|Science & Environmental Health Network|
Science, Ethics and Action in the Public Interest
Few topics are as fundamental and crosscutting as food. Meeting the basic need for nourishment is of great interest to a very large, diverse web of people, organizations, and institutions. They bring the perspectives of farming, nutrition, public health, spirituality, clinical medicine, economics, labor, ecosystem health, family and community, immigration policy, justice, land use, national security, pleasure, and convenience. This is a look from the perspective of the health care system. We know that what we eat is a major determinant of death and disease. The health care sector has an obvious interest and responsibility. It could be among the leaders in promoting healthy food and healthy agriculture.
The quality of nutrition and the contaminants in food affect consumers most directly, but the entire agricultural system has numerous indirect impacts as well. Dominant forms of agricultural practices are often enormously destructive, causing soil erosion; desertification; salinization; soil, water, and air pollution; habitat loss; diminished biodiversity and soil fertility; genetic contamination; and social and economic disruption. These are very real public health concerns in the dynamic, richly interconnected, whole biotic communities where people live.
Food Production and Distribution
in the U.S.
“What we eat is a major determinant of death and disease. The health care sector has an obvious interest and responsibility and it could be among the leaders in promoting healthy food and healthy agriculture.”Increasing concentration of people in large urban centers has led to redesign of food production systems and development of complex transportation systems to bring food to local markets. Today, food typically travels 1,500 miles from farm to fork, a 25 percent increase since 1980. Time delays due to transport over long distances increase opportunities for contamination and loss of nutrients. The entire system is increasingly dependent on fossil fuels for transportation, mechanized farming of crops and livestock, and petrochemical pesticides.
Many food products are designed to meet the needs of today's industrial agricultural system, with efficiency, durability, and marketability as drivers. Consequently, the nutritional quality of food often suffers, while the enormous environmental and social impacts of how it is produced are largely accepted as the cost of doing business in this way.
Nutritional Quality of Food
Many food analysts and health professionals note with concern the prevalence of obesity, diabetes, heart disease, foodborne illnesses, some kinds of cancer and birth defects, dementia, and other health conditions that are linked to what we eat as well as the food production and distribution system more generally. These diseases cause suffering, are increasingly expensive to treat, and are obvious targets for preventive measures.
Confined animal feedlots are just one example of the relationship between food production systems and nutrition. Beef cattle that are largely raised on corn in a feedlot and routinely treated with antibiotics and hormones reach marketable size more quickly than pastured animals. But the fat composition of the meat of the corn-fed animals contains a much higher ratio of omega-6 to omega-3 fatty acids than grass-fed counterparts (Wood 1999). Industrial poultry production has had a similar impact on chicken. Today’s typical diet in the U.S. has a far higher ratio of omega-6s:omega-3s than fifty to a hundred years ago, directly contributing to cancer, heart disease, arthritis, obesity, cognitive decline, and, in all likelihood, numerous other diseases (Allport 2006).
Foodborne Infectious Illnesses
Environmental Health Considerations
Pesticide runoff and air emissions from agricultural operations contaminate waterways, rainwater, and air (USGS 1999). Drinking water in the Midwest is contaminated with atrazine during seasons of herbicide use (U.S. EPA), and air monitoring in California shows that pesticide drift from spraying operations exposes farm communities to unsafe levels (Pesticide Action Network, 2006). Wildlife studies in the field and in the laboratory show adverse impacts at current levels of exposure.
A Role for the Health Care
An ethical dimension to this under-standing also places medical ethics within an expanded framework of bioethics. Any viable system of ethics must preserve the ecosystems from which it arises and that sustain it (Elliott 1997, Pierce 2004). That is, the rules of ethics must conform to the rules of nature. Bioethics and medical ethics need to seek a more unified ecological moral framework. The health care system has a particular responsibility to address today’s ecological realities because of its mission, its opportunities, and the size of its ecological footprint. A reformulated bioethic and medical ethic will see beneficence, nonmalfeasance, and justice not only through the eyes of the patient and health care provider, but also from the perspective of the entire community and the natural environment.
Proposed Goals for Health Care
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