Duration: 10/01/2001 to 09/30/2006

Administrative Advisor(s):

NIFA Reps:

Non-Technical Summary

Statement of Issues and Justification

Agriculture, food, and communities are three distinct systems that interact and overlap in important ways to improve and compromise human health. Each of these systems has changed over the past several decades with significant implications for health outcomes. Variations within these systems affect health within and across communities. Problems of community health are so complex that no single analysis can provide a full picture of how these systems fit together in a dynamic way.

However, this project proposes to begin the process by building a multi-dimensional analysis of the changes in agriculture and food systems and their impacts on community health. This research links three of the five national research priorities of the Land Grant Experiment Stations: 1) relationship of food to human health, 2) environment, natural resources, and landscape stewardship, and 3) rural community vitality. While research on these systems is important individually, critical interactions exist among these systems that are expected to be powerful influencers of human health. For this reason, we are proposing four objectives that represent different dimensions of the same phenomenon - local agri-food systems in globalized contexts - and these systems' relationships to local population health outcomes. Currently, it is not known how food systems, agricultural structure, and community problem solving responses affect population health. Past and current research has only given us small pieces of the larger puzzle. Not understanding the larger picture is a problem because policies and practices that support agricultural production, food distribution, nutritional interventions, and community development may not lead to better health outcomes. Our long-range goal is to build knowledge on how agriculture and food systems impact community health. The central hypothesis for this research is that variations in the structure of agriculture, food systems, and communities are associated with variations in place based population health.

Justification

The need to understand the causes of disease and illness is the reason for significant investment of dollars and research time in dietary behaviors and environmental relationships. Not unrelated is the increasing public concern about the effects of changes in food and agriculture systems on human health and environmental quality. These concerns reach across communities and have given rise to a remarkable range of new initiatives and civic organizations engaged in the search for information, new alternatives, and a better understanding of interlocking relationships across agri-food systems (see, for example, Henderson, 1998).

The industrialization of agriculture has been propelled by mechanization, the increased use of chemicals (i.e. synthetic fertilizers and pesticides), and most recently, advanced biotechnologies. Over the past 50 years, farms have become larger in size and fewer in number. Land is being used more intensively and yields per acre of farmland have increased dramatically.

After World War II, the contours of a truly "global" food system began to emerge as nationally organized food corporations grew in size. Beginning in the 1980s, a wave of mergers resulted in a tremendous consolidation of power in the food sector (Heffernan, 1997, 1999; Lyson and Raymer, 2000). The large multinational food corporations that came out of these mergers have increasingly taken on the task of organizing and coordinating the production, processing, and distribution of food. Today, mass-production food processors and distributors, along with mass-market retailers, are dominant fixtures in the American food economy. The degree of concentration has reached the point where the 10 largest U.S. based multinational corporations control almost 60 percent of the food and beverages sold in the U.S.
The industrialization and globalization of the food system means that a much smaller number of producers will interact with a small number of processors in highly integrated business alliances. Drabenstott (1999) estimates that "40 or fewer chains will control nearly all U.S. pork production in a matter of a few years, and that these chains will engage a mere fraction [italics added] of the 100,000 hog farms now scattered across the nation." In a similar vein, Gary Hanman, the CEO of Dairy Farms of America (the largest dairy cooperative in the U.S.), recently noted that, "We would need only 7,468 farms [out of over 100,000 today] with 1,000 cows if they produced 20,857 pounds of milk which is the average on the top four milk producing states" (Northeast Dairy Business, 1999:11).

As these changes have occurred, the food choices facing consumers decreased. Lyson and Raymer (2000) show how a food system dominated by a small number of large corporations offers consumers little real choice. Although over 16,000 new food products are introduced to the American consumer each year, the fact that most of these fail to gain market acceptance shows that large agribusiness firms are not responding to consumer demand, but rather 'trolling' for consumer dollars by offering repackaged, reformulated, and reengineered products in the hope that some of these products will be profitable. Coincidentally, as the consumer market is flooded with wave upon wave of 'new' products, the incidence of Type 2 diabetes, obesity, hypertension, hyperactivity, and other food related illnesses has increased.

