Investments aligned with this Strategic Goal aim to improve human health outcomes through sustainable agriculture.

The sections below include an overview of the approach for achieving desired goals, supporting evidence, core metrics that help measure performance toward goals, and a curated list of resources to support collecting, reporting on, and using data for decision-making.

What

Dimensions of Impact: WHAT

Investors interested in deploying this strategy should consider the scale of the addressable problem, what positive outcomes might be, and how important the change would be to the people (or planet) experiencing it.

Key questions in this dimension include:

What problem does the investment aim to address? For the target stakeholders experiencing the problem, how important is this change?

The impact of unsustainable agriculture extends beyond the environment. While the market value of the global food system is an estimated USD 10 trillion, the hidden, often externalized costs are USD 12 trillion (1). Of these massive costs, more than half—USD 6.6 trillion—are related to health (1). Many negative health outcomes result from agricultural practices and food systems, including undernutrition, overnutrition, cancer, fertility, and digestive diseases, among many others (2, 3, 4, 5, 6). While direct food production practices often drive such negative consequences for human health, changes in climate can also negatively affect health outcomes, as increasing concentrations of atmospheric carbon dioxide can reduce the nutrition of crops (7, 8).

Investments aiming to improve human health through sustainable agriculture can:

  • purchase or support the purchase of farmland or farming operations that emphasize improving plant, animal, and human health;
  • bring products to market that clearly articulate their connections to improving health;
  • develop new technologies to measure and monitor food quality;
  • advance the development of new crop and livestock breeds with improved nutritional qualities;
  • promote circular-economy approaches to nutrients from farm to fork (and back to farm); and
  • create new insurance mechanisms that internalize the true costs of agriculture and human health.

Outcomes of these investments could include:

  • reduced use of and exposure to toxic synthetic pesticides, herbicides, fertilizers, contaminated water, and antibiotics;
  • tracked and communicated changes in food quality and the potential health implications of such changes;
  • decreased rates of inflammation-based disease and other negative health outcomes; and
  • improved access to and consumption of a diversity of whole foods and availability of culturally appropriate diets.


Though agriculture, food, and diet all contribute to health outcomes, food and agricultural systems have many interrelated levers affecting whether end products confer positive health impacts. Many interventions that can improve health outcomes start in the soil, with an increasing number of demonstrated pathways from improved stewardship of agricultural soil to positive health impacts (9). Healthy soil with a flourishing microbiome helps to impart nutrition to food, as demonstrated in row crops, animals, and vegetables (10, 11, 12). While healthy soil stands at the core of agriculture, soil is embedded in a complex system of production in which diet, seed, and animal genetics, as well as inputs such as pesticides and antibiotics, are all factors that can impact human health (13, 14, 15, 16).

An example of an intervention that improves health outcomes through soil improvement is raising grass-fed beef or dairy cattle using methods such as managed grazing or adaptive multi-paddock (AMP) management. In these methods, cattle mimic interactions with natural landscapes: short durations of intensive use followed by long periods of rest and recovery. The interplay among deep-rooted perennial vegetation, symbiotic fungal networks, manure deposited by the animals, and grazing enhances the ability of a rich network of macro- and micro-organisms to efficiently move minerals and nutrients from the soil to plants to animals (17). The resulting more diverse, phytochemically richer diets lead to functionally different food products with significantly different chemical makeup from both grain-fed meat and plant-based meat alternatives (18, 19, 20, 21, 22). These differences can in fact affect inflammation in humans, with impact on long-term health through diseases like heart disease and cancer (11).

*The GIIN’s Understanding Impact Performance: Agriculture provides analysis of the impact performance of agriculture impact investments and showcase the real-world results associated with them.

What is the scale of the problem?

As of 2017, health care systems have a USD 7.8 trillion global economic burden, or about 10% of GDP (23). The most common food-related health issues are the twinned challenges of obesity and malnutrition, which largely results from our food system shifting focus to quantity over quality (24). An abundance of lower-quality, highly processed food grown and raised in ways that do not fully support human health contributes to the 41 million people killed each year by noncommunicable diseases, nearly 13 million of whom are in low- and middle-income countries (25). The novel coronavirus, COVID-19, also originated in connection to food-system infrastructure, with the pandemic causing an immense toll in terms of both individual human lives and economies (26, 27, 28).

Though most calculations of costs and benefits in the food system are framed in terms of today’s population, this problem also has longer-term, cross-generational dimensions. New research has shown how pesticides had limited effects on exposed individuals but deleterious effects that emerged several generations later (29). Investments in sustainable agriculture can not only positively impact the environment but also improve the health and well-being of farmers and ranchers, participants in the agricultural value chain, and eaters alike.

