EXPLORING HEALTH AND ENVIRONMENTAL

COSTS OF FOOD

WORKSHOP SUMMARY

Leslie Pray, Laura Pillsbury, and Maria Oria, Rapporteurs

Food and Nutrition Board

Board on Agriculture and Natural Resources

INSTITUTE OF MEDICINE AND
NATIONAL RESEARCH COUNCIL
                         OF THE NATIONAL ACADEMIES

THE NATIONAL ACADEMIES PRESS

Washington, D.C.

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Leslie Pray, Laura Pillsbury, and Maria Oria, Rapporteurs Food and Nutrition Board Board on Agriculture and Natural Resources

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THE NATIONAL ACADEMIES PRESS  500 Fifth Street, NW  Washington, DC 20001 NOTICE: The project that is the subject of this report was approved by the Govern- ing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineer- ing, and the Institute of Medicine. This activity was supported by Contract/Grant No. 200-2011-38807, Task Order 4, between the National Academy of Sciences and the Centers for Disease Control and Prevention. The views presented in this publication do not necessarily reflect the views of the organizations or agencies that provided support for the activity. International Standard Book Number-13: 978-0-309-26580-5 International Standard Book Number-10: 0-309-26580-0 Additional copies of this report are available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu. For more information about the Institute of Medicine, visit the IOM home page at: www.iom.edu. Copyright 2012 by the National Academy of Sciences. All rights reserved. Printed in the United States of America The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent ad- opted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin. Cover credit: Image designed by Casey Weeks. Suggested citation: IOM (Institute of Medicine) and NRC (National Research Coun- cil). 2012. Exploring health and environmental costs of food: Workshop summary. Washington, DC: The National Academies Press.

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The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Acad- emy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding en- gineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineer- ing programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Charles M. Vest is presi- dent of the National Academy of Engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Insti- tute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine. The National Research Council was organized by the National Academy of Sci- ences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Coun- cil is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Charles M. Vest are chair and vice chair, respectively, of the National Research Council. www.national-academies.org

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PLANNING COMMITTEE ON EXPLORING THE TRUE COSTS OF FOOD: A WORKSHOP1 HELEN H. JENSEN (Chair), Professor, Department of Economics, Center for Agricultural & Rural Development, Iowa State University, Ames BILLY COOK, Senior Vice President and Director, Agricultural Division, The Samuel Roberts Noble Foundation, Ardmore, OK JUSTIN D. DERNER, Rangeland Scientist, Agricultural Research Service, U.S. Department of Agriculture, High Plains Grasslands Research Station, Cheyenne, WY GREGORY A. KEOLEIAN, Professor and Director, Center for Sustainable Systems, University of Michigan, Ann Arbor CATHERINE L. KLING, Professor, Department of Economics, Iowa State University, Ames ROBERT S. LAWRENCE, Professor, Environmental Health Sciences, Health Policy, and International Health, and Director, Center for a Livable Future, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD AARON WERNHAM, Director, Health Impact Project, The Pew Charitable Trusts, Washington, DC WALTER C. WILLETT, Professor of Epidemiology and Nutrition, Harvard School of Public Health, Boston, MA IOM and NRC Staff MARIA ORIA, Study Director LAURA PILLSBRY, Program Officer ALLISON BERGER, Senior Program Assistant EMILY TOMAYKO, Mirzayan Science & Technology Policy Fellow ANTON L. BANDY, Financial Officer GERALDINE KENNEDO, Administrative Assistant LINDA D. MEYERS, Director, Food and Nutrition Board ROBIN SCHOEN, Director, Board on Agriculture and Natural Resources 1  Institute of Medicine planning committees are solely responsible for organizing the work- shop, identifying topics, and choosing speakers. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution. v

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Reviewers T his workshop summary has been reviewed in draft form by indi- viduals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent re- view is to provide candid and critical comments that will assist the institu- tion in making its published workshop summary as sound as possible and to ensure that the workshop summary meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this workshop summary: John Blanton, Agricultural Research Programs Manager, The Samuel Roberts Noble Foundation, Ardmore, OK James K. Hammitt, Professor of Economics and Decision Sciences, Center for Risk Analysis, Harvard University, Boston, MA Molly Jahn, Professor, Department of Agronomy, University of Wisconsin–Madison Shiriki K. Kumanyika, Professor of Epidemiology and Associate Dean for Health Promotion and Disease Prevention, University of Pennsylvania School of Medicine, Philadelphia Stephanie Mercier, Agricultural Policy Consultant, Alexandria, VA Liz Wagstrom, Chief Veterinarian, National Pork Producers Council, Washington, DC vii

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viii REVIEWERS Although the reviewers listed above have provided many constructive comments and suggestions, they did not see the final draft of the work- shop summary before its release. The review of this workshop summary was overseen by John W. Erdman, Jr., University of Illinois at Urbana- Champaign. Appointed by the Institute of Medicine, he was responsible for making certain that an independent examination of this workshop summary was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this workshop summary rests entirely with the authors and the institution.

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Contents 1 INTRODUCTION 1 Organization of This Report, 4 References, 6 2 THE ECONOMICS OF FOOD PRICES 7 Determining the Market Price of Food, 7 The Concept of Externalities: Costs and Benefits Not Reflected in Market Prices, 9 Things to Keep in Mind About the External Costs of Food, 10 Questions, 11 References, 12 3 UNDERSTANDING MEASURES AND STRATEGIES 13 Life Cycle Assessment, 14 Health Impact Assessment, 20 Environmental Consequences, 24 Public Health Consequences, 28 References, 33 4 EXAMINING SOCIAL AND ECOLOGICAL COSTS AND BENEFITS 35 Agricultural Ecosystem Services and the Costs of Food Production, 36 Impact of the Food System on Health Inequalities, 39 Accessibility to Food, 42 ix

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x CONTENTS Animal Welfare, 45 References, 49 5 ATTACHING VALUE TO COSTS AND BENEFITS 53 Lessons from The Hidden Costs of Energy: Unpriced Consequences of Energy Production and Use, 54 Valuing Agricultural Externalities and Public Health Impacts, 61 References, 66 6 EXPLORING COSTS AND BENEFITS 67 Effects of Food Production, Processing, and Consumption on GHG Emissions and Energy Use, 69 Soil, Water, and Other Environmental Consequences of Food Production, Processing, and Consumption, 72 Consequences of Antimicrobial Use in Agriculture, 74 Public Health Effects, 76 Major Overarching Themes of Working Group Discussions, 80 References, 81 7 REFLECTING ON THE PATH FORWARD 83 Are Externalities the Best Way to Frame the Problem?, 83 Trade-Offs Associated with Different Scales of Animal Production, 85 Uncertainty About the Magnitude of Some Effects, 86 Opportunities for More Data and Research, 87 The Daunting Challenge of Measuring “the” Cost of Food, 88 Wrap-Up, 89 References, 90 APPENDIXES A Workshop Agenda 91 B Speaker Biographical Sketches 95 C Workshop Attendees 101 D Abbreviations and Acronyms 105