The Disconnect Between Food Policy and the Public’s Health Jim Bloyd, MPH Cook County Department  of Public Health April 8...
<ul><li>“ Currently there is a great disconnect between public health diet-related diseases and agriculture policy issues,...
<ul><li>In 2007 it was estimated that 8.3% of adults over the age of 20 in Cook County (including the City ) had diabetes....
US Life expectancy  <ul><li>Increasing mortality inequality between 1983-1999 </li></ul><ul><li>Decrease 1.3 yrs </li></ul...
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.  <ul><li>Where does food come from? </li></ul><ul><li>H...
Sustainable Food System: <ul><li>Healthy food to meet current food needs </li></ul><ul><li>Healthy ecosystems </li></ul><u...
Source: www.ecocenter.org
Sustainable   Food System <ul><li>“  A sustainable and resilient food system conserves and renews natural resources, advan...
Sustainable Food Systems Model Source: 2007 ADA Primer on Sustainable Food: Healthy Land, Healthy People
Why the Farm Bill <ul><li>Renewed every 5-6 years </li></ul><ul><li>Impact on </li></ul><ul><ul><li>Ag production </li></u...
Farm Bill Critical because.. <ul><li>USDA-Very Low Food Security: 14.6% </li></ul><ul><li>Food Research and Action Center-...
About 94 Billion Dollars (Five Distinct Appropriations 2000-2006; Cong Res Svc in Imhoff (2007))
Proposed Principles on Fed Ag and Food policies <ul><li>US food system should serve population health, environmental healt...
Appendices Follow <ul><li>Cook County Data </li></ul><ul><li>Retail Food Prices </li></ul><ul><li>Chronic Care Model </li>...
Thank you <ul><li>Jim Bloyd, MPH </li></ul><ul><ul><li>Cook County Department of Public Health </li></ul></ul><ul><ul><li>...
Diabetes in Suburban Cook <ul><li>The South District had the highest rates of hospital discharges for diabetes.  The South...
Quality, Nutrient-Dense Food Costs More  (Townsend et al Am J Clin Nutr (2009))
Diet quality and cost  (Townsend 2009, Am J Clinical Nutr) <ul><li>More money spent = more nutrients/ calorie </li></ul><u...
Informed Activated Patient Productive Interactions Prepared Proactive Practice Team Functional and Clinical Outcomes Deliv...
WHO Model
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The Disconnect Between Food Policy and the Public's Health Jim Bloyd Cook County Illinois April 2010

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Presentation at Jane Addams Hull House Association April 8, 2010

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  • “ From 1983 to 1999, life expectancy declined significantly in 11 counties for men ( by 1.3 years) and in 180 counties for women (by 1.3 years); another 48 (men) and 783 (women) counties had non significant life expectancy decline. Life expectancy decline in both sexes was caused by increased mortality from lung cancer, chronic obstructive pulmonary disease (COPD), diabetes, and a range of other noncommunicable diseases, which were no longer compensated for by the decline in cardiovascular mortality. Conclusion: “Female mortality increased in a large number of counties, primarily because of chronic diseases related to smoking, overweight and obesity, and high blood pressure.” p. 0557 Ezzati Plos Med (2008)
  • Adapted using a CPI increase of 57% over that time period, from Putnam J, Allshouse J, Kantor LS. U.S. per capita food supply trends: More calories, refined carbohydrates and fats. FoodReview 2002; 25(3): 2-15.
  • These questions are usually not asked. Story p. 222
  • http://www.ecocenter.org/healthyfood/pdf/HealthyLand%20HealthyFood%20HealthyEaters.pdf
  • Source: Tagtow, A &amp; Harmon, A: Healthy Land, Healthy Food, Healthy Eaters: Dietitians Cultivating Sustainable Food Systems. 2009
  • Source: Healthy Land, Healthy People: Building a better understanding of sustainable food systems for Food and Nutrition Professionals: A Primer. March 2007 American Dietetic Association
  • Hunger and obesity are often flip sides to the same malnutrition coin: Joel Berg, NY City Coalition Against Hunger. Quoted NY Times March 2009 by Sam Dolnick. Less than one in ten americans meet guidance for fruit and vegetable intake. The average 300 kcal increase in daily intake for americans from 1985 to 2000 was made up of refined grains (46%), added fats for 24% and added sugars for 23%.
  • Food stamps and nutrition = 48.4% Commodity and Foreign = 33.2%
  • The Airlie Conference built on a landmark 2007 Wingspread Conference on Childhood Obesity, Healthy Eating and Agriculture Policy (the “ Wingspread Conference”), the first conference to discuss the impact of federal agricultural and food policies on public health, nutrition, and obesity and opportunities for agricultural policies to contribute to healthier eating (http://www.healthyeatin gresearch.org/content/view/90/145/). From the Wingspread Conference emerged two broad principles: (1) the nation’s food system ought to simultaneously serve the American population’s physical health and well-being, the environmental health of the planet, and the economic health of the food and agricultural sector. Public policies should support, rather than hinder, a health-based food system; and (2) agricultural policies must be realigned with national recommendations for healthy eating and good health, specifically the USDA/DHHS Dietary Guidelines for Americans, and support public health goals of preventing obesity and chronic diseases.
  • Higher quality diets are more costly for the low income women studied. Policy interventions are required to allow low income families tin the US to improve the quality of their diets given their food budget constraints. Conclusions: The finding that higher quality diets were more costly for these low-income women has implications for the food assistance and education programs of the US Department of Agriculture. Policy interventions may be required to allow low-income families in the United States to improve the quality of their diets given their food budget constraints.
  • The Disconnect Between Food Policy and the Public's Health Jim Bloyd Cook County Illinois April 2010

