Institute Insights: May 2020

Contents:

People maintain social distance as they in queue to receive free ration during lockdown in wake of Coronavirus pandemic in Prayagraj, India on Thursday, April 02, 2020. Prabhat Kumar Verma/iStock photo

From the Director

The COVID-19 pandemic has affected virtually every nation. Stay-at-home orders remain in effect in many places, while some countries and U.S. states are beginning to reopen. At this writing, the world has surpassed 4.5 million known cases and 300,000 deaths.

One thing we know is that daily life will never be the same for most of the world’s 7.8 billion people. We don’t know the details of the changes and we don’t have very much hard data, but the stories and pictures are a stark reflection of what people are experiencing right now. 

 So much of the future depends not only on the trajectory of the virus, but on human decisions over the next few months and the next several years. The situation will only worsen without urgent action. 

Bread for the World Institute and our partners who work to end U.S. and global hunger are paying close attention to the immediate shocks to food security and to the predicament of people who were trapped in a hunger crisis when the pandemic began. In countries such as Yemen and South Sudan, large numbers of people are acutely malnourished. Here in the United States, in April, more than one in five households, and two in five with children under the age of twelve, were food insecure. 

The COVID-19 crisis has exposed glaring inequities and vulnerabilities in society and in global and national food supply chains. The need for equity along race, class, gender, and other divides is arguably nearly as important in fighting the pandemic as the need for effective vaccines and treatments—and unlike medical research, building equity is something in which everyone can participate. 

This means that in the midst of this crisis and the need to rebuild, there are also opportunities to fix what is broken and to “build back better.” I reflected on what that might be like in a piece recently published in The Hill.

This month, we are releasing our 2020 Hunger Report, Better Nutrition, Better Tomorrow. The COVID-19 pandemic has shown that food systems are among the things that urgently need to be built back better. Good nutrition is critical to people’s health and to their future education and income potential. It is an integral part of ending hunger. The new Hunger Report offers recommendations to strengthen systems that are essential to improving nutrition outcomes, taking a critical look at food, health, social protection, and education systems. The 2020 Global Nutrition Report, launched this month, takes a close look at inequalities in the global burden of malnutrition and the role of food systems, and it offers recommendations on how to build nutrition equity. 

For society as a whole, the coronavirus has shown that being in better health and having a higher income is associated with better protection from the worst effects of the virus. Those who are older, immune-compromised, or have to work to survive or because their jobs are deemed essential to the survival of the rest of society, are far more at risk. Because of hoarding, lockdowns, and stay-at-home orders, the food supply is also at risk. 

The Hunger Report was finalized just before the news about the coronavirus hit. We had to decide whether to rethink it or to go ahead with it. We decided to go ahead, because what was happening illustrated the inadequacies and shortcomings we had found in the current food system. Nutrition is only an afterthought. All points in the food system exhibit huge inequities, from agricultural workers and low-income producers to restaurant workers and low-income consumers. And the entire system is vulnerable to the effects of climate change. In this month’s issue of Institute Insights, we connect the themes of the report with the current situation. 

As with the Hunger Report released in the midst of the Great Recession, 2010’s A Just and Sustainable Recovery, we hope that the COVID-19 crisis will jolt the United States into finding viable solutions to problems that perpetuate and exacerbate hunger, malnutrition, and food insecurity. The United States can lead the way in building greater equity here at home and supporting developing countries to do the same. 

The coronavirus came suddenly and swiftly. The climate crisis is less noticeable on a day-to-day basis to people in the United States, but the impacts are no less devastating and, in the end, may dwarf the impact of COVID-19. We still have time to do something about it. Fixing the food system is one step in the right direction, one that also comes with long-term benefits for human health and equity. 

Asma Lateef is director of Bread for the World Institute

Asma Lateef is director of Bread for the World Institute.

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Cover photo for the 2020 Hunger Report

Strengthening Food Systems for Nutrition from Farm to Fork

Chapter 1 of the 2020 Hunger Report

By Todd Post

There are so many reasons to be concerned about food systems in light of the COVID-19 pandemic. Most people do not spend a lot of time thinking about the food supply chain, but in the United States, it came to public attention because of unfamiliar sights such as almost empty supermarket shelves. 

The food system includes all the components of how societies organize to feed people. By definition, it is how individuals gain access to a healthy diet. Of course, people’s nutritional status depends on what they eat. Food systems deliver nutrients that are essential to fighting disease. Conversely, food systems that do not function well can instead weaken people’s health and increase their susceptibility to disease. 
 
