Policy Précis
Making the link: agriculture and health equity
The World Health Organization’s Commission on the Social Determinants of Health (CSDH) has identified
principles and recommendations to tackle health inequities: the factors responsible for avoidable health
inequalities, which persist globally and in the European Union. This series of summaries, updated and
expanded online at www.equitychannel.net, introduces how those and other recommendations, as part of
evidence based health promoting approaches, could be applied to a range of European Union legislations,
policies and programmes. The aim is to improve international, national and local policies and practices within
• Needs have changed
The European Union’s Common Agricultural Policy (CAP) consumes approximately 40% of the EU
budget - almost 55 billion Euro of production subsidies each year - and, through a variety of measures
affecting food availability, quality and cost, has a profound effect on the health of the population.
While the CAP’s original purpose was to ensure the availability of safe, adequate food at reasonable
prices and also sustainable production, measures such as intervention buying of surplus produce gave
rise to overproduction of foodstuffs. This overproduction has resulted in some adverse consequences
for the environment, international trade and economic burdens. It has also had a detrimental effect on
public health as dietary habits have been influenced, impacting most upon people from lower socioeconomic profiles in the EU and beyond.I
• Towards new goals
Successive attempts to reform the CAP have mitigated some adverse impacts, but have largely
overlooked public health concerns. An evaluation of the impact of agricultural policies on health equity
and well-being would make sense in terms of practical measures arising from the EC Communication
on Solidarity in Health, plus the CSDH priority recommendation on measuring and understanding
problems, in addition to the EC strategy on counteracting obesity. A sustainable food system that can
supply safe and healthy food, with a low environmental impact while contributing to overall well-being,
should be the renewed goal for agriculture policies.
“In the corn field”, Lars Plougmann, available under a Creative Commons Attribution-Share Alike license
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Policy Précis
The situation
• The causes of the causes of ill health
Subsidies have underpinned produce with high saturated fat and protein content, incentivising increased production
of these foodstuffs in nutritionally unbalanced proportions. In addition, the EU has used the instrument of intervention
buying for fruit and vegetables to keep prices high. Unbalanced overproduction increased availability of meat
products and relatively cheap dairy produce, and has contributed largely to the high consumption of saturated
fats, particularly in low income households. Although diet is influenced by many different factors of social, medical
and cultural origin, food choices are also largely determined by price, access and availability, most notably among
people from lower socio economic groups.II
• Burdens of diseases
Chronic Non-Communicable diseases (NCDs) pose one of the greatest threats to public health and economic growth. WHO
Europe report that obesity, CVD, cancer and diabetes collectively pose the greatest burden of disease (77%) in the European
region and furthermore, identify diet as one of the major modifiable risk factors for NCDs.II Societal and cultural trends have
indicated that EU Member States are moving towards converging diets characterised by energy dense, highly processed,
nutrient poor foods. This combined with lower levels of physical inactivity plays an important role in increasing rates of
Chronic Non-communicable diseases and thus, leads to diminishing health status and decreasing overall well-being.III
• Economic costs
As populations grow and age the burden of diseases associated with obesity will result in escalating numbers of
early deaths and long-term incapacity with associated reductions in quality of life. Not only will this nutrition-related
disease significantly reduce a person’s well-being but it also constitutes a significant economic burden for healthcare systems. For example, in England, the Sustainable Development Commission estimates that the cost of obesity
to the economy could be up to £3.7 billion per year.IV
“Fresh! Fruits and vegetables in León HDR”, marcp_dmoz, available under a Creative Commons Attribution-Noncommercial-Share Alike license
Making the link: agriculture and health equity
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Pathways to progress
Change is needed in the environments in which people live, but also a policy structure that supports making the healthy
choice the easy choice,VII such as progress towards increasing the availability and accessibility of nutrient dense foods
like fruit, vegetables, pulses and whole grains. This is not just for producers to do: cooperation is needed from all
relevant sectors including health, environments, transport, markets, trade and competition policy, and education.
