Health and Medicine

FSI’s researchers assess health and medicine through the lenses of economics, nutrition and politics. They’re studying and influencing public health policies of local and national governments and the roles that corporations and nongovernmental organizations play in providing health care around the world. Scholars look at how governance affects citizens’ health, how children’s health care access affects the aging process and how to improve children’s health in Guatemala and rural China. They want to know what it will take for people to cook more safely and breathe more easily in developing countries.

FSI professors investigate how lifestyles affect health. What good does gardening do for older Americans? What are the benefits of eating organic food or growing genetically modified rice in China? They study cost-effectiveness by examining programs like those aimed at preventing the spread of tuberculosis in Russian prisons. Policies that impact obesity and undernutrition are examined; as are the public health implications of limiting salt in processed foods and the role of smoking among men who work in Chinese factories. FSI health research looks at sweeping domestic policies like the Affordable Care Act and the role of foreign aid in affecting the price of HIV drugs in Africa.

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Rosamond L. Naylor
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This past autumn the Freeman Spogli Institute for International Studies (FSI) in conjunction with the Woods Institute for the Environment launched a program on Food Security and the Environment (FSE) to address the deficit in academia and, on a larger scale, the global dialogue surrounding the critical issues of food security, poverty, and environmental degradation.

"Hunger is the silent killer and moral outrage of our time; however, there are few university programs in the United States designed to study and solve the problem of global food insecurity," states program director Rosamond L. Naylor. "FSE's dual affiliation with FSI and the new Stanford Institute for the Environment position it well to make significant steps in this area."

Through a focused research portfolio and an interdisciplinary team of scholars led by Naylor and CESP (Center for Environmental Science and Policy) co-director Walter P. Falcon, FSE aims to design new approaches to solve these persistent and under-prioritized problems, expand higher education on food security and the environment at Stanford, and provide direct policy outreach.

Productive food systems and their environmental consequences are at the core of the program. While many of these systems are global in character, but they are influenced significantly by differing food objectives, income level, and instruments among nations. The program thus seeks to understand the food security issues that are of paramount interest to poor countries, the food diversification challenges that are a focus of middle-income nations, and the food safety and subsidy concerns prominent in richer nations.

Chronic hunger in a time of prosperity

Although the world's supply of basic foods has doubled over the past century, roughly 850 million people (12 percent of the world's population) suffer from chronic hunger. Food insecurity deaths during the past 20 years outnumber war deaths by a factor of at least 5 to 1. Food insecurity is particularly widespread in agricultural regions where resource scarcity and environmental degradation constrain productivity and income growth.

FSE is currently assessing the impacts of climate variability on food security in Asian rice economies. This ongoing project combines the expertise of atmospheric scientists, agricultural economists, and policy analysts to understand and mitigate the adverse effects of El Niño-related climate variability on rice production and food security under current and future global warming conditions. As a consequence of Falcon and Naylor's long-standing roles as policy advisors in Indonesia, models developed through this project have already been embedded into analytical units within Indonesia's Ministry of Agriculture, the Planning Ministry, and the Ministry of Finance.

"With such forecasts in hand, the relevant government agencies are much better equipped to mitigate the negative consequences of El Niño events on incomes and food security in the Indonesian countryside," explain Falcon and Naylor.

Food diversification and intensification

With rapid income growth, urbanization, and population growth in developing economies, priorities shift from food security to the diversification of agricultural production and consumption. "Meat production is projected to double by 2020" states Harold A. Mooney, CESP senior fellow and an author of the Millennium Ecosystem Assessment. "In China alone, meat consumption has more than doubled in the past generation." As a result, land once used to provide grains for humans now provides feed for hogs and poultry.

These trends will have major consequences on the global environment-affecting the quality of the atmosphere, water, and soil due to nutrient overloads; impacting marine fisheries both locally and globally through fish meal use; and threatening human health, as, for example, through excessive use of antibiotics.

