Slimko M. The emerging role of public health leadership in food systems transformation. HPHR. 2021;35.
Food systems and dietary patterns are inextricably linked to public and planetary health. These relationships are becoming more apparent every day, as the need to produce enough food to nourish a growing global population is impacted by issues such as pandemics, climate change, and biodiversity loss. These are just a few of the challenges impacting public health, and each will require continuous transformations to programming and practice to keep us moving towards healthier and more sustainable food systems.
Fortunately, there is a growing number of decision-makers dedicating themselves to addressing these issues, from local grassroots efforts to international initiatives. Although the approaches may differ drastically between groups, the end goals of protecting the planet and its inhabitants are a universal theme. At present, no entity knows exactly how to solve these complex and interconnected issues between health and sustainability, but it is clear that a “business-as-usual approach” may not be enough. The ability of DrPH leaders to facilitate collaboration (both within and across scientific disciplines, institutions, and industries) can be a key lever of change for food system transformation, as can be their ability to recognize and amplify the voices of those promoting the most promising evidence-based solutions and programming strategies. DrPH leaders should have ample opportunities to utilize their unique skillsets to redefine their roles within the larger context of food systems science and sustainability.
Food systems transformation will require many new and innovative approaches for solutions and practices if it is to be successful, but at the same time, it does not need to start from scratch. Working with the current robust body of peer-reviewed science, which continues to grow, can help guide best practices today and into the future. There is an enormous body of evidence already available, and many of the best practices from today will likely remain tomorrow. Ideally, this continuous transformation will rely heavily on science and social justice and aim to address all four sustainability domains – health, economics, society, and the environment (1) – so that the short-term and long-term trade-offs, synergies, and unintended consequences of any action plan are carefully weighed and balanced.
If it is to be successful, this great food system transformation will require stakeholders with local, national, and/or international expertise to work together along with the entire food system – from production and consumption to waste management and healthcare. And along the way, many of these stakeholders will be looking for people to learn from, collaborate with, and lead others. There will be opportunities at all levels for individuals, organizations, and for people along the food systems value chain to take on leadership roles in this transformation, and it is critically important that public health professionals who have been trained to understand and address these types of complex scientific issues help guide the way.
The food system transformation requires different kinds of leadership, comprising farmers, researchers, educators, businesses, trade groups, media, governments, and more. And the most valuable leaders will be able to interface with all of these actors, not only to address current issues, but also to anticipate future crises and help achieve the important long-term public health and sustainability agendas such as the United Nations (UN) Sustainable Development Goals (SDGs), food-based dietary guidelines, and Net Zero Initiatives. Several organizations have already taken the lead on these matters, collecting data, providing analysis, and sharing out their findings and opinions. But not all information is created equal, and it will require skilled professionals to help separate the “wheat from the chaff” on these health and sustainability assessments to help provide the public with a greater understanding of what’s good for people and good for the planet. The DrPH skillset sits at the interface of expertise required to both understand the vast and growing number of food system challenges spanning multiple sustainability domains, and to communicate these issues between scientists, industry, decision-makers, and the public. This is a vital skillset, since a large part of the inertia against transforming the food system may be due to the fact that this is an emerging field that requires various disciplines and stakeholders to work together in ways that haven’t been done before. The ability to get all parties on the same page as far as research priorities, future visions of the food system, and action plans, would be invaluable for implementing this type of massive transformation at local, national, and international levels.
At present, there are several groups leading the way to enact food system change. At the international level, the Food and Agriculture Organization (FAO) in conjunction with various other UN agencies and global experts, have been continually working towards healthier and more sustainable food systems for more than a decade (2). There are several findings noted in FAO publications: 1) there is need for systematic and evidence-based approaches, 2) all sustainability domains should be considered in decision making, as well as consideration of trade-offs and unintended consequences of policies and programs, 3) collaboration is necessary between scientific disciplines and across public and private sectors, 4) investments in new innovations and technologies are necessary, and 5) that animal agriculture can be part of the solution for healthier, more sustainable, more secure, and more resilient food systems (3-6).
