We discussed several social problems/issues in this class, and various solutions and suggested solutions to these problems. What social problems are you curious to know more about as a result of taking this class? Describe two that you would like to explore further and explain why these are interesting/important to you. One of these examples must come from our class materials (review lecture materials).
SUGGESTED OUTLINE FOR PART ONE:
- First social problem from class – identify and describe, including individual and structural solutions we discussed in class. Explain why this social problem is important to you.
- Second social problem that you are curious about – identify and describe, including at least one solution that is STRUCTURAL, not just solutions at the individual/micro level. (You may need to conduct brief research to fulfill this part of the prompt and include the articles or websites you used.) Explain why this social problem is important to you.
In your discussion of these social problems and their solutions, discuss how important it is to have cognitive empathy, cultural humility, cultural competency, and the sociological imagination. In your assessment, be sure to define these key concepts to demonstrate your understanding of them.
Welcome to SWF 1000-1!
“Reconciliation Well” by Safina Stewart
•
Name tents – please take yours
and bring to your seat.
•
Please put phones away at the
start of class.
•
Feel free to reflect on the image.
•
Music by @postwrigley
•
Please keep your masks over your
nose and mouth.
•
Reminders
•
Reflection, Discussion
•
Lecture
Syllabus, Canvas, Course Schedule
• Engagement and preparedness
• When sending emails
• Introduce Yourself, due 9/4
• Syllabus quiz, due 9/11
• Community Guidelines, Covenant
Reflection Questions
• To what extent have you changed since the COVID pandemic and the
lockdown in March 2020, and in what ways?
• What do you look forward to learning about yourself this semester?
Or, how are you looking to grow?
In Pairs…
• Introduce yourselves: fun fact, hometown, major, career goal/s.
• To what extent have you changed since the COVID pandemic and the
lockdown in March 2020, and in what ways?
• What do you look forward to learning about yourself this semester?
Or, how are you looking to grow?
What is empathy?
• the experience of understanding another
person’s thoughts, feelings, and condition
from their point of view
Emotional vs. Cognitive
Emotional Empathy
• appropriate response to another
person’s state
• automatic
• activation of the mirror neuron
system, premotor cortex
• helps with self-management and
relationships
Cognitive Empathy
Emotional vs. Cognitive
Emotional Empathy
• appropriate response to another
person’s state
• automatic
• activation of the mirror neuron
system, premotor cortex
• helps with self-management and
relationships
Cognitive Empathy
• “perspective taking”
• takes choice
• Activation of the prefrontal
cortex (language, meaning)
• linked to self-awareness and
social awareness
What are the benefits of practicing empathy?
What are challenges to building empathy?
What are challenges to building empathy?
• “bubble” (by choice or conditions in life)
• lack of opportunities/missed opportunities and social segregation
What practices help build empathy?
What practices help build empathy?
• role-playing in groups or
individually
• reading a wide array of stories
to have diverse characters
with whom you do not
necessarily identify (books,
movies, plays)
Elements for building empathy
Attention
Awareness
Ability to listen
Openness to learning
EMPATHY
Hurdles to empathy?
How to get over them?
1. Multi-tasking: completion
à Practice doing only one
of tiny tasks, dopamine =
thing at a time. Set a timer
reward hormone, instant
for that task. Turn off
gratification, neural addictions
notifications.
(MIT neuroscientist Earl
Miller)
Hurdles to empathy?
How to get over them?
1. Multi-tasking: completion
à Practice doing only one
of tiny tasks, dopamine =
thing at a time. Set a timer
reward hormone, instant
for that task. Turn off
gratification, neural addictions
notifications.
(MIT neuroscientist Earl
Miller)
2. Constant checking of and/or à Fast from social media
dependence on social media:
from time to time. Take
feeds self-absorption (U of
some time to quiet our
North Florida Psychology
minds and develop the
professor Tracy Alloway)
ability to reflect.
Hurdles to empathy?
How to get over them?
1. Multi-tasking: completion
à Practice doing only one
of tiny tasks, dopamine =
thing at a time. Set a timer
reward hormone, instant
for that task. Turn off
gratification, neural addictions
notifications.
(MIT neuroscientist Earl
Miller)
2. Constant checking of and/or à Fast from social media
dependence on social media:
from time to time. Take
feeds self-absorption (U of
some time to quiet our
North Florida Psychology
minds and develop the
professor Tracy Alloway)
ability to reflect.
3. Wandering minds and not
being present, not paying
attention or shorter attention
span (Harvard psychologists
Matthew A. Killingsworth and
Daniel T. Gilbert)
à Ask questions and take
notes actively.
à Practice meditating.
What is empathy?
“sociological imagination”
Emotional Empathy
Cognitive Empathy
Compassionate Empathy
Small Group Discussion Questions
• Briefly review the differences among emotional, cognitive, and
compassionate empathy.
• What have you done to help build cognitive empathy in yourself?
What is/was the process like?
• What other practices/ways to help build cognitive empathy? What
suggestions do you have for others?
Max Weber on “verstehen”
• “to understand in a deep way” (13)
C. Wright Mills on the “sociological imagination”
• “the ability to understand how your own past relates to that of other
people, as well as to history in general and societal structures in
general” (22)
history + biography + societal structures
C. Wright Mills on the “sociological imagination”
• “the ability to understand how your own past relates to that of other
people, as well as to history in general and societal structures in
general” (22)
history + biography + societal structures
• Mills: “the vivid awareness of the relationship between personal
experience and the wider society” (1959)
• “To a sociologist, the
personal decisions an
individual makes do not
exist in a vacuum.”
–from Chapter 1.1
• cultural patterns
• social conditions and
structures
• influences of
socialization agents
• agency
• “To a sociologist, the
personal decisions an
individual makes do not
exist in a vacuum.”
–from Chapter 1.1
• cultural patterns
• social conditions and
structures
• influences of
socialization agents
• agency
Welcome back! Please keep masks on
over your nose and mouth.
Please put your phones away.
CRIMINAL JUSTICE
SYSTEM, DAY 1
SWF 1000
Dr.V
SOCIAL CONSTRUCTION OF “CRIME”
TALK/CHAT
AMONGST YOUR
PEERS RE:
STRANGE STATE LAWS: THINGS YOU DIDN’T KNOW WERE ILLEGAL IN CALIFORNIA
MATCH THE CITY TO THE CRIME!
Blythe
Burlingame
Chico
Dana Point
Long Beach
Redwood City
Walnut
Fresno
San Diego
_________ 1. Children may not wear a Halloween mask without permission from the sheriff.
_________ 2. It is illegal to shoot a rabbit from the back of your car.
_________ 3. It is illegal to spit, except on baseball diamonds.
_________ 4. It is illegal to wear cowboy boots unless you own at least two cows.
_________ 5. Kids are not allowed to play on the sidewalk.
_________ 6. It is against the law to hold a private bingo game.
_________ 7. One may not use one’s own restroom if the window is open.
_________ 8. It is illegal to fry gravy.
_________ 9. It is illegal to curse on a mini-golf course.
Source: Sevens Legal, APC (San Diego Law Firm)
TALK/CHAT
AMONGST YOUR
PEERS RE:
STRANGE STATE LAWS: THINGS YOU DIDN’T KNOW WERE ILLEGAL IN CALIFORNIA
MATCH THE CITY TO THE CRIME!
Blythe
Burlingame
Chico
Dana Point
Long Beach
Redwood City
Walnut
Fresno
San Diego
__Walnut__ 1. Children may not wear a Halloween mask without permission from the sheriff.
_San Diego_ 2. It is illegal to shoot a rabbit from the back of your car.
_Burlingame_ 3. It is illegal to spit, except on baseball diamonds.
___Blythe__ 4. It is illegal to wear cowboy boots unless you own at least two cows.
___Chico__ 5. Kids are not allowed to play on the sidewalk.
___Fresno__ 6. It is against the law to hold a private bingo game.
_Dana Point_ 7. One may not use one’s own restroom if the window is open.
_Redwood__ 8. It is illegal to fry gravy.
_Long Beach_ 9. It is illegal to curse on a mini-golf course.
Source: Sevens Legal, APC (San Diego Law Firm)
SOCIAL CONSTRUCTION OF “CRIME”
TOPICS*
* NO NE E D TO WRIT E T H E SE . WE ’ L L G O T H RO U G H T H E M.
• 13th Amendment
• American public opinion on the death penalty
• “Just Mercy” excerpts
• Unequal surveillance and sentencing disparity
• Procedural Justice model, Restorative Justice model
• School-to-prison pipeline
• Words from Warden Mark Kawika Patterson
ON THE 13 TH AMENDMENT
The 13th Amendment abolished enslavement unconditionally.
