Food Justice: What is it? Where has it been? Where is it going?

Food justice has been described as a social concern, an economic matter, and a political problem [1]. Broadly speaking, food justice encompasses a vision of social, environmental, and economic justice; improved nutrition and health; and community activism [2]. Sometimes viewed as an amalgamation of the concerns of alternative food movements and environmental rights, food justice addresses the disproportionate burden of environmental barriers to healthy food experienced by low-income communities and communities of color [3,4]. The concept of food justice aligns itself with the goals of social justice, which demand recognition of human rights, equal opportunity, and fair treatment. Existing food justice literature calls for the mainstream, or global, food system to address issues of social justice [5].


Introduction
Food justice has been described as a social concern, an economic matter, and a political problem [1]. Broadly speaking, food justice encompasses a vision of social, environmental, and economic justice; improved nutrition and health; and community activism [2]. Sometimes viewed as an amalgamation of the concerns of alternative food movements and environmental rights, food justice addresses the disproportionate burden of environmental barriers to healthy food experienced by low-income communities and communities of color [3,4]. The concept of food justice aligns itself with the goals of social justice, which demand recognition of human rights, equal opportunity, and fair treatment. Existing food justice literature calls for the mainstream, or global, food system to address issues of social justice [5].
Over the past two decades, food justice has stimulated interest from both academic and social science perspectives [3]. As a social movement, food justice has emerged as an extension of environmental justice and been influenced by historical anti-oppression and civil rights efforts [2]. Indeed, the movement was initiated by urban social justice groups mobilizing around inequalities in the food system based on race and socioeconomic status [3]. Food justice typically focuses on processes that occur between food production and consumption, such as manufacturing and distribution, which require an exchange of money for labor or goods. Because of this (and also because food availability is influenced by income, access, and mobility of consumers), many processes of mainstream food systems can be regarded as generating inequality [3]. Successful food justice initiatives often involve systemic change around inequalities based on race, gender, and class, as well as promotion of economic exchange and labor systems that foster empowerment and autonomy among historically marginalized groups [6,7].
Food injustice and its implications on health, economic, environmental, and social systems have garnered attention in recent years. Many community-based organizations, youth groups, school gardens, and alternative food initiatives have begun protesting mainstream food systems and developing alternative solutions. More and more, communities are organizing for social change against dominant food systems that perpetuate injustices across all sectors of the food supply chain -from mistreatment of farm workers, to pollution associated with the industrialization of meat production, to lack of access to nutritious food [5,8].
While different disciplines tend to define it through their own respective lenses, food justice is a concept that informs multiple areas of thought, action, and study, including: 1) alternative, activist, and oppositional food movements [4,7,[9][10][11][12][13] 2) environmental justice [2,4,11,14,15] 3) food security [2,6,7,12,13] 4) health equity and disparity [7,11,13,16] Although they differ significantly in their scope and approach, these issues intertwine across the landscape of the literature, collectively defining the principles of food justice and suggesting strategies for intervention. As Gottlieb and Joshi explain, "What connects these approaches is the desire to create fundamental change as well as alternatives to the dominant food system" [8].

