The determinants of health
Food and Agriculture
Agricultural production issues and manufacturing
- Tobacco farming and its impact on heart disease, stroke, certain cancers and chronic respiratory disease. Including passive smoking and impact of foetal development. Pesticide policies on tobacco crops require consideration.
- Changes in land use, soil quality, choice of crop, use of agricultural labour and occupational health.
- Mechanisation of work previously done by hand, and plantation agriculture.
- Fisheries – biotoxins, pollution, chemical use, wastewater, processing, and occupational health
- Forestry – vector borne diseases, occupational health, and food security.
- Livestock use – vector borne diseases, drug residues, animal feed, waste, and food security.
- Sustainable farming including chemical and energy use, biodiversity, organic production methods, and diversity of foods produced.
- Fertiliser use – nitrate levels in food, pollution of waterways, re-use of agricultural waste.
- Water – irrigation use and its impact on river/water-table levels and production outputs.
- Pesticide usage and veterinary drugs– legal requirements, best practice, consumer issues.
- Food packaging, preservation and safety, and avoidance of long storage and travel.
Access to, and distribution of food
- Household food security – appropriate food being available, with adequate access and being affordable (location of markets, supermarkets and closure of small suppliers creating food deserts in cities).
- Food supplies, including national and regional food security, and regional production.
- National food security – able to provide adequate nutrition within a country without relying heavily on imported products
- Cold-chain reliability – the safety of transporting products that deteriorate microbiologically in the heat.
Dietary patterns, diversity of food available and home production, particularly:
- Fruit and vegetable consumption on reduced stroke, heart disease and risk of certain cancers,
- Total, saturated and polyunsaturated fat, carbohydrates and sugars consumption on obesity, heart disease, stroke and other vascular diseases.
- Alcohol consumption and impact on social effects related to behaviour (traffic accidents, work/home accidents, violence, social relations, unwanted pregnancy and STDs), and toxic effects (all-cause mortality, alcoholism, certain cancers, liver cirrhosis, psychosis, poisoning, gastritis, stroke, foetal alcohol syndrome and others).
- Micronutrients such as iron, vitamin A, zinc and iodine and their impact on deficiency syndromes.
Food safety and foodborne illness hazzards
Food and water are the major sources of exposure to both chemical and biological hazzards. They impose a substantial health risk to consumers and economic burdens on individuals, communities and nations.
- Microorganisms such as salmonella, campylobacter, E. coli O157, listeria, cholera.
- Viruses such as hepatitis A, and parasites such as trichomonosis in pigs and cattle.
- Naturally occuring toxins such as mycotoxins, marine biotoxins and glycosides.
- Unconventional agents such as the agent causing bovine spongiform encephalopathy (BSE, or "mad cow disease"),
- Persistant organic pollutants such as dioxins and PCBs. Metals such as lead and mercury.
- New foods developed from biotechnology such as crops modified to resist pests, changes in animal husbandry, antibiotic use and new food additives.
Documents on the evidence of food and agriculture
Public health aspects of the EU Common Agricultural policy
- HIA on Food, Nutrition and Agriculture in Slovenia - Appendix 4
- WHO/FAO release independent Expert Report on diet and chronic disease
- The World Health Report - 2002 Geneva, WHO
Report of the panel on food and agriculture
- WHO - Food Safety web site
- The US Food Safety Research Information Office
- Social Determinants of Health: the solid facts
- WHO, Concern for Europe’s tomorrow