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.

Authors
David Lobell
News Type
News
Date
Paragraphs

The impact of global warming on food prices and hunger could be large over the next 20 years, according to a new Stanford University study. Researchers say that higher temperatures could significantly reduce yields of wheat, rice and maize - dietary staples for tens of millions of poor people who subsist on less than $1 a day. The resulting crop shortages would likely cause food prices to rise and drive many into poverty.  

But even as some people are hurt, others would be helped out of poverty, says Stanford agricultural scientist David Lobell.

Lobell discussed the results of his research on Feb 19 at the annual meeting of the American Association for the Advancement of Science in San Diego.

"Poverty impacts depend not only on food prices but also on the earnings of the poor," said Lobell, a center fellow at Stanford's Program on Food Security and the Environment (FSE). "Most projections assume that if prices go up, the amount of poverty in the world also will go up, because poor people spend a lot of their money on food. But poor people are pretty diverse. There are those who farm their own land and would actually benefit from higher crop prices, and there are rural wage laborers and people that live in cities who definiztely will be hurt."

Lobell and his colleagues recently conducted the first in-depth study showing how different climate scenarios could affect incomes of farmers and laborers in developing countries.

Household incomes

In the study, Lobell, former FSE researcher Marshall Burke and Purdue University agricultural economist Thomas Hertel focused on 15 developing countries in Asia, Africa and Latin America. Hertel has developed a global trade model that closely tracks the consumption and production of rice, wheat and maize on a country-by-country basis. The model was used to project the effects of climate change on agriculture within 20 years and the resulting impact on prices and poverty.

Using a range of global warming forecasts, the researchers were able to project three different crop-yield scenarios by 2030:

  • "Low-yield" - crop production is toward the low end of expectations.
  • "Most likely" - projected yields are consistent with expectations.
  • "High-yield" - production is higher than expected.

"One of the limitations of previous forecasts is that they don't consider the full range of uncertainties - that is, the chance that things could be better or worse than we expect," Lobell said. "We provided Tom those three scenarios of what climate change could mean for agricultural productivity. Then he used the trade model to project how each scenario would affect prices and poverty over the next 20 years.

"The impacts we're talking about are mainly driven by warmer temperatures, which dry up the soil, speed up crop development and shut down biological processes, like photosynthesis, that plants rely on," he added. "Plants in general don't like it hotter, and in many climate forecasts, the temperatures projected for 2030 would be outside the range that crops prefer."

Results

The study revealed a surprising mix of winners and losers depending on the projected global temperature. The "most likely" scenario projected by the International Panel on Climate Change is that global temperatures will rise 1.8 degrees Fahrenheit (1 degree Celsius) by 2030. In that scenario, the trade model projected relatively little change in crop yields, food prices and poverty rates

But under the "low-yield" scenario, in which temperatures increase by 2.7 F (1.5 C), the model projects a 10 to 20 percent drop in agricultural productivity, which results in a 10 to 60 percent rise in the price of rice, wheat and maize. Because of these higher prices, the overall poverty rate in the 15 countries surveyed was expected to rise by 3 percent.

However, an analysis of individual countries revealed a far more complicated picture. In 11 of the 15 countries, poor people who owned their own land and raised their own crops actually benefited from higher food prices, according to the model. In Thailand, for example, the poverty rate for people in the non-agricultural sector was projected to rise 5 percent, while the rate for self-employed farmers dropped more than 30 percent - in part because, as food supplies dwindled, the global demand for higher-priced crops increased.

"If prices go up and you're tied to international markets, you could be lifted out of poverty quite considerably," Lobell explained. "But there are a lot of countries, like Bangladesh, where poor people are either in urban areas or in rural areas but don't own their own land. Countries like that could be hurt quite a lot. Then there are semi-arid countries - like Zambia, Mozambique and Malawi - where even if prices go up and people own land, productivity will go down so much that it can't make up for those price increases. In the 'low-yield' scenario, those countries would see higher poverty rates across all sectors."

Under the "high-yield" scenario, in which global temperatures rise just 0.9 F (0.5 C), crop productivity increased. The resulting food surplus led to a 16 percent drop in prices, which could be detrimental to farm owners. In Thailand, the poverty rate among self-employed farmers was projected to rise 60 percent, while those in the non-agriculture sector saw a slight drop in poverty. In Zambia, Mozambique, Malawi and Uganda, poverty in the non-farming sector was projected to decline as much as 5 percent.

Risk management

Lobell said that, although the likelihood of the "low-yield" or "high-yield" scenario occurring is only 5 percent, it is important for policymakers to consider the full range of possibilities if they want to help countries adapt to climate change and ultimately prevent an increase in poverty and hunger. 