An FSE project is looking at these trends as it relates to intensive livestock production and assessing the environmental impacts to gain a better understanding of the true costs of this resource-intensive system. A product of this work recently appeared as a Policy Forum piece in the December 9, 2005, issue of Science titled "Losing the Links Between Livestock and Land".

Numerous factors have contributed to the global growth of livestock systems, lead author Naylor notes, including declining feed-grain prices, relatively inexpensive transportation costs, and trade liberalization. "But many of the true costs remain largely unaccounted for," she says. Those costs include destruction of forests and grasslands to provide farmland for corn, soybeans, and other feed crops destined not directly for humans but for livestock; utilization of large quantities of freshwater; and nitrogen losses from croplands and animal manure.

Naylor and her research team are seeking better ways to track all costs of livestock production, especially the hidden ones related to ecosystem degradation and destruction. "What is needed is a re-coupling of crop and livestock systems," Naylor says. "If not physically, then through pricing and other policy mechanisms that reflect social costs of resource use and ecological abuse."

Such policies "should not significantly compromise the improving diets of developing countries, nor should they prohibit trade," Naylor adds. Instead, they should "focus on regulatory and incentive-based tools to encourage livestock and feed producers to internalize pollution costs, minimize nutrient run-off, and pay the true price of water."

Looking ahead

The future of the program on Food Security and the Environment looks bright, busy, and expansive. While a varied portfolio of projects is in line for the upcoming year, a strong emphasis remains in the area of food security. Building on existing research at Stanford, researchers are identifying avenues for enhancing orphan crop production in the world's least developed countries-crops with little international trade and investment, but with high local value in terms of food and nutrition security. The work seeks to identify advanced genetic and genomic strategies, along with natural resource management strategies, to improve orphan crop yields and stability, enhance crop diversity, and increase rural incomes through orphan crop production.

Another priority area of research centers on the development of biofuels. Biofuels are becoming increasingly a part of the policy set for world food and agriculture. As countries such as the United States seek energy self-reliance and look for alternatives to food and feed subsidies under WTO (World Trade Organization) rules, the conversion of corn, sugar, and soybeans to ethanol and other energy sources becomes more attractive. New extraction methods are making the technology more efficient, and crude oil prices at $60 per barrel are fundamentally changing the economics of biomass energy conversion. A large switch by key export food and feed suppliers, such as the United States and Brazil, to biofuels could fundamentally alter export prices, and hence the world food and feed situation. A team of FSE researchers will assess the true costs of these conversions.

The FSE program recently received a grant through the Presidential Fund for Innovation in International Studies to initiate new interdisciplinary research activities. One such project links ongoing research at Stanford on the environmental and resource costs of industrial livestock production and trade to assess the extent and rate of Brazil's rainforest destruction for soybean production. "Tens of millions of hectares of native grassland and rainforest are currently being cleared for soybean production to supply the global industrial livestock sector," says Naylor. A significant share of Brazil's soybeans is being shipped to China, where rapid income growth is fueling tremendous increases in meat consumption."

A team of remote-sensing experts, ecologists, agronomists, and economists will be looking at the ecological effects on the landscape through biogeochemical changes and biodiversity loss, the impacts of land clearing on the regional hydrologic cycle and climate change, the economic patterns of trade, and the role of policies to achieve an appropriate balance between agricultural commodity trade, production practices, and conservation in Brazil's rainforest states.

"I'm extremely pleased to see the rapid growth of FSE and am encouraged by the recent support provided through the Presidential Fund for Innovation in International Studies," states Naylor. "It enables the program to engage faculty members from economics, political science, biology, civil and environmental engineering, earth sciences, and medicine-as well as graduate students throughout the university-in a set of collaborative research activities that could significantly improve human well-being and the quality of the environment."

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"Feeding the World in the 21st Century: Exploring the Connections Between Food Production, Health, Enviromental Resources and International Security," was one of eight projects to be be awarded.

