Rulers have held conferences about food, hunger and health since the land between the Tigris and Euphrates rivers was farmed 11,000 years ago. Now every five years the United States Congress passes a comprehensive Farm Bill in that great tradition of balancing complicated and conflicting ideas about how to feed another generation. Governments have usually gotten their citizens enough calories in the short run, but screwed up the long run, turning farms turning into deserts. Mesopotamia, now Iraq, was “the fertile crescent,” just as northern Africa was the grainery of the Romans, just as Iowa is for us. Doesn’t bode well for Iowa.
At Joe Biden’s White House Conference on Food, Hunger and Health last week I sat behind Dr. Dean Ornish, the cardiologist who was derided for showing that one could reverse heart disease with nutrition, exercise and, even more controversially, social/spiritual support. On my left was the President of American Soybean Association, which has so successfully lobbied for their bean that it is second only to corn syrup as the most common ingredient in the American diet, including many products that are only barely identifiable as food. There were many such ironies in the room: food bankers munching on lunch provided by Google. Hospitals like mine highlighting community food initiatives in the shadow of our massive surgical towers that Dr. Ornish proved unnecessary decades ago. Meals on Wheels executives jostling with Instacart lobbyists. Organic farmers next to pesticide people. Chef José Andrés, the electrifying Puerto Rican Chef sounded the call to simply feed everybody…now; just do it.
The last time food rated a White House conference was under President Nixon 53 years ago when I was in high school. He opened the door to China, just as he opened the kitchen cupboards to food stamps, now called WIC and school lunch programs. He also had Earl Butts as Secretary of Agriculture who considered small farmers a silly distraction in favor of industrial behemoths. The mishmash of noble and industrial programs had all sorts of unintended consequences that their advocates understand need to be corrected. New York Mayor Eric Adams (sitting next to Dr. Ornish) wanted the health experts to be responsible for designed school lunches to be about nutrition, not calories: “we’re just feeding the next health crisis.” Donna Martin, The head of Burke County Georgia school kitchens asked for the same thing: “come to school, work in our kitchens, feed our kids.”
Food doesn’t come from a warehouse or even a kitchen; it comes from soil. The kitchen just links two astonishing complexities, the soil biome and the one in our gut where food turns into…us. We know now that the human gut biome determines much of our resilience and lifespan health. Many even speak of the “gut brain” to describe how the biome shapes our choices, emotions, patterns of behavior. The only thing more complex is soil itself. Bad dirt, bad gut, bad health.
Those complexities of soil and gut are largely shaped by the third, politics. Perhaps as complex as food and soil is the social biome; how the 8 billion of us love, fear and choose over our lifespans. Our social choices emerge from our social soil, not surprisingly these days producing poorly nourished decisions. Our civil society, Congress and courts are like children raised on Twinkies and Red Bull; our democratic process staggers in puff and bluster.
It is easy to be cynical about events like the White House Food, Hunger and Health Conference. But this is how democracies muddle our our way, and nearly infinitely smarter than letting the rich royalty dither. The day before the Conference, the White House released a thoughtful national food strategy with 5 pillars—the first one focusing on economic stability. This thoughtful document is only paper until it gets translated into the 2024 budget and the $1.1 trillion Farm Bill. That legislation will determine how many soybeans get subsidized, what kids get free lunches, what moms watch their kids grow healthy or smaller. As President Joe said, “if a mother can’t feed her child, what the hell else matters?” A handful of contested house seats will decide whether that legislation will will be shaped by the people who put together the White House food strategy or people with no strategy at all. Food policy shapes generations; Wendell Berry thought we should enact 50-year Farm Bill’s to break the dangerously short-term thinking. ( Jackson, Wes; Berry, Wendell (January 5, 2009). “A 50-Year Farm Bill”. The New York Times.)
The food conference should make everyone uncomfortable a half century after the last one. Different decisions could help our community systems produce much more health. But we have to include capital investments on the screen, which is especially sensitive for hospitals and industries such as soybeans and food chemicals. Once you’ve built something, you have to pay for it. Better scientific critique would prevent us making extravagant and unfounded investments that produce little real gain in health. Our non-profit industry has shielded our capital investment side from visibility to the community benefit legislation, so I don’t sense we have a lot of moral high ground on the soybean people. Like fixing the food stamp and school lunch programs, the hungry would have us fix community benefit legislation, too.
