The cost of living in The Bahamas continues to balloon, widening the gap between the 'well off' and those that must 'stretch they last dollar'. This stark reality was evident during the height of the COVID-19 pandemic, but the inequities inherent in our Nation are well known.
Last week, conversations about the cost of healthy eating were at the forefront of national news. Though the framing of this issue was around the inflation crisis and value-added tax (VAT), it is important to note that healthy eating is a public health priority that should remain high on the policy agenda.
Nutrition-related health outcomes, such as obesity and other non-communicable diseases (NCDs), remain prevalent and impact the less 'well off' disproportionately. NCDs, sometimes called chronic diseases, can have long durations, and though not spread between people, the financial and societal challenges are.
The Opposition urged the government to take action on high food prices by working collaboratively with major food stores to develop a VAT-free list of essential healthy food and expand the breadbasket items list. This is in line with recommendations made by the Ministry of Health. However, while multisectoral approaches are necessary to combat ill health, they must begin with the common goal of putting health above profits. Evidence suggests political and multisectoral integration challenges where reform processes, such as updating the breadbasket items list to include healthier options, are constrained due to stakeholders' different goals. The stagnation over this reform is one example of power asymmetry driven by corporate monetary and political influence. Despite this, there are also other initiatives that can make healthy foods more accessible and affordable for all.
Comprehensive and transformative approaches that consider the entire food system, from production to consumption, are needed. Investment in our agricultural industry is one way to expand access to Bahamian-grown fruits and vegetables. These investments should consider new global and climate challenges to ensure the industry becomes increasingly resilient. This would decrease our overreliance on food imports and help accelerate our progress to meet the 2025 goal to cut food imports in the region by 25%.
Further, investing in communities that have faced historical and compounding burdens of poverty and ill health can help to drive local community-based solutions. Empowering communities to innovate and work together can unlock programs and initiatives that address food deserts, affordable eating, and access to healthy, locally-produced foods. Lastly, a health-in-all policies approach is necessary.
The Ministry of Health cannot act alone. Other government ministries, civil society, and the private sector must work together to transform the food system to prioritize equitable access to quality healthy food. Legislation that regulates the food industry, food pricing, food quality, and the marketing of (un)healthy food is within the scope of work of the government and opposition.
The Bahamas has a history of leading multisectoral approaches to address priority health issues. The ongoing conversations about the cost of living may be an opportunity to galvanise support for reforming our food system.
Written by: Dr Francis K. Poitier | Leeds Institute for Health Sciences, University of Leeds
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