The Hunger Report analyzes the food supply chain from producers (farmers) to consumers. The goal is to identify opportunities all along the food chain to improve nutrition, and it turns out that there are many such opportunities. The processing link is one example: manufacturers can fortify foods by adding nutrients. Too often, however, they instead reduce the nutrient content by adding corn syrup or other unhealthy ingredients. 

In the United States, we still have a bountiful supply of food—shortages in grocery stores were caused by consumer hoarding, which is a problem on the demand side rather than the supply side. But the longer the pandemic lasts, there is reason for concern about supply.

Meatpacking plants have become hotbeds for the spread of COVID-19. Other foods come from planted crops, which of course must be harvested. A significant share of the agricultural workers on U.S. farms are immigrants or temporary workers. Ninety percent of those here through the “H-2A” visa program come from Mexico. If borders were closed, as is happening in some other countries, the United States could have too few workers to harvest fruits and vegetables—the very foods we need for better nutrition and the foods that few people eat in sufficient quantity. 

Every country is part of a global food system premised on the smooth flow of trade. Disruptions in global supply chains could unleash a rapid surge in hunger and malnutrition in some countries, especially those most dependent on food imports. Bloomberg News reported in April that global hunger could double in the next few months as a result of disruptions in supply chains. 

One component of the worldwide economic downturn now more than a decade behind us (whose U.S. impacts are usually called the Great Recession) was the global food price crisis. Economists consider 2006-2008 to be its main phase, although some of the impacts were most noticeable in 2008 and 2009. The crisis began as the prices of staple grains such as maize and wheat suddenly shot up, in some cases tripling within a few months. Once prices were no longer spiking, they remained volatile. Tens of millions of people joined the ranks of the world’s hungry and malnourished people. The crisis also led to rioting in dozens of countries. 

The hunger crisis was not caused by global food shortages. The main culprit was supply chain disruptions caused by bans on exporting food that were imposed by countries that produce and export surplus food. This is a structural problem that the global food system has done little to solve in the intervening years. There are now reports that some countries have once again begun to restrict food exports. 

The food price crisis was the main reason for the creation of the federal Feed the Future program, thanks in part to Bread for the World members and other anti-hunger activists, who advocated for more support to smallholder farmers in countries dependent on food imports. Through Feed the Future, the U.S. Agency for International Development (USAID) helps equip smallholder farmers with the information and tools they need to be successful and become part of a stronger national food system. This way, countries will have more options during crises. 

Before the food price crisis, agricultural development assistance had shrunk to a fraction of the overall U.S. development assistance portfolio. The vital role of agriculture was not recognized and supported. Bread helped change that. But the COVID-19 pandemic shows how much more needs to be done.

Students at the Wolcott Elementary School in West Hartford, Connecticut  enjoying lunchtime during Agriculture Secretary Tom Vilsack’s visit to outline the U.S. Department of Agriculture (USDA) efforts to raise a healthier generation of Americans - April

Improving Nutrition to Improve Health

Chapter 2 of the 2020 Hunger Report

By Todd Post

The leading causes of death around the world are related to people’s diets. Too much food, not enough food, or not enough food that contains essential nutrients lead to poor health, making people more susceptible to diseases and the complications that may accompany them.

Without good nutrition to boost their immune systems, no individuals are well prepared to survive COVID-19 when it arrives in their community. Diet-related health problems such as diabetes and heart disease also put people at higher risk of dying from the virus.  

People at greatest risk from COVID-19 are already grappling with poorer health, often caused or exacerbated by hunger and malnutrition. In the United States, we see this reflected in the disproportionate numbers of COVID-19 deaths in communities of color. Not only are food insecurity and some vitamin deficiencies more common in communities of color, but more people also suffer from respiratory ailments because their homes are closer to large industrial sources of air pollution. 

Since the beginning of the pandemic, nutrition advocates have been making the point that nutrition is closely connected to diseases, including COVID-19. “If we forget the food system right now, the COVID-19 health crisis will unwittingly use the food system as a catapult to have an even bigger impact on the global burden of disease,” reads a statement  from the Global Alliance for Improved Nutrition. 

From food safety and food security to dietary quality, food systems should ideally be working hand in hand with health systems to reduce hunger and malnutrition. Hands are figurative in "hand in hand," but hands also play a very literal role since handwashing with soap helps prevent the transmission of COVID-19 as well as of diarrheal diseases, aggravated by malnutrition, that continue to kill millions of children each year. Up to 75 percent of people in low-income countries lack access to soap and clean water—an alarming statistic for public health officials trying to prevent COVID-19 from spreading and protect young children from other diseases that can be deadly.    

