Food Sustainability


How our food is produced and what types of foods we’re consuming can have significant impacts on our environment. Nurses can play a key role in reducing these impacts through their own choices, client education, and being involved in the food choices available at their medical facility. Listed below are some of the challenges of our current food system that can impact health, including antibiotic resistance, farmworker exposures, industrial farming, access to fresh fruits and vegetables and the decline of the bee population due to pesticide use.

Food Systems Impact on Public and Environmental Health

While food is essential for health, the way our food is produced places strain on natural resources such as land and water. Attempting to balance feeding a larger population, while ensuring minimal environmental impacts will be a pressing issue facing the sustainability of our food systems. In addition, due the abundance of processed and fast foods, our diets tend to consist of low nutrient and calorie-dense contact foods that increase risk for diet related illnesses, such as obesity, heart disease, and diabetes.

Read the Institute of Medicine’s report: Sustainable Diets: Food for Healthy People and a Healthy Planet: Workshop Summary for a discussion on how food production impacts public and environmental health.

Watch the movie “Dirt!” to learn more about how agriculture practices are impacting the most essential component of food production.

Visit the Food and Agriculture Organizations of the United Nations’ website to learn more about how food sustainability is being addressed globally to ensure food security and access to  healthy foods.

View Food Tank’s list of 116 organizations that are working to create a more sustainable global food system.

Here are further resources on how current dietary factors impact health:

The Secrets of Sugar (short film documentary)

Interview with Michael Moss, bestselling author of “Salt, Sugar, Fat: How the Food Giants Hooked Us”

Interview with Michael Pollan discussing the disconnect between food production and consumption, and the lack of transparency in the food industry. Also, an author of multiple books on food and agriculture including “The Omnivore’s Dilemma: A Natural History of Four Meals” and “Food Rules: An Eater’s Manual”

Industrial Farm Animal Production

Farming practices over the last century have shifted from small family owned farms to large-scale industrial farms housing large amounts of animals in often confined and unhygienic conditions. Large-scale industrial farms and Concentrated Animal Feeding Operations (CAFOs) have become a mainstay in the agricultural industry as the demand for mass produced meats has increased. Industrial farming poses risks to public and environmental health, along with concern for animal welfare and safety of the food supply.

For further information on this topic, visit the PEW Commission’s report on industrial farm animal production.

Read the Environmental Working Group’s report on meat production and how choices impact climate, environmental, and health.

Antibiotic Use in Food Producing Animals

It is estimated that 70% of medically-important antibiotics sold in the United States are used in food producing animals. The addition of medically-important antibiotics has become common practice to offset crowded and unhygienic conditions often encountered in industrial farming. Antibiotics are added at routine and low doses to animal feeds for the purpose of preventing disease and promoting growth. Since doses are given at subtherapeutic levels, an ideal environment for the proliferation of antibiotic resistant bacteria is created. Resistant bacteria can then spread to humans through contamination of food supply, farm worker exposure, and environmental contamination of land, air, and water further exacerbating the global crisis of antibiotic resistance in humans. For further information, read the chapter in ANHE’s etextbook on Antibiotic Use in Agriculture.

Visit CDC’s website for more information on how antibiotic resistance can spread to humans from food producing animals.

Visit the Natural Resources for Defense Council’s website for more information on misuse of antibiotics in agriculture and what can be done to combat this issue.

Read Food and Water Watch’s report “Antibiotic Resistance 101: How Antibiotic Misuse on Factory Farms Can Make You Sick”.

Pesticide Use in Agriculture and Impacts  

Pesticides are commonly used in agriculture to minimize pests to improve crop yields and agriculture productivity. However, there are long term environmental impacts that result from the overuse of these chemicals. Pesticides have been shown to be carcinogenic as well as causing problems with our nervous system, endocrine system and lungs when inhaled. Pesticides infiltrate our groundwater supply polluting our water, contaminate our food, and create increased risk of exposure for farm workers. In addition, the use of neonicotinoids, a commonly used insecticide in agriculture, has been linked to a phenomenon called colony collapse disorder and subsequent decline in bee populations. This is concerning as bees are necessary for pollination of crops and for a thriving food environment.

Visit EPA’s website for further information on pesticide use in agriculture and ways to maintain safety for public and environmental health.

Review ANHE’s E-textbook Environmental Health in Nursing for more information on how pesticide use in farming, commercially, and homes can impact health.

Visit EPA’s website for information on how pesticide use is impacting bee populations and for an overview of colony collapse disorder.

Read this one-page article with additional information on the public health implications of bee decline globally.

Farmworker Justice

Our food system is dependent of the use of farmworker’s to ensure an adequate food supply, however farm workers face many challenges and environmental justice concerns as a result of working conditions.  Threats to health include working in strenuous conditions, lack of employment protections, exposure to pesticides and other toxic chemicals, and lack of access to health care.

For more information about the challenges facing farm worker’s visit Farmworker Justice’s website to read the latest reports on farmworker safety in agriculture.

Read about the issues facing farmworkers and the proposed changes to policy and regulations to address these concerns in the report “Justice in the Fields”.

Food Access and Insecurity

Access to quality, affordable and nutritious food is critical to promoting health across populations. However, food access remains a significant barrier to healthy eating in the United States today. Food deserts, communities with limited access to healthy and affordable food options, are greatly impacting the health of children and families. Certain populations, such as low-income, minority, and urban communities are more at risk for experiencing food insecurity and poor diets due to financial constraints, transportation limitations, and environmental factors, such a limited healthy food options in communities and the overabundance of food outlets offering minimal healthy options. Nurses can help address food insecurity and access through identifying community risk and working to implement interventions such as farmer’s markets that accept SNAP, community gardens, and adding healthy food options to local stores in food desert neighborhoods.

Visit the USDA’s website for the latest information on food insecurity and key statistics in the United States.

Review the Johns Hopkins Center for a Liveable Future’s survey of the scientific literature on food security in United States cities.

To learn more about community interventions to address food insecurity, review information on  community gardens and healthy stores initiatives.

Promoting Food Sustainability in Healthcare

As large purchasers and suppliers of food to patients, staff, and visitors, the choices healthcare facilities make when determining food options to serve can impact market-based change. By choosing to serve sustainable foods, such as meats produced without the routine use of antibiotics, local and if possible organic fruits and vegetables, and food produced in an environmentally friendly manner can both lower the facilities carbon footprint and lead the transition to a more sustainable food system.

Utilize Health Care Without Harm’s website for information on healthy food in healthcare and how the health sector can be a driver of change.

Read HCWH’s reports “Redefining Protein: Adjusting Diets to Protect Public Health and Conserve Resources” and “Seasonal Foods: A New Menu for Public Health” for information on how healthcare facilities can adjust menus to promote environmental and public health.