"It's like any sort of risk management or insurance program," he said. "You have to have some idea of the probability of events that have a big consequence. It's also important to keep in mind that any change, no matter how extreme, will benefit some households and hurt others."

The Program on Food Security and the Environment at Stanford is an interdisciplinary research and teaching program that generates policy solutions to the persistent problems of global hunger and environmental damage from agricultural practices worldwide. The program is jointly run by Stanford's Woods Institute for the Environment and the Freeman Spogli Institute for International Studies.

Hero Image
girl river logo
All News button
1
Paragraphs

Meeting the food needs of Africa's growing population over the next half-century will require technologies that significantly improve rural livelihoods at minimal environmental cost. These technologies will likely be distinct from those of the Green Revolution, which had relatively little impact in sub-Saharan Africa; consequently, few such interventions have been rigorously evaluated. This paper analyzes solar-powered drip irrigation as a strategy for enhancing food security in the rural Sudano-Sahel region of West Africa. Using a matched-pair comparison of villages in northern Benin (two treatment villages, two comparison villages), and household survey and field-level data through the first year of harvest in those villages, we find that solar-powered drip irrigation significantly augments both household income and nutritional intake, particularly during the dry season, and is cost effective compared to alternative technologies.

All Publications button
1
Publication Type
Journal Articles
Publication Date
Journal Publisher
Proceedings of the National Academy of Sciences
Authors
Jennifer Burney
Marshall Burke
Rosamond L. Naylor

Violent conflicts claim 3,000 lives per day through wars, bombings and attacks that dominate the news media. Meanwhile, behind the headlines, 20,000 people die each day from causes related to hunger and poverty. Physical security and food security are deeply connected. Over a billion people suffer from chronic food insecurity, a situation that feeds violent conflict and weakens national and international security. Food insecurity is especially problematic in agricultural regions where income growth is constrained by resource scarcity, disease, and environmental stress.

Paragraphs

Climate change and land use change can affect multiple infectious diseases of humans, acting either independently or synergistically. Expanded efforts in empiric and future scenario-based risk assessment are required to anticipate problems. Moreover, the many health impacts of climate and land use change must be examined in the context of the myriad other environmental and behavioral determinants of disease. To optimize prevention capabilities, upstream environmental approaches must be part of any intervention, rather than assaults on single agents of disease. Clinicians must develop stronger ties, not only to public health officials and scientists, but also to earth and environmental scientists and policy makers. Without such efforts, we will inevitably benefit our current generation at the cost of generations to come.

All Publications button
1
Publication Type
Journal Articles
Publication Date
Journal Publisher
Medical Clinics of North America
Authors
Holly Gibbs
Paragraphs

During the eighteen months after January 2007, cereal prices doubled, setting off a world food crisis. In the United States, rising food prices have been a pocketbook annoyance. Most Americans can opt to buy lower-priced sources of calories and proteins and eat out less frequently. But for nearly half of the world’s population—the 2.5 billion people who live on less than $2 per day—rising costs mean fewer meals, smaller portions, stunted children, and higher infant mortality rates. The price explosion has produced, in short, a crisis of food security, defined by the Food and Agriculture Organization (FAO) as the physical and economic access to the food necessary for a healthy and productive life. And it has meant a sharp setback to decades-long efforts to reduce poverty in poor countries.

The current situation is quite unlike the food crises of 1966 and 1973. It is not the result of a significant drop in food supply caused by bad weather, pests, or policy changes in the former Soviet Union. Rather, it is fundamentally a demand-driven story of “success.” Rising incomes, especially in China, India, Indonesia, and Brazil, have increased demand for diversified diets that include more meat and vegetable oils. Against this background of growing income and demand, increased global consumption of biofuels and the American and European quest for energy self-sufficiency have added further strains to the agricultural system. At the same time, neglected investments in productivity-improving agricultural technology—along with a weak U.S. dollar, excessive speculation, and misguided government policies in both developed and developing countries—have exacerbated the situation. Climate change also looms ominously over the entire global food system.

In short, an array of agricultural, economic, and political connections among commodities and across nations are now working together to the detriment of the world’s food-insecure people...

All Publications button
1
Publication Type
Journal Articles
Publication Date
Journal Publisher
Boston Review
Authors
Rosamond L. Naylor
Walter P. Falcon
Authors
News Type
News
Date
Paragraphs

This past autumn, the Freeman Spogli Institute ( 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 Stanford’s new Woods 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 Center for Environmental Science and Policy (CESP) co-director Walter P. Falcon, FSE aims to design new approaches to solve these persistent problems, expand higher education on food security and the environment at Stanford, and provide direct policy outreach.