• True or False?
ON THE 13 TH AMENDMENT
The 13th Amendment abolished enslavement unconditionally.
• True or False?
• FALSE. The 13th Amendment has a clause.
• “Neither slavery nor involuntary servitude, except as
a punishment for crime whereof the party shall have been
duly convicted, shall exist within the United States…”
Colorado became the first
state to repeal the exception
clause from their state’s
constitution in 2018.
Current bills to repeal similar
clauses have passed in Utah
and Nebraska after voters
approved them in a
referendum in 2020.
AMERICAN PUBLIC OPINION ON THE
DEATH PENALTY
• since the 1930s: steady decline of support for the death penalty
• 1960s: majority of adult Americans opposed the death penalty
AMERICAN PUBLIC OPINION ON THE
DEATH PENALTY
• since the 1930s: steady decline of support for the death penalty
• 1960s: majority of adult Americans opposed the death penalty
• 1980s-1990s public opinion polls: more than 80% supported the death
penalty (they desired harsher ways to punish those who commit crimes)
AMERICAN PUBLIC OPINION ON THE
DEATH PENALTY
• since the 1930s: steady decline of support for the death penalty
• 1960s: majority of adult Americans opposed the death penalty
• 1980s-1990s public opinion polls: more than 80% supported the death
penalty (they desired harsher ways to punish those who commit crimes)
• BUT…
• most impacted: poor, BIPOC communities
• punitive orientation soured relationship among police, courts, American
communities
AMERICAN PUBLIC OPINION ON THE
DEATH PENALTY
• since the 1930s: steady decline of support for the death penalty
• the
increased
awareness of fairness
• 1960s: majority of adult Americans opposed
death penalty
• 1980s-1990s public opinion polls: more thanand
80%innocence
supportedconcerns
the death and public
of alternatives
to the
penalty (they desired harsher ways to punish thosesupport
who commit
crimes)
• BUT…
• most impacted: poor, BIPOC communities
death penalty
• now: majority of Americans say
• punitive orientation soured relationship among that
police,
courts, American
alternatives
to death penalty
communities
are a better approach
George Stinney
• was a 14 yo Black boy, executed by South Carolina on June 16, 1944
• George and his siblings joined the search party for these two young white girls who were
picking flowers but never returned home, the girls were found the next day in a shallow
ditch; George was immediately arrested because he said he saw the girls before they
disappeared, subjected to hours of interrogation w/o parents or an attorney present
• sheriff claimed that George had confessed to the murders, though no written or signed
statement was presented, George’s father was fired from job, his family was told to leave
town or be lynched, George’s family left the town and he was left behind in jail
• a month later, a trial was convened, George was facing a charge of first-degree murder, sat
alone in front of a crowd of 1,500 white people who packed the courtroom and surrounded
the building, no Black people were allowed inside the court house, the only evidence was
the the sheriff’s testimony of George’s alleged confession, trial was over in a few hours, allwhite jury deliberated ten minutes, convicted George of rape and murder, sentenced to
death, lawyer said no appeal because his family didn’t have money to pay for it
• at 5’2” and 92 pounds, Stinney walked up to South Carolina’s electric chair with a Bible in
his hand, and had to sit on top the book since the prison staff couldn’t connect him to the
electrodes due to his height
• several years after Stinney’s death, a white man from a wealthy family confessed to killing the
girls on his deathbed
Antonio Nuñez
• lived in a neighborhood plagued by gang violence, abusively beaten by father, had severe
nightmares waking up screaming; mother was depressed, Antonio’s mom said he wanted to
be a police officer when he grew up
• in 1999 he was shot when he was 13, and his 14-yo brother killed by trying to help him, so
he was sent to live in Las Vegas with relatives, stayed out of trouble, but w/in a year, CA
probation authorities ordered him to return to L.A. because of his probation for a prior
offense of petty crime
• 14 yo was in a car with men who planned a fake kidnapping to get money from a relative for
ransom; the pretend victim sat in the backseat, while a 27-yo man drove and Antonio sat in
the passenger seat
• they were followed and chased by two Latino men in a gray van; Antonio was given a gun
and told to shoot at the van (the men were actually undercover police officers), he fired, and
then dropped the gun and then they crashed, no one was injured but charged w/ aggravated
kidnapping and attempted murder for police officers
• Antonio and the 27-yo were tried as co-defendants in a join trial, both found guilty; under
CA law, a juvenile has to be 16 to be sentenced to life imprisonment w/o parole for murder,
but no minimum age for kidnapping (and it was fake), so the Orange County judge
sentenced him to life imprisonment
• at 14, Antonio was the youngest person in the US condemned to die in prison for a crime in
w/c no one was physically injured
UNEQUAL SURVEILLANCE AND SENTENCING DISPARITY
UNEQUAL SURVEILLANCE AND SENTENCING DISPARITY
• Anti-Drug Abuse Act of 1986
• “crack more dangerous” but no scientific justification
• 5g of crack same mandatory minimum sentence as 500g of
cocaine (100 to 1)
• criticized by the US Sentencing Commission and the American
Bar Association
• Fair Sentencing Act 2010 à
• compromised, from 100-to-1 to 18-to-1 ratio (90g of cocaine,
5g of crack)
UNEQUAL SURVEILLANCE AND SENTENCING DISPARITY
• Anti-Drug Abuse Act of 1986
• “crack more dangerous” but no scientific justification
• 5g of crack same mandatory minimum sentence as 500g of
cocaine (100 to 1)
• criticized by the US Sentencing Commission and the American
Bar Association
• Fair Sentencing Act 2010 à
• compromised, from 100-to-1 to 18-to-1 ratio (90g of cocaine,
5g of crack)
UNEQUAL SURVEILLANCE AND SENTENCING DISPARITY
UNEQUAL SURVEILLANCE AND SENTENCING DISPARITY
• Anti-Drug Abuse Act of 1986
• “crack more dangerous” but no scientific justification
• 5g of crack same mandatory minimum sentence as 500g of
cocaine (100 to 1)
• criticized by the US Sentencing Commission and the American
Bar Association
• Fair Sentencing Act 2010 à
• compromised, from 100-to-1 to 18-to-1 ratio (90g of cocaine,
5g of crack)
• September 2021 Update
• the House of Representatives voted to approve H.R. 1693, the
Eliminating a Quantifiably Unjust Application of Law Act
• the EQUAL Act becomes law, it would permanently and
entirely eliminating the crack-cocaine disparity, and it would
retroactively apply to those who were previously sentenced
RESTORATIVE JUSTICE AND PROCEDURAL JUSTICE:
DEALING WITH RULE BREAKING
( T Y LER 20 06 )
RESTORATIVE JUSTICE AND PROCEDURAL JUSTICE:
DEALING WITH RULE BREAKING
( T Y LER 20 06 )
• Argument: “greater focus needs to be placed on
psychological approaches whose goals are…”
• to activate internal values within wrongdoers
• to encourage self-regulation in the future
ALTERNATIVES TO PUNITIVE JUSTICE
Self-regulatory motivations
Model
Focus
Motivation that is activated
Procedural Justice models
Legitimacy of authority
Obligation
ALTERNATIVES TO PUNITIVE JUSTICE
Self-regulatory motivations
Model
Focus
Motivation that is activated
Procedural Justice models
Legitimacy of authority
Obligation
“people generally more likely to regard the
police as legitimate if they believe that the
police exercise their authority through fair
procedures” (312)
ALTERNATIVES TO PUNITIVE JUSTICE
Self-regulatory motivations
Model
Focus
Motivation that is activated
Procedural Justice models
Legitimacy of authority
Obligation
•
Sunshine & Taylor 2003: people value having the police talk
to and cooperate w/ citizens to solve community problems
•
Skogan 1994: public complaints include “rude, arrogant,
unfriendly treatment” and “unreasonable/unfair behavior”
ALTERNATIVES TO PUNITIVE JUSTICE
Self-regulatory motivations
Model
Focus
Motivation that is activated
Procedural Justice models
Legitimacy of authority
Obligation
Restorative Justice models
Relationships to others
Shame
TOPICS*
* NO NE E D TO WRIT E T H E SE . WE ’ L L G O T H RO U G H T H E M.
