Food Systems and Health: Volume 18

Food system channels are proposed to be major components of the larger food system which influence health and illness.

Food system channels are defined, discussed in relationship to other food system components, considered in terms of historical food system changes, examined in relationship to wellbeing and disease, and proposed to have useful applications.

Food system channels are broad, organized, and integrated pathways through which foods and nutrients pass. Channels are larger in scale and scope than previously described food system structures like chains, stages, sectors, networks, and others. Four major types of contemporary Western food system channels differ in their underlying values and health impacts. (1) Industrialized food channels are based on profit as an economic value, which contributes to a diversity of inexpensive foods and chronic diseases. (2) Emergency food channels are based on altruism as a moral value, and try to overcome gaps in industrialized channels to prevent diseases of poverty. (3) Alternative food channels are based on justice and environmentalism as ethical values, and seek to promote wellness and sustainability. (4) Subsistence food channels are based on self-sufficiency as a traditional value, and seek self-reliance to avoid hunger and illness. Historical socioeconomic development of agricultural and industrial transitions led to shifts in food system channels that shaped dietary, nutritional, epidemiological, and mortality transitions.

Food system channels provide varying amounts of calories and types of nutrients that shape wellbeing and diseases. Sociologists and others may benefit from examining food system channels and considering their role in health and illness.

Improving the nutritious quality of diets for individuals and populations is a central goal of many public health advocates and intergovernmental organizations. Yet the outcome of healthy eating has been shown to systematically vary across individual-level socioeconomic lines, and across countries in different locations of the food system. We therefore assess variation in the association between eating nutritionally dense fresh fruits and vegetables and both self-rated health (SRH) and body mass index (BMI) across individual income and country locations in the food system.

We use nationally representative survey data from 31 countries drawn from the International Social Survey Programme’s 2011 Health module. We estimate the effect of the frequency of eating fresh fruits and vegetables using random-intercept, random-coefficient multilevel mixed-effects regression models.

We confirm that eating nutritionally dense fresh fruits and vegetables frequently associates with more positive health outcomes. However, this general conclusion masks substantial individual- and country-level heterogeneity. For both SRH and BMI, the largest beneficial associations are concentrated among the most affluent individuals in the most affluent countries. Moving away from either reduces the positive association of healthy eating.

Our results provide an important wrinkle for policies aimed at changing the nutritional quality of diets. Adjustments to diets without taking into account fundamental causes of socioeconomic status will likely be met with attenuated results.

We compare two important health outcomes across a wide variety of types of countries. We demonstrate that our main conclusions are only detectable when employing a flexible multilevel methodological design.

Food insecurity and hunger are found to have important adverse mental health effects, and have been of particular interest to epidemiologists and public health scholars. The primary goal of the present study is to expand our understanding of the mental health effects of food insecurity by assessing gender-based disparities among a nationally-representative sample of U.S. adults.

Using data from the combined 2011-2012 and 2013-2014 cycles of The National Health and Nutrition Examination Survey (NHANES) (N=11,539), we estimated multiple ordinary least squares and binomial models using adult food insecurity measures and self-reported gender as main predictors of depressive symptoms and alcohol use.

Our results demonstrate that food insecurity is associated with depressive symptoms but not alcohol consumption. Additionally, we found an association between food insecurity and increased psychological distress among women relative to men. In contrast, no evidence of a difference in the association between food insecurity and alcohol use was observed across the two genders, indicating that experiences of food insecurity are particularly salient for psychological health among women.

These findings add to the growing literature that household food insecurity has serious mental health consequences, and extend this work by clarifying ways in which gender accounts for differences in the association between food insecurity and psychological and behavioral outcomes.

Using a Constrained Choice Theory framework, this paper will identify variation in choosing the constraint-reflective priorities of budget, taste, or health by sociodemographic group, familial status, and weight category. Identifying which groups experience unique constraints will allow for customized healthy eating programs to address barriers specific to each group.

Data are derived from a paper survey of families with children in Lexington, KY and analyzed using logistic regression.