Four out of ten leading causes of death are related to dietary and lifestyle factors (USDHHS, 1998:2-3). Heart disease, some cancers, stroke, and diabetes are all associated with dietary behavior. Obesity is highly associated with several chronic diseases including diabetes, hypertension, and breast and colorectal cancer (Kayrooz et al., 1998; Lillie-Blanton et al., 1993). Food resources and social infrastructures that support access, availability, type, and quality of food to individuals and their families vary considerably from community to community. Evidence is convincing that mortality is lowest in populations with the healthiest diets (Lino et al., 1998). The next step is to engage in additional analysis to examine whether a relationship exists between the structure of our food system and the health of the nation's citizens.

It is important to understand the abilities of various communities to deal with these problems given the concerns that have centered on food safety, agricultural practices, and other food and agriculture system issues. Such an undertaking would encompass investigations of communication outlets and decision-making structures and processes. Few issues become actual social problems until these systems have become engaged. The results are short and long term consequences on other systems.

Various researchers have argued that the popular mass media play an integral role in setting the social agenda for society (e.g., Dearing and Rogers, 1996; Rochon, 1998). This assertion has been supported by studies that show strong relationships between media coverage and public awareness, political endeavors, and policy decisions in both point-in-time and longitudinal studies (Dearing and Rogers, 1996). Agricultural and food safety issues have not escaped the attention of the popular press, and while surveys have shown a general concern for food safety among the lay public (Bruhn and Schutz, 1999), the marginalization of these issues may impact public perceptions (Ten Eyck, 2000). For this reason, it is important to investigate both media portrayals of food and agriculture issues and public perceptions of these issues.

Political and policy decision-making structures play a major role in the development, maintenance, and treatment of social problems. Investigating the problem solving abilities of a community with regards to food and agriculture issues should involve the ability of different groups to enter into political and policy arenas. According to Rochon (1998), the political opportunity structure can be defined by institutional pluralism, institutional porousness, and alliance opportunities. Pluralism encompasses the number of possible entry points into political and policy structures. A group or movement expecting to make an impact on an issue will have more chances of success if the political opportunity structure is highly plural versus one with just one or two entry points. Institutional porousness, on the other hand, is defined by the ability of the group or movement to become part of the decision-making process. At the local level, this could manifest itself through invitations to city or county meetings, having a member become an elected official, or bringing a lawsuit against another company or organization. Finally, some groups may find that developing linkages with individuals or groups, which are already part of the political structure, may be the most efficient way to have their voices heard.

Many communities are experiencing the emergence of civic organizations whose efforts include public health partnerships, alternative agriculture initiatives, alternative food groups, and coalitions for food security. These self-organizing community programs have engaged the hopes and energies of growing numbers of people who are realizing and asserting their agency in reshaping the systems that provide the most fundamental component of human health food (Lyson, 2000). Farmers and consumers who have been marginal to the conventional food system are beginning to use the unoccupied space in this system to develop alternative production, marketing, and social movements around food issues (Whatmore, 1995). Civic engagement is one way that local communities undertake to solve problems of human and environmental health.

In this research we ask: How do these trends in agriculture and changes in our food systems affect local communities? What are the impacts to health and well being of place based populations?
Technical feasibility and multi-state appropriateness: This research will require secondary and primary data and include qualitative and quantitative methods. Secondary data on mortality and disease rates at the county level are available from local health departments and through CDC compressed mortality files (CMF) from 1968-97. Census of Agriculture data are available at the county level. Key informant surveys and random sample surveys will be necessary to collect information about the community social structure and local food and agricultural systems. Members of the research group have extensive experience in conducting research using both secondary and primary data. In addition, researchers represent a variety of disciplinary knowledge including rural sociology, plant and soil sciences, nutrition and food sciences, communications, epidemiology, health administration, and anthropology. This multi-state effort will compare communities and locales across 10 states. Multi-state participation is important because state and local variations are expected to be sources of community health variation. Agriculture, food systems, communities, and health status vary by region and state. Rural, farm, and food policies as well as land use and environmental polices (EPA, FDA, NRCS, USDA) are national in scope and in need of scientific information that represents different areas of the country and the effects of national applications of policies.

Leverage. This multi-state project will provide the basis for undertaking state specific AES research and to leverage the development of new grants in support of specific objectives under this project. To carry out this project, participants will be undertaking grant proposals to NRI (National Research Initiative) and NIH (National Institute of Health) and other granting institutions.

