Towards the Equitable and Sustainable Transformation of Agrifood Systems: Evidence at the Intersection of Agroecology and Public Health

Abstract

Food systems — the interconnected ways through which humanity produces, distributes, and consumes food — are culpable for a substantial share of today’s ecological crises, yet they also fail to deliver healthy, affordable food for all or secure decent livelihoods for those who produce it. While numerous solutions have been proposed to mitigate food systems’ disproportionate environmental impacts, most are incremental and neglect intertwined public health and social justice challenges, including persistent food inequities, rising rates of diet-related chronic disease, and mounting economic and climate stress for farmers and food system workers. Agroecology, by contrast, advances the premise that durable reform must be transformative, addressing the underlying social and structural drivers, such as power imbalances and consolidation, that perpetuate environmental degradation, inequities, and human health burdens. This dissertation offers novel insights at the intersection of agroecology and public health, examining how structural forces in U.S. food systems entrench unsustainability and identifying leverage points for transformation that could accelerate agroecological change, with benefits for environmental, social, economic, and public health. The first study (Chapter 1) examines how structural forces have shaped unsustainable agricultural practices in the U.S. by analyzing the relationship between county-level cropland consolidation and pesticide intensification. Despite the development of higher potency formulations, overall use has remained persistently high, raising planetary health concerns given pesticides’ significant human health and environmental impacts. However, little evidence has addressed how structural factors, such as the substantial consolidation of U.S. farmland and the expansion of average farm size, influence these patterns. Employing longitudinal data from 1,466 non-metro counties (1992–2012), we found that greater cropland consolidation was significantly associated with increased pesticide intensity, with an estimated 37% of this association explained by shifts toward high-pesticide-intensity crops. Stratified models revealed notable regional heterogeneity; positive associations emerged in the Southeast and Corn Belt, while a negative association appeared in Appalachia. Efforts to transition toward agroecological food systems and reduce agricultural inputs may need to address systems-level factors like consolidation through regionally tailored approaches. The second study (Chapter 2) examines how increasing supply chain opacity, driven in part by structural shifts such as consolidation in the retail food sector, may enable greenwashing — misleading consumers about the true environmental benefits of products. Greenwashing represents a structural barrier to food systems transformation by undermining consumer trust and preventing market signals from effectively supporting agroecological transitions. After developing and psychometrically testing a novel coding instrument, we applied it to more than 23,000 food and non-alcoholic beverage products across two major U.S. online retail platforms. Over 10% of products carried front-of-package environmental claims; of these, nearly two-thirds at the conventional supermarket and one-third at the natural food store were determined to be greenwashed, primarily due to inadequate claim substantiation. Most environmentally marketed products were ultra-processed, the vast majority of claims were executional in nature (i.e., relying on implicit design or visual cues rather than explicit statements), and greenwashing prevalence was highest in the meat and meat alternative categories. Regulating environmental claims in the food sector should be urgently considered as a strategy to both protect consumers and prevent greenwashing from impeding agroecological transitions. The third study (Chapter 3) explores how farmers’ relational values shape motivation and engagement in agroecological practices. While transforming food systems will require widespread adoption of ecologically and socially sustainable practices, limited U.S. research has examined how farmers' value systems influence both their adoption of on-farm sustainable practices and their participation in broader agroecological change. Interviews with 32 small- and mid-sized Oregon farmers revealed strong relational values — rooted in care for land, animals, and community — that motivated both ecological stewardship and social action, including efforts to improve community food security and well-being. However, farmers’ ability to act on these values was constrained by structural barriers, including economic precarity, policy exclusion, and sociocultural devaluation. Centering farmers’ values in policy and designing strategic supports that enable them to act in alignment with their existing relational values may be critical to accelerating the widespread adoption of agroecological practices and advancing a just, equitable transformation of U.S. food systems. Together, these three studies illuminate how structural forces have shaped and continue to reinforce unsustainable food systems, while identifying potential levers for advancing agroecological transitions in the U.S. Our findings underscore the importance of addressing social and structural determinants of sustainability and point to actionable pathways for change, including regulating environmental claims, scrutinizing ongoing farmland consolidation, and fostering cross-disciplinary collaboration between public health, environmental health, and agricultural stakeholders. Strengthening inquiry and practice in this area could accelerate the transformation toward food systems that restore ecological balance, promote human health, and foster social equity.