How Society Subsidizes Big Food and Poor Health.

Abstract

Approximately 80% of calories eaten in the United States are grown domestically.1 Yet, the US diet is a leading cause of morbidity. The analysis by Siegel et al2 in this issue of JAMA Internal Medicine suggests that through commodity subsidies that encourage poor diet we are, in part, paying for our own demise. However, commodity subsidies are a small part of a bigger problem. From 2014 to 2023, the 2014 US Farm Bill will cost $956 billion (letter from D. W. Elmendorf to Frank D. Lucas, chair of the House Committee on Agriculture; http: //www.cbo.gov/sites/default /files/cbofiles/attachments /hr2642LucasLtr.pdf ), of whichdirect support for commodityproduction is only $44.5billionover 10years. Furthermore, among a range of agricultural products, farmers receive the greatest share of the retail price in beef and milk at 50%comparedwithonly7%forprocessed food, suchasbread. So, while processed food prices may be low, commodity subsidies are not the primary cause. To understand better how the Farm Bill affects food consumption in theUnited States, consider theBill’s largest component, namely, support for low-income families to buy food. Although initially introduced between 1939 and 1943, food stampsweremade a permanent part of US social policy in the early 1960s,were joined to farmsupports in the 1970s, andbecame the SupplementalNutritionAssistance Program (SNAP) in 2008. SNAP is now the largest part of theFarmBill, responsible for $756 billion of the spend, and 65million households are eligible for the benefits today, although only 47 million take advantage of it (letter from D. W. Elmendorf to Frank D. Lucas, chair of the House Committee on Agriculture; http: //www.cbo.gov/sites/default/files/cbofiles/attachments /hr2642LucasLtr.pdf). One response has been to see SNAP as away to shapepreferencesamongthosewithlowincomes,whichismisguided.The poorest families spend a greater share of their food budget on fresh fruits andvegetables and cook at home farmore than the richest families.3 Furthermore, such restrictionsmaynotbeeffective. Most important, while the subsidy is a necessary support to families on low incomes, it is also a substantial gift to one of the largest players in the food system. The Wall Street Journal reports that Walmart “rakes in about 18% of total US outlays on food stamps” (http://www.wsj.com/articles /SB10001424052702303843104579168011245171266). As the largest grocery store and therefore the most visited conduit for benefits to support low-income shoppers, Walmart finds SNAP a reliable source of revenue. Assuming the trend continues, $136billionof thenext FarmBillwill be spent at the world’s largest retailer, which points to a more general phenomenon around agricultural subsidies that many of its ultimate beneficiaries are large corporations operating within the food system. The FarmBill supports farmers, although not quite in the way that advocatesof agricultural subsidy reformmight think. Farmer debt has increased since the farm crisis of the mid1980s. Subsidies are vital for highly indebted farmers to pay their creditors. Not all farmers benefit from government support: previous FarmBills have supported approximately 40% of US farmers, with the rest being ineligible for subsidy. Although some among the beneficiaries are larger-scale enterprises,manyarenot.Yankingaway the incomeonwhichmany depend will do little to help andmay cause harm. Our foodpoliciesmustalso take farmworkers intoaccount. Agricultural laborersearnameanannualsalaryof$19300inthe United States.4 Farmworkers in the United States are not covered by the 1935 National Labor Relations Act (National Labor Relations Act of 1935. [49 Stat 449] 29 USC §151-169), and attempts to unionize can bemet with retaliation or evasion. Althoughrestrictionson the right tounionizearenotadirectpayment fromthegovernment toaparticular industry,production is cheaper becauseofworkers’ lackof legal bargainingpower.5 In everyway thatmatters,workers’ inability to bargain collectively is a subsidy to the industry inwhich theywork. It reduces thepriceofcommodity foodandmakessuchfoodcheaper.But, ifweopen thedoor toabroaderunderstandingof subsidy—and weshould—thenweareforcedtoconsiderother instanceswhere the food industry benefits from social subsidies. Related article page 1124 Research Original Investigation Consumption of Subsidized Foods and Cardiometabolic Risk in US Adults