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How the US Farm Bill Contributes to Adverse Human Health Outcomes

Although the United States Farm Bill was created to maintain a steady supply of food, it has evolved into a policy that now results in numerous adverse human health outcomes.

Created in 1933, the United States Farm Bill provides a solid foundation for farmers, ranchers, and private agricultural landowners by supplementing and securing their incomes, maintains a steady supply of affordable food, and supports the American farming economy. However, this piece of legislation contributes to numerous adverse human health outcomes, directly and indirectly.

As noted in a UN report, “roughly 87% of the $540 billion in total annual government support given worldwide to agricultural producers includes measures that can be harmful to nature and health.”

Currently, most agricultural support comes from federal price incentives, including import tariffs, export subsidies, and fiscal subsidies tied to a specific commodity's production. As noted in the UN report, current policies are inefficient, harm human health, damage the environment, and are often inequitable.

What Is the US Farm Bill?

In the 1930s, the US Farm Bill was initially introduced to keep food prices reasonable for farmers and consumers, ensure an ample food supply, and protect and sustain the nation’s vital natural resources. However, over the years, this omnibus legislation has evolved to make ultra-processed foods cheaper and has failed to make nutrient-dense crops, such as fruits and vegetables, affordable.

Every five years, the Farm Bill is updated, revised, and approved by the US Congress, signed into law by the current President, and implemented by the US Department of Agriculture (USDA).

The current farm law, the Agriculture Improvement Act of 2018, was signed on December 20, 2018, and comprises 12 titles (or sections) — including commodity revenue support, conservation, trade, nutritional programs, credit, rural development, research, forestry, energy, horticulture, crop insurance, and miscellaneous policies and programs.

The Farm Bill negatively impacts the human population more than is immediately apparent by effectively subsidizing the production of lower-cost fats, sugars, and oils that intensify the obesity epidemic, all while emphasizing environmentally destructive agricultural practices that threaten human and environmental health.

Commodity vs Specialty Crops

Through the 2018 Farm Bill, the US government only subsidizes five commodity crops — corn, soy, wheat, cotton, and rice, some of which are processed as livestock feed to produce cheaper meat and dairy products. Because farmers rely on government payments for economic stability, they typically choose to plant crops that the farm policy encourages them to grow.

Unfortunately, these subsidies mainly support high-income corporations and agribusinesses and often exclude small rural farmers.

In a study published in the Journal of Hunger and Environmental Nutrition, researchers found that 70–80% of all farm subsidies are directed toward commodity crops, covering a total of 74% of US cropland.

Farmers who grow specialty crops such as fruits, vegetables, tree nuts, and horticulture and nursery crops, including floriculture, “are not eligible for direct subsidies and are penalized if they have received federal farm payments for other crops,” the researchers wrote. “In addition, large farms, which make up only 7% of the total, receive 45% of all federal payments. Meanwhile, small farms, which are 76% of the total, receive just 14% of the payments.”

This inequitable policy results in a government-structured food supply chain that heavily favors only a few crops grown by large-scale farming operations that fail to fulfill the appropriate dietary needs of the human population.

Adult and Childhood Obesity

As found in the State of Obesity 2022 report by Trust for America’s Health, between 2017 and 2022, nearly half (41.9%) of all adults in the United States were obese. This percentage marks a substantial increase in obesity rates between 1999 and 2000, which were 37% lower.

Roughly $170 billion in healthcare spending — around 20% of all healthcare spending in the US — annually is linked to obesity-related health conditions in adults and children, such as diabetes, high blood pressure, depression, and stroke, among others.

Beyond decreasing life expectancy, obesity can also limit physical function, impact energy levels, and increase the risk of other chronic conditions that reduce the quality of life. These chronic conditions may include type 2 diabetes, heart disease, stroke, cancer, asthma, and other respiratory illnesses.

As a result, many patients who are obese spend 30–40% more on healthcare due to an increased likelihood of comorbid conditions. Unfortunately, patients who are obese tend to forgo regular checkups due to fear of judgment, resulting in the unmanaged progression of these related illnesses.

