food justice martin donohoe. physician activism schism between medicine and public health medical...
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Food Justice
Martin Donohoe
Physician Activism
• Schism between medicine and public health
• Medical ethics deficient re public health
• Social, cultural, and economic contributors to health and illness important
ExampleExample
• Equalizing the mortality rates of Equalizing the mortality rates of whites and African-Americans would whites and African-Americans would have averted 686,202 deaths have averted 686,202 deaths between 1991 and 2000between 1991 and 2000– Whereas medical advances averted Whereas medical advances averted
176,633 deaths176,633 deaths• AJPH 2004;94:2078-2081AJPH 2004;94:2078-2081
UN Declaration of Human Rights
“Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care”
Food Justice: Overview
• Agriculture - consequences• Biodiversity
– 75% decrease over 20th Century– Vulnerability to infestations (e.g., Irish potato famine)– Svalbard Seed Bank
• Deforestation– Overpopulation, unsustainable agricultural practices
• Soil erosion• Water availability
Corporate Control of Agriculture
• Monsanto, Novartis, Pioneer/Dupont, Aventis CropScience, Bayer CropScience, BASF, Syngenta, Dow
• Mid 1970s – 7,000 seed companies (none controls over 0.5% of market)
• 2011 – 10 companies control 2/3 of seeds
• Control/harassment of scientists
Food Justice
• Lobbying, governmental influence (revolving door)
• Production and Distribution– Local vs international, greenhouse
gasses/global warming
• Diversion of food crops to biofuels
Poverty and Famine
• U.S. Poverty– 15% (22% children)– Racial disparities
• Worldwide– 1.1 lack access to clean water– 2.6 lack adequate sanitation
• Famine: 18,000 people starve to death daily (1 Hiroshima every 8 days)
Poverty and PrioritiesPoverty and Priorities
• Amount of money needed each year (in Amount of money needed each year (in addition to current expenditures) to addition to current expenditures) to provide water and sanitation for all people provide water and sanitation for all people in developing nations = $9 billionin developing nations = $9 billion
• Amount of money spent annually on Amount of money spent annually on cosmetics in the U.S. = $8 billioncosmetics in the U.S. = $8 billion
• One week of developed world farm One week of developed world farm subsidies = Annual cost of food aid subsidies = Annual cost of food aid required to eliminate world hungerrequired to eliminate world hunger
Foreign Aid
• In total dollars: U.S. #1In total dollars: U.S. #1• As a % of GDP, U.S. ranks 21As a % of GDP, U.S. ranks 21stst among among
the world’s wealthiest nationsthe world’s wealthiest nations• U.S. Aid: Over 1/3 military, 1/4 U.S. Aid: Over 1/3 military, 1/4
economic, 1/3 for food and economic, 1/3 for food and developmentdevelopment
• Most U.S. aid benefits U.S. corporationsMost U.S. aid benefits U.S. corporations• GM crops and food aid (Zambian GM crops and food aid (Zambian
famine, Africa - Wikileaks)famine, Africa - Wikileaks)
Foreign AidForeign Aid
• 0.9% of the total federal budget, 1.6% 0.9% of the total federal budget, 1.6% of the U.S. discretionary budgetof the U.S. discretionary budget
• On average, Americans think that On average, Americans think that 24% of the federal budget goes 24% of the federal budget goes toward foreign aidtoward foreign aid
Foreign AidForeign Aid
• Structural adjustment policies of Structural adjustment policies of World Bank, IMF, WTO force World Bank, IMF, WTO force developing nations to convert from developing nations to convert from production of food crops for local production of food crops for local consumption to profitable export consumption to profitable export cropscrops
• Land purchases by China, Brazil in Land purchases by China, Brazil in AfricaAfrica
PesticidesPesticides
• 2.2 billion lbs/yr pesticides2.2 billion lbs/yr pesticides
