Agriculture Bill

Written evidence submitted by the Public Health Policy Evaluation Unit at the School of Public Health, Imperial College London (AB21)

 

Who are we?

The Public Health Policy Evaluation unit is a research group within the School of Public Health, Imperial College London, with a research focus on evaluating public health policies to improve health outcomes in the UK and abroad. Some of our recent work has used scenario modelling approaches to estimate the potential impacts of post-Brexit trade and agricultural policies on dietary intake and health outcomes.

Summary

· Agriculture is an important determinant of public health as it can influence food systems by affecting availability, quality, and price of food commodities.

· The new agricultural policy has the capacity to promote public health by supporting domestic production of fruit and vegetables and increase their consumption through a comprehensive strategy that intervenes across the supply chain.

· We provide quantitative evidence on the potential impacts of increasing land allocated to fruit and vegetable production in England on cardiovascular disease and inequalities.

Introduction

Agricultural policy is an important determinant of the food system as it can affect availability, accessibility, affordability and acceptability of food commodities. This can shape what and the way people eat and consequently impact public health.

Low intake of fruit and vegetables is among the most important dietary risk factors of chronic disease, including heart disease and stroke. In the UK, intake of fruit and vegetables is suboptimal. Only 31% of adults and 8% of children achieve the governmental recommendation of five fruit and vegetables per day1. Moreover, we produce much less fruit and vegetables than we consume, with only 16% of fruit supply and 52% of vegetable supply being attributed to domestic production2.

What is our proposal?

We recommend an amendment to Clause 1(1) (page 2, line 5) of the Agriculture Bill to include that the Secretary of State may additionally give financial assistance for or in connection with the following:

(k) promoting public health outcomes

The promotion of public health through the Agriculture Bill can be achieved in different ways as it has been previously recommended by food and farming think tanks through written evidence3, 4. In our proposal, we recommend that improved public health can be achieved by strengthening mechanisms within the Bill to support the domestic supply and demand for British-grown fruit and vegetables.

Evidence to support our proposal

We quantified the potential impact on cardiovascular disease of increasing land allocated to fruit and vegetables in England in order to increase domestic production as part of a comprehensive strategy that intervenes across the supply chain5.

According to data on Agricultural Land Classification6, 19% of agricultural land in England can be used for cultivation of crops such as fruit and vegetables. However, currently only 1.4% of agricultural land is used for this purpose.

We estimated that if there was a gradual increase in land used for fruit and vegetable production until it reached 10% of suitable land (1.9% of total land), fruit and vegetable intake could increase by approximately 3.7% (95% Uncertainty Interval: 1.6% – 8.6%) and 7.8% (4.2% – 13.7%) respectively, preventing or postponing approximately 3,890 (1,950 – 7,080) cardiovascular disease deaths between 2021 and 2030. We should note that this scenario is comparable with historic land use for fruit and vegetable production, based on average land use estimates between 1983 and 19907.

In a more ambitious scenario, we found that if land used to grow fruit and vegetables gradually increased until it reaches 20% of suitable land (3.9% of total land), fruit and vegetable intake could increase by approximately 17.4% (9.1% – 36.9%) and 37% (24.3% – 55.7%) respectively, preventing or postponing approximately 18,010 (9,840 – 28,870) cardiovascular disease deaths between 2021 and 2030.

We also investigated how these health benefits could impact health inequalities by estimating impacts across five deprivation groups in England. Both our modelled scenarios suggest that inequalities would be reduced, with 16% of averted deaths occurring in the least deprived group compared with 22% in the most deprived.

In order to achieve these estimated benefits, an increase in production would have to be combined with a range of policies to ensure that this extra production is consumed domestically, after considering losses between agricultural supply and purchases and household waste. We believe that this is possible through a comprehensive farm-to-fork agricultural policy that intervenes across the supply chain to support increased demand for fruit and vegetables as well as supply.

There are different ways that the new agricultural policy can support fruit and vegetable demand. These include, but are not limited to, improving local accessibility, quality, and affordability of domestic fruit and vegetables by supporting shorter supply chains through local markets and farm shops, investing in marketing and promotion of local fruit and vegetables, supporting public procurement of British fruit and vegetables, and promoting other innovative measures, such as community-supported agriculture.

February 2020