While childhood obesity rates are not as high as adult obesity rates, from 2017 to 2022, nearly 20% of children in the US were obese. While varying in magnitude, the rising rates have appeared across all age, sex, racial, and geographical groups, indicating that this is a widespread public health issue.

As a StatPearls study indicates, “Obesity is an alarmingly increasing global public health issue. Several countries worldwide have witnessed a double or triple escalation in the prevalence of obesity in the last three decades, probably due to urbanization, sedentary lifestyle, and increased consumption of high-calorie processed food.”

Dietary Health

According to the NIH, eating a healthy diet high in vitamins and minerals and limiting the intake of added sugar, saturated fats, salt, and processed food is one of the best ways to prevent or delay health complications. However, due to the high cost of fruits, vegetables, whole grains, beans, seeds, nuts, and fish, sticking to a healthy diet can be challenging and expensive in America due to restricted access and the lack of federal subsidies.

Even though the NIH and other health organizations recommend a diet rich in fruits and vegetables, less than 4% of the total cropland in the US was reserved for growing these commodity crops in 2004.

In 2013, roughly only 2% of US farmland was devoted to growing fruits and vegetables, while 59% was used to grow commodity crops, according to Kranti Mulik, Senior Economist with the Union of Concerned Scientists.

This unfortunate trend and year-long demand for fresh produce have led to a consolidated system that depends on importing fresh fruits and vegetables from over 125 different countries, including Mexico and Canada. In 2019 alone, the US imported almost two-thirds of its fresh fruit and one-third of its fresh vegetables.

Food Safety

Because the current US farm policies encourage a highly centralized system that relies on large amounts of imported food, fresh food travels many miles. It passes through countless hands before reaching our mouths, and each transport stage presents a new opportunity for food contamination.

Foodborne Pathogens

To encourage rapid growth in cattle production, large quantities of grain are used as feed — a practice known to alter the acidity of the digestive system, making cattle more vulnerable to pathogenic strains of E. coli. As a result, inadequate manure treatment practices leading to contaminated fields, water sources, or slaughtered livestock are often suspected sources of pathogenic outbreaks.

Each year in the US, foodborne pathogens trigger roughly 76 million illnesses, 325,000 hospitalizations, and 5,000 deaths.

Antibiotic Resistance

To combat bacteria and maintain livestock health, many operations administer several antibiotics that impact public health and exacerbate the growing antimicrobial resistance concern. The use of antibiotics in animals may increase the risk of “transmitting drug-resistant bacteria to humans either by direct infection or by transferring resistance genes from agriculture into human pathogens,” researchers caution.

By 2050, researchers have predicted that antibiotic resistance will cause 10 million deaths annually, surpassing cancer as the leading cause of global mortality.

Environmental Health

Mass production and highly centralized agribusinesses are more likely to result in environmental damage that leads to rising healthcare costs. For example, fossil fuels are commonly used to manufacture and transport fertilizer, pesticides, and other essential resources over long distances, producing additional greenhouse gas emissions and air pollutants.

Animal waste is expensive to transport, store, and dispose of without on-site sewage treatment plants. Instead, many operations rely on problematic storage pits that can leach into groundwater and streams, especially during storm flooding.

In addition to antibiotics, several other components used in animal feed pass through the animal and into the surrounding environment as manure, such as carcinogenic heavy metals (arsenic), nitrogen, and phosphorus. Manure also contains contaminants such as mold, dust, bacteria, and bacterial endotoxins.

Unfortunately, widely accepted livestock waste management practices do not effectively protect water resources from contamination with excessive nutrients, microbial pathogens, and pharmaceutical chemicals.

Accordingly, healthcare professionals are encouraged to advocate for patient health by seeking a change in agricultural support to help produce nutrient-dense foods locally, promote sustainable practices and healthy lifestyles, limit pollution, and reduce inequalities.

As stated in the UN report, “continuing with support-as-usual will worsen the triple planetary crisis and ultimately harm human well-being.”

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