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This piece moves the needle, but even freedom to choose food is often out of people's hands. Fed policy has heavily influenced what we choose to buy and eat, contributing to obesity, health care costs, and a socioeconomic gap in chronic disease. 1/ https://twitter.com/TheEconomist/status/1120342053232283651
First, some background: two in every three American adults are considered either overweight or obese, the obesity epidemic alone costs the U.S. health care system $117 billion each year, and rising obesity rates in the U.S. may be responsible for up to 186,000 deaths per year.
Second, some history: since 1995, the USDA has given farmers ~$300B in ag subsidies. However, instead of supporting small farms who grow berries, almonds, broccoli, i.e. specialty crops, subsidies primarily support large farms that produce commodity crops, e.g. corn, wheat, soy.
Small farms make up three-fourths of the country’s farmland, yet receive only 14 percent of government subsidies. Adjusted for inflation, fruits and vegetables have become 40 percent more expensive over the last 30 years, whereas the price of sweets and fats has decreased.
The result is that corn, grain, and soy, crops that fueled the rapid growth of the food processing industry, have become the cheapest calories. Our supermarkets, restaurants, and convenience stores are stocked to the brim with cheap foods that lack any nutritional value.
Consequently, America’s poorest families, particularly the 1 in 8 Americans receiving SNAP benefits, have much higher obesity rates relative to the rest of the population. Limited purchasing power of food stamp recipients means they often have to turn to the cheapest calories.
The impact of this antiquated policy most often manifests itself within the walls of our medical centers. Both food insecurity and obesity are major risk factor for hypertension, heart disease, stroke, cancer, diabetes, arthritis, kidney disease, and hepatitis, among others.
Doctors can manage the worst manifestations of chronic disease in the hospital, but the environment that these patients return to once they leave–block corner convenience stores, cheap junk food, and limited options for nutrition–only exacerbates the problem.
The key point and tl;dr – Effective Health care reform and cost control is futile if we don't consider and revisit how upstream, historical policy choices affect both current and future health care and budget policy.
Two potential solns: 1) redistribute ag subsidies to the small farms growing fruits/veggies, and 2) increase SNAP funding/incentives to nudge consumption of more nutritious food. This fosters competition b/w farms and give our most vulnerable population more financial freedom.