–Almost 8 lbs/person/yr in USAlmost 8 lbs/person/yr in US
• Linked to autism, Parkinson’s Linked to autism, Parkinson’s Disease, Alzheimer’s disease, Disease, Alzheimer’s disease, diabetes, obesity (with prenatal diabetes, obesity (with prenatal exposure), depression, ADHD, breast exposure), depression, ADHD, breast cancercancer
PesticidesPesticides
• EPA: U.S. farm workers suffer up to EPA: U.S. farm workers suffer up to 300,000 pesticide-related acute illnesses 300,000 pesticide-related acute illnesses and injuries per yearand injuries per year– 25 million cases/yr worldwide25 million cases/yr worldwide
• NAS: Pesticides in food could cause up to NAS: Pesticides in food could cause up to 1 million cancers in the current generation 1 million cancers in the current generation of Americansof Americans
• WHO: 1,000,000 people killed by WHO: 1,000,000 people killed by pesticides over the last 6 yearspesticides over the last 6 years
Indoor combustion of coal and Indoor combustion of coal and biomassbiomass
• For cooking, heating and food For cooking, heating and food preservationpreservation– Used by almost 3 billion people Used by almost 3 billion people
worldwideworldwide– Causes close to 2 million deaths/yrCauses close to 2 million deaths/yr– Associated with multiple pulmonary Associated with multiple pulmonary
conditionsconditions– Women and children predominantly Women and children predominantly
affectedaffected
Agricultural Antibiotic UseAgricultural Antibiotic Use
• Agriculture accounts for 70% of U.S. Agriculture accounts for 70% of U.S. antibiotic useantibiotic use
–Use up 50% over the last 15 yearsUse up 50% over the last 15 years
Antibiotic Resistant PathogensAntibiotic Resistant Pathogens
• CDC: “Antibiotic use in food animals is the CDC: “Antibiotic use in food animals is the dominant source of antibiotic resistance dominant source of antibiotic resistance among food-borne pathogens.”among food-borne pathogens.”
• $4billion/yr to treat antibiotic-resistant $4billion/yr to treat antibiotic-resistant infections in humansinfections in humans
• US Preservation of Antibiotics for Medical US Preservation of Antibiotics for Medical Treatment Act, 2007 – awaiting voteTreatment Act, 2007 – awaiting vote
Genetically-Modified Crops
• 29 countries, 250 million acres (10% of global farmland), commercialized 1994
• Most soybeans, cotton, corn; other crops• 80% herbicide-resistant (e.g., Roundup
Ready soybeans); 20% produce their own pesticide (e.g., Bt corn)
• No commercially available GE crop that is drought-resistant, salt- or flood-tolerant, or which increases yields
Genetically-Modified Crops: Risks
• Contamination– Financial consequences
• Allergies
• Superweeds
• Changes in soil, soil bacteria
• Altered nutritional value, potential adverse health effects
• Increased herbicide/pesticide use
Biopharming
• The engineering of plants to produce pharmaceuticals (enzymes, antibiotics, contraceptives, abortifacients, antibodies, chemotherapeutic agents, vaccines) and industrial chemicals
• Secrecy, violations, poorly regulated• Risks – similar to GM crop risks, and more• Widespread opposition (NAS, UCS, BMA,
Consumers Union, others
Other Issues
• COOL (Country of Origin Labeling)
• Inadequate funding of food inspection enterprise
• Genetic modification of vertebrates
• Cloned meats
• Artificial meat
• Patenting life forms (Supreme Court to ultimately decide)
Obesity Epidemic
• 1/3 of adults overweight, 1/3 obese
• Health consequences
• Economic and health care costs
ObesityPublic Health Approaches
• Education
• Exercise
• Obesity report cards
• Improving National School Lunch Program
ObesityPublic Health Approaches
• Restrictions on Food Stamp use
• Insurance discounts/surcharges
• Menu labelling
• Trans fat bans
ObesityPublic Health Approaches
• Soda tax
• Advertising restrictions/halting predatory marketing to children
• Zoning laws for fast food outlets
• Lawsuits
Recombinant Bovine Growth Hormone (rBGH)