• 13th Amendment
• American public opinion on the death penalty
• “Just Mercy” excerpts
• Unequal surveillance and sentencing disparity
• Procedural Justice model, Restorative Justice model
• Labeling Theory
• Zero Tolerance Policy, School-to-prison pipeline
• Words from Warden Mark Kawika Patterson
ALTERNATIVES TO PUNITIVE JUSTICE
Self-regulatory motivations
Model
Focus
Motivation that is activated
Procedural Justice models
Legitimacy of authority
Obligation
Restorative Justice models
Relationships to others
Shame
ALTERNATIVES TO PUNITIVE JUSTICE
Self-regulatory motivations
Model
Focus
Motivation that is activated
Procedural Justice models
Legitimacy of authority
Obligation
Restorative Justice models
Relationships to others
Shame
• “reintegrative shaming” = disapproval + respect
• key = social connections, encourage feelings of responsibility to others
• includes the victimized in the process
CONCLUSION
• both “procedural justice” and “restorative justice” models more
likely to be effective in reducing crime
• underlying belief: people can be rehabilitated
CONCLUSION
• focusing on the possibilities of rehabilitation and restoration of
people as members of a society are beneficial for all
• we need to help shape public views about people who commit
crime, how we approach each other
Welcome back! Please keep masks on
over your nose and mouth.
Please put your phones away.
CRIMINAL JUSTICE
SYSTEM, DAY 1I
SWF 1000
Dr.V
Announcement
about the quiz at
the end!
Attendance on
11/2 Tuesday is
worth 5 points.
J
• What were your whoa’s and hmm’s?
• Antonio
• Trina
• Ian
• In what ways would you suggest we can help some of these
problems in city’s like South Central LA, or poor urban areas, or
areas like such that are epicenters for many issues and struggles,
big and small?
• I want to talk with he class about the faults of our justice system
and how it can be improved. Can we even change it? Why was it
made this way and who made it this way? Are we still following
the system that was used 400 years ago, and is it the most
effective?
• How can we, as a society, fix that so there is not a coming wave
and also how can we not blame just one group of children, but
look to ourselves for the problem and fix it that way?
HOW DO WE APPROACH PEOPLE WHO
HAVE COMMITTED CRIMES?
• Labeling Theory
• labels impact behavior, identity
HOW DO WE APPROACH PEOPLE WHO
HAVE COMMITTED CRIMES?
• Labeling Theory
• labels impact behavior, identity
HOW DO WE APPROACH PEOPLE WHO
HAVE COMMITTED CRIMES?
• Labeling Theory
• labels impact behavior, identity
Allan Weaver: autobiography of an ex-offender and
two-time prison inmate who is now a social work
team-leader in his native Scotland.
IMPORTANCE OF RESTORATIVE JUSTICE
IN SCHOOL SETTINGS
• Alternative to “Zero Tolerance Policies” in schools but
implementation requires institutional support
• What are Zero Tolerance Policies currently in place in school?
• What are its intents? What are its impacts?
ZERO TOLERANCE POLICIES
• What are Zero Tolerance Policies currently in
place in school?
• What are its intents? What are its impacts?
• à school-to-prison pipeline
SCHOOL-TO-PRISON PIPELINE
• children funneled out of schools, into the juvenile/criminal
justice systems
• these children often have learning disabilities, histories of
poverty, abuse, or neglect, and would benefit from educational
and counseling services
SCHOOL-TO-PRISON PIPELINE
• “zero-tolerance” criminalize minor infractions of school rules
• police (called School Resource Officers) in schools deal with
children instead of counselors and principals
SCHOOL-TO-PRISON PIPELINE
• pipeline begins with inadequate resources in public schools
• schools may encourage dropouts due to pressures from testbased accountability regimes (No Child Left Behind Act),
incentives to push out low-performing students to boost overall
test scores
SCHOOL-TO-PRISON PIPELINE
• students have been expelled for bringing nail clippers or
scissors to school
• one study found that 95% of out-of-school suspensions were for
nonviolent, minor disruptions such as tardiness or disrespect, or
even dress code violations or hair
INVESTING IN RESTORATION: WHAT
CAN THAT LOOK LIKE?
INVESTING IN RESTORATION: WHAT
CAN THAT LOOK LIKE?
Some ideas
• repeal the exception clause in the 13th Amendment
• pass the EQUAL Act
• fair policing, implicit bias training for officers, judges, etc.
• Restorative Justice
• fund schools more than prisons
• build community, more dialogue
Mark Kawika (sounds like “Kavika”) Patterson
“We’ve forgotten how to be a village–how to depend on each other. We used to take care of
the kolohe, the people who are hard-headed. But now we don’t rely on our neighbors
anymore. It’s easy to take the kolohe person and just throw them away. My idea is to
get the community involved in bringing [the women] back into the community.”
“These women don’t need punishment, Patterson realized. They need a place to heal. […] In
traditional Hawaiian culture, a pu’uhonua is a sanctuary where those who break a taboo or rule,
or are fleeing violent conflict, can go for forgiveness and transformation.”
Mark Kawika (sounds like “Kavika”) Patterson
“We’ve forgotten how to be a village–how to depend on each other. We used to take care of
the kolohe, the people who are hard-headed. But now we don’t rely on our neighbors
anymore. It’s easy to take the kolohe person and just throw them away. My idea is to
get the community involved in bringing [the women] back into the community.”
“These women don’t need punishment, Patterson realized. They need a place to heal. […] In
traditional Hawaiian culture, a pu’uhonua is a sanctuary where those who break a taboo or rule,
or are fleeing violent conflict, can go for forgiveness and transformation.”
• in 2021, Patterson’s work continues with the Hawai’i Youth Correctional Facility (HYCF),
which is rebranding itself to become the Kawailoa Youth and Family Wellness Center and to
realize a new vision for Hawaiʻi’s juvenile justice system
• Patterson recognized that the youth who are brought in have also experienced some form
of family trauma due to poverty, houselessness, abuse, and substance addiction; instead of
focusing on punishment, Patterson seeks to provide them safe shelter, stability, and a sense
of community
• it worked: incarceration was reduced by 75% and the funding initially meant for corrections
have been channeled towards the building of the Youth and Family Wellness Center, which
includes: a young adult homeless shelter, a residential vocation training program for youth
and young adults, and an assessment center and shelter for young victims of sex trafficking
IMPORTANT REMINDERS
• Honorlock Practice Quiz
• Check out the Study Guide (see
addition re: Investing in Restoration)
• All handwritten notes and hard copies
of your notes OK – no books, no iPads,
no laptops à ZERO score
• Time increased from 75 to 90 minutes
• Exam available by 7am on 10/29 Friday,
due by 10/30 Saturday 11:59pm
• Please email me to remind me of the
DRC accommodations – thank you!
• Best wishes!
Annu. Rev. Public Health 2021.42:233-255. Downloaded from www.annualreviews.org
Access provided by 2607:fb90:6631:a7f5:dd95:4471:8d7b:4126 on 08/20/21. See copyright for approved use.
Annual Review of Public Health
Climate Change, Food Supply,
and Dietary Guidelines
Colin W. Binns,1 Mi Kyung Lee,2 Bruce Maycock,3,4
Liv Elin Torheim,5 Keiko Nanishi,6
and Doan Thi Thuy Duong7
1
School of Public Health, Curtin University, Perth, Western Australia 6845, Australia;
email: c.binns@curtin.edu.au
2
College of Science, Health, Engineering and Education, Murdoch University, Murdoch,
Western Australia 6150, Australia; email: m.k.lee@murdoch.edu.au
3
College of Medicine and Health, University of Exeter, Exeter EX1 2LU, United Kingdom
4
Asia-Pacific Academic Consortium of Public Health (APACPH), APACPH KL Secretariat
Office, Department of Social and Preventive Medicine, Faculty of Medicine, University of
Malaya, 50603 Kuala Lumpur, Malaysia; email: bmaycock@iinet.net.au
5
Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan
University, NO-0130 Oslo, Norway, email: livtor@oslomet.no
6
Office of International Academic Affairs, Graduate School of Medicine, The University of
Tokyo, Bunkyo-Ku, Tokyo 113-0033, Japan; email: keikonanishi@yahoo.co.jp
7
Faculty of Social Sciences, Behavior and Health Education, Hanoi University of Public Health,
Bac Tu Liem District, Hanoi 100000, Vietnam; email: dttd@huph.edu.vn
Annu. Rev. Public Health 2021. 42:233–55
Keywords
First published as a Review in Advance on
January 26, 2021
climate change, food supply, human nutrition, dietary guidelines,
breastfeeding, Sustainable Development Goals
The Annual Review of Public Health is online at
publhealth.annualreviews.org
https://doi.org/10.1146/annurev-publhealth012420-105044
Copyright © 2021 by Annual Reviews. This work is
licensed under a Creative Commons Attribution 4.0
International License, which permits unrestricted
use, distribution, and reproduction in any medium,
provided the original author and source are credited.