Health systems are not designed to prevent hunger, and yet hospitals and clinics are where hungry people turn up when their bodies are broken by hunger. Doctors see this but do not often speak out. That is why it is refreshing to see an article, published in the Journal of the American Medical Association, in which three doctors argue that addressing food insecurity during an emergency such as COVID-19 is not only a matter of equity but “a critical strategy to reduce transmission” of the virus. 

The nutrition safety nets that Bread supports, such as SNAP, school meals, and WIC (the Special Supplemental Nutrition Program for Women, Infants, and Children), all enhance public health outcomes. Naturally they accomplishes this more easily if they have enough funding and are straightforward for participants and applicants to access. Bread for the World and other groups are calling for increasing the SNAP benefit by at least 15 percent. When this was done during the Great Recession, the hunger rate among SNAP households fell.  

School meals are such a part of children’s daily lives that we may forget how important they are to public health. Each day, the National School Lunch Program serves more than 30 million children, two-thirds of whom receive free or reduced-price meals. One of the biggest concerns about closures for the sake of public health is how to prevent children who rely on those meals from going hungry. Handling the logistics of transporting and delivering meals is now a major challenge for the food system.

The pandemic has led to school closures around the world. Nearly every country has some form of school meals program, so hundreds of millions of children suddenly stopped receiving the meals they were served at school. For many, they were sometimes the only nutritious meals they had. International support to fill this void is critically important as struggling economies slide into recession.

Fossil fuel power plant. Credit: Sebastian Schlüter

Championing Nutrition in Sustainable Climate-Resilient Food Systems

Chapter 3 of the 2020 Hunger Report

By Todd Post

The Hunger Report considers how food systems contribute to climate change. The global food system is responsible for up to 30 percent of greenhouse gas emissions

This is due primarily to its dependence on fossil fuels. Modern food systems guzzle petroleum, from fertilizers and other chemical inputs used in production, to diesel powered ships and trucks that transport foods around the globe, to the ubiquitous plastics food manufacturers use to preserve freshness.

The deforestation of the Amazon is motivated primarily by the desire to clear the land for cattle grazing. If people in rich countries ate less meat, it could become possible to halt deforestation and/or begin to reforest various areas. Large reforested areas might even be capable of storing or “sequestering” enough carbon dioxide to begin to reverse climate change. The key is in adapting Western-style diets to promote both health and sustainability. 

Deforestation also contributes to human vulnerability to zoonotic diseases. COVID-19 is a zoonotic disease, meaning it is caused by an infectious virus that is carried by wildlife, to whom it may or may not be harmful. Other deadly zoonotic diseases include HIV, Ebola, MERS, SARS, and H1N1.

In the case of COVID-19, bats may have been the original carriers, and an intermediary species that hosted the virus was possibly a type of anteater called a pangolin. Humans clearing vast land areas for food production then came in closer contact with these hosts and contracted the virus themselves. The human species has no immunity to the novel (new to us) coronavirus, which first appeared in people sometime in late 2019 and is obviously harmful. 

In a review of scientific studies covering the last 80 years, researchers found that agricultural practices were responsible for 50 percent of zoonotic diseases, and they wrote that the proportion “will likely increase as agriculture expands and intensifies.”

Factory farming is one vector of transmission of zoonotic disease. Researchers have documented links between commercial poultry systems and the emergence of virulent strains of influenza. Deforestation is probably the agricultural practice most responsible for human vulnerability to zoonotic diseases. Forests are being destroyed primarily to raise cattle or for crops used to feed them. Deforestation is also a main driver of climate change. As most of us probably know, climate change is a result of excess greenhouse gases in the atmosphere.

Fossil fuels can weaken people’s respiratory systems and increase their vulnerability to viral infections. Low-income communities in the United States, especially communities of color, are more exposed to fossil-fuel related air pollution, and as such are more vulnerable to COVID-19 than communities with less exposure. COVID-19 attacks the lungs, with serious cases often leading to death from pneumonia. The mortality rate of children with acute malnutrition (wasting) increases 15-fold if they also have pneumonia.

Climate change is linked to a rise in number and intensity of droughts and severe storms. Water shortages increase the risk of transmission and put children who live in the drought affected regions at higher risk of malnutrition. Presently, several countries in East Africa, the Middle East, and South Asia are enduring unprecedented locust infestations, the result of unseasonable rains caused by climate change. Early rains extended the breeding times for the locusts, leading to massive swarms that are devouring food crops and threatening widespread hunger across the entire region. The food security outlook was already alarming before the emergence of COVID-19.