Who

Dimensions of Impact: WHO

Investors interested in deploying this strategy should consider whom they want to target, as almost every strategy has a host of potential beneficiaries. While some investors may target women of color living in a particular rural area, others may set targets more broadly, e.g., women. Investors interested in targeting particular populations should focus on strategies that have been shown to benefit those populations.

Key questions in this dimension include:

Who (people, planet, or both) is helped through investments aligned with this Strategic Goal?

While investments aligned with this Strategic Goal could positively affect health outcomes quite broadly, the following are some specific target stakeholders.

  • Farm and food workers. Workers in the food system face increased risk of occupational illness, injury, and death compared to workers in other industries (30). These workers face high physical and mental health exposure risks from handling and applying herbicides, pesticides, fertilizers, antibiotics, growth hormones, and waste from industrial livestock production (31). An increasing body of research links toxic chemicals used in agricultural production to several common acute and long-term conditions such as asthma, diabetes reproductive dysfunction, and several types of cancer (32, 33, 34). Furthermore, the insecure status of hired and migrant workers undermines the reporting of abuses and injuries (35). Eliminating agriculture’s reliance on synthetic toxic chemicals and improving workplace conditions directly benefits the health and wellbeing of the laborers who produce, harvest, process, and deliver food and other agricultural products. More specifically, smallholder farmers across the world can benefit. (See the IRIS+ Smallholder Agriculture theme for Strategic Goals focused on those production systems.)
  • Children. Children’s diets, particularly those of young children, are critical to their health outcomes. In developing countries, inadequate intake of calories and proteins (protein-energy malnutrition, or PEM) is the leading cause of death in children. Stunted growth and compromised neurodevelopmental capacity are also common consequences of malnourishment (31). Furthermore, children face a disproportionate burden of exposure to toxic contamination of food. Though representing only 9% of global population, children under five incur 43% of the disease burden of contaminated food (35). Food and other environmental exposure have particularly significant impacts on infants in their first 1,000 days (36). Evidence links acute malnourishment and undernourishment with gut microbiota immaturity in children, which results from a lack of widely produced and available nutrient-dense foods (37).
  • Agricultural communities. Some of the greatest human health risks due to industrial agriculture are faced by people living in rural and agricultural communities, particularly in developing countries, who lack access to potable water infrastructure and rely on contaminated water bodies and groundwater wells (31). Their health would benefit from improved agricultural practices and investments that reduce toxic pesticide and chemical use by, for example, eliminating nitrogen fertilizer use and runoff or promoting and maintaining the healthy outdoor habitats and non-confinement of livestock (58).
  • Low-income communities. Increased access to more nutritious foods helps low-income communities in both poorer and richer countries, as evidence links many poor health outcomes to malnutrition in adults and children (37). Low-income households often find it difficult to afford enough food or enough healthy food to support appropriate nutrition. Investments in health through sustainable agriculture could improve the nutrient levels of food, but investment in food system infrastructure (for example, storage buildings, transportation networks) is required to ensure that vulnerable, underserved populations benefit. Healthy food should be accessible not only to those who can pay a premium; healthy food should be placed at the core of safety net programs, with true cost accounting methodologies connecting the long-term costs and benefits across agriculture and human health.

What are the geographic attributes of those who are affected?

Industrial agriculture worldwide has harmed human health worldwide. Rural areas where industrial agriculture dominates agricultural production systems are a particular target of impact investments aligned with this goal. For example, in the United States, concentrated animal feeding operations, or CAFOs, have become the predominant method of raising livestock in rural regions such as those in the Midwest and South. People in these regions report many negative changes, including higher incidence of health and environmental concerns (38, 59).

Regions where soils are already experiencing high rates of degradation are also ideal targets for investments aligned with this Strategic Goal. Degraded soils due to poor soil management and contamination have been linked to food insecurity, disease, malnutrition, and ingestion issues (39). Soil acidification is also a serious global threat to soils and human health. The most acidic soils are in South America in regions that have experienced deforestation and industrial agriculture. While loss of soil nutrients is occurring in many regions, soil loss is particularly acute in sub-Saharan Africa. As of 2015, the United Nations found that all but three African countries extract more nutrients from the soil each year than are returned, depletion which leads foods to be less nutrient-dense and creates ongoing concerns regarding health and food security (40).

Contribution

Dimensions of Impact: CONTRIBUTION

Investors considering investing in a company or portfolio aligned with this strategy should consider whether the effect they want to have compares to what is likely to happen anyway. Is the investment's contribution ‘likely better’ or ‘likely worse’ than what is likely to occur anyway across What, How much and Who?

