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An Advocacy Agenda
Kendra Klein, PhD (ABD)University of California, Berkeley
Department of Environmental Science, Policy & Management
Thomas Jefferson UniversityPhiladelphia, PAJune 11th, 2011
Health Care Without Harm would like to thank
David Wallinga and the Institute for Agriculture and Trade Policy
for contributing many of these slides as well as
advocacy resource materials to the Food Matters program.
I. Changing Thinking
Health behaviors Food environments
Farm as factory Healthy food system
II. Advocacy
Changing Thinking
Food Environments
Brownell et al., Health Affairs, March 2010 Parker et al.,IOM, 2009
.
Story M, Hamm MW, Wallinga D, eds. Food Systems and Public Health: Linkages to Achieve Healthier Diets and Healthier Communities. Journal of Hunger & Environmental Nutrition, Volume 4, Issues 3 & 4. December 2009
Farm & food policy
Behavior Change
Food System
Intensive water, soil use Energy use & climate change Antibiotic, hormone use Rising, pesticide, fertilizer use
Healthier eating environments
Changing Thinking
A Systems Perspective
Production-
dominated
agriculture
1800s 1900s 1950s 2000
Hunger
Hunger
Military readiness
Cheap food policy,
1974 - 2011
calorie
and obesity
Public health references: Horrigan et al. 2002.
EHP; Walker et al. 2005. Public Health Nutrition;
Lang and Heasman 2004. Naylor et al. 2005.
Science.
• Specialization
• Focus on inputs / outputs
• Resource intensive
• Large-scale
“Industrial agriculture views the farm as a factory with ‘inputs’
(such as pesticides, feed, fertilizer, and fuel) and ‘outputs (corn,
chickens, and so forth). Union of Concerned Scientists
Farm as Factory
U.S. Hogs, 20021 dot = 15,000
Intensive monocultures
Farm as Factory
Yield
Economic Efficiency
Biodiversity
Human health
Animal welfare
Soil erosion
Food security
Local economies
Flavor
Pesticide pollution
Sustainability
Greenhouse gas emissions
HEALTHEXTERNALITIES
Chronic diseases (cancer, diabetes, obesity)
Antibiotic resistance & food-borne pathogens
Pesticide exposure (cancer, reproductive, neuro-developmental, and endocrine impacts)
Micronutrient deficiency
Asthma and respiratory illness
Food justice (hunger, food deserts)
HEALTH
SOCIETY
ENVIRONMENT
Chronic diseases (cancer, diabetes, obesity)
Antibiotic resistance & food-borne pathogens
Pesticide exposure (cancer, reproductive, neuro-developmental, and endocrine impacts)
Asthma and respiratory illness
Food justice (hunger, food deserts)
Local economic development
Labor issues
Water and air quality
Energy use and GHG emissions
Loss of crop and biological diversity
Soil erosion
Healthy food comes from a food system that is:
Ecologically sound
Economically viable, and
Socially responsible
Changing Thinking
A Systems Perspective
I. Changing Thinking
Health behaviors Food environments
Farm as factory Healthy food system
II. Advocacy
Why advocacy?
CredibilityInfluenceExpertise
Why advocacy?
Power
Change behavior,Treat disease
Promoting healthReducing disease
Households
Institutions
Communities
Regionally
Nationally, Globally
18
Making change
In your practice
19
Making change
In your practice
Promoting health
Institutions
Making change
In Hospitals
Over 340 Pledge signers
in 26 states
HealthyFoodinHealthcare.org
Making change
In Hospitals
Farmers markets and hospital gardens
Healthy vended items
Fast-food-free zones
Composting and food waste reduction
Comprehensive ‘Healthier Food in Health Care’ policies
Local, organic, fair trade and sustainably grown foods in cafeterias and on patient trays
Antibiotic-free meat/poultry; rBGH-free dairy
Cage-free eggs
HealthyFoodinHealthcare.org
Reducing meat purchasing by 20% in 12 months 4 hospitals reduced on avg. by 28%
$402,000 savings on meat purchases in a year Use savings to purchase more
sustainably produced meat
Over 1,000 tons/year reductions in greenhouse gas emissions
23
Making change
In Hospitals HealthyFoodinHealthcare.org
Promoting health
Communities
Making change In Communities
Founding Co-Signers
Richard Conlin, City Council PresidentDenis Hayes, President Bullitt Foundation, James Kelly, CEO, SeattleUrban LeagueDr. David Fleming, Public Health Seattle-King CountyMary Embleton, Exec. Dir., Cascade Harvest CoalitionTrudy Bialic, PCC Natural Markets
Reverend Dr. Robert L. Jeffrey, Exec. Dir., Clean Greens
Siri Erickson-Brown, Co-owner, Local Roots FarmDr. David R. Montgomery, MacArthur Fellow and author, DIRT: The Erosion of CivilizationsAndrew Stout, CEO-Founder, Full Circle Farm
Making change In Communities
Farm to School Farmtoschool.org
Sustainable Table Sustainabletable.org
Community Food Security Coalition Foodsecurity.org
Food Policy Councils