See credit lines of images or other third-party
material in this article for license information.
Abstract
Food production is affected by climate change, and, in turn, food production is responsible for 20–30% of greenhouse gases. The food system
must increase output as the population increases and must meet nutrition
and health needs while simultaneously assisting in achieving the Sustainable Development Goals. Good nutrition is important for combatting infection, reducing child mortality, and controlling obesity and chronic disease
throughout the life course. Dietary guidelines provide advice for a healthy
diet, and the main principles are now well established and compatible with
sustainable development. Climate change will have a significant effect on
food supply; however, with political commitment and substantial investment,
projected improvements will be sufficient to provide food for the healthy
233
diets needed to achieve the Sustainable Development Goals. Some changes will need to be made
to food production, nutrient content will need monitoring, and more equitable distribution is
required to meet the dietary guidelines. Increased breastfeeding rates will improve infant and
adult health while helping to reduce greenhouse gases.
1. INTRODUCTION
Annu. Rev. Public Health 2021.42:233-255. Downloaded from www.annualreviews.org
Access provided by 2607:fb90:6631:a7f5:dd95:4471:8d7b:4126 on 08/20/21. See copyright for approved use.
This article is the third review on nutrition and climate change in the Annual Review of Public
Health (ARPH), which reflects its importance to global health and extends the discussion of food
for population health and changes brought on by climate change (63, 102). A decade ago, the
Lancet Commission concluded that anthropogenic climate change threatened to undermine the
healthy lives of billions and to undo the past 50 years of gains in public health. An effective response to climate change could be the greatest global health opportunity of the 21st century (36).
Food production is affected by climate change, which in turn is responsible for 20–30% of greenhouse gases (GHGs). The food system must increase output as the population increases and must
meet nutrition and health needs while simultaneously assisting in the achievement of the Sustainable Development Goals (SDGs) (15, 99, 136). The climate crisis comes from a rapid increase in
human use of natural resources to satisfy rising standards of living, increased energy use, population growth, and dietary shifts toward higher consumption of animal products (45). The effects of
climate change on nutrition and health have been discussed for at least six decades (49, 87). Many
of the causes and outcomes identified decades ago have since worsened, with only limited international cooperation emerging to change global trajectory. Substantial increases in the production
of CO2 and other GHGs have resulted in overall global warming during the Anthropocene (1).
While a proportion of the CO2 generated is utilized by plants, excess accumulates in the atmosphere or oceans, the latter being the great CO2 sink. The result is increasing ocean acidification,
altering its ecology (35, 116). Water vapor is also a GHG, levels of which increase by rising temperatures and in turn increase rainfall in some areas, contributing to adverse weather events. If
climate change continues unabated, in a generation 1–3 billion people will be attempting to live
in temperatures experienced now by only small populations in the Sahara (154).
Since the publication of the previous ARPH articles on this subject, world events have illustrated the fragility of global initiatives against climate change; efforts to reduce the rate of change
stall as major countries withdraw or do not meet commitments outlined in the Paris Accord (85).
The rate of climate change is increasing: 2015–2019 was the hottest five-year period on record,
resulting from ever-increasing CO2 emissions (152). There has been increased crop damage from
storms, droughts, floods, salination, landslides, and wildfires on all continents. The loss of plants
and animals from these events, together with the concentration of cropping on fewer hectares,
reduces biodiversity (62). These changes will increase climate-related strain on food supplies and
nutrition and health, with the coronavirus disease 2019 (COVID-19) pandemic imposing additional health and economic burdens.
The aim of this review is to consider the ways in which climate change is altering food supply
and how these changes will relate to dietary guidelines in the future.
1.1. Progress and Challenges in Global Health, Food, and Nutrition
Substantial improvements have been made to health and nutrition in recent decades, even though
a number of the Millennium Development Goals targets were not fully met. The global under-5
child mortality rate decreased from 118/1,000 live births in 1980 to 39/1,000 in 2018. In West and
Central Africa, the corresponding values were 217/1,000 down to 97/1,000. Changes in China
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are even more dramatic; infant mortality declined from an estimated 300/1,000 (in 1941) to 7
per 1,000 (in 2018), demonstrating concerted efforts to improve nutrition and health (139). The
global prevalence of underweight due to insufficient energy intake has been reduced by nearly
50% since 1990, driven largely by increased yields of the major crops, including wheat, rice, and
maize (53). The Intergovernmental Panel on Climate Change (IPCC) has estimated that, since
1961, per capita availability of food has increased by one-third (96). This increase has required
greater use of nitrogen fertilizers (up by 800%) and water resources for irrigation (by at least
double). Despite the improvements in the proportion of the population suffering from nutrition
problems, in absolute numbers an estimated 821 million people are currently undernourished,
150 million children under five are stunted, and 613 million women aged 15–49 suffer from iron
deficiency (96). The world is still faced with the tragedy of nearly 5 million child deaths annually.
Micronutrient deficiencies affect an estimated 2 billion people worldwide, which could increase
in the coming decades as food diversity decreases (133). Improvements in food supply resulted in
a shift to the right of the distribution curve of food consumption, decreasing undernutrition. An
unwanted side effect was an increase in the global prevalence of overweight and obesity.
Climate change and malnutrition in all its forms, including obesity and undernutrition, constitute two of the greatest threats to planetary and human health (44). Risks to human health include
increases in infectious diseases, heat-related chronic disease, allergies, and injuries and stress from
adverse weather events (30, 63, 79, 144). Pollution occurring concurrently with climate change
may affect health (98). The exact impacts will vary with location and national wealth, but most
impact will still fall on children and poorer populations. Children should be the focus of climate
change discussion and implementation of the SDGs (34, 157). This approach is consistent with
the legal obligations to which most countries have committed by their ratification of the Convention of the Rights of the Child, which includes obligations to protect children’s right to a healthy
food environment (140).
The Global Burden of Disease (GBD) study provides a comprehensive description of the impact of suboptimal diets on chronic disease morbidity and mortality, around 60% of the risk of
disability-adjusted life years (DALYs), and demonstrates the need for improving nutrition in all
regions and at all levels of development to control disease burden (2, 61, 127). Despite the decrease
in world poverty levels and increase in world food production, both in absolute terms and in per
capita availability, dietary inequalities persist, a condition all countries have committed to ending
by 2030 in accord with the SDGs. Overall food energy supply by region, with inequities between
rich and poor populations, is illustrated in Figure 1 (54).
While food production has increased, a large amount of food is wasted, estimated at 35%
(11). Food waste is often underestimated and has a double or even triple effect, as energy is required for production, by humans in agriculture labor, and in food preparation, all contributing
to GHGs (143). Wastage occurs at many stages of food production, including mechanical damage
and spillage during harvest, sorting, handling, storage, transportation, processing, retailing, and
home use (14, 58). Wastage at final consumption varies, depending on economic level; for fruit and
vegetables, it is estimated to be 2–5% in Africa, Asia, and Latin America compared with 12–17%
in Europe, North America, Oceania, and industrialized parts of Asia (51, 55).
1.2. Food Security and the United Nations Sustainable Development
Goals (SDGs)
The Food and Agricultural Organization (FAO) lists four dimensions of food security (50):
Sufficient food is available.
Everyone has access to it.
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Africa
Asia
Oceania
America
Europe
3,500
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Calories
3,000
2,500
2,000
1,500
1,000
1999–2001
2003–2005
2007–2009
2011–2013
2016–2018
Figure 1
Average dietary energy supply by region. Figure adapted from Reference 35.
The food supply is well utilized.
All three of these dimensions are stable over time.
Sustainable diets are defined as being “protective and respectful of biodiversity and ecosystems,
culturally acceptable, accessible, economically fair and affordable; nutritionally adequate, safe and
healthy; while optimizing natural and human resources” (82, p. 641; 113). To the economist, that
real prices of agricultural products have been trending downward for the past 50 years suggests
that food production is sufficient, but the prevalence of undernutrition, overnutrition (obesity),
and micronutrient deficiency shows that distribution is inequitable. The global food system faces
an ambitious challenge in meeting nutritional needs for all, while reducing GHGs. Goal 2 of the
SDGs emphasizes nutrition, “End hunger, achieve food security and improved nutrition and promote sustainable agriculture,” but the majority of the SDGs affect food production and nutrition
in some way (19). This is illustrated in Figure 2, using as its basis the UNICEF framework on
nutrition, its antecedents, and outcomes.