Key questions in this dimension include:

How can investments in line with this Strategic Goal contribute to outcomes, and are these investments’ effects likely better, worse, or neutral than what would happen otherwise

Organizations can consider contribution at two levels—enterprise and investor. At the enterprise level, contribution is “the extent to which the enterprise contributed to an outcome by considering what would have otherwise happened in absence of their activities (i.e., a counterfactual scenario).” To learn more about methods for assessing counterfactuals, see the Impact Management Project.

Investors can contribute toward addressing the larger issues related to human health and sustainable agriculture in the following ways.

  • Signal that impact matters. While other industries such as infrastructure, energy, and financial services have received the majority of blended finance, food systems and agriculture, and nutritious food even less, have received lesser attention. Targeted investment in nutritious food that supports positive health outcomes will be necessary in a global marketplace that often favors non-nutritious foods with less complex supply chains and higher profit margins (46).
  • Engage actively. Stakeholders in sustainable agricultural value chains can advance nutritional outcomes through various forms of engagement with both new and established companies. To reach a shared, mutual vision for transforming food systems, investors and investor groups can work to set standards for agriculture based on nutritional density and worker health and safety (47).
  • Grow new or undersupplied capital markets. Small and medium-sized enterprises (SMEs) provide most of the food consumed worldwide. Such businesses, including those in the nutritious food sector and particularly those in the Global South, have identified access to finance as a major challenge. Appropriate financing and technical assistance can increase operational efficiencies and expand reach, leading to increased production, larger margins, and expanded reach to low-income and rural communities (46). Additional support for SMEs could be provided through shifts in food pricing—moving away from pricing based on quantity to pricing based on quality, inclusive of nutrient density.
  • Provide flexible capital. Financial investors face several risk–return tradeoffs when investing in projects that support healthy food systems. Risks can be mitigated through blended finance techniques: using philanthropic funds to reduce risk for private investors, creating flexible and favorable debt or equity, and using insurance policies and guarantees to protect investors from losses (47). Flexible capital can incentivize the production of nutritious foods while maintaining both social and environmental integrity.

How Much

Dimensions of Impact: HOW MUCH

Investors deploying capital into investments aligned with this strategy should think about how significant the investment's effect might be. What is likely to be the change's breadth, depth, and duration?

Key questions in this dimension include:

How many target stakeholders can experience the outcome through investments aligned with this Strategic Goal?

All 7.8 billion people on Earth (as of 2021) benefit from investments in sustainable agricultural systems. Some groups nevertheless benefit from outcomes more directly and immediately. Workers and agricultural laborers receive the most direct benefits from improved working conditions. Nearly a third of the world’s population (28.5%) is employed in the agricultural sector —and all of the top 12 countries with the highest percentages of their populations employed in agriculture are in Africa (41, 42).

Regarding malnutrition, furthermore, more than 10% of the world’s population is undernourished, with 26% experiencing moderate or severe food insecurity. While the percentage of children with stunted development due to malnutrition has decreased over the last two decades, it remains at 22% globally, while adult obesity has risen to more than 13% (41).

How much change can target stakeholders experience through investments aligned with this Strategic Goal?

Target stakeholders will experience change primarily through higher quality and longer duration of life as a result of improved nutrition and diet-related health. Good nutrition improves quality of life by promoting health, preventing dietary deficiencies, and averting malnutrition that may be caused by or associated with other diseases (43). Morbidity and premature mortality rates also decrease with better nutrition and decreased exposure to food, land, water, and air that has been contaminated by industrial agriculture inputs and practices (44, 45).

In addition to its essential health-promoting functions, food also provides sensory and psychological benefits. Preparing meals can imbue a day with a sense of security and structure, while eating with others promotes healthy social interaction. The pleasure of eating good food—food that fuels one’s body while also triggering sensory delights—is an important contribution to one’s daily happiness and well-being.

Risk

Dimensions of Impact: RISK

Key questions in this dimension include:

What impact risks do investments aligned with this Strategic Goal run? How can investments mitigate them?

Multiple points within food and agricultural systems affect whether the end products confer positive or negative health impacts and whether investing in sustainable agriculture can shift the balance of these impacts to a net positive value. With that complexity in mind, the following are impact risk factors for investments in line with this Strategic Goal.