Productive food systems and their environmental consequences form the core of the program. Fundamentally, the FSE program 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. 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 Ministries of Agriculture, Planning, and 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 Mooney, CESP senior fellow and an author of the Millennium Ecosystem Assessment. As a result, land once used to provide grains for humans now provides feed for hogs and poultry.

These trends will have major consequences for 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 analyzing the impact of intensive livestock production and assessing the environmental effects 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."

Factors contributing to the global growth of livestock systems, lead author Naylor notes, are declining feed-grain prices, relatively inexpensive transportation costs, and trade liberalization. “But many of the true costs remain largely unaccounted for,” she says, including destruction of forests and grasslands to provide farmland for feed crops destined not 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 hidden costs of 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 and expansive. Building on existing research at Stanford, researchers are identifying avenues in the world’s least developed countries to enhance orphan crop production— crops with little international trade and investment, but high local value for food and nutrition security. This work seeks to identify advanced genetic and genomic strategies, and natural resource management initiatives, to improve orphan crop yields, enhance crop diversity, and increase rural incomes through orphan crop production.

Another priority research area is development of biofuels. As countries seek energy self-reliance and look for alternatives to food and feed subsidies under World Trade Organization (WTO) 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 high crude oil prices 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 research activities. One project links ongoing research at Stanford on the environmental and resource costs of industrial livestock production and trade to assess the extent 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. An interdisciplinary team will examine strategies 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 new Presidential Fund,” 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.”

All News button
1
Authors
Marshall Burke
Rosamond L. Naylor
News Type
News
Date
Paragraphs

The Bill & Melinda Gates Foundation’s Agricultural Development Program has awarded Stanford University’s Program on Food Security and the Environment (FSE) and a team of collaborators $3.8 million over three years to conduct a quantitative assessment of the effect of biofuels expansion on food security in the developing world. This work will determine how different scenarios of expanded biofuels production in rich and poor countries will affect global and regional food prices, farmer incomes, and food consumption of the poor. In three case-study countries (India, Mozambique, Senegal), it will make a more detailed assessment of the opportunities and pitfalls associated with an array of possible biofuels development scenarios (e.g., using different crops for biofuels production, using marginal land versus highly productive land, etc.). We expect the work will represent the first systematic, detailed effort to address the effects of biofuels expansion on welfare in poor countries and the first available analytic tool for assessing possible biofuels investments in individual developing countries. Project collaborators include FSE, the International Food Policy Research Institute, the Center on Chinese Agricultural Policy, and the University of Nebraska.

Through this grant, the Bill & Melinda Gates Foundation aims to assess how biofuels may affect smallholder farmers in the developing world. This includes assessing both the risks, such as increasing food prices, and the potential opportunities for smallholder farmers to leverage biofuels to boost their productivity, increase their incomes, and build better lives for themselves and their families. The foundation and Stanford University will disseminate the findings widely to inform a broad audience, including policymakers.

FSE is also very pleased to announce a private gift from Lawrence Kemp for further work in the biofuels area. The Kemp gift will be devoted to building a team of faculty and students on campus who will analyze the transmission of global price effects to local markets, provide policy advice and communication on biofuels, and expand the field-level coverage of Stanford’s biofuels work.

In the November 2007 issue of Environment, project collaborators Rosamond L. Naylor (FSE), Adam Liska, Marshall Burke (FSE), Walter P. Falcon (FSE), Joanne Gaskell, Scott Rozelle (FSE), and Kenneth Cassman demonstrate how high energy prices and biofuelspromoting agricultural policy result in higher food prices generally and then examine in detail the potential global effects of biofuels expansion in four countries for four crops—corn in the United States, cassava in China, sugarcane and soy in Brazil, and palm oil in Indonesia. They argue that in each case, the threats to global food security from biofuels expansion likely outweigh the benefits, especially in the short run. This is because in many poor countries these crops play an important role in the diets of the poor and because the poorest in the world typically spend more money on food than they earn in income through farming. They also note that “second generation” technologies such as cellulosic biofuels will likely not play a significant role in biofuels production over the next decade or longer—and thus in the near-term are very unlikely to be the win-win that their proponents suggest. “The ripple effect: biofuels, food security, and the environment” excerpted from Environment, November 2007

The integration of the agricultural and energy sectors caused by rapid growth in the biofuels market signals a new era in food policy and sustainable development. For the first time in decades, agricultural commodity markets could experience a sustained increase in prices, breaking the long-term price decline that has benefited food consumers worldwide. Whether this transition occurs—and how it will affect global hunger and poverty—remain to be seen. Will food markets begin to track the volatile energy market in terms of price and availability? Will changes in agricultural commodity markets benefit net food producers and raise farm income in poor countries? How will biofuels-induced changes in agricultural commodity markets affect net consumers of food? At risk are more than 800 million food-insecure people—mostly in rural areas and dependent to some extent on agriculture for incomes— who live on less than $1 per day and spend the majority of their incomes on food. An additional 2–2.5 billion people living on $1 to $2 per day are also at risk, as rising commodity prices could pull them swiftly into a food-insecure state.

