Conferences don’t typically lead to groundbreaking policy change, but in 1969, the Nixon administration hosted a summit that did just that. The White House Conference on Food, Nutrition and Health led to the creation or expansion of virtually all of the country’s major food and nutrition programs, including school-based food programs, the food stamp program (now known as the Supplemental Nutrition Assistance Program, or SNAP), and the Special Supplemental Nutrition Program for Women, Infants and Children (WIC). A recent article in Nature Food called the conference “historic in its vision, bipartisanship and impact.”
For the first time in over 50 years, the Biden administration is holding another food conference, the White House Conference on Hunger, Nutrition and Health, to be held on September 28. Pointing out that the 1969 conference “helped galvanize actions that included the creation of life changing programs,” the administration outlined its own ambitious goals: “The 2022 White House Conference will catalyze the public and private sectors around a coordinated strategy to accelerate progress and drive transformative change in the U.S. to end hunger, improve nutrition and physical activity, and close the disparities surrounding them.”
In advance of the conference, the administration held listening sessions and requested input from experts from multiple sectors, as well as the public at large. Philanthropy was one of the sectors that the administration turned to for input. In response, Grantmakers in Health (GIH) teamed up with Sustainable Agriculture and Food Systems Funders (SAFSF), as well as The Funders Network, Grantmakers for Education, Native Americans in Philanthropy, and 49 other funders, in a joint letter to President Biden.
The letter applauds the administration for addressing the issues of hunger and health disparities; it also pushes it to go further, recommending deep, transformative changes to address the systemic inequities that perpetuate hunger and malnutrition in the wealthiest country on the planet. Taking a decidedly bolder stance than the White House, the document offers insights into how funders are thinking about food, health and social justice — and how ahead of the curve the often stodgy sector is on some social issues these days.
Five pillars and social determinants
When the White House announced the conference, it emphasized the social justice impacts of food and nutrition policies, pointing out that hunger and diet-related diseases disproportionately impact “underserved communities, including communities of color, people living in rural areas, people who are differently abled, older adults, LGBTQI+ people, military families, and military veterans. Lack of access to healthy, safe, and affordable food, and to safe outdoor spaces, contributes to hunger, diet-related diseases, and health disparities.” The conference also has a bold, long-term goal: to end hunger and reduce diet-related diseases in the U.S. by 2030.
But while the five “conference pillars” outlined by the White House touch on the central issues impacting hunger and food-related health issues, they struck me as being anodyne and overly broad: Improve food access and affordability; integrate nutrition and health; empower all consumers to make and have access to healthy choices; support physical activity for all; and enhance nutrition and food security research. The pillars don’t identify the entrenched systemic problems that perpetuate hunger in America.
In their letter, without criticizing the pillars, GIH, SAFSF and the other signatories urged the administration to more directly target the root of the problem: “We believe the pillars need a solid foundation in systemic approaches to the underlying issues of poverty and discrimination — which have a direct impact on hunger, nutrition and health — in order to be truly transformative.”
The letter includes four recommendations that identify the core causes of hunger and malnutrition, including poverty, a food production system that perpetuates inequalities, hunger and nutrition policies that favor large food producers and distributors over community-driven local and regional food systems, and a healthcare system that emphasizes treatment of diet-related diseases rather than working to prevent those disease in the first place. The letter urges the administration to address these systemic issues head-on — in strong language that contrasts with the administration’s innocuous five pillars.
Philanthropy often gets a bad rap (including on this website) for being out of touch with the issues impacting most Americans. But the letter from GIH, SAFSF and other funders reflects a clear-eyed understanding of the mechanisms that cause far too many Americans to go to bed hungry. The letter demonstrates the positive role philanthropy can play when it uses its experience and connection to local communities to push our public institutions to do better.
For example, on the issue of poverty, which the letter identifies as “the most critical social determinant of health,” the authors address the role structural racism and rural disinvestment play in creating and perpetuating poverty.
COVID-19 has just made matters worse for poor communities, said Cara James, the president and CEO of Grantmakers in Health. “We’ve seen increasing utilization of food pantries and other food programs because of job loss, or just an inability to access food programs that may have been available through the schools, as well as the increasing cost of food, and those issues have obviously disproportionately affected our communities of color. And as we’ve moved into the endemic side of COVID from the pandemic, and with the increase in inflation, those challenges have lingered.”
Health funders have long understood the impact of social, environmental and economic factors on health, according to James. “Our members recognize that most of our health outcomes have very little to do with what’s happening in a doctor’s office, and more with the conditions in which we live, learn, work and play,” she said. This tracks with what we’re seeing among regional and national health funders alike, which are just as likely to make a grant to a community organizing group as they are to fund direct services these days.
James described a recent trip she and her colleagues took to a rural area of the country. While rural communities are often associated with farming, many are actually food deserts with few grocery stores and little access to fresh produce. “Many of the communities that we visited didn’t even have a Walmart; the closest store, for many people, required a long drive and often didn’t have many options in terms of fresh fruit and vegetables,” James said. “A community health worker we spoke to told us a really heart-wrenching story about an older adult, who, because of challenges in terms of age and lack of transportation, was not eating and was relying on whatever their neighbors were bringing them to eat.”
Hunger, 50 years later
Nixon’s 1969 conference may have been a watershed event, but hunger and diet-related health problems remain a fact of life for many Americans. In 2020, 38.3 million people (including 6.1 million children) lived in households that were food-insecure, according to the USDA. As inflation (and food prices) rise, food banks are seeing increasing demand. Vince Hall of Feeding America recently told NPR, “We’re the wealthiest nation in the history of civilization, and the idea that millions of our children are going to bed hungry at night is an intolerable crisis that we should resolve to end as quickly as possible.”
Meanwhile, diet-related health problems are widespread: Half of all American adults have diabetes or prediabetes, for example, and over 73% are overweight or obese, according to the CDC. Poor diet increases the risk of heart disease, the leading cause of death in the U.S.
Can the 2022 Conference on Hunger, Nutrition and Health make a difference? At the conference, the White House plans to announce a national strategy “that identifies actions the government will take to catalyze the public and private sectors to drive transformative change and address the intersections between food, hunger, nutrition and health,” according to a recent press release. But Washington, and the national political landscape as a whole, is far more polarized today than it was at the time of the earlier conference in 1969. The last few years have demonstrated how difficult it is to get anything done in such a partisan and acrimonious environment. This daunting political climate will make progress on the scale achieved 50 years ago difficult, as Roll Call observed: “... Washington is more partisan in 2022, and the administration faces the prospect of a Republican Congress early next year, posing a challenge to match the previous conference, which by one count had more than 90% of its recommendations implemented within two years.”
In the same article, Dariush Mozaffarian, the dean of the Tufts University Friedman School of Nutrition, Science and Policy (which was founded by Jean Mayer, who organized and chaired the 1969 conference), underscored both the complexity and the centrality of the issues the conference will grapple with. “The challenge is that food touches everything,” he said. “It touches equity. It touches culture. It touches taste. It touches the economy. It touches health. It touches hunger. It’s so diffuse it’s hard for people to get their minds wrapped around it.”
Still, GIH’s James is optimistic. “I do think that the conference can make a difference,” she said. “The fact that the White House is pulling together such a broad array of organizations and individuals to focus on these important issues, I think, can lead to meaningful change. We are in a divided time in our country, but I think there is bipartisan support for efforts to reduce hunger and improve outcomes. Of course, one conference alone is not going to solve these problems. But we are hopeful that it will provide a roadmap and a guide for how we can work collectively to improve health and address hunger across the country.”