• EU initiatives
Efforts have been made by the EC to find synergies between agriculture policy and stimulating healthier food choice.
This resulted in the introduction of programmes designed to increase the access for vulnerable groups and children
to food. For example:
- School Milk Scheme; VIII
- School Fruit Scheme; IX
- Most Deprived Person Scheme. X
A stronger health dimension in impact assessments in agriculture policy is needed to assess the real impact of the
CAP on health and well-being. However, 2010-2011 will prove the most important years in terms of framing the post
2013 CAP reform debate. This will provide the opportunity for advocates to push for more health and health equity
initiatives to be part of reforming the CAP. In addition, the European Parliament’s role in the CAP has increased due
to the changes implemented under the Lisbon Treaty and this may serve as a useful avenue to pursue in order to
achieve a CAP that is conducive to supporting healthy lifestyles and well-being.
• The CSDH recommends actions to:
- Encourage healthy eating through retail planning to manage food availability and access;
- Including health equity in rural development programmes, including action on sustainable employment;
- Health equity impact analysis on agricultural transport, fuel, buildings, industry and waste as part
of climate change strategies;
- Include health and well-being in trade and development policies, not only in global health planning. XI
Policy Précis
Making the link: agriculture and health equity
Additional Information
• A CAP on Health? The impact of the EU CAP on Public Health, Lang., Tim., Faculty of Public Health, 2007.
• Promoting Social Inclusion and Tackling Health Inequalities in Europe, an overview of good practices from the
health field.
• Focusing on obesity through a health equity lens - a collection of innovative approaches and promising practices
by health promotion bodies in Europe to counteract obesity and improve health equity.
• Closing the gap in a generation. Report of the World Health Organization Commission on the Social Determinants
of Health.
• DETERMINE - www.health-inequalities.eu
• Directorate General for Agriculture and Rural Development
Contacts
Please visit our website – www.equitychannel.net/publications – for an electronic version of this Policy Précis and also
for the additional Policy Précis in this series. Join the Equity Channel community to add your comments or publicise
your work in this field.
EuroHealthNet is a member of the European Public Health and Agriculture Consortium (EPHAC) pressing for health
promoting food policies in the EU. For information see www.healthyagriculture.eu
Sources
A CAP on Health? The impact of the EU CAP on Public Health.
Lang., Tim. Faculty of Public Health, UK. 2007.
Fact Sheets: Tackling Europe’s major disease: the challenges and the solutions.
WHO, Regional Office for Europe. 2006.
III
Nutrition in transition: the changing global nutrition challenge. Popkin, B. M., Asia Pac. J. Clin. Nutr., 10 Suppl, S13-S18, 2001.
IV
Health, place and nature: How outdoor environments influence health and well-being: a knowledge base. Sustainable Development
Commission. London, 2008.
http://www.sd-commission.org.uk/publications/downloads/Outdoor_environments_and_health.pdf
EuroHealth. “Integrating Public health with European food and agricultural policy”,
(pgs. 17-20). (Vol 10, No 1, 2004)
“Focusing on obesity through a health equity lens - a collection of innovative approaches and promising practices by health promotion bodies
in Europe to counteract obesity and improve health equity”. Kuipers Y. M. EuroHealthNet, July 2009.
I
II
V
VI
VII
Foresight: Tackling Obesities: Future Choices - Project Report. Government office for science, London, 2nd edition, 2007.
VIII
The EU School Fruit Scheme - http://ec.europa.eu/agriculture/markets/fruitveg/sfs/index_en.htm
Most Deprived Persons Scheme - http://ec.europa.eu/agriculture/markets/freefood/index_en.htm
Closing the gap in a generation. Report of the World Health Organization Commission on the Social Determinants of Health, Geneva, 2008.
IX
X
European School Milk Scheme
http://ec.europa.eu/agriculture/markets/milk/schoolmilk/index_en.htm
XI
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