Related, Current and Previous Work

The central focus of the proposed research project is population health. Our interest is to understand how agricultural systems, food systems, and community systems affect place based population health. Research on population health status and disease is extensive. One book that provides a useful systems framework that integrates social and physical environments into health and well being is, "Why are some people healthy and others not?" (Evans, Barer, and Marmor, 1994). They suggest that there are "systematic differences between the average health status of people in different regions, occupations, time periods, educational levels, and social classes" and that important information is missed when only individuals are studied (p. xii). Factors that determine health status are complex and linked to cultures, places, social, and economic factors. Evans, Barer, and Marmor (1994:46) write that their findings imply "that there are underlying factors that influence susceptibility to a whole range of diseases." This means that an analysis of health on a more general level may be more productive than the "etiology of specific diseases." Evans, Barer, and Marmor do not provide any analysis of agriculture and/or food systems and their potential link to general health.
Levin (1999) offers one of the most complete scientific expositions on understanding the link between environment, food quality, and disease in his book, "Environmental Nutrition." His work provides a systems approach to thinking about health, eating, nutrients, and food in the environment. The nutrient and health values of food are affected by dynamic interactions within the environment: soil, rainfall, harvest, storage, value added reformulation, and packaging. Levin's analysis focuses beyond the traditional "food as fuel" to an information based perspective that takes into account the roles of flavonoids, carotenoids, and toxins in a dynamic interactive system that sends and receives messages (via cellular communication) that ultimately affect human health. Levin's work provides a chemical explanation for how the environment could affect the macro and micronutrients in food, however, he only briefly discusses without depth systems of agriculture and communities.

While there is a significant body of research reported in the CRIS database on agriculture and food systems, very few seek to understand public health within the context of changes in those systems. Community economic health and individual farmer financial well being are investigated, and individual nutritional interventions and potential general health relationships are alluded to through diet associations. However, none use health outcomes as measures of system-wide impacts. Below are several current research projects on food systems, regional food production, structure of agriculture, and civic communities that provide a foundation for moving to place based population health analysis.

The Black Churches for Better Health Project (Simmons, 1994) is a dietary change program that used a community based voluntary organization to intervene in fruit and vegetable consumption behaviors of the adult church population. While this was an individual behavior change program, this is an example of how civic communities, communities with high levels of voluntary organizational involvement in food and health issues, can impact the overall health of the community. Another project, Delta NIRI (1996), is evaluating the nutrition and health of lower Mississippi Delta residents and designing nutritionally responsive interventions. Although the focus of this project has also been on individual nutritional behaviors and interventions, some key findings suggest there are also structural problems in health-nutrition relationships. Findings from a key informant survey of 500 people in 36 Delta counties were: 1) people eat too much fast food and junk food (94 percent), 2) people don't eat enough fruits and vegetables (67 percent), 3) there are too few groceries and food markets (45 percent), and 4) health problems have gotten worse in the last 5-10 years (60 percent). Other current healthy diet research on individuals' behaviors (NHANES and the Continuing Survey of Food Intakes by Individuals CSFII) find support for food, diet, and health relationships but are missing place based analysis that examines how the local food infrastructures affect food availability, access, and health outcomes.

The Role of Mass Media, Information, and Social Change: Publicity and Health Information Exposure in Community Campaigns (Finnegan and Tichenor, 1999) is an example of current research that examines population knowledge and opinion about health issues arising from public health campaigns in communities. However, this study and others examine public perceptions of food safety, health and food relationships, and agriculture and health, but seldom link findings to actual health outcomes.

A Hatch Project in New York (Gillespie, Hilchey, and Lyson, 1996) is designed to identify, examine, and compare the economic and geographic spaces occupied by large-scale, globally-oriented agricultural producers and smaller scale, community-integrated agricultural entrepreneurs. Measures of community welfare and socioeconomic well being associated with each type of agriculture are being examined. This research is confined to New York State and deals primarily with agricultural production and does not include distributional aspects of the food system or health relationships.

In New York, results of a survey of 500 northeasterners were used to provide background support for the development of a Regional Food Guide (Wilkins, 1995). Respondents expressed a preference for locally produced foods as well as reducing the cost and resources used to transport food from great distances, the preservation of the region's farmers and farmland, and their role as individuals in maintaining this agriculture. Nearly all respondents (98 percent) agreed that keeping farms viable in the northeast is important, and 97 percent noted that buying local produce is an effective way to keep farms viable in the northeast. While this regional food guide research supports healthy food selection, it did not directly address health outcomes.

