A public health approach to the US food system Introduction to the US Food System: Public Health, Environment, and Equity is a comprehensive and engaging textbook that offers students an overview of today's US food system, with particular focus on the food system's interrelationships with public health, the environment, equity, and society. Using a classroom-friendly approach, the text covers the core content of the food system and provides evidence-based perspectives reflecting the tremendous breadth of issues and ideas important to understanding today's US food system. The book is rich with illustrative examples, case studies, activities, and discussion questions. The textbook is a project of the Johns Hopkins Center for a Livable Future (CLF), and builds upon the Center's educational mission to examine the complex interrelationships between diet, food production, environment, and human health to advance an ecological perspective in reducing threats to the health of the public, and to promote policies that protect health, the global environment, and the ability to sustain life for future generations. Issues covered in Introduction to the US Food System include food insecurity, social justice, community and worker health concerns, food marketing, nutrition, resource depletion, and ecological degradation. * Presents concepts on the foundations of the US food system, crop production, food system economics, processing and packaging, consumption and overconsumption, and the environmental impacts of food * Examines the political factors that influence food and how it is produced * Ideal for students and professionals in many fields, including public health, nutritional science, nursing, medicine, environment, policy, business, and social science, among others Introduction to the US Food System presents a broad view of today's US food system in all its complexity and provides opportunities for students to examine the food system's stickiest problems and think critically about solutions.

Roni Neff, PhD, is an assistant professor in the Department of Environmental Health Sciences at the Johns Hopkins Bloomberg School of Public Health, with a joint appointment in Health Policy and Management. She directs the Food System Sustainability Program at the Johns Hopkins Center for a Livable Future. She teaches courses on Baltimore's food system and food system environmental sustainability, and lectures frequently in other classes and around the country. She has received multiple recognitions for teaching and service-learning. Her research interests include food waste, urban food system resilience, and farm policy.

List of Figures and Tables ix Introduction xvii Acknowledgments xxv About the Editor xxvi Author Affiliations xxvii About the Center for a Livable Future xxxiii Chapter 1 Food Systems 1 Roni A. Neff and Robert S. Lawrence The Food System as a System 2 Focus 1.1. Complex Adaptive Systems 5 Focus 1.2. Food in the Food System 6 Public Health 8 The US Food System: An Overview 9 Perspective 1.1. When Your Boat Rocks, You Want Resilience Not Efficiency 12 Focus 1.3. Principles of a Healthy, Sustainable Food System 14 PART 1 OUTCOMES 23 Chapter 2 Food System Public Health Effects 25 Brent F. Kim and Jennifer L.Wilkins Dietary Health 26 Perspective 2.1. Gut Bacteria, Diets and Inflammation 28 Occupational and Environmental Health 33 Focus 2.1. Pesticides and Children's Health 35 Focus 2.2. Food System Workers at Risk 39 Food Safety 40 Focus 2.3. Bisphenol-A: A Ubiquitous Food System Contaminant 42 Chapter 3 Ecological Threats to and from Food Systems 51 Molly D. Anderson Status of Natural Resources and Ecosystem Services Essential to Food Systems 53 Focus 3.1. Assessing Ecological Integrity of Food Systems 54 Focus 3.2. Farmland Protection 57 Focus 3.3. Virtual Water and Food Systems 60 Processes Through Which Ecological Health isThreatened 64 Moving Toward More Environmentally Sustainable Practices 68 Perspective 3.1. A Farmer'sThoughts on Defining Sustainable Farming 70 Perspective 3.2. Consumer Perceptions of Environmentally Sustainable Foods 73 Chapter 4 The Food System and Health Inequities 79 Roni A. Neff, Anne M. Palmer, Shawn E. McKenzie, and Robert