The U.S. Department of Agriculture as a Public Health Agency? A 'Health in All Policies' Case Study
39 Pages Posted: 18 May 2014 Last revised: 26 Jun 2014
Date Written: 2013
Health agencies at every jurisdictional level are exploring new ways to promote healthy eating and physical activity. At the federal level, the U.S. Centers for Disease Control and Prevention has made “nutrition, physical activity and obesity” a top priority. Ultimately, however, a non-health agency has primary authority over what is arguably the most important modifiable determinant of obesity in the United States. The U.S. Department of Agriculture plays an enormously important role in shaping our nation’s food system — the food that’s available in stores, restaurants, schools, workplaces, and our homes; how it is produced and sold; how it is consumed and by whom. And in turn, that food system is crucial to public health — how long people live and how healthy they are, not just as a matter of individual medical treatment but as a matter of population-level causes, patterns, and disparities among and between social and economic groups. Historically, USDA has principally served the interests of the food and agriculture industries. This is not just a matter of agency capture; as public health advocates have pointed out, the U.S. Secretary of Agriculture’s statutory mandate includes duties to foster “new or expanded markets” and move “larger quantities of agricultural products through the private marketing system to consumers.” Now, a growing coalition of advocates and commentators are pressuring Congress and USDA to reform federal nutrition and agriculture programs in light of public health goals.
This Article investigates the extent to which USDA-administered programs — including dietary guidelines, agricultural subsidies, nutrition assistance, and school meal subsidies — have been (and are being) shaped by cross-sector advocacy. I situate this investigation within a broader global movement to recognize the importance of “Health in All Policies.” This Article’s discussion of public health-focused USDA reform seeks to demonstrate that the HiAP approach requires coordinated advocacy and coalition building to exert pressure on the legislative and executive branches of government. This external pressure should be aimed at producing substantive mandates from the legislature to administrative agencies in “non-health” sectors, rather than simply focusing on imposing procedural requirements that health impacts be taken into account in the work of those agencies.
Keywords: food law, USDA, agriculture, food stamps, SNAP, nutrition, farm subsidies, public health, obesity, chronic disease
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