1.3. Population Trends Affecting Food Requirements and Production
Additional changes in human ecology are occurring in parallel with climate change. The world
population growth rate has slowed to 1.1%, but the population is still increasing by 83 million
annually. The globe is becoming more urbanized, and vast numbers of migrants and refugees
are changing population structures and water, food, employment, and housing requirements. The
United National Development Program (UNDP) has summarized population trends that will
affect the production of, and requirements for, food (142). The world’s population has grown
from 2.6 billion in 1950 to 7.7 billion in 2019 and will reach 8.5 billion in 2030 and 9.7 billion
in 2050. By 2050, the world will have 9 billion people, and providing them with enough food,
despite climate change and environmental pressures, will be the greatest challenge of the twentyfirst century (40). The population will continue to age (>60 years) from 901 million in 2015 to
1.4 billion in 2030 and will continue to urbanize, with cities (>1 million) increasing from 23%
of the world’s population to 28% in 2030. The rural population will decline from 45% to 40%,
decreasing the workforce for food production (137, 141). While the population of Sub-Saharan
Africa will double by 2050, many higher-income countries (HICs) will continue to have declining
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The Sustainable Development Goals
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Intergenerational
consequences
Short-term
consequences
Long-term
consequences
Mortality morbidity disability
Cognitive development,
health, economic productivity
3, 5.B
1, 2, 3, 4, 5, 7, 8, 9, 10, 11, 16, 17
Maternal and child undernutrition
2, 3
Immediate
causes
Underlying
causes
Basic
causes
Inadequate dietary intake
Disease
2, 4, 5, 10, 12
3, 4, 5, 10, 12
No.
Goal
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Poverty
Zero hunger
Health
Learning, education
Gender equality
Clean sustainable water, sanitation
Energy
Economic growth, work
Industry
Reduce inequality
Sustainable communities
Responsible consumption
Climate action
Life below water
Life on land
Peace
Partnership
Household
food insecurity
Inadequate foods, feeding
practices, and care practices
House, environment,
and health service
1, 2, 12, 13, 14, 15
2, 4, 13
3, 6, 11, 12, 13, 14
Inadequate access
to services
Inadequate financial
and human resources
Sociocultural, economic
and political context
3, 4, 6, 9, 10
4, 5, 8, 10, 11, 16, 17
4, 5, 8, 10, 11, 16, 17
Climate
change
Figure 2
Relationship between UNICEF conceptual framework of undernutrition and the Sustainable Development Goals (SDGs). Numbers
correspond to the relevant SDGs. Figure adapted from Reference 44.
populations. Infants, young children, pregnant women, and the elderly will be more impacted by
climate change (28, 34, 131).
2. IMPACT OF CHANGES IN CLIMATE ON FOOD PRODUCTION
AND SUPPLY
2.1. Changes to Global Food Supply
In a series of reports over the past 15 years, the IPCC has provided scientific evidence of the effect
of climate change on global food supplies (2, 50–55, 57, 59–71).
Hotter climates will shift production toward the poles and will also cause faster plant growth
and ripening and decrease nutrient density.
Areas of dry land will increase, while some regions will have increased rainfall (80). The
amount of arable land in use is almost at a maximum. Increasing environmental degradation, desertification, soil depletion, overgrazing, rising sea levels, urban development, roads,
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238
and industrial use may reduce land further. Saltwater encroachment will affect some particularly low-lying, but highly productive rice-growing areas of Asia. As a result, agricultural
productivity will have to increase.
Adverse weather events including storms, hurricanes, droughts, flooding, landslides, and erosion will increase in frequency and severity, which will damage crops and disrupt harvesting,
transportation, and storage.
Transport will be disrupted owing to adverse weather events, increased fuel costs, conflict,
and political issues.
Spoilage and bacterial damage, including Listeria, Salmonella, and mycotoxin contamination, increase with rising temperatures and increased numbers of extreme heat days (100).
Mitigating this damage will require improved agricultural practices and better processing,
packaging, and storage.
Agricultural yields depend on crop protection measures. The main purpose of pesticide use is
to increase food security by controlling pests and weeds, and these will increase with climate
change. The increased number of insects, including locust plagues, will cause crop damage,
decrease crop yield, and result in greater costs with increased chemical residues (43, 153).
Pesticide use will increase, and higher temperatures and adverse weather may cause faster
dissipation (41).
Contaminants may enter food at several stages of agriculture, processing, packaging, transport, or storage. New toxic residues (emerging contaminants) in food are increasing as a consequence of changes in industrial processes, intensifying agricultural practices, environmental pollution, and climate change (57). Chemical contaminants have become a food safety
concern, owing to pesticide residues and environmental contaminants (74).
Climate change will have a serious negative impact on crop productivity as the level of warming progresses (80). Productivity of both commercial crops (maize, rice, and wheat) and crops
such as millet and sorghum will be affected. Impacts will vary depending on CO2 concentrations, fertility levels, and region (80). A meta-analysis shows that adoption of improved
farming practices and technologies such as improved varieties, planting at optimal times,
and improved water and fertilizer management has the potential to reduce the negative impact on crop yield (3). With this scenario, climate change may not add significantly to the
challenge of food production for the majority of countries except for some potential hot
spots around the world. However, massive investment, policy, and institutional support will
be required to facilitate adoption and scaling-out of such practices and to address climatic
variability (3).
Food variety will decrease, as measured by the “food diversity index” (47). Diverse food systems are more resilient in enhancing food security in the face of climate change. They are
important for nutrient cycling, carbon sequestration, control of soil erosion, reduction of
GHG emissions, and control of hydrological processes (97). For human nutrition, food diversity is important, especially for children, because it increases the likelihood of meeting
nutritional needs, including intakes of phytochemicals, and decreases the impact of contaminants and toxicants (83, 123).
Potable water supplies will decline owing to decreased rainfall, salinization, pollution, increasing population, and industrial use. This decline will affect water-intensive production
systems, and dairying will be the most affected (67, 73). Decreases in milk production will
reduce the availability of an important source of calcium and high-quality protein. At the
same time, osteoporosis will become more prevalent in aging populations, which may require additional interventions. Decreases in the dairy herd may have a public health benefit
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by reducing the production and use of infant formula. More irrigation is a strategy to increase food production, but the lack of water will limit its expansion (38).
The global food system contributes 25% of GHG emissions, with the largest source being
livestock production. The food and agriculture industries project that an increase in demand
for meat is likely to undermine efforts to keep global average warming below a 2°C target
(114). How GHGs are accounted for may differ in the country of production compared with
the country of consumption. For example, the GHG production of Hong Kong is underestimated as imports of meat are ignored. GHG emissions hidden in meat and dairy products,
which are all imported into Hong Kong, demonstrate that consumption is about 59% higher
than the city’s total GHG emissions using conventional production-based calculations (155).
Nuts have important benefits for nutrition, but yields will decrease with climate change (4).
2.2. Oceans, Fish, and Seafood
Fish and seafood, containing protein, a high level of omega-3 fatty acids in fatty fish, and micronutrients, are important components of a healthy diet (148). Fish provide at least 15% of the
daily average intake of animal protein for 4.5 billion people, and in 2010 it provided more protein than cattle and poultry combined (13). For some populations in West Africa, island states,
and coastal Asia, fish consumption is over 50% of the total animal protein consumed; small fish,
eaten whole, are also an important source of many micronutrients (76). As ocean health changes,
sustainable production will decrease, requiring more effort to reduce pollution (42). The world’s
oceans are changing because of increasing acidification (dissolved CO2 ), increased fishing, minerals and petroleum extraction, and increasing use for aquaculture (35, 106). Ocean acidification has
the greatest effect on calcifying organisms, including mollusks, corals, and plankton (25), which
affects species higher up the food chain. Acidification can affect the growth and life span of some
fish, such as sea bream, and can reduce plankton size, which decreases the growth of species such
as anchovy and sardines (6, 31).
Catching and consuming fish are generally localized activities. Nine of the top 15 countries for
marine capture are in the Asia-Pacific region, accounting for 87% of the global catch (52, 78). The
EAT-Lancet Commission on healthy diets recommended 28 g per day of fatty fish for the protective
effect of omega-3, but only the East Asia-Pacific region currently achieves this goal. The 2010
dietary guidelines for Americans encourage individuals to double their intake of fish (94), which
would require a doubling of the current production to meet these recommendations (148). The
oceans cannot supply these recommended levels of fish; the maximum sustainable catch has already
been exceeded, with 30% of ocean wild fish stocks overfished and 60% fully fished (52). Wild fish
stocks face compounding pressures from pollution, loss of habitat from coastal developments, and
increased eutrophication. Increasing sea temperatures will result in the migration of stocks toward
the poles (59). Aquaculture is the only method available to increase fish production, and currently
two-thirds of production comes from Asia (excluding China). Changes to fish feeding methods
and growth patterns may alter nutritional content, with reduced lipids, vitamin D, omega-3 fatty
acids, and proteins (59, 81, 103, 134, 148). These changes will need monitoring and research to
reduce the environmental impacts of mariculture (52).