Several other state-level projects have examined agriculture and community linkages. A project in Missouri (Gilles, 1993) used survey data from two agriculturally-dependent towns to examine the relationship of export agriculture to community vitality. In California, a recently completed project (Rudy, 1995) examined changes in agriculture and rural communities in the Imperial Valley. The relationship of sustainable agricultural practices to the viability of rural communities was also the focus of a Minnesota project (Levins, 1996). Finally, an Idaho project (Harp, 1996) was centered on modeling the relationship between social well being of rural communities and the structure of the local economic base. All of these projects deal with only one or two communities and none look comprehensively at food systems and population health.

Several state-level projects touch on different aspects of local food and agricultural systems. The role of cooperatives in rural community development was the topic of a recently completed project at the University of Wisconsin (Cropp, Acton, and Cottingham, 1994). Research at the University of Vermont (Kolodinsky, 1996) focused on factors related to the decision to join a CSA (community-supported agriculture).

The global aspects of food and agricultural production are the focus of research projects underway in several states. In New York (McMichael, 1996), research will develop a systematic comparative analysis of the regional and global institutional forces affecting the structure and trajectory of the U.S. farm sector. In Missouri (Heffernan, 1996), an ongoing research project is documenting the process of vertical and horizontal integration of the global food system and attempting to discern the effects of the globalization process of local agriculture and rural communities. A second Missouri project (Bonanno, 1996) deals with farmers' perceptions of the globalization process.

While numerous studies have examined specific types of farms as well as specific commodity price structures and policies, only a few have studied entire commodity systems with local development and equity as central issues of concern. Most of the projects focus on only a very limited set of aspects of the commodities examined. For example, Davis (1995) proposes to develop and test export market assessment models for dry beans. Similarly, Ray (1993) proposes to develop a linear programming model of agricultural policy. Yonkers and Ford (1991) are working on developing a model of factors influencing profitability in the dairy industry. Ricks et al. (1993) is examining the competitiveness of the U.S. fruit and vegetable production system. Anderson, Gates, and Wessels (1991) are working on an analysis of strategies used by firms operating in the food system.
Although there are many regional research projects with a commodity focus, virtually all of these projects deal with the economic or technical aspects of the commodity (for example, see NC-186, Structural Changes in the U.S. Grains and Oilseeds Marketing System in a Dynamic and Global Marketplace; NC-119, Dairy Herd Management Strategies for Improved Decision Making and Profitability; or NE-177, Organizational and Structural Changes in the Dairy Industry). Similarly, regional projects dealing with the food system have a decidedly economic focus to them (i.e. NE-165, Private Strategies, Public Policies, and Food System Performance).

The recently completed regional project S-246, The Transformation of Agriculture: Resources, Technologies, and Policies, was designed to examine the consequences of agricultural restructuring on farms, families, communities, and society. While this project addressed some of the issues related to farming and community linkages, it did not deal with food system issues comprehensively at the local level, nor did it address the linkages to population health.

NE-185, Commodities, Consumers, and Communities: Local Food Systems in a Globalizing Environment, is an analysis of the restructuring of local food and agricultural systems in response to increased global and national competition and consolidation. It documents strategies that producers, consumers, and communities are using to reestablish and sustain local/community food and agricultural systems. This research and many of those cited above are analyses of one or two components of agriculture, food systems, and community systems. However, most are focused on economic, individual, and community sustainability without explicit reference to population health.
The NRI Linking Agriculture, Food Systems, Communities and Population Health Conference (Morton, 2000) provided a forum for multiple disciplines and institutions to discuss conceptualized roles of agriculture in public health. This conference offered a beginning opportunity for researchers to forge a new research agenda for evaluating changes and trends in agriculture, food systems, and community systems and their impacts on health.

No current or recent regional research project takes into account population health outcomes associated with food and agricultural systems. And no regional or state projects are taking a multi-dimensional approach to examining system relationships of food, agriculture, and communities to community health. This will be the goal of our project. To achieve this goal, we propose the four following research objectives.

Objectives

1. Determine the consequences of agriculture and food systems on the health of distinct populations.
   
2. Determine the impact community problem solving around food issues has on population health.
   
3. Determine the relationships among collective action, agriculture and food systems, and population health.
   
4. Determine the relationships between the scale of the agri-food system and population and landscape health.
   
5. 
   

