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Unravelling the food-health nexus: Addressing practices, political economy, and power relations to build healthier food systems

This report from the International Panel of Experts on Sustainable Food Systems and the Global Alliance for the Future of Food describes food systems as a series of complex and interconnected pathways that have significant human and economic costs. However, the health impacts of food systems are often seen in isolation from one another rather than as a result of a set of symbiotic and interdependent activities.

This extensive report advocates for a cross-sector coordinated dialogue about the interconnectedness of food system pathways to position health at the centre of food system activities and policy.

Pathways between food systems and health impacts

Food systems may impact health through five key pathways:

  1. Occupational hazards for farmers, food and agriculture workers
  2. Environmental contamination that impacts nature and people
  3. Contaminated, unsafe and altered food that results from pathogens and other means by which foods are made unsafe to consume
  4. Unhealthy dietary patterns due to unhealthy food environments that shape eating behaviours
  5. Food insecurity resulting from the inability to access food due to financial and other constraints

Opportunities for public health to build healthier food systems

The report highlights five opportunities to build healthier food systems through collective action and understanding.

Within practice and policy, public health can:

  1. Promote food systems thinking. This includes building greater understanding of complex connections between food system activities and human and ecological health.
  2. Reassert scientific integrity and research as a public good. This includes paying attention to scientific knowledge about the health impacts of food system activities and considering different forms of research and knowledge to inform policy decisions.
  3. Bring alternatives to light. This involves documenting alternative food system activities to improve health outcomes.
  4. Adopt the precautionary principles. This includes intentional action by weighing the evidence on relative risk and health-promoting factors.
  5. Build integrated food policies under participatory governance. This includes integrated approaches to food policy that align with sustainable and healthy food system outcomes. 

Power imbalances are a key influence in food systems. At the individual level, food workers may experience an imbalance of power dynamics through unsafe working conditions that results in health risks at various points across the food system. At the organizational level, non-industrial food systems lack power compared to large-scale industrial food systems, which creates barriers for smaller-scale agricultural activities and communities to influence narratives around food and food policy.

Building healthier food systems, therefore, involves redistributing power and changing the way food systems are operated more broadly, in addition to addressing individual food system activities.

Use this resource to

  • Deepen understanding of the political, economic, environmental and power aspects of food systems
  • Facilitate discussion about compounding factors of food systems and channels of impact on human and ecological health outcomes
  • Increase knowledge about how non-health sectors influence food system impacts on health, including transportation, agriculture, trade, politics, employment and economics

Alignment with NCCDH Work:

Food systems impact health and well-being and should be considered by public health in policy and practice. The NCCDH is exploring food systems as a determinant of health and examining public health’s role in building healthier, more sustainable and just food systems.

The 2024 resource Determining Health: Food systems issue brief is the first NCCDH resource to explore this topic.

Several NCCDH resources explore power dynamics and working conditions as determinants of health, calling for a redistribution of power to advance health equity.


Related resources:

Niagara Region adapts their COVID-19 response to prioritize seasonal agricultural workers. Equity in Action

Podcast episode transcript & companion document: Disrupting food insecurity & fat phobia (Mind the Disruption, Season 1, Episode 5)


International Panel of Experts on Sustainable Food Systems (IPES-Food). (2017). Unravelling the food-health nexus: Addressing practices, political economy, and power relations to build healthier food systems. Global Alliance for the Future of Food; IPES-Food.

Tags: Food security, Structural determinants, Document, Report / Document