Eight research projects led by multidisciplinary-faculty teams have jointly received $1.05 million in the first round of awards made by Stanford's new $3 million Presidential Fund for Innovation in International Studies.

Coit D. Blacker, director of the Freeman Spogli Institute for International Studies, said the fund is the first program launched by the university's International Initiative, which seeks to encourage collaborative, cross-disciplinary approaches to address the global challenges of pursuing peace and security, improving governance and advancing human well-being.

The multi-year projects, selected by the International Initiative's executive committee from 37 proposals, will bring together faculty from fields that traditionally do not collaborate to produce new courses, symposia, conferences and research papers. Blacker, who chairs the executive committee, said additional awards totaling about $2 million will be made in 2007 and 2008.

President John Hennessy said he supports the research projects. "The world does not come to us as neat disciplinary problems, but as complex interdisciplinary challenges," he said. "The collaborative proposals we have selected for this first round of funding offer great potential to help shed light on some of the most persistent and pressing political issues on the global agenda today."

Projects in the first round of funding include:

Governance under Authoritarian Rule. Stephen Haber and Beatriz Magaloni, political science; Ian Morris, classics, history; and Jennifer Trimble, classics. The researchers will examine the political economy of authoritarian systems and determine why some authoritarian governments are able to make the transition to democracy, stable growth and functioning institutions, while others prove predatory and unstable.

Addressing Institutional and Interest Conflicts: Project Governance Structures for Global Infrastructure Development. Raymond Levitt, civil and environmental engineering; Doug McAdam and W. Richard Scott, sociology. The project will analyze the challenges of creating efficient and effective public/private institutions for the provision of low-cost, distributed and durable infrastructure services in emerging economies.

Combating HIV/AIDS in Southern Africa: The Treatment Revolution and Its Impact on Health, Well-Being and Governance. David Katzenstein, infectious diseases; and Jeremy Weinstein, political science. Based on the 2005 Group of 8's commitment to put 10 million people infected with HIV/AIDS on treatment within five years, this project will research the impact of this treatment revolution on health, well-being and governance in sub-Saharan Africa.

Evaluating Institutional Responses to Market Liberalization: Why Latin America Was Left Behind. Judith Goldstein, political science; Avner Greif, economics; Steven Haber, political science; Herb Klein, history; H. Grant Miller, Freeman Spogli Institute (FSI)/medicine; and Barry Weingast, political science. The project will research the interaction between inequality and Latin American institutions in explaining the poor economic performance of countries in the region during the past two decades, examining why reforms such as trade liberalization have failed to yield expected results.

Feeding the World in the 21st Century: Exploring the Connections Between Food Production, Health, Environmental Resources and International Security. Rosamond L. Naylor, FSI/economics; Stephen J. Stedman, FSI/political science; Peter Vitousek, biological sciences; and Gary Schoolnik, medicine, microbiology and immunology. The group will launch a new research and teaching program, titled "Food Security and the Environment," with an initial priority on determining linkages between food security, health and international security, and globalization, agricultural trade and the environment.

The Political Economy of Cultural Diversity. James D. Fearon, political science; and Romain Wacziarg, Graduate School of Business. The researchers will assess the impact of ethnic, linguistic and religious diversity on economic growth, trade and capital flows, governance, development of democracy and political stability.

In addition, two grants to plan forthcoming research projects have received $25,000:

Global Health by Design. Geoffrey Gurtner, plastic and reconstructive surgery; David Kelley, mechanical engineering; Thomas Krummel, surgery; Julie Parsonnet, medicine, health research and policy; and Paul Yock, medicine, bioengineering. The group will design a project to examine how new technology can be used to develop effective, affordable and sustainable methods and devices to prevent disease in the world's poorest countries.

Ecological Sanitation in Rural Haiti: An Interdisciplinary Approach to Sanitation and Soil Fertility. Ralph Greco, surgery; and Rodolfo Dirzo, biological sciences. The researchers will develop a plan to test the efficacy of ecological sanitation in decreasing disease and enhancing soil fertility in rural Haiti.