2.3. Interactions Between Climate and Food Production
The global food production system is influenced by climate change, while the system itself
in turn influences GHGs (see Figure 3). As production increases, land use will intensify and
biodiversity will be lost, as fewer cultivars are used to increase yields. Land and sea pollution will
increase, particularly in lower-income countries (LICs), where the majority of farmers have small
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239
Global health
Health for all
Food consumption,
Equity
Climate change
Negative impact
Positive effect on healthy food supply
Wastage (35%)
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Nutritious food,
Breastfeeding
Ultra processed food
High fat, high sugar,
SSB, infant formula
Agriculture
Fisheries
Food processing
Transport storage
Relationship between climate change,
food consumption, and health
Positive and negative impact
on health and climate change
Dietary
guidelines,
RDI/RDA, NRV
Figure 3
Food production, dietary guidelines, and healthy diet. Wastage is depicted as a negative impact (red arrows), but if wastage can be
reduced, it will have a positive impact on food supply (green arrows). Abbreviations: NRV, nutrient reference value; RDA, recommended
dietary allowance; RDI, recommended dietary intake; SSB, sugar-sweetened beverages.
holdings and will find it difficult to invest in technological solutions (68, 126). Some proposed
climate mitigation strategies could have adverse side effects on food production; for example,
using land for afforestation may reduce the land available for food production (65). The opposite
effect may occur in some countries, with forests being destroyed to increase agricultural land.
Another important issue for nutrition is a decrease in micronutrient density, as yield increases
require improved monitoring and efforts to increase the nutrient content in food crops (90).
Dietary choices affect food production, which in turn has an effect on the environment. Dietary
guidelines recommend eating fewer animal products. If this guidance is followed, the decrease in
production will lessen GHG emissions (115). Some of the interactions between climate change,
dietary guidelines, and food production are shown in Figure 3.
3. BRINGING TOGETHER CLIMATE CHANGE, FOOD, AND HEALTH
3.1. A Diet That Is Good for the People and the Planet
Recommendations for healthy eating go back millennia to Hippocrates and earlier. Scientific nutrition recommendations began with the era of analytical chemistry in the nineteenth century,
which led to the measurement of protein and subsequently energy, vitamins, and micronutrients.
Recommendations were initially made for nutrient deficiencies in vitamin C and thiamin, followed by additional micronutrients, including iron and iodine (101, 121). Beginning in the 1950s,
the infectious disease burden of undernutrition was documented, and, more recently, the burden of
chronic disease, including obesity, diabetes, heart disease, and cancer, has come to the fore. Other
important areas include the effect of early-life nutrition (the first 1,000 days and developmental
origins of health and disease hypothesis) and the maintenance of a healthy human microbiome for
good health (10, 122, 138). The promotion of sustainable, resilient food systems for healthy diets
is the first principle for action during the UN Decade of Action on Nutrition (86).
3.2. Food-Based Dietary Guidelines
Most food-based dietary guidelines (FBDG) are based on the following principles: address significant public health issues, both acute and chronic; be food-based to allow for easier translation into
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practical dietary advice; achieve required nutrients; maintain healthy growth and body weight; and
optimize whole of life health. In addition, guidelines should meet the SDGs and reduce GHGs
(22). A review of food-based dietary guidelines from 34 European countries and their sustainability credentials concluded that shifting from current Western diets to more sustainable dietary
patterns produces benefits. Consuming more plant-based foods (e.g., vegetables, fruit, legumes,
seeds, nuts, whole grains) and fewer animal-based foods (especially red meat), snack foods, and
beverages would improve health and have environmental benefits (12). Recent regional dietary
guidelines recommend similar changes and usually include physical activity, healthy body weight,
breastfeeding, clean water, safe food, less sugar and salt, decreases in saturated fats, and elimination of trans fats (22). Another example of regional recommendations is the Nordic Nutrition
Guidelines, which would produce health benefits such as a reduction in cardiovascular disease and
cancer and would lessen environmental stress (117). In Table 1, the general recommendations in
dietary guidelines are shown for the major food groups, current production levels, and suggested
changes to implement by 2030.
3.3. Dietary Guidelines and Changes Needed to Ensure Sustainable
Food Production
In a summary of 12 major reviews of DGs and climate change, all the diets optimized for sustainability and nutrition were more plant based, with reductions in meat, particularly ruminant meats
(beef and lamb). Six studies recommended increased fish intake, while the majority suggested
fewer dairy products. Other foods to be reduced included sweet foods (biscuits, cakes, desserts),
savory snacks, white bread, and both alcoholic beverages and sugar-sweetened beverages (SSBs).
These findings are similar to those in 7 out of 8 recent review articles on the sustainability of diets
(150). Examining the 14 discrete environmental areas of concern identified in the SDGs, most
studies are on GHG emissions and, to a lesser extent, land and water use. In the case of GHG
emissions, changes in land use and soil carbon stocks were seldom considered, which represents a
disconnect between science informing strategic climate action in the agricultural sector and science informing public health nutrition. In the case of land and water use, few studies used metrics
that are appropriate in a life-cycle context. The evidence available shows that recommended diets
have lower environmental impacts than do typical diets (112). A consistent scientific approach to
estimating the impact of climate on diet and vice versa is required (68, 71, 72).
Many national DGs already include recommendations related to changes that would improve
health and would be beneficial to the environment and sustainability. For example, Argentina
Australia, China, New Zealand, Sweden, Switzerland, the United Kingdom, and the United States
suggest increasing consumption of whole plant foods, vegetables, fruits, legumes, and fewer animal
foods (7, 29, 32, 48, 66, 95). Canada is representative of a number of countries who also recommend
reducing SSBs and eliminating trans fats (8).
3.4. Special Population Groups
The special needs of some population groups, including infants, children, pregnant women, and
the elderly, should be considered in planning responses to climate changes and healthy eating. In
many countries, complementary diets given to infants after the age of six months are high volume
and often low nutrient density, limiting nutrient intake (e.g., iron) (18). While nutrient density is
important in infants and young children, a diet high in fiber becomes more important in adults
for the prevention of chronic disease.
Children are the population segment most susceptible to the effects of climate change, bearing
an estimated 88% of the increased burden of disease (108, 110, 128). Food security for infants
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Table 1 Changes to food production to meet sustainable dietary guidelines
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Food group
Projected
changes in
DGs
food
production recommendationsa
(IPCC)
Nuts
Meat, animal
products
Decrease
Decrease
Fish
Insufficient Increase
Grains
Increase
Vegetables,
pulses
Increase
WHO
Nordic
HICs,
nutrition
recommen- recommen- current
dations
availability
dations
Conclusion:
changes needed
by 2030
Increase
Decrease
Insufficient
High
(reduce)
Insufficient
Sufficient
Increase needed
Decrease red and
processed
Increase
Increase
Insufficient
Coastal areas vary;
often sufficient
Increase
(aquaculture)
Increase
whole
grain
Increase
Increase
Insufficient
Usually sufficient
Increase
Increase
Increase
Increase
Insufficient
Sufficient
Increase
Fruits, berries Decrease
Increase
Increase
Increase not Insufficient
enough
Insufficient
Increase
Dairy
Decrease; use
low fat
Decrease;
Too high
use low fat
Insufficient
Decrease
Fats and oils
Decrease
overall,
especially
saturated
and trans
Increase unsaturated
Avoid animal
fats; limit
saturated;
No trans
Decrease fats
Decrease fats
Sugar, SSB
Decrease
Prefer unsaturated
Increase unsaturated Increase unsaturated
from fish, plants
from fish, plants
Decrease
Decrease
Salt
Decrease
Decrease;
use iodized
Alcohol
Limit
Limit
Limit
Limit
Limit
Decrease
Breastfeeding
Increase
Increase
Increase
Insufficient
EBF
Insufficient EBF
Increase EBF
Food
processingb
Decrease
ultra
processing
Wastage
Decrease
Increase
Increase
Decrease red Decrease
and
processed
LICs, current
availability
Decrease
Decrease
Decrease
Too high
High
Decrease
Too high
Too high
Decrease
Implement DGs in
processing
Too high
35%
Less than 20%
Reduce wastage
Abbreviations: DG, dietary guidelines; EBF, exclusive breastfeeding; HICs, high-income countries; IPCC, Intergovernmental Panel on Climate Change;
LICs, low-income countries; SSB, sugar-sweetened beverages; WHO, World Health Organization.