Alternative Food Movements
Alternative food movements defy predominant political structures that control the food system and strive to create a structure that is environmentally, economically, and socially just [10]. The goal of alternative food movements, sometimes called "slow food" or "local food" movements, is to shorten the distance between food developers and consumers, particularly through direct marketing by farmers [3,7,17]. These movements also tend to support sustainable agriculture and fair trade initiatives [3,4]. Key players may consist of representatives from stakeholder groups (such as food cooperatives), parents who desire healthier school foods, or food pantry volunteers [11]. While constructive alternative food movements primarily focus on developing alternative solutions, oppositional alternative food movements directly protest and criticize mainstream institutions and policies [18]. Constructive alternative food movements advocate for low-income communities to enable them to gain access to the conditions and resources necessary for good health without directly protesting current, broader political and systemic issues [10,19], such as through implementation of farmers' markets and sustainable farming movements [19]. While constructive approaches tend to operate within prevailing systems, oppositional movements seek new structural configurations [10] by reforming prevalent agricultural and food systems, such as through protests of "corporate globalization," genetic modification, and fast food advertisements [19]. There are numerous ways to categorize and describe agrifood movements; however, for the purposes of this commentary, we align our definition with those who assert that oppositional and constructive initiatives fall within the broader umbrella of alternative agrifood initiatives [19]. We selected this approach because all the initiatives we discuss can be viewed as alternative, although they vary in the degree to which they either directly oppose the dominant food system, or constructively locate alternatives within it.
Although many initiatives may contain elements of alternative food movements, food justice focuses specifically on social justice within the food system, such as the treatment of low-income communities and communities of color [3]. Alternative food movements often align themselves with the goals of food justice, aiming to increase access to healthy, culturally-appropriate food for marginalized communities [5]. Despite this intent, food justice supporters can be critical of alternative food movement activists who promote local, organic food without bearing in mind the underlying social disparities existing within the food system [9]. Consequently, despite the capacity for such alternative food movements to shorten the links in the food commodity chain, a disconnect can emerge between alternative food activists who support local, sustainable, and community-owned food practices and the reality that these practices often represent the ideals and values of white, middle-class communities at the exclusion of more vulnerable populations. This disconnect can result in a replication of the same oppressive power dynamics that exist within mainstream food systems [5,9]. In this sense, alternative food movements inform elements of food justice in terms of their problemitization of conventional food systems, and in fact provide opportunities for consumers to participate in and protest food systems during their everyday lives [5]. Yet, the notion of food justice illuminates a broader commitment toward meliorating the social and economic foundations within which marginalized groups exist, thus innovating the traditional food environment.
Published work on alternative, activist, and oppositional food movements includes topics such as activism around organic and health foods, ethics of animal agriculture, and the relationship between the slow food movement and breastfeeding. This body of literature appears to be less focused, however, on examining the intersection between such movements, social determinants of health (such as educational opportunities, economic opportunities, access to health care, and literacy), and cultural characteristics (such as race, class, gender, and sexual orientation). Inclusion of these issues, as well as analytic studies to help quantify the relationship between alternative food movements and food justice, would be of interest to researchers and practitioners alike.

Environmental Justice
It is well known among the public health sector that neighborhood environments can both contribute to and prevent healthy behaviors [14,16]. For instance, distance from playgrounds, parks, and grocery stores affects communities' dietary intake and physical activity patterns. In this sense, as Allen argues, health, justice, and ecology are inherently related [5]. Social justice researchers often attribute health disparities to the human-constructed spaces in which people live, work, learn, and play -our "built environments." Indeed, environmental ecology is instrumental in physical activity-related behaviors, eating patterns, and access to nutritious foods. Yet, disparities exist within physical environments based on factors such as neighborhood socioeconomic status [20,21].
The field of environmental justice is characterized by fair treatment and substantive involvement of people in the design, implementation, and administration of environmental systems and policies [14]. It strives to improve situations in which people are disproportionately exposed to environmental harms or lack of resources based on demographic factors such as race, class, gender, and citizenship [4]. Thus, initiatives revolve around a commitment to equitable distribution of environmental health burdens and resources, including both obvious health hazards such as environmental pollution, and more subtle health inequities, including limited access to healthy food [14]. Given this, it follows that food justice derives its concentration on environmental positionality from historic environmental justice movements, uniting it with political and economic principles of alternative food system activism.
Of the expansive body of environmental health literature, work focused on environmental justice often includes descriptive studies presenting theoretical and conceptual frameworks around issues such as asthma and air pollution, chemical hazards, toxic waste disposal, diesel emissions, regulatory action, child health and school exposures, federal policies, and farm worker health. A number of these studies also focus on the benefits of employing community-based and participatory approaches to identify and address these complex public health issues [22][23][24][25]. Although the prevailing literature explores connections between environment, positionality, and health outcomes, there appears to be a paucity of studies dedicated to critical examination and analysis of the relationship between the environment and food access.