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The prospect of another agricultural revolution evokes both hope and fear. The first agricultural revolution--the domestication of edible plants--began a long process of narrowing the genome of plants for farming. Centuries of selecting, crossbreeding, and propagating plants for traits such as grain size, pest resistance, food safety safety, and color have increased and refined our food, but have also inadvertently eliminated countless genes that are important for crops' natural defenses and for our nutrition.

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Proceedings of the American Philosophical Society
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Rosamond L. Naylor
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Walter P. Falcon
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The film "Silent Killer: The Unfinished Campaign Against Hunger," hosted by NPR's Scott Simon, offers a compelling examination of both the problem and solutions surrounding world hunger. The program aired on PBS station KQED/San Francisco on Wednesday, November 2nd at 11:00 p.m.

SEATTLE - There are a billion hungry people in the world. Fifteen thousand children-the equivalent of five times the victims of the World Trade Center bombings-die each day of hunger. Yet it doesn't have to be this way. We can end hunger-if we make a commitment to doing so. The new one-hour documentary Silent Killer: The Unfinished Campaign Against Hunger shows how it can be done. Shot on location in the United States, South Africa, Kenya, Rome, Mexico and Brazil, Silent Killer examines both the problem of hunger and solutions. The documentary and its companion Web site (www.SilentKillerFilm.org) will provide viewers with inspiration and information to become part of the effort to end hunger.

Produced by Hana Jindrova and John de Graaf (Affluenza, Escape from Affluenza), in association with KCTS/Seattle Public Television, Silent Killer will air on several California public television stations as follows:

KTEH/ San Jose: Sunday, October 16 at 5:00 p.m. (please confirm).

KOCE/ Huntington Beach: Sunday, October 23 at 4:00 p.m.

KQED/ San Francisco: Wednesday, November 2 at 11:00 p.m., repeating on

KQED Encore (Digital Channel 189), Thursday, November 3 at 10:00 p.m.

KVCR/ San Bernardino: Thanksgiving evening, Thursday, November 24 at 8 p.m.

KVIE/ Sacramento: Airdate and time to be announced.

KCSM/ San Mateo: Airdate and time to be announced.

(For all other stations, please check local listings).

Narrated by National Public Radio's Scott Simon, the film begins in South Africa's Kalahari Desert, where razor-thin Bushmen use the Hoodia cactus to fend off hunger. But now, a drug firm has patented the Hoodia's appetite-suppressant properties and is using it to make a diet product for obese Americans and Europeans. Hoodia is a metaphor for a world where some people die from too much food, but millions more die from too little.

We discover how serious the problem is in Kenya as we meet Jane Ininda, a scientist who is trying to make agriculture more productive in her country, while her own brother, Salesio, barely survives the drought, poor soils and pests that constantly threaten his crops. Through powerful stories, we come to understand the dimensions of the hunger crisis.

At the World Food Summit in Rome, we learn how activists have been working to end hunger since President John Kennedy declared war on it in 1963. But today, America's commitment to food security is less clear. In fact, world financial commitments to hunger research are now in decline.

But Silent Killer does not leave viewers feeling helpless. A visit to Brazil finds a nation energized by a new campaign called FOME ZERO-Zero Hunger. In the huge city of Belo Horizonte, we meet a remarkable leader and see how, under the programs she supervises, the right to food is guaranteed to all. In the countryside, we are introduced to the Landless Peasants' Movement, which is giving hope to millions of hungry Brazilians.

Can we end hunger, or will it always be with us? Why should we try? What will it take? What are we doing now? Can biotechnology play a role, and if so, how? Is hunger just a problem of distribution, or do we still need to produce more and better crops? These are the questions considered in this exquisitely photographed documentary.

