From the earliest developments of agriculture, a major goal has been to attain sufficient foods to provide the energy and nutrients needed for a healthy, active life. Food production has adapted to changing demographics; consumer preferences; ideas about health, social, and economic conditions; environmental concerns; and advances in science and technology. As a result, the U.S. food system today has many actors and processes, affecting numerous areas of our lives that go beyond providing nutritious foods. Over time, food production has evolved and become highly complex. This complexity takes many forms, such as (1) interconnected markets that function at global, regional, national, and local levels; (2) the diversity of public interventions in those markets, from information and research through subsidies, regulations, and standards to taxes, mandates, quotas, and requirements; and (3) the varying needs, perceptions, and values among all actors. The result is a multilayered, dynamic, multipurposed food system. The behavior of actors can lead to unforeseen, unintended, or unwanted results, even with the best analytical techniques. Other characteristics of the system—its permeable borders that connect it both to a global food system and to a diverse, changing broader economy and society and the different tolerances for risk and values as well as changing individual and societal priorities—add further dynamism to the food system and uncertainty to its analysis.
Due to limited time and resources, the committee made the following simplifying decisions that should be borne in mind by those using the framework:
- The extensive connections of the U.S. food system to the global food system, and the effects of changes in the U.S. system on other countries, are not included in the committee’s review of effects of the food system; and
- The extensive connections to labor markets and social structures that have significant behavioral (e.g., habits and lifestyle choices) and socioeconomic (e.g., working conditions) effects and are important to consider in assessing causality between the food system and its effects are not explored in detail.
Policy or business interventions involving a segment of the food system often have consequences beyond the original issue the intervention was meant to address. Because of these consequences, when considering actions affecting a segment of the food system, decision makers must think broadly about potential intervention options and effects. They will also need to make trade-offs, that is, situations that involve losing one quality or aspect of something in return for gaining another quality or aspect.
Making decisions is typically challenging as the number of trade-offs among potential options is large, comparisons among trade-offs are not always clear, and measuring the effects resulting from decisions is complicated. To add to the challenge, individuals differ in their values and in how they weigh trade-offs. This study examined the U.S. food system from the perspective of its domestic health, environmental, social, and economic effects. Its aim is to develop an analytical framework that will enable decision makers, researchers, and others to examine the possible effects of alternative policies on agricultural or food practices.
This introductory chapter discusses the origins and justification of the study, describes the charge and formation of the committee, and outlines the general approach to accomplishing the task. The chapter also describes the organization of the report.
ORIGINS AND NEED FOR THE STUDY
The U.S. food system is a dynamic, fast-changing, multidimensional enterprise. Through many technological advances, policies, market forces, and other drivers, it has managed to provide abundant food at relatively low cost in the midst of a growing world population. Yet, it also affects the environment (e.g., biodiversity, water, soil, air, and climate, both domestically and globally), human health (e.g., direct health effects, such as nutrition and hunger, foodborne illnesses or diet-related chronic disease risk, and indirect health effects, such as those associated with hunger and stunted development or soil, air, and water pollution), and society (e.g., effects on
food accessibility and affordability, land use, labor, and local economies). Some of these consequences are not captured in the price of food, but rather, are incurred by society at large in the form of health care costs, environmental remediation, and other “hidden” costs. Other consequences are intensified by changes in food price levels or price volatility. If ignored, these costs will continue to compromise health and food security, the environment, and the resilience of the food system. Finding the best solutions that minimize costs to society can only be achieved when the options are well considered and their differing effects are measured and weighed. In addressing these issues, questions arise as to how to measure the effects and consider trade-offs resulting from agricultural and food system practices, what current methodologies can be used to analyze and compare the tradeoffs, and what data gaps and uncertainties exist to hamper decision making.
As the population continues to grow, important questions about the future of the food system have been raised (see Box 1-1). In many different ways and from many different perspectives, various groups (e.g., U.S. Department of Agriculture, U.S. Agency for International Development, Food and Agriculture Organization, UN Environment Programme, World Food Program) have expressed concerns and made serious calls and efforts
Selected Concerns About the Food System
- Availability, accessibility, affordability, and quality of the food supply.
- Effects of global climate change on agricultural productivity.
- Emissions of greenhouse gases that result from the activities in the food system.
- The prevalence of antibiotic-resistant bacteria in food or the environment, with serious consequences in human health.
- Levels and quality of water and other natural resources that are important for sustaining life.
- The prevalence of obesity and diet-associated chronic diseases.
- Global and U.S. food security and malnutrition, particularly when the global population is predicted to increase to 9 billion by 2050.