For the sake of human and planetary health, governments need to make sustainable food systems a core component of international climate agreements. We are overexploiting natural resources at our peril, as COVID-19 and climate change demonstrate. Land, water, climate, and biodiversity are the building blocks of food systems. All food systems have these common building blocks, but all food systems are not created equal when it comes to environmental footprints. Food systems with industrial-scale production practices are more harmful to the environment. 

A migrant workers picks cucumbers on the farm of Ricky Horton and Sherilyn Shepard (brother and sister) on Monday, July 25, 2011, in Blackwater, Virginia, near the border with Tennessee. Laura Elizabeth Pohl for Bread for the World

Advancing Equity for Workers in Food Systems

Chapter 4 of the 2020 Hunger Report

By Todd Post

Covid-19 has made it clear that poorly-paid work in food systems is in fact very valuable. Food systems employ more people than any other sector, but food system jobs are invariably among the lowest-paying in any country. Most of the people who plant, grow, harvest, pack, process, and serve the food consumed around the world do not earn enough to meet their own basic nutritional needs. 

U.S. food workers qualify for federal nutrition programs such as the Supplemental Nutrition Assistance Program (SNAP) at twice the rate of workers in any other sector. In low- and middle-income countries, smallholder farmers and landless agricultural laborers produce the mother lode of food but are the poorest of the poor; they and their children make up the largest share of the global population living in extreme poverty.

During the COVID-19 pandemic, food workers across the food chain remain on the job: planting and harvesting crops, processing food in small and large factories, serving customers in checkout lines, and transporting, stocking, and delivering food. Public health emergencies make it obvious to everyone: food system workers are essential to the food security of everyone. 

To continue to do their jobs day in and day out, despite the danger and anxiety of COVID-19, food system workers need basic employee protections such as health insurance and paid sick leave. But in most countries, few such protections apply to food system workers. These are longstanding fundamental economic inequities. 

So far, it is not at all clear whether governments will update legislation and policies to restructure the labor market for greater equity and take other actions to repair and relaunch the social contract, even in the face of the dire necessities created by a global pandemic. Some U.S. states have made efforts to support the food system workers who are making it possible for the country to function. For example, in Minnesota, grocery store personnel are classified as essential workers and entitled to free child care during the COVID-19 pandemic. 

The food systems of most countries employ large numbers of immigrants. When California ordered residents to shelter in place, farm workers were exempt. They continued to work even though most laborers live in communal housing that is often crowded—ideal conditions for COVID-19 to spread rapidly from person to person. Employers are required to comply with several safety requirements, but there are documented cases of violations, e.g., workers have not been given gloves or access to soap. Nearly half of all U.S. farm workers are undocumented, making them nearly powerless to push for safe working conditions. Cases all over the world reveal that, as in California, COVID-19 makes the most vulnerable people even more vulnerable.

The Hunger Report’s discussion of equity gives further illustrations of exploitation and discrimination in food systems. Some are inequities based on race, particularly in the United States, while others are biases against groups such as indigenous people, undocumented workers, or child laborers. Gender discrimination overlays and magnifies other inequities. Women are the primary actors in the food system as both producers and consumers. They do most of the food-related work, paid and unpaid, at work, in fields and markets, and at home.   

The pandemic is already pushing additional families into extreme poverty.  Supply chains have been disrupted by restrictions on work activities and, in some outbreak areas, high rates of illness among workers. Reductions in agricultural production lead to higher food prices. During the 2013-2014 Ebola outbreak in West Africa, for example, food prices in the affected countries of Liberia, Guinea, and Sierra Leone soared by an average of 24 percent

The impact of COVID-19 and other shocks on nutrition in families is not gender neutral. In poorer families, a significant portion of the household income is already being spent on food, so there are few options when prices increase significantly. Households are forced to use negative or harmful coping strategies such as reducing the size and frequency of meals. In many societies around the world, women and girls are expected to eat last and least, so they are more likely to suffer from hunger and malnutrition. 

Todd Post is senior researcher, writer, and editor with Bread for the World Institute. 

A latino family. Margaret Nea for Bread for the World

Past and Current Health Crises: Why Applying Racial Equity is More Important than Ever

By Christian Martinez

In my previous blog, Equitable Access to Organic Foods: Why It Matters, I emphasized  the urgency of applying a racial equity lens to access to organic foods and other nutritious foods. This could lead to policies that would expand the access of communities of color to foods that are more nutritious. In turn, that would help individuals and families improve their health.