S. Lawrence Health Inequities and Food Systems in the United States 81 Perspective 4.1. Foodies on a Mission 84 Elaborating the Pathways 85 Perspective 4.2. Realizing Justice in Local Food Systems 90 Perspective 4.3. The People Who Touch Your Food 93 Perspective 4.4. Contract Chicken Farming 94 Perspective 4.5. Food, Equity, and Health: Making the Connections in Public Health Practice 97 Chapter 5 Public Health Implications of Household Food Insecurity 107 Mariana Chilton, Amanda Breen, and Jenny Rabinowich Definition, Distribution, and Determinants of Food Insecurity 108 Perspective 5.1. Witnesses to Hunger: Participation byThose Who Know Poverty and Hunger Firsthand 112 Nutrition Assistance Programs 114 Perspective 5.2. The Wrong Path Forward: Restricting Food Choices in SNAP 118 Perspective 5.3. A Defense of Excluding Foods of Minimal Nutritional Value from SNAP 119 Perspective 5.4. The Public Health Case for Universal Free School Meals 121 Focus 5.1. What Do People Do When They Are Worried about Feeding Their Families? 124 Broader Perspectives 125 Chapter 6 Community Food Security 135 Anne M. Palmer,Wei-Ting Chen, and MarkWinne History and Evolution of CFS 137 Focus 6.1. Food Hubs: Supporting Healthy Farms, Healthy People, Healthy Economy 139 Measuring Community Food Security 141 CFS Policies at Multiple Levels 144 How Does CFS Change Happen? 146 Focus 6.2. Case Study: Iowa Food Systems Council, a Second-Generation Food Policy Council 147 CFS and Public Health 148 Challenges for the CFS Field 148 Perspective 6.1. The City That Ended Hunger 150 PART 2 DRIVERS OF THE FOOD SYSTEM 157 Chapter 7 Food System Economics 159 Rebecca Boehm, Sean B. Cash, and Larissa S. Drescher Economics Boiled Down: Models, Optimization, Equilibrium, and Social Optimality 160 Agriculture and Food Production 163 Food Manufacturing and the Food Supply Chain 168 Focus 7.1. Price Transmission in the Distribution System: Retail Responses to Supply Price Changes 170 Food Consumption 171 Focus 7.2. US Farm Subsidies Do Not Make Americans Fat 174 Focus 7.3. Recent Progress in Private Sector Voluntary Initiatives to Promote Healthy Eating 177 Chapter 8 Policies That Shape the US Food System 185 Mark Muller and DavidWallinga Federal Food System Legislation:The Process 189 Focus 8.1. Turning Policy Ideas into Legislative Realities 190 How Alliances Shape Policy 190 Focus 8.2. A Brief Look at Agenda-Setting, Policy Analysis, and Food Systems 192 The Policy-Making Process and the Role of Stakeholders: The Farm Bill as an Example 193 The History of US Food and Agriculture Policy: An Overview 194 Perspective 8.1. Why America's Food is Still Not Safe 198 Perspective 8.2. Produce Imports 200 The Politics of Food System Policy:The Farm Bill as an Example 203 How PolicyDrives the Future Food System: The Role of Price 204 State and Local Policy 207 Focus 8.3. Preemption and Local Food and Agriculture Policies 208 Chapter 9 Food, Culture, and Society 215 Sarah Chard and Erin G. Roth Culture and Food 217 Perspective 9.1. Beyond White Bread, a Better Society? 217 Foodways and Identity 219 Food As Ritual 221 Focus 9.1. Food and Faith 222 Food, Healing, and Health Beliefs 225 Food and Gender 226 Food, Power, and Politics: Food Movements 228 Perspective 9.2. Zombies, Food Writing, and Agribusiness Apocalypse 229 Implications For Food Systems 232 Chapter 10 Promotional Marketing: A Driver of the Modern Food System 237 Corinna Hawkes What Are Food Marketing and Promotion? 238 Types of Food Promotion 239 Focus 10.1. "Supermarketing" and the Impact on Food Choice 240 Segmentation and Targeting in Food Promotion 242 Focus 10.2. POP! Point-of-Purchase Nutrition Labels Are Everywhere: Who Benefits? 244 Extent of Food Promotion 245 Where Promotional Marketing Fits Into the Modern Food System 246 Dietary Effects of Promotional Marketing 250 Perspective 10.1. Front Groups: Who is Shaping the Conversation about Health and Wellness? 