- Exposure to chemical contaminants occurring in the environment and to chemical residues as a result of agriculture and food-producing activities.
- The social and economic viability of livelihoods of rural or fishing communities.
- The balance of natural ecosystems and biodiversity.
- Workers’ quality of life characteristics, including access to health, safety concerns, and adequate wages.
to address a range of world food problems. The report elaborates on many of them.
The idea for this study originated at a 2012 Institute of Medicine (IOM)/National Research Council (NRC) workshop, Exploring the True Costs of Food. The workshop was designed to spur interdisciplinary discussion about the domestic environmental and health effects of the food system. It brought together expert stakeholders who rarely explore these questions together, and individual speakers who stressed the need for an evidence-based, integrated framework that could systemically examine the complex relationships among domestic environmental and health effects of the U.S. food system. At a meeting immediately after the workshop, attendees generated key questions about emerging challenges in food and agriculture. Those ideas led to many conversations that resulted in the current study.
To inform business and management decisions, a first task when addressing these challenges is to understand and measure the various costs and benefits of the food system. At the 2012 IOM/NRC workshop, the speakers shared tools and methodologies, and these presentations highlighted two important problems that limit a comprehensive approach to addressing the complex relationships that exist within the U.S. food system. The first is that current methods designed to examine impacts, such as life cycle assessment (LCA) and health impact assessment (HIA), are limited in a variety of ways. LCA—the evaluation of the environmental costs and benefits across a product’s life span—has been used to compare the effects of alternative practices and for business/management decision-making processes. However, an LCA rarely includes health or socioeconomic effects and often only accounts for a limited number of environmental effect categories (e.g., greenhouse gas emissions). HIA is a systematic process to assess the potential health effects of proposed policies and programs that have historically not been recognized as related to health; however, HIA has not been broadly used in the context of agriculture and food. Other analytical tools, such as risk assessments, continue to be improved, but they are generally used only to assist in making decisions about chemical and microbiological safety. These methodologies work well in some situations but may have critical limitations when measuring the complex relationships within the food system. Their limitations have led to disagreements about their proper use, which hinders potential improvements in decision-making processes.
A second problem that was highlighted at the workshop is that although a siloed approach (taking one effect at a time) to making decisions might be clearer at communicating with others, it may also lead to potential unintended and undesirable effects. For example, evaluations about the merits of various farm animal housing designs can lead to unintended consequences
if important dimensions (health, environmental, social, or economic effects) are absent from the decision-making process. Several reports also have recommended improved consistency and alignment between agriculture and health and nutrition policies, which highlight the need for improved approaches (Hawkes, 2007; IOM, 2012). Such challenges become even greater when the effects of U.S. actions on the global food system are added to the equation.
Understanding the relationships among components of the food system and their effects on health, the environment, and society are essential prerequisites for attempting any quantitative evaluation of costs and benefits of the food system. Building on the methods mentioned above, a common analytical framework for decision makers, researchers, and practitioners is needed to systemically consider and evaluate contentious topics.
STATEMENT OF TASK AND APPROACH OF THE COMMITTEE
The IOM and the NRC convened an expert committee to develop an analytical framework for assessing the health, environmental, social, and economic effects (whether positive or negative, intentional or unintentional) associated with the ways in which food is grown, processed, distributed, and marketed in the United States. It was desired that the framework would provide a systemic approach that would examine the effects of activities, practices, or policies within the U.S. food system and across its broader global and societal settings. This framework would use a variety of methods that could enable decision makers, researchers, and others to understand the potential impact of a proposed change. To assist readers in understanding the framework, the committee was also charged with selecting examples to illustrate the potential utility of the framework, and to identify gaps in areas where further information is needed for more accurate assessments (see the Statement of Task in Box 1-2).
Because of the tight timeline, early on the committee decided to focus primarily on the domestic effects of the U.S. food system. Consequently, the discussions about the effects of the food system do not include discussion of important consequences of U.S. food-related actions for the rest of the world, or feedbacks from global responses to changes in the U.S. food system. Those discussions need to be understood with that limitation in mind.
This study has three major aims: (1) facilitating understanding of the environmental, health, social, and economic effects associated with the food system and how these effects are interlinked; (2) encouraging the development of improved metrics to identify and measure these effects; and (3) enhancing decision making about agricultural and food policies and practices
Statement of Task
The expert committee will develop a framework for assessing the health, environmental, and social effects (positive and negative) associated with the ways in which food is grown, processed, distributed, marketed, retailed, and consumed within the U.S. food system. In developing the framework, the committee will undertake the following activities:
- Examine available methods, methodologies, and data that are needed to undertake comparisons and measure effects. Examples of such needs that the committee will examine are:
- Defining comparable characteristics of different configurations of elements within the food system.
