Nutrition News for Africa

Abstract - March 31, 2007

An article entitled “The links between agriculture and health: an intersectoral opportunity to improve the health and livelihoods of the poor” was published by Hawkes and Ruel in The Bulletin of the World Health Organization. December 2006, 84 (12)

Introduction: Many studies have looked at the social and environmental determinants of health, but one important aspect has been inadequately addressed, that of agriculture. Agriculture is linked to the main causes of death and disease – malnutrition, infectious diseases and chronic diseases. The links between agriculture and health are bidirectional: agriculture influences health and health influences agriculture. However, health and agricultural sectors remain poorly coordinated. The objective of this paper was to highlight the potential advantages of closer interaction between the health and agricultural sectors by presenting a conceptual framework of agriculture-health links, and illustrating how these links operate in specific settings in the developing world.

Conceptual Framework: The authors developed a conceptual framework showing the links between agriculture and health (please refer to article). The first step in the development of the framework was to identify key health issues and diseases associated with agriculture. These included malnutrition, water-associated vector-born diseases, foodborne illnesses, HIV/AIDS, and others. The second step was to look at how agriculture is associated with these conditions. Through the review, it became clear that the entire agricultural supply chain has implications for health, including agricultural producers, systems and outputs. The final step was the identification of common processes mediating the relationships between the agricultural supply chain and the health conditions. The literature review revealed that there are four interlinked social and environmental determinants of health that are critical: income; labor; access to food, water, land and health-related services; and environmental changes in water, air and soil.

Bidirectional links: The authors proceeded to examine the bidirectional links of each component of the agricultural supply chain in relation to health. Agricultural producers earn income from agriculture, which in turn influences their purchasing power and access to food, water, land, and health-related services and thus determines their overall health status. In the other direction, malnutrition and poor health affect their ability to gain a livelihood from agriculture by affecting their capacity to work and generate food and income. Agricultural systems vary, and so do the types and severity of diseases associated with them. In the other direction, poor health reduces the ability of producers to innovate, invest in and operationalize changes in agricultural systems-including changes that promote health. Agricultural outputs such as agricultural policies that create incentives or disincentives to the production of different crops such as tobacco affect the environment in which people make choices about these products, and their subsequent level of exposure to risk factors for chronic disease. In the other direction, health affects people’s abilities, needs and desires to consume different amounts and types of food, which in turn affects demands from agricultural systems and the types of products.

Conclusion: The conceptual framework and examples presented show that agriculture can provide the environmental and/or economic conditions conducive to the spread of disease, but can also provide the conditions conducive to the prevention and control of disease The conceptual framework can be used in several ways to promote the importance of examining the links between agriculture and health. The authors conclude by presenting four main steps to encourage greater synergies between agriculture and health: compile and communicate evidence of successes and failures in the field of agriculture and health; build capacity, policies and governance structures to facilitate linked approaches; identify and prioritize research gaps and needs, and develop a joint research agenda; and, invest in capacity building to help translate the conceptual links into comprehensive actions on the ground.