Statement by Partnership for a Healthier America to the United Nations Food Systems Summit 2021

Partnership for a Healthier America (PHA), the premier food equity organization in the United States, joined nations, companies and other non profits in affirming the statement by UN Secretary General Antonio Guterres in calling for a reform of the food system to better address hunger, climate and conflict.

But while working toward these critically important goals that he emphasized, we absolutely cannot fail to leverage the food system for better global health for all.

Obesity and diet-related disease should be considered urgent global health priorities. More than a quarter of the population in 53 countries suffer from obesity including Canada, Chile, Dominican Republic, Hungary, Israel, Mexico, New Zealand, South Africa, Turkey, the United Kingdom and the United States. Obesity kills people, diminishes quality of life and poses an enormous economic burden globally. It is not just a problem for developed countries. A study published in The Lancet in 2014 found that one-third of the world’s population is now overweight or obese, and 62% of these individuals live in developing countries.

There are two dangerous misunderstandings about obesity and diet-related disease that serve as obstacles to solving these urgent problems:

1. A misguided belief that obesity results from a lack of personal discipline. Rather, it is a severe form of malnutrition most often caused by food inequity – a lack of access to foods that build health like fruits, vegetables, legumes, nuts and seeds, coupled with excess exposure to calorie dense, nutrient poor ultra-processed foods. This food inequity results in excess weight, undernutrition, and a greater disease burden.

2. The second is that obesity and diet-related disease are less urgent problems than malnutrition resulting from hunger. This often leads to positioning hunger as a rival of obesity when in fact they are companion problems that are better solved in tandem.

Prevalence of Obesity in the United States & the Link to COVID-19

Forty two percent of adults and 19.3% of children ages 2-19 in the US live with obesity. Obesity rates across the US have been rising consistently since the 1990’s as have diet-related chronic diseases including hypertension, heart disease, diabetes, and cancer. The national adult obesity rate has increased by 26% since 2008 alone. While most diet-related diseases manifest later in life, recent research has shown that the incidence of the six cancers linked to obesity have increased significantly among people under 50.

The link between rising rates of obesity and diet-related chronic disease alongside the spread of COVID-19 has been referred to as a fast pandemic on top of a slow pandemic, and it is impacting low-income communities and communities of color the hardest. In 2020 life expectancy in the US fell an average of 1.5 years overall, but declined 2.9 years for African Americans and 3 years for Hispanics.

The Economic Burden of Obesity

According to a recently released report from the Rockefeller Foundation, the true cost of food in the US, including the cost to human health and the environment, is $3.2 trillion, three times higher than direct supply chain expenses.

Adults with obesity spend 42% more on direct healthcare expenses than peers at a healthy weight. Estimates from the Centers for Disease Control and Prevention and the Agency for Healthcare Research and Quality attribute between 75 and 86% of all US healthcare spending to patients with one or more chronic conditions. Heart disease remains the number one cause of mortality in the US, causing one in every four deaths and costing more than $300 billion per year to treat. Annual healthcare costs related to diabetes and obesity equal $604 billion and $359 billion respectively.

Food as a Determinant of Health

Food is both a primary driver of poor health and an essential tool for preventing, slowing, or, in some cases, reversing the development of diet-related disease. Heart disease, stroke, and type 2 diabetes are diet-driven. Ten foods – eating too much or too little – are at the root of nearly half of US deaths from heart disease, stroke, and type 2 diabetes each year.

A growing body of research supports the adoption of specific dietary patterns to treat or reverse common chronic diseases, including the Dietary Approaches to Stop Hypertension (DASH) developed by the National Heart, Lung, and Blood Institute and plant-based diets which can reverse diabetes and significantly decrease heart disease related mortality.

*Source: Tufts University Friedman School of Nutrition Science & Policy

Hunger and Health in the US

Limited access to healthy, affordable food and an overabundance of cheap, highly processed food influences consumption patterns, particularly among economically disadvantaged individuals. There is a strong link between food insecurity and obesity, with food insecurity being associated with all ten of the chronic diseases measured by the CDC. A USDA report released in June of 2021 found that 88% of Supplemental Nutrition Assistance Program participants faced barriers to eating healthily over the course of the month. The most common environmental barrier, reported by 61% of participants, was price. Participants said they could not afford the foods that are recommended as part of a healthy diet. The lack of affordable healthy food was shown to have the largest adverse effect on the food security status of SNAP households.

PHA’s Vision for Food Equity

PHA envisions a world where every person has a fair chance at education, employment and well-being – each supported by access to good food. There is no true equity in society without health equity; there is no health equity without food equity. Our overarching vision is for every family in the United States to have affordable access to good food. This is food equity. Establishing food equity requires us to capture and build demand for vegetables and fruit and other good food. We must also work to improve and expand the existing supply of that food.

In conclusion, PHA strongly believes in addressing global hunger and hunger in the United States. But we also believe that obesity and diet-related disease are urgent problems that must be addressed at the same time. We do not have the luxury of addressing our world’s global social problems one at a time. We must address them in tandem. PHA believes in ending the two-tiered food system to create food equity. Only when all people have consistent and affordable access to high-quality, nutrient dense foods will we be able to end hunger and its companion problems – obesity and diet related disease.

We urge both Summit leaders and participants to call on governments, corporations and civic society to leverage the food system for health and well-being even as we work to end hunger and improve the climate. We do not have the luxury of working on global social problems one or two at a time.