Methods

All objectives include the collection, analysis, and interpretation of qualitative and quantitative data (primary and secondary) on specific geographic locations. Units of analysis will range from county to community to neighborhood depending on objective and participating researchers. Places of study will be selected to allow data to be collected on multiple objectives. This will permit incorporated comparisons of particular places yielding a multi-dimensional view of systems impacts on health. For example, Objective 4 will use specific criteria for selecting a mix of seven rural based and urban based counties in each state. Objectives 1 and 2 will use one or more of these same counties to examine rural aspects and link these systems to population health. Media content analysis, communication messages from media sources, rural food supply (food deserts), and issues of poverty, race/ethnicity, and age are parts of these analyses. Urban areas will use neighborhoods as their unit of analysis for Objectives 1 and 2. Key informant surveys will be used to collect data on food supply and community infrastructures. Secondary data and individual surveys will collect health data and food practices. Objective 3 will use whole communities to analyze informal and formal group organizations and activities related to food and agricultural issues. Population health outcomes information will be derived from secondary and primary data collection. Places selected for Objective 3 may overlap urban and rural regions selected by Objectives 1, 2, and 4. Specific Methodologies for Each Objective Objective 1. Determine the consequences of agriculture and food systems on the health of distinct populations. Distinct populations for study under this objective are: 1) rural and urban populations, 2) income groups, 3) age groups (youth, young adults, middle adults, and elderly), 4) race/ethnicity groups, and 5) regions/counties/communities/neighborhoods with high and low problem solving capacities. The characteristics of specific populations make them vulnerable in terms of health to how agriculture and food systems are organized. The physical and social infrastructures that support a community food supply affect food availability, access, and quality. This means that the density and type of food stores, eating places, farmers' markets, community gardens, and other food sources as well as community organization around food issues will have an influence on health outcomes of distinct populations. Methodology: The physical and social infrastructures of communities constrain or enlarge residents' food purchasing and healthy diet options. To assess how the health of individuals living in communities are influenced by the food system, each state participating in this objective will use health statistical data from their state, county health departments, and the most recent five-year county average of mortality and specific diseases from the CDC CMF. Locales of study will be selected to represent high and low rates of diabetes, cardiovascular disease, and obesity, and intersect with rural and urban places chosen for Objectives 3 and 4. Once counties have been identified, further secondary data will be gathered for each community on the following variables: demographic composition; socioeconomic status indicators; natality and mortality statistics by age, health and nutrition status indicators, ethnicity, and gender; lifestyle and environmental data; health systems information; nutrition and food assistance programs and resources; and agricultural and food systems in place. Health status indicators will include morbidity, mortality, and disability rates, and incidence and prevalence of specific diseases. These data will be collected through existing resources in each community (health departments, state planning agencies, local hospitals, and census data). Nutrition status indicators will include information on obesity, diet intake, knowledge and beliefs about food, and the amount of food insecurity present in the community. These data will come from secondary and primary sources (surveying, interviewing informants, oral histories, and focus groups.) Food system information will include location and types of grocery stores, co-ops, and restaurants in the community; the availability of alternative foods (sustainably and organically grown and produced); and types of foods available in worksite and school cafeterias. To complement the secondary data, it will be necessary to obtain some of the above information using surveys, interviews, and focus groups. In order to assess the problem solving ability of each identified community, data will be collected on the social organization of the area. The goal is to discover all groups and organizations in the area/county who contribute to solving community problems relating to food and nutrition. This information intersects with Objective 3's data needs and efforts will be made to standardize information collection. Information on both the density (the number of groups) and types of groups (e.g., public, private, single focus, multi-focus, bridging organizations, citizen group) will be collected. County public health departments will be asked to partner in the research and application of findings. Data will be gathered on the structure and functions of state and local public health and the division of labor/function between health, agriculture, environmental quality, and social service agencies. For example, many county level health departments have responsibilities for restaurant inspections, sanitation and water supply, as well as community nutrition and health planning. Some states assign the state agriculture department responsibility for inspections of grocery stores, food warehousing, and food production and processing. Other local agencies and organizations will be interviewed regarding their services that include food, nutrition, and health. They will also be used to identify other related groups in the area. States that participate in this research objective will be encouraged to contact their state Expanded Food and Nutrition Education Program (EFNEP) and Food Stamp Nutrition Education Program (FSNEP) for support and potential funding of small segments of the project. This linkage will be especially important in disseminating results. Objective 2. Determine the impact community problem solving around food issues has on population health. Food problems are socially constructed. Problem definition often originates in