The 10 Democrats who took the debate stage on Sept. 12 discussed many critical issues, from health care and climate change. But one important topic they didn’t discuss was access to healthy food.

As a researcher focused on nutrition and health, I found this disappointing. Not only is access to food an important issue in its own right, but it underlies many of the topics they did debate.

The Threat of Food Insecurity

In this land of plenty, millions still don’t have reliable access to enough food to maintain a healthy life. The United States Department of Agriculture recently reported that 11.1% of Americans – 14.3 million people – experienced food insecurity in 2018. That means they didn’t have reliable access to enough healthy food for at least part of the year.

The candidates spoke at length about providing health care – whether to offer “Medicare for All” or take a more incremental approach to universal coverage. They said little, however, on how to actually assure Americans’ health.

Food insecurity threatens children’s physical and mental development, increasing their disease risk. Studies find that areas with higher food insecurity have higher prevalence of diabetes and obesity – two very costly diseases. Better access to healthy food would help reduce our health care costs, increase labor productivity and boost overall quality of life.

The candidates agreed that climate change is a fundamental threat but did not discuss how it disrupts the food supply. Food shortages threaten health and social and political stability. Consider last year’s food riots in Venezuela.

The candidates decried corporate money’s influence in the political process, but there was no mention of how the agricultural industry is increasingly dominated by a handful of companies who spend millions lobbying.

Increased market concentration generally results in higher prices. And higher prices at the grocery store are associated with greater food insecurity.

It also confers monopsony power – a market situation in which there are few buyers of a resource such as labor – which can depress wages. And in turn, lower wages reduce the ability to purchase healthy food.

Although most of the candidates have in the past said they agree on the need to strengthen and enforce antitrust regulations in agriculture, they failed to take advantage of the national stage to make their case.

Patricia Smith, Professor of Economics, University of Michigan

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