EXPERTS featured in Silent Killer: The Unfinished Campaign Against Hunger and available for press interviews include:

David Beckmann - President, Bread for the World. Since 1991, Reverend David Beckmann has served as president of Bread for the World, a Christian group that lobbies the U.S. government for policy changes to end hunger in the United States and around the world.

Per Pinstrup-Andersen - World Food Prize Laureate 2001. A native of Denmark, Per Pinstrup-Andersen is the H.E. Babcock Professor of Food, Nutrition and Public Policy at Cornell University. He also serves as the chairman of the Science Council of the Consultative Group on International Agricultural Research.

Chris Barrett - Development Economist, Cornell University. Dr. Barrett is a professor of applied economics and management at Cornell University. His focus is on rural communities, primarily in Africa, concentrating on the dynamics of poverty, food security and hunger.

Walter Falcon - Development Economist, Stanford University. Dr. Falcon is the Farnsworth Professor of International Agricultural Policy at Stanford University (emeritus), co-director of the Center for Environmental Science and Policy, and former director of the Stanford Institute for International Studies.

PROGRAM TIE-INS: October 16 is the 25th observance of World Food Day-a worldwide event designed to create awareness, understanding and year-round action to alleviate hunger. (See www.worldfooddayusa.org.) In addition, October 24 is the 60th anniversary of the founding of the United Nations and its first agency, the Food and Agriculture Organization (FAO).

CREDITS: Silent Killer was produced by Hana Jindrova and John de Graaf in association with KCTS/Seattle Public Television and is narrated by NPR's Scott Simon. Writer: John de Graaf. Photographers/Editors: Diana Wilmar and David Fox. Composer: Michael Bade. Executive Producer: Enrique Cerna, KCTS. Funding was provided by The Rockefeller Foundation.

DISTRIBUTOR: Silent Killer is presented nationally by KCTS/Seattle Public Television and is distributed by the National Educational Telecommunications Association (NETA).

WEB SITE: See www.SilentKillerFilm.org for more information about the film, including a full transcript, in-depth interviews with film characters and experts on hunger, a guide for teachers, a list of hunger facts and myths, a detailed "Take Action" section and additional resources. Color images from the film are posted on the site for press use, along with an online press kit.

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Feeding the World is a sizable volume that covers the nature of current foor problems; the scientific underpinnings of food production, including their environmental implications; a delineation of the various resource bases that serve agriculture; the basics of food comsumption, diets, and nutrition; the role of animal products; an assessment of postharvest losses; and an analysis of China's future capacity to feed itself.

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The Evolving Sphere of Food Security seeks to answer two important questions: How do the priorities and challenges of achieving food security change over time as countries develop economically? And how do the policies used to promote food security in one country affect nutrition, food access, natural resources, and national security in other countries? The volume presents the many faces and facets of food security—their symptoms, their roots, and their possible remedies—through the lens of a multidisciplinary group of scholars. The authors share personal stories of research and policy advising from their field experiences to provide readers with a real-world sense of the opportunities and challenges involved in promoting food security at local to global scales. Their observations from countries around the world demonstrate how food security is tied to security of many other kinds: energy, water, health, climate, the environment, and national security. The book’s main goal is to connect these areas in a way that tells an integrated story about human lives, resource use, and the policy process—a story about global food security.

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Rosamond L. Naylor
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Senior Fellow, Stanford Woods Institute and Freeman Spogli Institute for International Studies
William Wrigley Professor of Earth System Science
Senior Fellow and Founding Director, Center on Food Security and the Environment
Roz_low_res_9_11_cropped.jpg PhD