Most politics is mostly projected out of the past, not the future. The arguments focus on keeping privileges, not getting new ones. That’s how the 3/5th of a citizen idea got into our founding documents: it kept slavery and made inevitable the Civil War. This is also how the subsidies for cotton, sugar, soybean and petrochemical industries end up the Farm Bill cycle after cycle. I was representing Stakeholder Health which has dozens of healthcare non-profits, so I was not comfortable about our illogical privileges, too. We give away a lot of free care. But we could be way more scientific about our investments, including the vast sunk cost of buildings. If we stacked all our bed towers next to all the soybean silos, I think ours would be higher, more expensive and harder to defend.
The day before the White House Conference I was part of a workshop convened by the Stand Together Foundation—a child of the Koch Brothers Foundation. It would have been easy to be cynical about this one, too. But the invitation was just as hard to turn down as the White House Conference, as the subject was just as fundamental: “social dynamics of health.” The two were windows on opposite side of the house peering into the same phenomenon.
The link between the tiny San Diego workshop and massive WH Conference is hard to miss as both events raise fundamental issues of how to achieve fundamental public good. One of the big changes since the last WH Conference is the huge expansion in the non-governmental non-profit sector, especially in healthcare. Neither meeting was about more charity. Rather, the issue is how to appropriately recognize our part of the community systems that create the population scale patterns of health. Whether we are big hospitals or soybean farmers, we should thoughtfully subjecting all of our community-facing policies to basic science critique, especially procurement and capital planning.
The place to start is the same place as doctors do, “first, do no harm.” Wendell Berry was a young man during the Nixon Conference. He was already famous for taking on the agro-industrial machinery that found small farmers so inconvenient and illogical. “What I wish to speak for here is the discipline in the Human character that makes him able to forebear and restrain himself when he’s doing obvious damage to other people.”
Bad food and bad food policy comes from ravaged social soil. Ours is worse than depleted; actively poisoned. Carpet bomb spraying of pesticides makes it impossible for bees to fly or think. Anyone who would do that has drunk their own poison. Dirty politics? I only wish that politics were as healthy, resilient and self-cleansing as dirt.
The maven at the heart of the San Diego meeting was Tom Romeo, VP of the Charles Koch Foundation. Tom had gathered a group of thinker-doers working with the homeless, in public housing developments, with police and troubled kids and two surprisingly cheerful economists. Tom gifted the participants with copies of Ivan Illich’s 1973 book, Nemesis and Deep Economy by Bill McKibben. The third hand-out was a paper TC, Jim Cochrane and I wrote for the National Academies of Sciences about “the health of complex human systems.” These are not what you’d expect of a Koch workshop; a signal that something very basic is changing in the idea soil out of which grows the social dynamics.
Illich, McKibben and my team argue that we have to see human health as the fruit of nested complex systems, just related as soil and gut. This is not a metaphor; this is why things happen as they do. It is why the planet is melting, bees dying and neighborhoods go hungry. If we do not think, analyze and dialogue in the complexity of the nested systems, we will break those systems. The farms will turn to desert and our children will grow small, theirs smaller still.
The data say that we are well beyond the tipping point and that we should despair. However, the natural systems testify that they rebound once the poisoning stops. The ozone hole we thought our doom two decades ago, is already half healed. The Monarch and the Honeybees will thrive too, as will all that comes from healthy soil, meadow and forest. The only question is whether our grandchildren will be here to enjoy it.
Winston Churchill used to say that you can on Americans to do the right thing…after we have exhausted all possible alternatives. Surely we have arrived at that place now since there is still a chance for the children. Bill McKibben, in his latest book, The Flag, the Cross and the Station Wagon notes that there aren’t many things an old person can do better than a young one, except getting arrested on behalf of their grandchildren. We have to try, take risks, be bold for those we love.
Trying in complex human systems means grown-ups talking to each other, especially those expecting to disagree. That’s why I reluctantly went to the San Diego conference and found myself among new friends. Trying means thousands of committees, some dealing with the trillion-dollar Farm Bill, some about the neighborhood school kitchen, some with the homeowners’ association figuring out how to stop spraying dumb chemicals.
Complex human systems seem overwhelming. But they invite us to be part of the complexity because everything matters. Just as every quart of poison spray matters, just as does every choice, every vote, every conversation with someone you thought opposite. Every kindness is honored; no love wasted, no healing intention lost. Chef Andreas is right; we have all the ingredients; we just have to try.