The results of this study confirm that some sociodemographic groups are more likely to choose priorities that reflect contextual constraints in their lives than others. In particular, having a higher income reduces likelihood of prioritizing budget and increases chances of prioritizing taste. Being married or cohabitating is correlated with choosing health, but having more children reduces the likelihood of prioritizing health. Being obese correlates with increased likelihood of prioritizing budget. Membership in each of these categories reflects constraints on which foods are purchased for the home.

Families are encouraged to improve their diets by eating at home, but families face many constraints when choosing healthy foods at the grocery store. Understanding the constraints experienced by various groups when shopping for food will lead to health policy that more fully addresses barriers to healthy eating for groups with disproportionately high incidence of diet-related disease.

This paper extends Constrained Choice Theory by applying it to a new aspect of health, purchasing groceries, and also by examining a wider variety of sociodemographic groups than previous research.

In this chapter, we draw on health lifestyle, human capital, and health commodity theories to examine the effects of educational attainment on a wide range of individual dietary behaviors and dietary lifestyles.

Using data from the 2005-2006 iteration of the National Health and Nutrition Examination Survey (n = 2,135), we employ negative binomial regression and binary logistic regression to model three dietary lifestyle indices and thirteen healthy dietary behaviors.

We find that having a college degree or higher is associated with seven of the thirteen healthy dietary behaviors, including greater attention to nutrition information (general nutrition, serving size, calories, and total fat) and consumption of vegetables, protein, and dairy products. For the most part, education is unrelated to the inspection of cholesterol and sodium information and consumption of fruits/grains/sweets, and daily caloric intake. We observe that having a college degree is associated with healthier dietary lifestyles, the contemporaneous practice of multiple healthy dietary behaviors (label checking and eating behaviors). Remarkably, household income and the poverty-to-income ratio are unrelated to dietary lifestyles and have virtually no impact on the magnitude of the association between education and dietary lifestyles.

Our findings are consistent with predictions derived from health lifestyle and human capital theories. We find no support for health commodity theory, the idea that people who are advantaged in terms of education live healthier lifestyles because they tend to have the financial resources to purchase the elements of a healthy lifestyle.

Only a handful of studies have examined social interactions between parents and children around food choice, though these have important implications for health. Moreover, we know very little about how socioeconomic status might influence these exchanges, including the nature and outcomes of children’s requests for specific foods and drinks.

Data are from a survey of 401 families with children ages 2-17. Using formal mediation models to decompose direct and indirect effects, we test three potential mechanisms of socioeconomic differences in caregivers’ propensity to indulge children’s requests for specific foods or drinks: (1) Children’s food-seeking behaviors; (2) Caregivers’ nutritional attitudes and values; and (3) Caregiver social control and monitoring of children’s diets. We also present a symbolic indulgence explanation, which is not empirically testable using our data, but is consistent with qualitative evidence (Pugh, 2009).

We find significant SES differences in the frequency and nature of children’s requests for foods, nutritional attitudes and values, and opportunities for caregiver monitoring of children’s eating habits, but these mechanisms explain little of the association between socioeconomic status and caregiver responses.

Limitations of this study include the non-probability sample and the inability to demonstrate the meaning and intention underlying SES effects. Nonetheless, our findings provide information about how SES does and does not influence parent-child interactions around food choice, which has important implications for developing effective policies and interventions for improving children’s diets.

In light of null findings regarding alternative explanations, children’s requests for unhealthy food and parents’ willingness to grant them may be related to cultural practices around parenting that differ by social class. Consequently, culture may be an important yet under-emphasized mechanism contributing to socioeconomic disparities in children’s dietary habits and health.

As a movement for alternative means of food production and consumption has grown, so, too, have civic efforts to make alternative food accessible to low-income persons (LIPs). This article examines the impact of alternative food institutions (AFIs) on low-income communities in the United States and Canada, focusing on research published since 2008.

Through a three-stage literature search, I created a database of 110 articles that make empirical or theoretical contributions to scholarly knowledge on the relationship of AFIs to low-income communities in North America. I used an in vivo coding scheme to categorize the impacts that AFIs have on LIPs and to identify predominant barriers to LIPs’ engagement with AFIs.

