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The European Journal of Public Health Advance Access published online on September 1, 2005
The European Journal of Public Health, doi:10.1093/eurpub/cki166
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© The Author 2005. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
Received October 20, 2004
Accepted June 7, 2005

Article

The European Common Agricultural Policy on fruits and vegetables: exploring potential health gain from reform

J. Lennert Veerman 1*, Jan J. Barendregt 2, and Johan P. Mackenbach 1

1 Department of Public Health, Erasmus MC--University Medical Centre Rotterdam, The Netherlands
2 Department of Public Health, Erasmus MC--University Medical Centre Rotterdam, The Netherlands; School of Population Health, University of Queensland, Australia

* To whom correspondence should be addressed.
J. Lennert Veerman, E-mail: j.veerman{at}erasmusmc.nl


  Abstract

Background: Consumption of fruits and vegetables is associated with a reduced risk of cardiovascular disease and cancer. The European Union Common Agricultural Policy keeps prices high by limiting the availability of fruits and vegetables. This policy is at odds with public health interests. We assess the potential health gain for the Dutch population of discontinuing EU withdrawal support for fruits and vegetables. Methods: The maximum effect of the reform was estimated by assuming that a quantity equivalent to the amount of produce withdrawn in recent years would be brought onto the market. For the calculation of the effect of consumption change on health we constructed a multi-state life table model in which consumption of fruits and vegetables is linked to ischaemic heart disease, stroke, and cancer of the oesophagus, stomach, colorectum, lung and breast. Uncertainty is quantified using Monte Carlo simulation. Results: The reform would maximally increase the average consumption of fruits and vegetables by 1.80% (95% uncertainty interval 1.12-2.73), with an ensuing increase in life expectancy of 3.8 (2.2-5.9) days for men and 2.6 (1.5-4.2) days for women. The reform is also likely to decrease socio-economic inequalities in health. Conclusion: Ending EU withdrawal support for fruits and vegetables could result in a modest health gain for the Dutch population, though uncertainty in the estimates is high. A more comprehensive examination of the health effects of the EU agricultural policy could help to ensure health is duly considered in decision-making.

Keywords: fruits; health impact assessment; modelling; quantitative method; vegetables.
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