the media. It is the media that sets the agenda for action or inaction. Community awareness and interpretation of food issues and the way individuals and groups participate in problem solving as a result of knowledge influence the political and social infrastructure (including laws and public actions) that supports or constrains population health. Methodology: Each of these components (agenda-setting, public perceptions, and political/policy structures) has been heavily researched, therefore, a body of literature on methodological approaches already exists. Agenda setting is typically studied by comparing media coverage to public opinion. Media coverage is gathered through content analyses of print and broadcast news often relying only on the major national newspapers such as The New York Times and Washington Post. While these are news sources that should be taken into account, local news sources should be drawn upon to understand the context of how issues are being discussed at the local level. Typical variables such as placement of the article/broadcast, length of article/broadcast, and affiliations of sources used in the article/broadcast will be analyzed to gain a greater understanding of the media coverage for both local and national news. In addition, interviews with authors and sources will be conducted to gain further insight into the making of the news (Ten Eyck, 1999). Public perceptions will be measured through standard survey methodology. The main concern is to develop questions that measure knowledge and awareness of food and agriculture issues within the local context. This requires that the investigators understand the issues which have appeared in local media discourse, as well as other issues that may be discussed within the local community but not part of the local media discourse. This will mean relying on some local informants such as extension agents or food co-op managers to help understand issues facing the community. Finally, opportunities within the political/policy structure can be measured though content analyses of media discourse (e.g., are new groups being mentioned by the press) and internal documents from the challenging groups and within the formal political structure. These content analyses can be supplemented with interviews with individuals within the groups and within the formal political structures. Developing a typology of the political strategies through these data collection methods has been offered by various authors such as Rochon (1998) who looked at the relationship between alliances and goals of different groups and movements. Gamson (1990) has also developed a categorization scheme for measuring the success of challenging groups which includes co-optation (gaining access to the formal political structure without gaining requested benefits), preemption (gaining requested benefits from the formal political structure without gaining access), full response (gaining both benefits and access), and full collapse (no benefits or access). Integrating these findings with those of the agenda-setting study and public opinion surveys will help to understand the ability of various communities to deal with community problems generated by food and agriculture systems and practices. States participating in this objective will select one or more locales from sites in Objectives 1, 3, and/or 4 for communication and local problem solving analyses. Objective 3. Determine the relationships among collective action, the structure of agriculture and food systems, and population health. The range of civic organizations whose missions encompass combinations of human health, sustainable communities, and environment is remarkable. For example, alternative food initiatives seek to reconnect farmers and consumers through farmers' markets, community-supported agriculture, and the reinvigoration of family farms. Other organizations work to organize and empower disenfranchised communities through urban gardens and micro enterprises. Still others advocate for improved standards for food quality and the practices under which food is produced. A number of groups provide agricultural, environmental, food and nutritional education in schools, and alternative training programs. Some address the problem of community food security (the need to ensure that all people are provided with access to secure, sufficient, and nutritious food) through a community based food system grounded in regional agriculture and local decision making. Clearly, if we are to understand how systemic change in local agri-food systems occurs and how these changes affect human health, it will be important to analyze the activities and impacts of local actors, groups, and organizations on the health of local populations. Methodology: This objective will first document local agri-food networks and analyze their impacts on the health of the local population and ecological landscape. Then, it will compare the health and well being of people who are members of groups that are engaged in food and/or health related activities with those who are not involved. A two-part methodology is proposed. In phase one, two communities will be identified in each participating state for intensive study. One of the communities in each state will be urban based, while the other will be a non-urban community in an agricultural region of the same state. In both cases, communities that have high organizational densities (relative to other areas of that state) of civic engagement will be selected. That is, both communities should have a number of local groups and collective actors that are engaged in promoting social change, although not all of these collective actors need to be engaged directly in promoting changes in the agri-food system or local population health. This methodology assumes that organizations are connected to one another through formal and informal links. Systematic and in-depth interviews will be conducted with key informants from those groups. Through the use of a snowball technique, other actors and organizations inside and outside of the community will be identified and interviewed. The interviews will include the organization's orientation toward problems and solutions in agri-food systems practices and policies, perceived relationships among the food system and health, perceived relationships among agricultural and food production systems and environmental health, and actions the group has taken regarding these issues. In phase two, researchers will analyze the