- Mapping the pathways through which different configurations of elements of the food system create or contribute to health, environmental, and social effects.
- Determining the contribution of those configurations to effects relative to those from other influences.
- Characterizing the scale of effects (e.g., individual, national).
- Quantifying the magnitude and direction of effects.
- Monetizing effects, when appropriate.
- Addressing uncertainty, complexity, and variability in conducting comparisons and measuring effects.
so as to minimize unintended consequences across the health, environmental, social, and economic dimensions.
The committee envisions the framework to be useful in many ways and to be used by different audiences (e.g., policy makers, researchers, practitioners, other stakeholders). For example, policy makers could use the framework to compare the effects and trade-offs of alternative food system policies or practices. The proposed framework is also relevant for researchers who are interested in examining the health, environmental, social, and economic effects of food production, processing, distribution, and marketing. Practitioners and other stakeholders working in agriculture, health, and the environment can use the framework to develop evidence that would be helpful in understanding the costs and benefits of alternative configurations1 (e.g., activities, practices, or policies) within a food system.
1 Configurations are elements within the food system, such as policy interventions, technologies, market conditions, or organizational structure of different segments of the food system,
- Describe several examples of different configurations of elements within the food system and describe how the framework will be applied, step by step, to compare them. Examples should be drawn from different parts of the food system (production, harvest, processing, distribution, marketing, retailing, and consumption). The emphasis will be on those effects that are generally not recognized (i.e., they may not be fully incorporated into the price of food). Different configurations for the committee to consider might include regionally based food systems and a global food system; free-range production of poultry and caged housing practices; and reduced retail presence of processed food and current availability of processed food.
- In constructing examples, describe the strengths and weaknesses of the framework in different contextual situations and suggest how and when adjustments to the framework may lead to more accurate comparisons. The goal of the examples is to illustrate the potential use of the framework to analyze a variety of questions and compare, measure, and, in some cases, monetize the effects of different scenarios on public health, the environment, and society. The focus of these exercises should be in explaining the elements of the framework, not in attempting the analyses.
- The committee will also identify information needs and gaps in methods and methodologies that, if filled, could provide greater certainty in the attribution and quantification of effects related to food system configurations and improve the predictive value of the framework for evaluating how changes in and across the food system might affect health, the environment, and society.
An ad hoc, expert committee of 15 experts was convened to conduct the study and develop a consensus report. The committee members have expertise in agricultural production systems; food system analysis; food and nutritional sciences; environmental effects of food and agriculture; HIA; LCA; health, agriculture, and food economics; and complex systems modeling. The composition of the committee reflects the fact that the main goal of the Statement of Task is to develop an analytical framework to assess the food system (which requires highly technical skills and knowledge of methodologies) and not to evaluate food system configurations.
The committee met five times in closed session to gather information,
that can be modified to achieve a particular goal or to explore how potential drivers (e.g., growth in demand for foods with particular traits) might impact the distribution of health, environmental, social, and economic effects.
assess literature and other evidence sources, and deliberate, and they had numerous other interactions by telephone and e-mail. In addition, the committee conducted two public sessions and one 1.5-day workshop. The public sessions and workshop provided an opportunity for the committee to obtain information helpful to accomplishing its tasks (see Appendix A for public sessions and workshop agendas).
Before developing its framework, the committee believed it was necessary to define critical terms to provide context for its task. In that vein, the committee first undertook an exercise to describe the U.S. food system and to examine how the current system has evolved. In examining the domestic food system, the intricacies and nuances of the system were revealed, along with its numerous interactions across multiple dimensions, confirming the need for a comprehensive assessment that would consider these complexities.
Boundaries and Clarifications About the Task
Although the task of the committee is clear in delineating the scope of the committee’s work, a few aspects of the task deserve further explanation so that the reader has the appropriate expectations about the report.
The committee carried out its task from the U.S. perspective, which was used in the description of the U.S. food system and a brief historical overview of how it evolved. Similarly, the descriptions of the effects and its complexities have focused on the U.S. population and environment. Given the level of international trade, investment, and institutional relationships of the U.S. food system and the global nature of the food and agriculture industry as a whole, the committee recognizes that any actions in the United States will have effects not just at the domestic level, but globally as well. Given widely different levels of economic and food system development worldwide, effects of similar policies or practices elsewhere could be both important and very different. Such variations and trade-offs are important considerations when crafting effective interventions.