    1. 1. The Disconnect Between Food Policy and the Public’s Health Jim Bloyd, MPH Cook County Department of Public Health April 8, 2010
    2. 2. <ul><li>“ 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.” </li></ul><ul><li>Story, Hamm, Wallinga (2009) Journal of Hunger and Env Nutrition </li></ul>
    3. 3. <ul><li>In 2007 it was estimated that 8.3% of adults over the age of 20 in Cook County (including the City ) had diabetes. </li></ul><ul><li>Nationally 24 million people have diabetes. </li></ul><ul><li>National direct medical costs are estimated at $116 Billion </li></ul><ul><li>National total costs are $174 Billion </li></ul>Diabetes in Cook County
    4. 4. US Life expectancy <ul><li>Increasing mortality inequality between 1983-1999 </li></ul><ul><li>Decrease 1.3 yrs </li></ul><ul><ul><li>Men 11 counties </li></ul></ul><ul><ul><li>Women 180 counties </li></ul></ul><ul><ul><li>Source: Ezzati et al (2008) PLoS Med </li></ul></ul>
    5. 5. Retail food-price increases, 1985 to 2000 Source: Muller (2004) cited by Wallinga (2009)
    6. 6. Without a food system approach dietary guidelines will not be met. <ul><li>Where does food come from? </li></ul><ul><li>How is it produced? </li></ul><ul><li>What is produced? </li></ul><ul><li>How is it priced? </li></ul><ul><li>Is it subsidized? </li></ul><ul><li>How is it distributed? </li></ul><ul><li>How is labor treated? </li></ul><ul><li>Story et al (2009) </li></ul>
    7. 7. Sustainable Food System: <ul><li>Healthy food to meet current food needs </li></ul><ul><li>Healthy ecosystems </li></ul><ul><li>Minimal impact on the environment </li></ul><ul><li>Promotes local production and distribution infrastructures </li></ul><ul><li>Nutritious food available for all </li></ul><ul><li>Humane and just </li></ul><ul><ul><li>APHA and AMA resolutions </li></ul></ul>
    8. 8. Source: www.ecocenter.org
    9. 9. Sustainable Food System <ul><li>“ 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.” </li></ul><ul><ul><li>Harmon, A. & Tagtow, A. 2008 Dieticians Cultivating Sustainable Food Systems </li></ul></ul>
    10. 10. Sustainable Food Systems Model Source: 2007 ADA Primer on Sustainable Food: Healthy Land, Healthy People
    11. 11. Why the Farm Bill <ul><li>Renewed every 5-6 years </li></ul><ul><li>Impact on </li></ul><ul><ul><li>Ag production </li></ul></ul><ul><ul><li>Rural development </li></ul></ul><ul><ul><li>Food assistance </li></ul></ul><ul><ul><li>Conservation </li></ul></ul><ul><ul><li>Research </li></ul></ul>
    12. 12. Farm Bill Critical because.. <ul><li>USDA-Very Low Food Security: 14.6% </li></ul><ul><li>Food Research and Action Center-Food Hardship:19% in the US </li></ul><ul><li>Production, industrial agriculture is not producing better nutrition </li></ul><ul><li>Farmers net income is decreasing, often below cost of production </li></ul>
    13. 13. About 94 Billion Dollars (Five Distinct Appropriations 2000-2006; Cong Res Svc in Imhoff (2007))
    14. 14. Proposed Principles on Fed Ag and Food policies <ul><li>US food system should serve population health, environmental health, and economic health of food and ag sector </li></ul><ul><li>Ag policies need to align with healthy eating recommendations and support public health goals </li></ul>
    15. 15. Appendices Follow <ul><li>Cook County Data </li></ul><ul><li>Retail Food Prices </li></ul><ul><li>Chronic Care Model </li></ul>
    16. 16. Thank you <ul><li>Jim Bloyd, MPH </li></ul><ul><ul><li>Cook County Department of Public Health </li></ul></ul><ul><ul><li>708-492-2019 </li></ul></ul><ul><ul><li>[email_address] </li></ul></ul><ul><ul><li>www.cookcountypublichealth.org </li></ul></ul><ul><ul><li>1010 Lake Street </li></ul></ul><ul><ul><li>Oak Park, IL 60301 </li></ul></ul>
    17. 17. Diabetes in Suburban Cook <ul><li>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. </li></ul><ul><li>Source: Cook County DPH, wePLAN </li></ul>
    18. 18. Quality, Nutrient-Dense Food Costs More (Townsend et al Am J Clin Nutr (2009))
    19. 19. Diet quality and cost (Townsend 2009, Am J Clinical Nutr) <ul><li>More money spent = more nutrients/ calorie </li></ul><ul><li>Low income women purchasing more calories-no ‘full’ signal from hi-fat food </li></ul><ul><li>SNAP Education reaches few but… </li></ul><ul><li>Need to change the environment </li></ul>
    20. 20. Informed Activated Patient Productive Interactions Prepared Proactive Practice Team Functional and Clinical Outcomes Delivery System Design Decision Support Clinical Information Systems Self- Management Support Health System Resources & Policies Community Health Care Organization Chronic Care Model
    21. 21. WHO Model

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