252 Responses From Government and Industry 253 PART 3 FOOD SUPPLY CHAIN: FROM SEED TO SALES 263 Chapter 11 Crop Production and Food Systems 265 Charles A. Francis History of Farming Systems--From Local to Industrial 266 Traditional Systems in the United States 267 Emergence of an Industrial Agriculture 267 Perspective 11.1. The Relevance of Genetically Engineered Crops to Sustainable Agriculture 269 Industrial Crop Farming: An Overview 271 Focus 11.1. The Proliferation of Corn 273 Farms Producing for Local and Regional Markets 274 Perspective 11.2. A Bright Future for Farmers in the "Middle"? 274 Agroecology and Organic Farming 277 Crop Production--Impacts on Environment, Food Security, Public Health, and Society 278 Chapter 12 Food Animal Production 289 Brent F. Kim, Leo Horrigan, David C. Love, and Keeve E. Nachman Focus 12.1. Seafood Harvest and Production 292 Industrialization of Food Animal Production 294 Perspective 12.1. Husbandry and Industry: Animal Agriculture, Animal Welfare, and Human Health 294 Public Health Impacts of IFAP 300 Focus 12.2. A Case Study in Rural Community Exposures: Yakima Valley, Washington 303 Perspective 12.2. Living in Duplin County 304 Global and Ecological Concerns 307 Agroecological Approaches to Food Animal Production 308 Policy and Dietary Change 309 Focus 12.3. The Pew Commission on IFAP: Policy Recommendations and Barriers to Reform 309 Chapter 13 Food Processing and Packaging 317 George A. Cavender Food Processing 318 Perspective 13.1. Food Technology: Equal Partner for a Healthy Future 321 Perspective 13.2. Ten Food Secrets You Need to Know 323 How Do We Process Foods? 324 Focus 13.1. On the History of Freshness 328 Food Packaging 331 Food Processing and Packaging: Challenges 335 Perspective 13.3. Ultra-Processing and a New Classification of Foods 338 Food Processing and the Environment 340 Chapter 14 Food Distribution 345 EdwardW. McLaughlin and Miguel I. Gómez Primary Segments of the Food Distribution System 348 Evolution of US Food Distribution 352 Perspective 14.1. The Impact of Walmart 353 Perspective 14.2. Walmarting the Food Chain 355 Focus 14.1. The Growth of Private Label Products in the US Supermarket Sector 358 System Trends in Consumer Expenditures 361 Focus 14.2. Regional Food Systems 363 Focus 14.3. Local Food Systems 363 The Future of Retail Food Distribution 365 PART 4 FOOD IN COMMUNITIES AND ON TABLES 371 Chapter 15 Food Consumption in the United States 373 Alanna Moshfegh Changing Eating Patterns 376 Focus 15.1. Methods for Assessing Diets of Individuals 377 Focus 15.2. National Dietary Surveys in the United States 378 Perspective 15.1. The Supersizing of America: A Time for Action 381 Meal Patterns--When We Eat 383 What We Eat 387 Focus 15.3. What about the Food That's Not Eaten? Food Waste in America and Its Ecological Impacts 392 Chapter 16 Nutrition 399 Courtney A. Pinard, Amy L. Yaroch, and Teresa M. Smith Perspective 16.1. Consumer Perspectives 401 What Is Nutrition? 403 Nutrients 101 403 Focus 16.1. The Science behind Food and Addiction and the Potential Impact on the Food System 405 Other Nutrients 411 Other Considerations: Additives and Naturally Occurring Chemicals In Food; Organic Food 416 Perspective 16.2. Reasonable Certainty of No Harm? 416 Public Health Nutrition Approaches 418 Chapter 17 Healthy Food Environments 425 Patricia L. Truant and Roni A. Neff What Is a Food Environment? 426 Focus 17.1. Measuring the Food Environment 429 Equity 431 Perspective 17.1. Connecting Civil Rights to Contemporary Food Justice 434 Homes, Schools, Workplaces 435 Perspective 17.2. Striving for "Food Service for a Sustainable Future" 439 The Built Food Environment 440 Focus 17.2. Is There a Map forThat? Using GIS Maps to Understand Our Food Systems 441 Focus 17.3. Connecting People andTheir Food Systems: Why Gardens Matter 447 Chapter 18 Intervening to Change Eating Patterns: How Can Individuals and Societies Effect Lasting Change throughTheir Eating Patterns? 457 Linden Thayer, Molly DeMarco, Larissa Calancie, Melissa Cunningham Kay, and Alice Ammerman Designing Successful Dietary Change Interventions 460 Focus 18.1. Framing Public Health Messages to Improve Diet: Taking Measures to Avoid Weight Stigma 463 Case Studies 466 Focus 18.2. Meatless Monday: A Simple Idea That Sparked a Movement 467 Focus 18.3. Real Food Challenge 470 Perspective 18.1. Building a Better Food Environment 473 Future Directions For Dietary Change Interventions 477 Glossary 483 Photo Credits 501 Index 511