Food Security
According to the United States Department of Agriculture (USDA), food security refers to the ability of all people to have access at all times to enough food for an active, healthy life and pertains to the availability and accessibility of nutritious, safe, and acceptable foods in a socially acceptable way. Socially acceptable, in this case, means without resorting to coping strategies such as scavenging, stealing, or relying on emergency food supplies [13,26]. Food insecurity is associated with myriad negative community health outcomes, ranging from malnutrition to "globesity" (a term used to describe the global obesity epidemic [27]). Because food insecurity implies a lack of access to food, it is most often associated with malnutrition and weight loss. However, research also indicates that reliance on low-quality, energyrich foods can result in overweight or obesity [28], particularly when combined with other socioeconomic or geographic obstacles prevalent in food-insecure areas. For example, people living in these areas often have limited agency over their environments and face barriers to safe outdoor physical activity and the opportunity to purchase and prepare healthful foods [29].
Although related and often used interchangeably, the concepts of food security and food justice differ significantly. Food security is typically measured by the USDA in terms of access to supermarkets, but lacks focus on certain food justice considerations such as institutional racism, socioeconomic status, and minority status [3,6]. Some food justice scholars have criticized food security initiatives, such as anti-hunger programs, because although they focus on outcomes of food insecurity (namely, hunger), they may not focus on the societal structures responsible for those outcomes [3]. These findings highlight the importance of examining the social, economic, and political conditions existing within the food system, along with food security issues.
Interestingly, some terminology that was popularized through food security initiatives can be a point of contention among food justice researchers. For instance, the term "food desert" refers to geographic areas that don't have access to affordable foods necessary for a healthy diet, such as produce, whole grains, and low-fat dairy products [30]. This term evokes the image of a desert, but ignores the underlying oppression that may have created such challenging environmental conditions and associates people of color with barren environments [6,31]. Controversies also exist around strategies to combat food insecurity. For example, the conventional food system is shaped by supermarkets, which expand food access, but can also tempt consumers to overspend on less healthy products and undermine smaller, independent grocers [6,32]. In this sense, food security interventions that rely on the establishment of grocery stores may not be operative in food system change. Similarly, emergency food programs targeting diverse populations may not be effective in decreasing food insecurity if service providers fail to offer culturally-appropriate food and support services when distributing food [20,33]. Food security initiatives, like alternative food movements, can be seen as seeking a re-distribution of benefits within dominant, oppressive food systems to combat hunger and promote wholesome, nutritious ways of eating within marginalized communities. However, the spirit of food justice necessitates a focus on equity to foster health behavior change among diverse populations.
Numerous United States-based and international intervention studies have been published regarding food security. Many of these focus on at-risk groups such as children, pregnant women, and older adults and revolve around foodborne illness and food safety; measures of food security; environmental issues such as climate change and genetically modified crops; and national and global food aid policies. The concept of food security benefits from the diverse and experimental nature of the literature, particularly given the associations between food insecurity, health status indicators such as obesity and malnutrition, and special interest groups such as immigrants, school children, and mothers [20,28,33].

Health Equity and Disparity
Despite the number of alternative food movements in operation, the alarming prevalence of hunger and obesity among low-income communities and communities of color demonstrates the pressing need for attention to equity in agrifood initiatives. Among foodinsecure households, rates of food insecurity are higher than the national average for families with children; those run by a single-parent, particularly single mothers; black, non-Hispanic households; Hispanic households; and those with incomes below 185% of the federal poverty threshold [34]. Globally, women experience food insecurity at higher rates than men [5], and in the U.S., immigrant families are twice as vulnerable to household food insecurity as U.S.-born families [33]. Beyond consumers, health disparities impact producers in the food commodity chain as well, such as farm workers -who are too often exploited through mistreatment, dangerous working conditions, low wages, minimal access to health care, and harmful pesticide exposures [5].
Health equity is focused on recognizing and leveling the sociallyproduced factors that influence health, such as gender, race, indigenous status, poverty, and citizenship status [13,35]. It is important to note the distinction between "inequity" and "inequality" in relation to health. Inequality describes differences among people, such as those caused by accidents or genetics; inequity describes differences among people that are unjust, including those caused by differences in access to healthcare, physical activity, or nutritious food [16]. Inequalities are not always unjust; however, the concepts of inequality and inequity frequently interact. For example, while genes can increase one's risk of developing a particular disease, behavior may exacerbate this risk and behavior is often tied to social and environmental health inequities [16]. Health equity can be achieved through alleviation of health disparities, which often contribute to differences among people in length and quality of life, prevalence and severity of disease and disability, and access to health care [36]. Similar to health equity, the concept of food justice acknowledges that good health stems from equitable social, economic, and environmental foundations.
Published work on health equity and health disparities is diverse, including richly descriptive studies, commentaries, and evaluation reports focused on national survey data, ethics, and policy-level issues. Although some studies discuss the impact of equity on food access, relatively few appear to present experimental data about equity within the production and distribution stages of the food commodity chain. Work in this area, while inherently challenging due to multiple intervention points, potential impacts, and levels of analyses, would help to determine group-level associations between opportunity and food justice outcomes, as well as develop solutions to promote a more just, equitable food system.