extent to which organizational participation is correlated with healthier eating and living habits. A survey will include questions about respondents' food acquisition, eating, and health habits, and will be administered to two groups. One group will be a sample of members of an active local organization promoting change in the local food system. The other will be a comparable sample of non-group members living in the same community. Survey results will be compared within the community, within the state, and across states. Objective 4. Determine the relationships between the scale of the agri-food system and population and landscape health. The industrialization of agriculture and the globalization of the food system have brought new foods, marketing strategies, and innovations that have changed the consumption patterns of Americans and the environmental/landscape patterns of their local communities. Many of these impacts are the result of changes in the concentrations and scale of agriculture and food systems. What are the relationships between community health and changes in the scale of these systems? Methodology: In order to accomplish Objective 4, data on relevant agricultural conditions and health are required. As existing data tends to be available at the county level, the county will serve as the unit of analysis in accomplishing this objective. Seven different types of counties from each of the participating states will be identified using the following criteria as guidelines (but varying as appropriate to conditions): each county should contain a minimum of 100 farms. The seven counties will be distinguished by the degree of agricultural concentration, the importance of agriculture (both conventional and diversified), the importance of production for both local and global markets, and integration into standard agriculture and into organic or other alternative agricultural systems. Using the 1997 Census of Agriculture, concentration will be represented through the selection of a county in which 5 percent of the agricultural producers produce 85 percent of farm sales, and the selection of a county in which 50 percent of the farms produce at least 50 percent of farm sales. The percent of direct sales in counties will provide data on production for the local market. We will select the county with the highest percentage of direct farm sales and the county with the lowest percentage of direct sales. Finally, the use of agri-chemicals will reflect integration into standard agriculture. The county with the highest level of fertilizer and chemical sales per acre and the county with the lowest in sales per acre of these chemicals will be selected. Once these counties are identified from each state, data on concentration, agricultural land use, direct sales, and use of agri-chemicals (when available) will be drawn from successive agricultural censuses beginning with the 1950 Census of Agriculture. Health data (mortality by cause; morbidity by cause) will be obtained through the state health departments of each participating state and CDC CMF 1968-1997. Specifically, data on illnesses or deaths due to chronic illnesses such as coronary hearth disease, various cancers, diabetes, and hypertension will be based on 5 and 10-year averages to protect confidentially and provide stability for small numbers. While the time series data on agriculture and health will be insufficient for standard time series analyses, they will provide a means of comparative analysis of the relationship between agriculture and health at the county level. Cross-sectional multivariate analysis, however, will be possible (Chin and Newsted, 1999). In order to fully accomplish Objective 4 and contribute to the accomplishment of other objectives, primary data will be collected from a telephone interview of 40 adults in each of the 7 counties in each of the participating states. This sample will be obtained via random digit dialing. Data from these interviews will be aggregated in order to make use of them in our analyses of the effects of agriculture on health. The telephone interviews will provide us with health data unobtainable from county level morbidity and mortality statistics. First, we will be able to obtain data on subjectively experienced health. Such data are important for they are excellent predictors of future health problems (Idler and Kasl, 1991). Second, we will be able to obtain data on obesity by obtaining height and weight data from the respondents. While there are some problems with the reliability of such self-reports, such data serve as the primary means by which the CDC calculates the annual incidence of obesity in the U.S. In addition, we will be able to obtain data on the individuals' participation in the food system. We will determine the usual sources of various food items such as fruits and vegetables, meats, and dairy products. Finally, we will collect data on the individuals' perceptions of the role that food plays in health as well as their knowledge of both the local and global food system. A second source of primary data will be obtained through interviews of a random sample of supermarket/grocery store managers, restaurant managers, and directors of emergency food pantries/food banks. These interviews will focus on manager/director perceptions of the role that food plays in health and their knowledge of the local and global food systems. We will also ascertain their perceptions of their customers' interest in healthy food. A third source of data will be gathered using farm-landscape case histories. In each participating state, cases will be documented using ethnographic interviews, observations, and photographs to describe the existence (or non-existence) of integrated agroecological, family, and community characteristics that contribute to overall landscape, farm system, and community health. Systems will be selected for their variation in type and scale. Specific management practices such as the following, but not limited to these, will be identified: intercropping, crop rotations, agroforestry, biological pest management, animal-plant integration, open grazing, minimum tillage, buffer strips, habitat restoration, etc. Attention will be given to family members' self-assessment of their own aptitudes, goals, and values regarding issues of sustainability and health and well being. Other qualities to be documented include marketed innovations (local and global) and links to the community and/or regional socioeconomic and political system.