The limited access to healthy food of people living below the poverty line, who are disproportionately people of color, is one factor that helps explain the racial health disparities in diseases such as obesity, diabetes, and heart disease. In order to end hunger by 2030, everyone must have equitable access to healthy, nutritious foods—but this has not yet been achieved. 

COVID-19 is affecting people of color more severely than whites. A virus itself cannot exhibit bias, but the data tell us that so far, people of color have both a greater risk of becoming infected and a greater risk of death if they become ill. African Americans, Latinos, and Indigenous communities all face obstacles that make them more likely to contract and die from COVID-19  than whites, but the greatest disparities impact the African American community. 

National data show that for every 100,000 African Americans, about 26 have died, compared to 11 of every 100,000 Latinos, 10 among Asians, and nine among whites. Moreover, in six states and the District of Columbia, the African American mortality rate is five times the national average mortality rate. The barriers and constraints that structural racism imposes on accessing healthy, nutritious foods, discussed in my earlier blog, helps explain the racial divide in chronic diseases, which in turn helps explain why communities of color have higher rates of infection and death from COVID-19. 

The factors that put people of color at higher risk are not new. We can look to the responses and outcomes of past health crises to guide preparations for future health crises. For example, public health officials reviewing the data after the 2009 H1N1 pandemic could have noticed that mortality rates were strikingly different based on race. The Indigenous, African American, and Latino communities are each a minority of the U.S. population, and their mortality rates from H1N1 were disproportionately high. Compared to their share of the population, four times as many Indigenous people, three times as many African Americans, and twice as many Latinos died. Public health officials could have investigated the causes of these disparities and begun to implement strategies designed to reduce them before the next pandemic—COVID-19, as it turns out. 

Applying a racial equity lens to the disproportionate mortality rates would have drawn attention to the need to reduce underlying racial health inequities. Being in poorer health as a group made communities of color more susceptible to contracting and dying from H1N1. We know that nutrition plays a key role in health. It would have been essential in 2009, and it is even more essential in 2020, to explore problems that played a role, such as inequitable access to healthy food options and possible solutions. Expanding access to healthy foods as a top priority is one action that could have made a difference. 

Nutrition is not the only factor in health disparities, and health disparities are not the only cause of the disproportionate impact of COVID-19. It is equally important to consider access to high-quality health care, population density in neighborhoods, the types of jobs that people of color are more likely to have than whites, access to protective equipment, and so on. But not including nutrition in the discussion would mean missing important potential solutions. 

More broadly, understanding the root causes and outcomes of health crises requires much more thought as to how communities of color are affected. Federal and state governments should continue to strive to make access to resources, such as nutritious foods, racially equitable to help meet the goal of ending hunger by 2030. What they should also consider is how prioritizing the application of a racial equity lens to health crises can help prevent racial inequities during future health crises. This will make our country better equipped to reduce hunger and to maintain this progress. 

Christian Martinez is a Racial Equity and Hunger intern with Bread for the World Institute

Tools
from our Resource Library

For Education

  • Election Resources

    One of the best times to raise the issues of hunger and poverty is during election campaigns. Engage candidates in your state/district on hunger and poverty using our elections resources.
  • U.S. Hunger and Poverty State Fact Sheets

    These fact sheets provide a snapshot of hunger and poverty in the United States and in each state plus Washington, D.C. 

  • Conflict and Fragility Are Hunger Issues

     Conflict is a main driver of the recent increase in hunger around the world and of forced migration. Hunger also contributes to conflict. 

For Faith

  • The Bible on Health as a Hunger Issue

    “As you therefore have received Christ Jesus the Lord, continue to live your lives in him, rooted and built up in him and established in faith.” These words from Colossians 2:6 remind us of the faith that is active in love for our neighbors.

    The Bible on...

  • Unity Declaration on Racism and Poverty

    A diverse body of Christian leaders calls on the churches and Congress to focus on the integral connection.

    Dear Members of Congress,

    As the president and Congress are preparing their plans for this year, almost 100 church leaders—from all the families of U.S. Christianity—are...

  • In Times Like These … A Pan-African Christian Devotional for Public Policy Engagement

    This devotional guide invites deepened relationship with and among Pan-Af­rican people and elected leaders in the mission to end hunger and poverty.

For Advocacy

Faith

African at Heart

November 22, 2019

Insight

From the Blog