Rosamond Naylor is the William Wrigley Professor in Earth System Science, a Senior Fellow at Stanford Woods Institute and the Freeman Spogli Institute for International Studies, the founding Director at the Center on Food Security and the Environment, and Professor of Economics (by courtesy) at Stanford University. She received her B.A. in Economics and Environmental Studies from the University of Colorado, her M.Sc. in Economics from the London School of Economics, and her Ph.D. in applied economics from Stanford University. Her research focuses on policies and practices to improve global food security and protect the environment on land and at sea. She works with her students in many locations around the world. She has been involved in many field-level research projects around the world and has published widely on issues related to intensive crop production, aquaculture and livestock systems, biofuels, climate change, food price volatility, and food policy analysis. In addition to her many peer-reviewed papers, Naylor has published two books on her work: The Evolving Sphere of Food Security (Naylor, ed., 2014), and The Tropical Oil Crops Revolution: Food, Farmers, Fuels, and Forests (Byerlee, Falcon, and Naylor, 2017).

She is a Fellow of the Ecological Society of America, a Pew Marine Fellow, a Leopold Leadership Fellow, a Fellow of the Beijer Institute for Ecological Economics, a member of Sigma Xi, and the co-Chair of the Blue Food Assessment. Naylor serves as the President of the Board of Directors for Aspen Global Change Institute, is a member of the Scientific Advisory Committee for Oceana and is a member of the Forest Advisory Panel for Cargill. At Stanford, Naylor teaches courses on the World Food Economy, Human-Environment Interactions, and Food and Security. 

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1936-2023
Helen Farnsworth Professor of International Agricultural Policy, Economics (Emeritus)
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Walter Falcon was former deputy director of the Center on Food Security and the Environment, former director of the Freeman Spogli Institute for International Studies, and Farnsworth professor of International Agricultural Policy and Economics at Stanford University (Emeritus). He died on August 2, 2023. Read his obituary here.

In 1972, Falcon moved from Harvard University to Stanford University's Food Research Institute where he served as professor of economics and director until 1991. From 1991-1998, he directed the Freeman Spogli Institute for International Studies, and from 1998-2007 he co-directed the Center for Environmental Science and Policy. He also served as senior associate dean for the social sciences, a member of the academic senate, and twice a member of the University's Advisory Board.

Falcon consulted with numerous international organizations, and had been a trustee of Winrock International and chairman of the board of the International Rice Research Institute (IRRI) and the International Center for Wheat and Maize Improvement (CIMMYT). Falcon became a Fellow of the American Association for the Advancement of Science in 1991. Falcon was cited as the outstanding 1958 graduate of Iowa State University in 1989 and in 1992 he was awarded the prestigious Bintang Jasa Utama medal of merit by the government of Indonesia for twenty-five years of assistance with that country's development effort. His recent co-authored papers have analyzed the effects of El Nino on Asian agriculture; Mexican agricultural policy; food price volatility; and biofuels.

Falcon received a BS in Agricultural Economics at Iowa State University in 1958, an MA in Economics at Harvard University in 1960, and a PhD in Economics from Harvard University in 1962.

FSI Senior Fellow, Emeritus
Stanford Woods Institute Senior Fellow, Emeritus
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This paper explores the significance of policy-induced technological change for the design of carbon-abatement policies. We derive analytical expressions characterizing optimal CO2 abatement and carbon tax profiles under different specifications for the channels through which technological progress occurs. We consider both R&D-based and learning-by-doing-based knowledge accumulation, and examine each specification under both a cost-effectiveness and a benefit-cost policy criterion. We show analytically that the presence of induced technological change (ITC) implies a lower time profile of optimal carbon taxes. The impact of ITC on the optimal abatement path varies. When knowledge is gained through R&D investments, the presence of ITC justifies shifting some abatement from the present to the future. However, when knowledge is generated through learning-by-doing, the impact on the timing of abatement is analytically ambiguous. Illustrative numerical simulations indicate that the impact of ITC upon overall costs and optimal carbon taxes can be quite large in a cost-effectiveness setting but typically is much smaller under a benefit-cost policy criterion. The impact of ITC on the timing of abatement is very weak, and the effect (applicable in the benefit-cost case) on total abatement over time is generally small as well, especially when knowledge is accumulated via R&D.

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