In addition to developing a framework, the committee was asked to provide different examples within the food system on how proposed changes in one area could affect others. These examples would demonstrate how the framework could be applied to assess different configurations within the food system. Although it was outside the committee’s task to conduct any actual assessments, the examples reiterate how decisions may have unanticipated consequences across the food system. The six examples chosen by the committee are relevant for the current U.S. food system because they raise important and complex questions. The issues touch on healthy and safe diets, food security, animal welfare, environmental health, and natural resource use. In presenting the examples, the committee strove to provide
contextual information and evidence relative to the potential effects. The examples have global effects that in some cases were not assessed; still, the intention of the committee was that any user of the framework would also consider effects at the global level. The committee did not conduct any analysis or make recommendations on how to improve any aspect of the food system by new processes or policy interventions. In addition, the committee did not make recommendations on how the framework could be used in the policy-making process. Because the committee did not conduct actual assessments, it did not attempt to gather all of the necessary data or review the evidence in a systematic manner. Therefore, these applications of the framework are conducted in relatively brief and theoretical terms.
The framework is intended to be an analytical tool to evaluate discrete components of the food system and their interplay with the broader food system. When analyzing specific areas of the food system, users of this framework will need to be aware of as many effects as possible, even when they cannot all be included in an analysis. The committee recognizes that for many of the effects mentioned, the data are scarce and assessments are difficult to conduct. In such circumstances, decisions still need to be made about agriculture and food and data or analytical deficiencies should be noted. However, with enough interest and urgency from stakeholders, data can be collected and analyzed and scientific assessments can be conducted to strengthen analyses and decisions.
As noted earlier, the U.S. food system is embedded in a broader social, biophysical, and economic context within American society. Within that context, many factors play a role in shaping the health, environmental, social, and economic effects of the food system. The committee recognizes that neither all of the factors nor all of the effects and complexities of the food system were identified in the report. For example, significant factors that need to be considered, such as the anthropological and cultural aspects of populations, were omitted. Important effects such as genetic biodiversity, food waste, and others are also not mentioned. Furthermore, the committee made no attempt to assess levels of causation to attribute to these factors or to provide guidance for what will constitute various levels of evidence, but it does refer to other authoritative reports and papers that have addressed this difficult question.
In addition, there are many other important scenarios (or configurations) of the food system that could have been used as examples to show the application of the framework. For example, the framework could be used by private companies or public institutions to help guide decisions about management of food waste or of food defense concerns, but none of these aspects (or many others) are elaborated in the report.
ORGANIZATION OF THE REPORT
This introductory chapter has described the origins of the study, the Statement of Task, and the approach taken by the committee to address its charge. Chapter 2 describes the U.S. food system and highlights the evolutionary process that has led to its current configuration. The next series of chapters discuss important effects in four dimensions of interest, namely, health (Chapter 3), environmental (Chapter 4), and social and economic (Chapter 5) dimensions. Chapter 6 discusses the food system as a “complex adaptive system”2 and Chapter 7 describes the committee’s analytic framework. In describing the utility of the framework, Chapter 7 takes the issue of antibiotics to illustrate steps for applying the framework. Chapter 7 also illustrates the use of the framework with five additional examples (Annexes 1 through 5): (1) recommendations for fish consumption; (2) biofuels; (3) recommendations for fruit and vegetable consumption; (4) nitrogen use in agriculture; and (5) hen housing practices. The committee notes that some readers might want to go directly to Chapter 6 (“The U.S. Food and Agriculture System as a Complex Adaptive System”) and Chapter 7 (“A Framework for Assessing the Food System and Its Effects”), but other readers might find the effects of the food system (Chapters 3, 4, and 5) useful as they provide valuable details demonstrating the complexities. The report ends with concluding comments in Chapter 8. Finally, the appendixes present the open sessions’ agendas (Appendix A); tables of selected metrics, methodologies, data, and models (Appendix B); a list of acronyms (Appendix C); and short biographies of the committee members (Appendix D).
Hawkes, C. 2007. Promoting healthy diets and tackling obesity and diet-related chronic diseases: What are the agricultural policy levers? Food and Nutrition Bulletin 28(2 Suppl):S312-S322.
IOM (Institute of Medicine). 2012. Accelerating progress in obesity prevention: Solving the weight of the nation. Washington, DC: The National Academies Press.
2 A complex adaptive system is a system composed of many heterogeneous pieces, whose interactions drive system behavior in ways that cannot easily be understood from considering the components separately.