• aka recombinant Bovine Somatotropin (rBST), brand name Posilac©
– Monsanto → Elanco (Eli Lilly)
• 10-15% of U.S. dairy cows injected with rBGH
• Used to increase milk production by cattle
rBGH
• Marketed primarily to large dairy farms (LDFs), which are supplanting small dairy farms
• LDFs have
– Worse environmental impact records
– Higher rates of workplace injuries
– Contribute to decreasing agricultural diversity
Effects of rBGH on Humans
• Increases IGF-1– suspected contributor to breast, prostate and
GI cancers– may be partly responsible for earlier onset of
puberty
– causes 16 different harmful conditions in cattle
rBGH Worldwide
• Canada, Australia, New Zealand, Japan, and the European Union have banned rBGH
• The Codex Alimentarius, the UN’s main food safety body, has refused to certify rBGH as safe
rBGH Today
• All fluid milk products in Oregon now rBGH-free
• 55 of the top 100 U.S. dairies are now at least partially rBGH-free or have announced that they will be
• Starbucks (company-owned stores), Chipotle, 160 hospitals nationwide rBGH-free
Oregon Measure 27GM Food Labeling (2002)
• Required labeling of wholesale and retail GM foodstuffs
• Defeated 70% to 30%– Despite widespread public support for labeling
• Opponents outspent proponents $5.5 million to $200,000– Out of state ag biotech money– Disinformation campaign
GM Food Labeling Today
• Many countries ban or limit GM crop production and importation
• Vermont requires GM labeling, CA ballot measure proposed, Alaska outlaws GE fish (Washington considering), Arkansas bans GE rice, Boulder (CO) bans GE crops on public lands, certain Northern California counties ban GM crops
Representative Kucinich’s House Bills (all pending)
• The Genetically Engineered Food Right to Know Act, or H.R. 6636
• The Genetically Engineered Food Safety Act, or H.R. 6635
• The Genetically Engineered Technology Farmer Protection Act, or H.R. 6637
Representative Kucinich’s House Bills (all pending)
• Mandate GMO labeling
• Require proper GMO safety testing
• Eliminate seed patenting
• Increase rights and protections for farmers
• Administer full liability to biotechnology companies for damage caused by GMOs
Oregon Biopharm Bill
• Signed 2007, MOU completed 2010
• Opposition: agricultural biotech, Oregonians for Food and Shelter
• ODA and Public Health Dept. must approve permits before field trials
• FDA preliminary safety opinion required
Oregon Biopharm Bill
• Public comment period, public meeting
• Preference for non-food crops, secured indoor greenhouses
• $10,000 fee to company
• Company responsible for required remedial action
Priorities
• UN FAO: enough food produced daily to provide UN FAO: enough food produced daily to provide every living person with over 2700 calories/dayevery living person with over 2700 calories/day– Even so, half the world’s food is wasted (UN FAO)Even so, half the world’s food is wasted (UN FAO)
• One week of developed world farm subsidies = One week of developed world farm subsidies = annual cost of food aid to solve world hungerannual cost of food aid to solve world hunger
• Hunger: solution requires political willHunger: solution requires political will
Suggestions for Health Care Professionals
• Education (self, patients)• Op-eds• Vote• Lobbying• Work with groups (see phsj website “food
safety issues” page)– Oregon Physicians for Social Responsibility’s
Campaign for Safe Food
• Run for office
Rudolph Virchow
“Doctors are natural attorneys for the poor … If medicine is to really accomplish its great task, it must intervene in political and social life…”
Speak Up for the Disenfranchised
“The first job of a citizen is to keep your mouth open.”
- Günter Grass
Have Faith in Your Ability to Affect Change
"If you think you are too small to have an impact, try going to bed with a mosquito in your tent“
- Anita Roddick
Martin Donohoe
http://www.publichealthandsocialjustice.org
http://www.phsj.org