The potential impact of a large global expansion of biofuels production capacity on net food producers and consumers in low-income countries presents challenges for food policy planners and raises the question of whether sustainable development targets at a more general level can be reached. Achieving the 2015 Millennium Development Goals adopted by the United Nations General Assembly in 2000, which include halving the world’s undernourished and impoverished, lies at the core of global initiatives to improve human well-being and equity, yet today virtually no progress has been made toward achieving the dual goals of alleviating global hunger and poverty. The record varies on a regional basis: Gains have been made in many Asia-Pacific and Latin American-Caribbean countries, but progress has been mixed in South Asia and setbacks have occurred in numerous sub-Saharan African countries. Whether the biofuels boom will move extremely poor countries closer to or further from the Millennium Development Goals remains uncertain.

Biofuels growth also will influence efforts to meet two sets of longer-run development targets. The first encompasses the goals of a “sustainability transition,” articulated by the Board on Sustainable Development of the U.S. National Academy of Sciences, which seeks to provide energy, materials, and information to meet the needs of a global population of 8–10 billion by 2050, while reducing hunger and poverty and preserving the planet’s environmental life-support systems. The second is the Great Transition of the Global Scenario Group, convened by the Stockholm Environment Institute, which focuses specifically on reductions in hunger and greenhouse gas (GHG) emissions beyond 2050. As additional demands are placed on the agricultural resource base for fuel production, will ecosystem services (such as hydrologic balances, biodiversity, and soil quality) that support agricultural activities be eroded? Will biofuels development require a large expansion of crop area, which would involve conversion of marginal land, rainforest, and wetlands to arable land? And what will be the net effect of biofuels expansion on global climate change?

Although the questions outnumber the answers at this stage, two trends seem clear: Total energy use will continue to escalate as incomes rise in both industrial and developing countries, and biofuels will remain a critical energy development target in many parts of the world if petroleum prices exceed $55–$60 per barrel. Even if petroleum prices dip, policy support for biofuels as a means of boosting rural incomes in several key countries will likely generate continued expansion of biofuels production capacity. These trends will have widespread ripple effects on food security—defined here as the ability of all people at all times to have access to affordable food and nutrition for a healthy lifestyle—and on the environment at local, regional, and global scales. The ripple effects will be either positive or negative depending on the country in question and the policies in play.

Hero Image
1564 small 3
All News button
1
Paragraphs

Climate change is projected to have adverse impacts on public health. Cobenefits may be possible from more upstream mitigation of greenhouse gases causing climate change. To help measure such cobenefits alongside averted disease-specific risks, a health impact assessment (HIA) framework can more comprehensively serve as a decision support tool. HIA also considers health equity, clearly part of the climate change problem. New choices for energy must be made carefully considering such effects as additional pressure on the world's forests through large-scale expansion of soybean and oil palm plantations, leading to forest clearing, biodiversity loss and disease emergence, expulsion of subsistence farmers, and potential increases in food prices and emissions of carbon dioxide to the atmosphere. Investigators must consider the full range of policy options, supported by more comprehensive, flexible, and transparent assessment methods.

All Publications button
1
Publication Type
Journal Articles
Publication Date
Journal Publisher
Annual Reviews of Public Health
Authors
Holly Gibbs

Energy and Environment Building - 4205
473 Via Ortega
Stanford University
Stanford, CA 94305

(650) 721-5767
0
PhD student (former)
gaskell.jpg

Joanne Gaskell comes from Vancouver, where she first developed her taste for the outdoors. She graduated with honors from Swarthmore College, with a Bachelor's Degree in Biology and Economics.

Prior to joining IPER she worked for two years at the International Food Policy Research Institute (IFPRI) in Washington, D.C. as a Research Assistant in the Environment and Production Technology Division. Joanne's research addressed the impact of food production on the environment, and the contribution of environmental factors to food security. While at IFPRI, Joanne served as an author on the Food and Cultivated Systems chapters of the Millennium Ecosystem Assessment. She also co-authored a United Nations Hunger Task Force-commissioned paper on environmental and social correlates of child hunger in Africa.

Joanne's current research interests include biofuels, the value of genetic diversity to crop production systems and the water and nutrient implications of intensive livestock production. She is a member of Sigma Xi and a recipient of the Science Council of British Columbia's "Headed for Success" award.

Subscribe to Health and Medicine