Colors: green, increase; red, decrease or limit; yellow, insufficient or change needed.
a
Recommendations common to most dietary guidelines.
b
Important for reducing wastage, improving bioavailability; aim to achieve DGs.
and young children is not possible without promoting and achieving high rates of breastfeeding.
Despite endorsements by all international professional organizations, the World Health Organization (WHO), and governments, breastfeeding targets have never been achieved on a global scale
(118). The health benefits of breastfeeding, both during infancy and throughout life, including
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the preservation of a healthy microbiome, have been extensively studied and will provide some
protection against the effects of climate change (16, 17, 149). Even in disaster situations, including
famine, breastfeeding remains the best option for meeting infants’ nutritional needs (23). The
alternative to breastfeeding is infant formula, which is usually based on cow’s milk. While milk
production in the twenty-first century is more efficient than in the past, the total impact is greater
owing to increased production (27). When compared with breastmilk, milk production uses large
amounts of water, which will be in scarce supply with climate change, and has a high carbon
footprint (124, 130).
Vietnam is an example of a low- to middle-income country (LMIC) that will experience water stress owing to climate change affecting the Mekong system; at the same time, Vietnam’s milk
production has increased by 12% per annum over the past decade (146). In LMICs, infant formula
is increasingly advertised on the Internet, which is accessible almost everywhere by smartphone
and is driving increased consumption and decreased breastfeeding. In recent years (2006–2011),
imports of infant formula to Vietnam have increased by 150%, and the response of the local industry, with government support, is to boost the formula and dairy industries (125). Breastmilk is the
ideal food for infants, with benefits that last into adulthood, which is important for achieving the
SDGs; however, the global infant formula and dairy industries are formidable opponents (19, 21,
88, 124). Extensive promotion of breastfeeding would provide benefits for infant health, reduce
health costs, and benefit the environment (46). The increase in adverse weather events along with
rising population densities and uncontrolled distribution of infant formula heightens the risk to
breastfeeding in disaster situations (i.e., the possibility of breastfeeding being discontinued) (23).
The elderly are vulnerable to increasing temperatures and require extra fluids and access to nutritious diets. They often move to urban environments away from traditional foods and extended
family support. For them, food traditions are deeply engrained in culture and change is not easy.
Traditional foods may no longer be available owing to agriculture shifts because of climate change,
and meeting their nutrient needs is often compounded by dentition and mobility problems. Specific nutrients at risk include vitamin D, B12 , iron, and protein (105). In a Swedish study, the diets
of the elderly were found to be more GHG intensive (129).
4. IMPLEMENTING CHANGE: WHAT WILL BE NEEDED?
Future objectives for the food and nutrition sector will be to improve the quality of the food supply
for everyone (food and health for all) while navigating the changes expected in food production
over the next several decades. Nutrient deficiencies may increase in LICs and recur in HICs, as
food diversity decreases and changes in nutrient content occur. The changes in crops and farmed
seafood (aquaculture) will require monitoring of nutrient composition and bioavailability, phytochemicals, and dietary content. The predominant guiding philosophy of public health nutrition
has been to meet all nutrient needs through eating a variety of healthy foods. This approach may
no longer be possible and may have to be met by fortification and supplements.
Micronutrient deficiencies, particularly iron, zinc, and vitamins, are of great importance (39).
Issues around interventions are complex because it is difficult to ensure adequate amounts without
a risk of toxicity (84). Biofortification with iron and vitamin A has proved challenging in delivering consistently safe doses while minimizing side effects, including infections (24). The preferred
option is always to eat a varied diet of nutrient-dense foods.
With improved food production in recent decades, the distribution of food consumption has
shifted to the right. Too little food, the left of the curve, results in undernutrition with a substantial
burden of morbidity and mortality, whereas at the opposite end of the spectrum obesity and its
sequelae cause major health problems for the two billion adults who are now overweight or obese.
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India is an example of an LMIC that succeeded in shifting the food distribution curve to the
right, with less undernutrition but more obesity (5, 156). Reduction of both undernutrition and
overconsumption (obesity) simultaneously implies a compression of the food consumption curve
by balancing increased physical activity with energy intake. This approach requires improvements
in food and nutrition equity within and between countries (18, 109, 145). Swinburn et al. (132)
describe an international pandemic of obesity, undernutrition, and climate change causing major
health problems for humanity as a “syndemic.” The obesity epidemic is also affecting infants and
young children, owing at least in part to declines in breastfeeding, increased use of infant formula
and SSBs, and disruption of the microbiome (60, 120) (see Figure 3).
Consumption of food groups such as fruits, berries, nuts, and unsaturated oils should be increased. However, these groups are projected to decrease, and research is required to increase
yields. Ensuring potable water for all (for drinking, food preparation, cleaning, washing) rather
than using it for increased irrigation and other projects will be difficult. The inevitable decrease
in meat supplies (and other animal foods) will cause tension as decisions are made either to distribute meat more evenly around the world to meet iron and protein deficits or to supply steaks
and hamburgers to wealthy countries. Additional promotion is needed for breastfeeding and for
the reduction of wastage, food contamination (chemical and microbiological), and spoilage. Better
packaging and storage are needed to achieve these aims.
Meeting future food needs (up to 50% more by 2050) is possible and can result in healthier
diets (91). However, improved diets will not just happen from changes made to food production
to moderate climate change. Health promotion will be needed to actively drive changes in eating
practices (75). The strengthening of health promotion and public health programs, aimed at preventing overweight and obesity and treating chronic disease with nutrition interventions, will be
an effective climate change adaptation strategy (127).
Some nutritional needs will be met with fortification or supplementation (e.g., sprinkles) rather
than through an increased variety of foods (37, 111). Aquaculture and mariculture of fish with
monitoring for nutrient content and improved food stocks will be needed. Nutrient content in
and technological modification of cultivars will need ongoing monitoring to maintain and improve nutritional quality. Toxicants may be produced by plants in response to climate change and
must be monitored. Research is needed for improving the production of fruits, nuts, berries, etc.
With the loss of biodiversity, nutritional deficiencies may emerge, and it may be many decades before all nutrient functions are discovered. Potential interactions with the use of supplements and
fortification should be monitored. Continuing research into the promotion of dietary guidelines
and better food storage, packaging, and preservation is required. There may be a loss of cultural
and culinary traditions. While change has always been a part of human society, the impact of the
relatively rapidly changing climate is unknown.
Generally, the dietary guidelines that already exist are more environmentally friendly than are
existing food consumption patterns, and, if applied uniformly, they will improve health and enable
the SDGs to be met. A carefully selected diet that meets environmental needs can meet all nutrient
requirements (9). Overcoming the barriers will depend on health promotion and motivation to
change, equity in food distribution, and international collaboration to meet the threat to human
life as we know it. Actions needed to improve and apply dietary guidelines in the climate change
era are as follows:
1. Global commitment to international collaboration on environmental action and to carbonneutral economies;
2. Education on nutrition and health;
3. Improved monitoring of food production and safety and nutrient content;
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4. Control on the reckless promotion of unhealthy foods by industry (and by governments,
e.g., the US government pressuring countries to accept infant formula);
5. Elimination of government subsidies for the production of unhealthy foods and foods that
are detrimental to the environment;
6. Increases in the production of fruit, nuts, and vegetables (how do we do this when forests
and orchards are disappearing?);
7. Reductions in the use of discretionary foods that are generally high in sugar, fat, or salt;
8. Taxes on sugar, salt, and saturated and trans fats, with incentives for nuts, etc. (107);
9. Breastfeeding promotion, control on infant formula sales, and implementation of WHO
code (107, 147);
10. Improved distribution of food across countries at all levels of development along with a
reduction in food wastage (104); and
11. More research on implementing change, including on determining how to get wealthy nations to reduce excessive intakes of environmentally costly foods.
We recommend that research focuses on the following three considerations. First, nudge theory
may produce gradual change over time (20). Because healthy diets alone may not produce substantial reductions in GHG emissions, DGs need to emphasize recommendations for environmental
sustainability. Minimizing the shift from current foods is likely to make changes more achievable (77). Second, changing populations’ ambitions is a concern; when a country becomes richer,
its population adopts Western diets. Why does this happen when Western diets are less healthy
and have environmental and social disadvantages? Third, why are fat chubby babies perceived as
healthy and desirable in Asia (33, 93)?
