emissions ofgases (£ m), from soil erosion and organic carbon losses (£ m), fromfood poisoning (£ m), and from BSE (£ m) (Pretty et al. ).
While the analysis of Pretty et al. represents a significant attempt to unravelthe false costs surrounding the cheap food policy that has dominated the UKfood system, from an ecological public health model it does not include thefull externalities of consumption and diet-related health costs. Cardiovasculardiseases (basically coronary heart disease and stroke) are the main cause ofdeath in the UK, accounting for over , deaths, and , deathsbefore the age of . About a third of deaths from cardiovascular diseasebefore the age of (i.e. about ,) are due to poor nutrition—i.e. dietswhich are too high in fat, saturated fat and salt and too low in fruit, veget-ables and cereal-based products. About the same number of premature deathsfrom cancer are also due to poor nutrition. Coronary heart disease alonecosts the NHS about £. billion and costs the economy a further £.
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billion in lost production due to death and illness in those of working age.This means that coronary heart disease costs the country about £ billion ayear, £. billion of which could be saved if diets were improved (BHF ).
There is a clear need for a more integrated approach to health and environ-mental impact assessments (British Medical Association ). There is alsoneed for food and nutrition policy specialists to develop new methodologiessuch as Life Cycle Analysis to assess the impact of food production anddistribution both on nutrition and on the environment. Sweden is one countrythat is pioneering integrated policy experimentation. Both the Agricultureand Environment Ministries are developing reorientation programmes toreduce fossil fuel/energy use and to meet health targets. This is based on theFactor Four approach of the Wuppertal Institute (von Weizacher et al. )trying to increase efficiency fourfold by increasing technological sophist-ication. Sweden intends to halve resource use by (Swedish Environmen-tal Protection Agency ). Sweden is also exploring how to achieve toughtargets on reducing greenhouse gases from food consumption (Carlsson-Kanyama ). This was one of the public health recommendations of thejoint WHO, World Meteorological Organization and UN Environment Pro-gramme report on climate change and public health (McMichael et al. ).On current evidence, Sweden reports that it is not close to meeting thosetargets. One comprehensive audit of the consequences of eating and travel-ling in Sweden has shown that far more energy is used than fits the pro-posed, self-imposed energy quotas. The situation appears to suggest the needfor “substantial lifestyle changes” (Carlsson-Kanyama ). To ensure thatpolicy is both comprehensive and accurate, new methodologies are requiredto improve energy auditing in food systems.
Conclusions
After a period of some considerable turbulence, food policy has emergedas an area of public policy with both peculiar and common themes. Itsimportance centres on the fact that food is a basic human need and thathumanity’s capacity to produce enough health-enhancing food requiressensitivity to ecology that has recently been somewhat lacking. As the firstindustrial nation, the UK experience is particularly rich and worthy ofscrutiny. The last two decades of the twentieth century brought the UKproductionist experiment with a combination of intensive and industrial-ized food production and highly concentrated distribution and logisticssystems under particular scrutiny. The critique of this post-World War IIfood revolution has moved food policy from the periphery of public policyto its heartlands.
At the core of the twenty-first century policy challenge also lie some oldgoals: social justice, food for all, a decent quality of diet, full democraticaccountability in governance, a desire to ensure that there is not just enoughfood but also well-produced food and fair access to food. These are policygoals that food thinkers and campaigners from public health or popularmovements in the eighteenth, nineteenth and twentieth centuries would recog-nize as theirs too (Paulus ; Birchall ).
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This paper has suggested that a central challenge for future public policyis the need to link policy areas too often dealt with in a disparate manner.Failures of governance make harder humanity’s capacity to harvest ratherthan weaken the earth’s capacities to generate food. We have suggested thatthe immense challenges of the future—e.g. population, sustainability, socialjustice—require better links between environmental and public health. Itis easier to raise questions about whether human health can be achievedwithout compromising ecological health than it is to produce solutions. Yetsustainable agriculture and food networks now have a rich tradition ofexperimentation with growing and distributing food in ways which at leastrecognize the enormity of the ecological challenge.
If in the past, food policy has been a national concern, today public policyrequires coordinated action at all levels. We are encouraged by initiatives atthe European level; these are long overdue. We argue, too, that governmentsshould promote a view that what matters is not just what people eat but alsohow food is produced and how equitably it is distributed and consumed. Thisrequires the exploration of new configurations. If, for instance, consumersare to increase their fruit and vegetable consumption to reduce cardiovascu-lar disease, it surely matters if that fruit generates more long-distance fooddistribution rather than encouraging more local production. Similarly, thegoal of improving and protecting biodiversity should mean not morebiodiversity on supermarket shelves but also back in the fields whence theproduce came. In our ecological health model, the goal would be to getbiodiversity from the field to the stomach locally and with minimal energyuse. The currently dominant productionist model, however, is unconcernedabout where food comes from, only its traceability (to meet due diligencelegal requirements and protect brand value).
On a positive note, after years of denial governments are reforming theirrole in food. Setting up a food agency could enable the state to put distancebetween it and political blame for food crises. Governments still have nottaken on board the need to espouse what we call the ecological health model;sustainable farming is still a “niche”. Policy is still too focused on food safetyand not enough on the social and wider ecological concerns raised in thisarticle. The UK has now abolished the Ministry of Agriculture, Fisheries andFood, and replaced it by a Department of the Environment, Food and RuralAffairs. The Blair government was re-elected in committed to setting upan Independent Commission into food and farming. The challenge is tocreate a genuinely appropriate food supply chain for the twenty-first centurythat fits the ecological health model outlined here.
There are, in short, critical policy choices ahead. If, as is predicted, over per cent of Europeans will be living in cities by the year , it isimportant for food and health policy planners to ask who will produce thisfood and how? The ecological consequences of increasing urbanization sug-gest new need to rebuild local food systems and policies. But such policiesare in conflict with the dominant neo-liberal, trade-oriented approach ofmacro-economic theory. This tension, too, would have been recognizable toour policy ancestors.
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