The impacts of AFIs span seven outcome categories: food consumption, food access and security, food skills, economic, other health, civic, and neighborhood. Economic, social and cultural barriers impede LIPs’ engagement with AFIs. AFIs can promote positive health outcomes for low-income persons when they meet criteria for affordability, convenience and inclusivity.

This review exposes productive avenues of dialogue between health scholars and medical sociology and geography/environmental sociology. Health scholarship offers empirical support for consumer-focused solutions. Conversely, by constructively critiquing the neoliberal underpinnings of AFIs’ discourse and structure, geographers and sociologists supply health scholars with a language that may enable more systemic interventions.

This article is the first to synthesize research on five categories of alternative food institutions (farmers’ markets, CSAs, community gardens, urban farms, and food cooperatives) across disciplinary boundaries.

Research has established a connection between industrially-produced food and negative health outcomes. Scholars have also shown a significant link between poor food environments and health. This paper explores the experiences of university extension program agents in order to initiate greater dialogue about the role of extension in lessening the deleterious health impacts of unequal access to high quality and sufficient quantity foods. Specifically, we consider the role of food self-provisioning instruction (e.g., food gardening, preservation).

The paper draws on semi-structured interviews with 20 university extension program officers in the state of Washington.

Although our participants report that demand for education in food production skills is on the rise across Washington, there are barriers to the equitable distribution of self-provisioning skills.

There is considerable promise for extension programs to have positive implications for health and nutrition for communities struggling to access quality foods. To meet this progress, extension must be more aware of serving the entire public either through hiring agents mirror their constituencies or funding a more diverse array of programming.

Little existing research examines or evaluates using university extension programs as a vehicle for teaching food self-production, though these topics have been taught since the founding of extension.

This paper describes how community gardens generate social capital, and with what potential implications for the health of gardeners and their communities.

This analysis draws on data from focus groups with gardeners from four community gardening programs, two each in Boston and Lynn, MA. The participants represent a diverse sample of community gardeners (n=32).

We identify four mechanisms through which community gardening increases social capital, with implications for individual and community health: (1) building social networks; (2) providing opportunities for resource sharing and social support; (3) preserving cultural knowledge and practice in diaspora; and (4) reflecting and reinforcing collective efficacy. We also describe gardeners’ perspectives on gardening itself as a political activity.

While much of the literature on social capital and health in community gardens comes from in-depth studies of single, relatively homogenous gardens, this analysis draws on data from focus group interviews with a diverse group of participants who garden in varied neighborhood settings. In contrast to studies that have suggested that the social capital generated in community gardens does not extend beyond the group of individuals actively involved in gardening, our study identifies multiple community level benefits. Consequently, this paper lends support to recent calls to consider community gardening as strategy for amplifying community assets in support of public health.

This article addresses the health problems of Puerto Rico by looking at them from the perspective of food and agriculture, underlining that there is a substantial policy divide between agricultural policy and health. This reframing insists that we attend to the relationships between agriculture and food policy in order to offer new ways to think about the prevalence of so-called “lifestyle diseases” in Puerto Rico.

This study draws on a forensic research strategy that follows the framing of food and agriculture policies through a three-step diagnosis process using a mixed method approach. This three-dimensional analysis focuses on (1) history, (2) statistics, and (3) policies and legislations.

The disconnection between health and agriculture policies materializes (1) throughout 19-20^th century agricultural developments, (2) across the current agriculture organization, and, (3) through legislations and policies. A dominant understanding of agriculture as a predominantly economic and trade-driven sector fuels this policy divide.

This article calls for a new policy imagination that will allow for a re-conceptualization of agriculture policies as health policies. In order to bring forward this policy imagination, this article suggests returning to ideas that precede the production and articulation of the policy divide through a re-appropriation of Latin American indigenous knowledge and ideas. As such, the Andean concept of Buen Vivir represents a particularly promising path explored in this article.