A current hot topic related to these recommended principles is the questioning of the role of animal agriculture in healthy and sustainable diets and food systems. These questions generally focus on the effects of reducing livestock in the food supply to mitigate greenhouse gas (GHG) emissions; whether the water and land used for producing livestock (or their feeds) could be put to better use growing human-edible crops; and whether the consumption of animal-sourced foods (ASF) is good or bad for health. These food system issues and others are now constantly being discussed in the research literature, in the news, and on social media – with a fair serving of misinformation/disinformation being shared along with the credible facts and stats. The truth is these are all complex and contextual issues and they do not have single or simple solutions. When sustainable food system issues are viewed in siloes or with a limited context that ignores nutritional, health, environmental benefits, geographical, and socioeconomic impacts – the value of animal agriculture gets shortchanged. For example, while certain groups have been calling for a reduction in ASF production for environmental reasons (7, 8), others are quick to point out the limited effects that significantly reducing animal agriculture would have on environmental impacts (especially when compared to transportation and energy sectors), as well as the negative health, economic, and sociocultural consequences of this type of action (9-11). The FAO, along with other international research organizations such as the Global Alliance for Improved Nutrition (GAIN) and the International Food Policy Research Institute (IFPRI) recognize a holistic approach is necessary, and that practices and recommendations across entire food systems must focus on the big picture by also considering the context and nuances that allow for food system adaptations to suit historical, cultural, geographical, economical, and individual preferences and needs in addition to environmental factors (12, 13). With all the elements to consider, there is no perfect food system nor one-size-fits-all solution for a healthy and sustainable food system. Rather, there are many types of food systems that can be healthy and sustainable, and these will vary with geography and over the generations (14).
While it is true that agriculture is a contributor to GHG emissions, this is the case for both plant and animal agriculture. Both plant-sourced foods (PSF) and ASF require precious natural resources, provide essential nutrition for humans, produce byproducts and waste products, and both agricultural systems can be improved upon in all these areas. Farmers and researchers focused primarily on animal agriculture have been addressing these existing and emerging issues over the last several years — with the goals of improving efficiencies, reducing environmental impacts, utilizing renewable energy, working pre-competitively, and helping to get the entire value chain involved (15, 16).
The most prominent example of these efforts has been demonstrated by the U.S. dairy industry, which has taken a leadership role in food system sustainability and environmental stewardship research for the last decade (17). These dairy-led efforts operate at local, state, regional, national, and international levels, and are constantly aiming for increased crosstalk and collaboration both inside and outside of the dairy sector. One of the biggest sustainability efforts to date of any industry is exemplified by the Dairy Sustainability Framework. This international initiative was launched in 2013, and is focused on contributing holistically towards the delivery of the SDGs, by committing the global dairy sector to continuous improvements in producing nutritious, affordable, and accessible foods in environmentally sound and responsible ways (16, 18). At the national level, in the U.S., the dairy industry also is leading a Net Zero Initiative, which is an industry-wide effort aimed at enabling dairy farms of all sizes to implement new technologies and practices to achieve carbon neutrality, improve water quality, and optimize water usage (19). Both the Dairy Sustainability Framework and Net Zero Initiative are focused on investing in research and development, promoting evidence-based best practices, tracking and reporting progress, and sharing out their success stories — all of which have set up these initiatives as examples for other industries to learn from and aspire to. It’s important to note, however, that ongoing efforts need to continue from not only the dairy industry but from all food systems actors in order to achieve food systems transformation that ultimately supports healthier people, communities, and the planet.
Furthermore, while most people still think of food system sustainability in terms of environmental impacts such as GHGs, the core of the work to be done on food system transformation can be holistic: focused on numerous aspects of health, society, economics, and the environment, which must go beyond just GHGs to include water quality and quantity, air pollution, soil health, biodiversity loss, deforestation, plastic and electronic waste, and ocean acidification. These are all interconnected issues that tie back to public health since deteriorating societies, economies, and/or environments can contribute to worsening human health outcomes by increasing the risk for communicable diseases, non-communicable diseases, all forms of malnutrition, mental health disorders, mortality, and morbidity. In effect, public health is at the crux of food system sustainability and deserves much greater representation in food system transformation efforts.
In the end, the success of the great food transformation (and the future of humanity) will depend on its leaders, whether they come from academia, industry, government or the community-at-large. It will depend on their abilities to think holistically, act on scientific evidence, understand potential tradeoffs, adapt to new challenges, work together, and educate the public. While most leaders are equipped with a few of these skills, DrPH leaders are trained to address many of these challenges.
If you, or someone you know is looking for a good place to learn more about the SDGs, collaboration, and food system transformation, the UN will convene a Food Systems Summit in the Fall of 2021, aimed at bringing all food systems actors to the table to help achieve the SDGs for 2030 (https://www.un.org/en/food-systems-summit/about).
DrPH leaders are trained and exposed to various leadership skills in order to manage complex public health problems that span an array of transdisciplinary areas. As the area continues to evolve, it will be important for public health leaders to understand the important voices, actors, and change agents at the table to effectively advance public health research, practice, and theory.
Recognizing and elevating the need for food systems transformation to other public health leaders can help set the future agenda, build stronger interconnections between various sectors, and provide greater opportunities to support contributions to the evidence base of public health practice.
Michelle L. Slimko, DrPH, MPH, RD is currently the SVP of Environmental and Nutrition Research at National Dairy Council. She is a Registered Dietitian and graduated from the University of Illinois at Chicago School of Public Health DrPH Leadership Program.