Nationally
Uniting health professions in a common vision
ADA, ANA, APA, APHA, www.APA.org
Making change Nationally
Making change Nationally
$284 billion, 673 pagesRe-authorized every 5 yrs15 Titles
Title I: Commodities Title II: Conservation Title IV: Nutrition Title VI: Rural Development Title VII: Research Title IX: Energy Title X: Hort & Organic Ag Title XII: Crop Insurance
Summary at: www.ers.usda.gov/farmbill/2008
commoditiesconservationtrade/food aidnutritioncreditrural developmentresearchforestryenergyhorticulture/organiclivestockcrop insurancecommodity fu-turesmiscellaneous
Nutrition(SNAP)
Commodities
ConservationCrop Insur-
ance
Understanding the Farm Bill
Understanding the Farm Bill
FacebookA Citizen’s Guide to a Better Food System
Literature: Wallinga D. Contribution of Agricultural Policy to Childhood Obesity. Health Affairs, March 2010
Webinars: Healthy food, Healthy farms www.HealthyFoodAction.org
Philip R. Lee, MD
Howard Frumkin, MD, DrPH
Walter C. Willett, MD, DrPH
Robert S. Lawrence, MD
David O. Carpenter, MD
James Krieger, MD, MPH
Victoria Maizes, MD
Andrew Weil, MD
Dick Jackson, MD, MPH
Kelly D. Brownell, PhD
Mary Story PhD, RD
Philip J. Landrigan, MD, MSc
and over 500 more
Sign the Charter @www.HealthyFoodAction.org
Making change Nationally
Preservation of Antibiotics for Medical Treatment Act
S. 619: Senator Feinstein (17 cosponsors)
HR 1549: Rep. Slaughter (108 sponsors)
Endorsed by: American Medical Association American Nurses Association American Academy of Pediatrics American Public Health Association More than 350 other organizations
www.SaveAntibiotics.org
www.ProtectAntibiotics.org
www.HealthyFoodAction.org
Making change Nationally
Sign the
Health Care Without Harm
Petition • www.noharm.org• www.protectantibiotics.org
Please let Congress know that I, _____________________________
support the Preservation of Antibiotics Medical Treatment Act and that
I would like to know what they are doing to protect antibiotics.
Making change Nationally
Alliance of Nurses for Healthy EnvironmentAmerican Nurses AssociationThe CRS InstituteDrGreene.comHealth Care Without HarmMount Sinai Children's Environmental Health CenterNurses for Global HealthNorth Carolina Chapter of the American Academy of PediatricsPhysicians for Social ResponsibilityPhysicians for Social Responsibility - AustinPhysicians for Social Responsibility - ChicagoPhysicians for Social Responsibility - ColoradoPhysicians for Social Responsibility - Greater Boston
Physicians for Social Responsibility - Los AngelesPhysicians for Social Responsibility - OregonPhysicians for Social Responsibility - SacramentoPhysicians for Social Responsibility - San Francisco Bay AreaPhysicians for Social Responsibility - Tampa BayScience & Environmental Health NetworkWashington Physicians for Social ResponsibilityWashington State Association of Occupational Health NursesWashington State Nurses AssociationYale School of Medicine, Environmental Health Group
Making change Nationally
Reform TSCA to keep toxins out of food
Making change Nationally
Provide anticipatory guidance to patients and families about the importance of healthy foods and a healthy food system.
Work within health care facilities to create a healthy food service model that is recognized as integral to a preventive health agenda.
Work within the community at a local, regional and national level, to promote policies that support the development of a healthy, accessible, and fair food system.
Making change Food Matters HealthyFoodinHealthcare.org
Clinical advisory group
Clinical curriculum development and trainings
Nationwide clinical network
Maternal/child health calendar
Video for waiting rooms, clinics, exam rooms, community meetings
Healthy Foods in Hospitals national campaign
Making change Food Matters HealthyFoodinHealthcare.org
Food Matters Action To Date
2,000 Food Matters calendars distributed in SF Bay Area
Food Matters Grand Round series planned with
development of local faculty
New collaboration with County Maternal/Child Health program
Translation of Food Matters materials into Spanish, and training
with Promotoras program
National Food Matters Webinar Series (AMA/Kaiser)
Follow-up intensive Food Matters Train-the-Trainer planned
Food Matters Clinical Advisory TeamJudy Focareta, RNJoel Forman, MD
Sarah Janssen, MD PhDPreston Maring, MDJoanne Perron, MD
Naomi Stotland, MDTed Schettler, MD MPH
David Wallinga, MD MPA
Food Matters is made possible with generous support from:The Cedar Tree Foundation
The Claneil FoundationThe Orchard Foundation
Rose Foundation Stonyfield Organics Profits for the Planet Program
W.K. Kellogg Foundation
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