4.1. Threats to Progress
A range of responses to the simultaneous climate and COVID-19 crises are possible. Governments
may seek rapid recovery from the COVID-induced economic crisis and use cheap fossil fuels to
pursue economic growth regardless of the environmental costs. An optimistic scenario would see
governments working together with low-carbon technologies to reduce GHGs while reducing
poverty and inequality (135).
4.2. Food Equity
In nutrition, equity implies enough food to grow and develop optimally and to avoid deficiencies,
stunting, obesity, infectious diseases, and excess chronic disease. It will never mean that everyone
will eat exactly the same food prepared in the same way—a monotonous uniformity that ignores
millennia of culinary traditions. It also means adequate amounts of potable water for drinking,
food preparation, and washing.
4.3. Pandemics
Public health workers have been dreading another influenza pandemic. But the risk of other
epidemic infectious diseases (EIDs), including newly emerging diseases, is ever present. Few
recent epidemics have the global significance of COVID-19. Around 70% of EIDs, and almost
all recent pandemics, have originated in animals (the majority in wildlife), and their emergence
stems from complex interactions among wild and/or domestic animals and humans (45). The
COVID-19 epidemic is imposing strains on the world food supply chain, including labor
shortages, transport constraints, and the closure of food processing plants (151). People who
live in areas of food crises have higher rates of malnutrition (acute, chronic, and micronutrient
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deficiencies), weakened immune systems, and increased rates of chronic disease. If they contract
COVID-19, the consequences will be more severe. Increased illness and death will create further
food shortages owing to labor shortages, which will exacerbate the effects of climate change on
food production. Individuals with obesity and noncommunicable diseases have an increased risk
of a more severe course of COVID-19 infection, which should give more impetus to governments
to tackle and prevent obesity and related noncommunicable diseases (119).
4.4. Conflict
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Shortages of water and/or food have historically been major sources of conflict, and these conflicts
continue to this day (92). Conflict or other security issues were the main cause of food crises in
2019, but weather extremes and economic shocks became increasingly significant compared with
2018. Most of the countries with food insecurity have limited resources to deal with epidemics or
severe adverse weather events. The Global Report on Food Crises documents that during 2019
135 million people were classified as acutely food-insecure (up by 12% from the previous year)
(70). Food insecurity along with water shortages, poor sanitation facilities, and lack of access to
quality health care have contributed to declines in child nutrition. Most instances of severe food
and water shortages in Africa are often related to conflict (64, 70). A long-term association has
been demonstrated between food crises and conflict (26). Rapid increases in food prices in urban
areas can result in social and political unrest and, at a regional level, can be a trigger for conflict.
Changes in climatic conditions, including long-term climate changes, increase the risk of violence
and conflict (26).
4.5. Political Inertia and Short-Term Planning
Both climate change and the emergence of overweight and obesity are slowly evolving issues, and
humans have difficulty in appreciating the need for urgent action in these situations (69). Too
much time has already been lost, and this effort needs to begin now and to be integrated across all
disciplines (68, 72, 132). As consumers become richer, they tend to purchase more varied, higher
priced, and highly processed foods, or they eat out (72). The rich pay higher prices per nutrient
and outbid poorer countries for foods that provide essential nutrients, such as iron from meat.
Food prices, especially of nutritious foods, may increase as a consequence of reduced productivity,
putting further strains on low-income households (56). Policies aimed at reducing poverty and income inequality, while enhancing employment and income-generating activities, are key to raising
people’s incomes and ensuring the affordability of healthy diets.
4.6. Multinational Businesses and Climate Change
The agriculture, transport, food processing, retail, and marketing sectors need to orient their goals
toward improving health and the environment by producing and advertising foods that meet the
SDGs while consuming less energy. There is an increasing need for responsible corporate policy
and investment to contribute toward improving the environment (89). Can the corporate world
change its ways? Can they be encouraged to produce foods that minimize climate impact, are
environmentally friendly, and are health oriented?
5. CONCLUSION
Substantial progress has been made in improving global nutrition. Obesity and chronic disease
now represent new global challenges, even while undernutrition persists in some populations.
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Reducing and even reversing anthropogenic climate change have so far proved extremely difficult
or impossible. GHGs, which are environmentally detrimental, are still increasing, driven by higher
standards of living in modern consumer societies. Getting people to change individual habits and
cultures and to share with other nations who are less well-off has not proved possible to date.
Many studies have shown how following dietary guidelines could improve overall health and
reduce obesity and chronic disease if food production, processing, distribution, and consumption follow this advice. Research has offered consistent predictions on how food production will
change in the future and how these changes could be compatible with healthy diets. As the climate
changes, improved technology will be needed to maintain food supplies and ensure that all nutrition requirements are met. If food variety declines, additional research will be needed to improve
micronutrient content to meet nutritional needs.
Some foods that should be made more accessible and are associated with improved health, such
as whole grain cereals, fruits, vegetables, legumes, nuts, berries, and olive oil, have low environmental impacts. Red meat and dairy products have the largest negative environmental impacts and
are generally associated with a higher disease risk. Increases in supplies of fish are needed, while
ensuring that their nutritional quality is maintained. Increasing breastfeeding rates is important
and achievable for improving health and reducing the environmental impact of alternatives. Dietary transitions toward greater consumption of healthier foods would improve environmental
sustainability and health. However, considerable change in the food industry and consumer behavior will be required, as, so far, no country has successfully reversed the obesity epidemic because
the systemic and institutional drivers of obesity remain largely unabated.
The evidence, to date, demonstrates that major advances in sustainable food production and
availability can be achieved if all the political efforts and science can be mobilized to apply improved technologies.
SUMMARY POINTS
1. Nutrition improved in the last few decades, but undernutrition is still prevalent in some
regions while obesity is increasing in others.
2. Climate change will affect health and will substantially change food production. For the
medium term, it will be possible to produce enough food to maintain adequate intakes,
using improved farming practices and technology and more equity in distribution.
3. Following dietary guidelines would improve health, help reduce GHGs, and meet the
SDGs.
4. Monitoring of nutrients in food will be essential.
5. Increasing breastfeeding has benefits for health and the environment.
6. The combination of climate change and improvements in the quality of nutrition is the
major public health challenge of this decade and, indeed, this century.
FUTURE ISSUES
1. Ongoing monitoring of and research on food supply (quantity and quality) and nutrient
content are required.
2. Monitor and promote breastfeeding and the marketing of artificial substitutes.
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3. Research into the environmental footprint of foods is needed.
4. Continuing efforts should focus on understanding ways of encouraging populations to
follow DGs. Monitor the DGs in the light of climate and health changes.
DISCLOSURE STATEMENT
Annu. Rev. Public Health 2021.42:233-255. Downloaded from www.annualreviews.org
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The authors are not aware of any affiliations, memberships, funding, or financial holdings that
might be perceived as affecting the objectivity of this review.
AUTHOR CONTRIBUTIONS
All authors have read the final manuscript and approved its contents. C.W.B. and M.K.L. undertook the initial literature search. All authors wrote sections of the manuscript. C.W.B. and M.K.L.
undertook final editing and formatting before final approval by all authors.
ACKNOWLEDGMENTS
This research is funded in part by a grant from the Vietnam National Foundation for Science
and Technology Development (NAFOSTED) and the National Health and Medical Research
Council of Australia under grant number NHMRC.108.03-2018.09.
We are grateful to the following colleagues who reviewed the paper: Alice Lakati,
AMREF University, Nairobi, Kenya; Liqian Qiu, Zhejiang University PR China; Li Tang,
Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic
Science and Technology of China, Chengdu, China; Jessica Lin, Taipei Medical University; Minh
Pham, Thai Nguyen University, Vietnam; Tomiko Hokama, University of the Ryukyus, Japan;
Mahnaz Zarshenas, Shiraz University of Medical Science, Iran; Masaharu Kagawa, Kagawa Nutrition University, Japan; Wah Yun Low, University of Malaya, Malaysia; Raheema Abdul Raheem,
The Research Centre, Maldives National University, Male’, Maldives; Philip Baker, Queensland
University of Technology, Australia; Hazreen Abdul Majid, University of Malaya; Noran Naqiah
Hairi, University of Malaya; Awang Bulgiba Awang Mahmud, Academy of Sciences, Malaysia; and
Indika Karunathilake, Faculty of Medicine, University of Colombo, Sri Lanka.
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