Measurement of Progress and Results

Outputs

• As a result of this research, it is expected that a number of publications including journal articles, popular press articles, and extension bulletins will be produced. In addition, an edited book of research findings will provide a comparative analysis of locales and communities' studied and a summary of important findings in order to begin to answer the question, "How do agriculture and food systems impact community health?"

Outcomes or Projected Impacts

• It is expected that the outcome of this research will be increased knowledge and understanding about how these systems interact to influence community health. This knowledge will provide the basis for educating citizens and stakeholder groups about the complex relationships between how food is produced and distributed and the choices they have for accessing foods. This means helping people understand that these are related systems and when one part of one system is not functioning well it will have an impact on the whole system and other inter-related systems.
• public health, extension, and community educators understand the importance of engaging stakeholder groups in critical food issues - assessment through problem solving and evaluation
• increased research knowledge from which to build appropriate public policies, regulations, and interventions relating to agriculture, food systems, communities, and their relationships to population health
• community leaders and educators better understand the interdependencies of system components
• greater public information for informing public discourse and the development of public policies and practices
• 6. new intervention strategies to improve community health<br> 7. identification of activities that influence community health<br> 8. identification of possible best practices that would improve community health<br> 9. new frameworks for reducing the cost of health and environment interventions to society, including reducing the burden on the economy and society<br> 10. new strategies for increasing civic engagement in the food system<br> 11. expand new markets for agricultural products that support health<br> 12. increased agricultural and food systems literacy

Milestones

(1):search committee organized and proposals for funding objectives developed

(2):gin research on each objective, use in-house resources to carry out low cost portions, and await funding support from proposals

(2):carry out research including secondary data analysis and interpretation; primary data collection, analysis, and interpretation

(4):synthesis across objectives in support of the overarching research question; write publications; lay the groundwork for outreach and extension activities

(0):0

Projected Participation

View Appendix E: Participation

Outreach Plan

This project outreach plan includes a continuous process of involving local stakeholders and community leaders in the development of standardized data collection instruments and in the identification of key informants and participants. As a result of their involvement in the research process, it is expected that they will have some ownership of the results and work with individual state teams to develop policies and practices that support findings. A series of workshops and interactive forums will provide follow-up opportunities for participating faculty and students and communities and their leaders to learn from this project. In addition, it is expected that results will be summarized in extension bulletins and mass media to increase awareness, understanding, and alternative solutions to improving community health. Specific efforts will be undertaken to share these research findings with public and community health educators and policymakers at local and state levels.

Organization/Governance

A Regional Technical Committee will be organized according to procedures in the "Manual for Cooperative Research" dated 1992. The voting membership of the Committee includes one representative from each cooperating experiment station, appointed by the Station Director, and a representative of each cooperating USDA-CSREES research division. Other representatives of participating organizations, including the Administrative Advisor, Administrative Representative, and CSREES representative, are nonvoting members. All voting members of the Technical Committee are eligible for office. The primary role of the Technical Committee will be coordinating the work of the project. Annual meetings will be held for the purpose of conducting business related to the project.

The offices of the Regional Technical Committee will be Chair, Vice-chair, and Secretary. Subcommittees will be named by the Chair. The Chair, in accord with the Administrative Advisor, will notify the Technical Committee of the time and place of annual meetings, prepare agendas and preside at meetings of the Technical and Executive Committees. The Chairperson's responsibilities will include preparation of annual and regional reports. The Vice-chairperson will assist the Chair in all functions. The Secretary will record minutes and perform other duties assigned by the Technical Committee or Administrative Advisor.

Literature Cited

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Attachments

Land Grant Participating States/Institutions

CA, IA, MI, MN, MO, MS, NJ, NY, OH, PA, TX, WA

Non Land Grant Participating States/Institutions

California-Santa Cruz, Cornell University