What's Next for Food Justice?
Justice plays a pivotal role in the food system, yet there is a relative paucity of published studies related to food justice. Much of what does exist is descriptive. This gap calls attention to the need for further research to identify best practices to support hunger and food justice initiatives that promote public health and sustainable community practices. Moreover, the absence of food justice literature within mainstream, peer-reviewed publication databases (such as MEDLINE/ PubMed) evokes the question of whether food justice requires further definition as a research topic, or, alternatively, whether food justice as implied by the four related concepts discussed here, is adequate. Certainly, more controlled studies are called for, allowing the field to employ what we know about the causes of food injustice to refine measurement tools, design and test community-based interventions, and initiate policies that impact community-and system-level changes. Yet, still we wonder -is it enough for food justice to strive toward more controlled intervention studies, as opposed to descriptive research? Indeed, despite its inability to quantify relationships between phenomena, the advantages of descriptive studies may be particularly relevant to food justice advocacy, which relies on stories of peoples' lived experiences and the utilization of novel, participatory data collection techniques.
There are multiple potential entry points for food justice engagement [8]. In Resnik and Roman's bioethical examination of the relationship between environment and inequalities in health, the authors argue that "... justice in health should expand beyond the topic of access to health care and cover such issues as occupational hazards, safe housing, air pollution, water quality, food and drug safety, pest control, public health, childhood nutrition, disaster preparedness, literacy, and many other environmental factors that can cause differences in health" [16]. Just as these authors propose that a broader view of justice is needed, food justice, too, would benefit from a comprehensive perspective in order to cultivate a solid research base.
Here, we have positioned our discussion about food justice as a concept that informs and overlaps with parts of four broad areas of study, each of which constitute research and practice areas in their own right. Although these areas intertwine and collectively inform the field, system-level intervention strategies are not widely reflected in the literature. Given the strength and utility of each of these areas, we propose that future studies consider employing a cross-section of issues in their design, implementation, and evaluation. Some grassroots initiatives have already done so, for instance, through the implementation of mobile farmers' markets [37] or community-owned grocery stores [38]. Through partnerships with community members, municipal departments, local farms, housing authorities, and local colleges, these initiatives fill substantial gaps in their communities. Most visibly, they operate within alternative food movement frameworks to partner with local farmers to provide food to communities, typically targeting food-insecure, culturally-diverse, or marginalized environments. They can promote equity by employing community members; providing training around economics and management; and providing education around nutrition, food preparation, and food preservation. Researchers are uniquely poised to further the work initiated by communities to legitimize the role of food justice in the food system by including its elements in their research questions and study designs, and by engaging "real people in their real lives" [5].
Indeed, because social justice revolves around recognition, inclusion, and participation of traditionally marginalized populations, community-based participatory research (CBPR) methods have unique potential to mobilize and improve health within such communities. CBPR is defined as "a collaborative, partnership approach to research that equitably involves, for example, community members, organizational representatives, and researchers in all aspects of the research process" [39]. Although the academic world may identify those with the most education as most knowledgeable, CBPR principles demonstrate that successful advocacy work often relies on collaborations with community members, who are most able to affect change and provide insight. From this perspective, the field of food justice could benefit from research and interventions grounded in community-based and participatory principles. In line with Campbell and Scott, who emphasize the importance of marginalized communities seeing themselves as "active agents" in control of their health [40], we suggest that community-based and participatory practices can help community-led initiatives to build both capacity and supportive social environments. In this way, food injustice may be addressed by enabling those in need to safely voice their concerns for those in positions of power to act upon their requests.
Food justice has been associated with public health, agricultural, civil rights, and environmental efforts. Despite this, or perhaps because of it, questions persist regarding definition of the term, how to fill gaps in intervention efforts, and identification of future research needs. It remains to be seen whether current terms and definitions fully capture what food justice is and will be in the 21 st century. Although a comprehensive review of the literature is beyond the scope of this commentary, results of our examination of the field make clear that practical, broad-based approaches to planning, implementing, measuring, and evaluating community-based food justice intervention efforts and policies are needed.