  • Execution Risk: Challenging the prevailing “productivist” industry narrative—that is, exclusive focus on increasing crop yields—requires a re-prioritization of quality food that contributes toward healthy, equitable, renewable, resilient, just, inclusive, and culturally diverse food systems. Improved health outcomes result from an interplay of food production practices, dietary choices, environmental conditions, and other social determinants of health. These complex connections between agriculture and health lead to clear execution risk. Key decision-makers and thought-leaders, including governments, investors, business, civil society, community leaders, health practitioners, farmers, and Indigenous Peoples will need to adopt and adapt new health-focused visions, prioritizing policies, practices, and business models that align human, ecological, and animal health (48). Generating sustained positive impacts on people and the planet will require coordinated investment and innovation across multiple spheres.
  • Alignment Risk: The current global production model focuses on short-term results, yield, and productivity measures such as gross domestic product. Many agricultural businesses aim to increase yield, which can sometimes trade off against the health value of food. Applying a true cost accounting approach can internalize the full health costs and value to society of healthy food, shifting focus to long term and systemic impact (48).
  • Evidence Risk: Although emerging and growing evidence and research links sustainable agriculture and nutrient-dense foods, nutrient-related interventions take time to achieve impact, which makes it harder to demonstrate (47). It can also be challenging to connect a single agricultural intervention to a change in personal or community health outcomes, because improved health outcomes often result from an interplay of food production practices, dietary choices, environmental conditions, and other social determinants of health. Furthermore, little market data exists on investment opportunities and risk–return trade-offs, especially in developing markets. This risk can be mitigated through the use of concessionary capital to fund market research and increase the transparency of market opportunities that could incentivize investment (47). Finally, while agriculture may have both direct and indirect effects on health, other social determinants of health should also always be considered.

What are likely consequences of these impact risk factors?

These risks may lead to unintentional support of our current food system, which prioritizes quantity, disregards food nutritional value and far workers’ health, and perpetuates vulnerabilities to economic, health, regulatory, and environmental shocks. These risks may lead to financial losses for both investors and investees. In addition, poor management of an investment or inequitable social outcomes may tarnish an investor’s reputation and credibility.

 

Illustrative Investment

COMACO is a Zambia-based social enterprise that supports nearly 200,000 small-scale farmers over 70,000 square kilometers to provide both food and carbon and conservation outcomes. COMACO brought in $3.5 million from one investor, AHL Venture Partners (60). Over almost 20 years, COMACO’s programs and market-building strategies have led to a more biodiverse landscape and a population with increased food security. Anchored in the production and sales of nutrient dense food, COMACO has sequestered carbon and kept wildlife populations thriving. Intensive agroforestry systems have increased yields and decreased dependence on external inputs. COMACO have pioneered a biofortified breakfast cereal made with local varieties, which they have provided to schools across Zambia to increase nutritional security. COMACO has been financed by grants and loans (56); in 2017, they sold nearly USD 500,000 worth of carbon credits to the World Bank (57). COMACO also conducts ongoing research into increasing food’s nutrient density. Their success is demonstrated by their displacement of foreign-controlled resource- and chemical-intensive cropland adjacent to that acreage controlled and managed by farmers in the COMACO value chain. Land that was once managed with intensive chemical inputs, the products of which were destined for export markets, is now managed locally, using regenerative techniques to produce nutrient-dense food.

Manna Tree Partners, an investment firm focused on improving human health through nutrition, invested USD 15 million in Verde Farms to expand their product lines. Verde Farms is a grass-fed beef company that sources cattle from Uruguay, the U.S., Australia, and New Zealand (49, 50). In their primary market, the United States, grass-fed beef sales grew by 18.5% between 2017 and 2019 (51). With this additional capital, they plan to expand to markets outside the United States while increasing their U.S. market share. Interest in grass-fed beef has been increasing for its environmental and health-related benefits. Studies have shown that grass-fed beef has an improved ratio of Omega-6 to Omega-3 fatty acids and increased amounts of secondary compounds, among other health-providing benefits (52) (11). The brand also maintains USDA-organic certification, which for livestock ensures that no antibiotics were used in the production process.

Brightseed, has a mission of exploring the connections between humans and plants by analyzing plants’ chemical compounds to enable a healthier future. Powered by artificial intelligence, Brightseed has developed an innovative technology, Forager, which it uses to track and map millions of active plant compounds. Rather than focusing on creating new synthetic drugs, Forager identifies naturally existing compounds within plants as a source of potential preventative medicines (53). By applying this computational analysis to study plant compounds, Brightseed can predict strong candidate compounds for later targeting and development into therapeutics in clinical trials (54). As an outcome of their research, they have identified specific nutrients found in plants that can be used to therapeutically maintain liver and metabolic health (54). The resulting therapies could combat chronic metabolic diseases that plague U.S. populations. To date, Brightseed’s technology has analyzed nearly 700,000 compounds (55). The company aims to analyze 10 million compounds before 2025. Brightseed has brought in $27 million from 7 investors to date (61).

Draw on Evidence

This mapped evidence shows what outcomes and impacts this strategy can have, based on academic and field research.

NESTA: 2
The Soil Microbial Community and Grain Micronutrient Concentration of Historical and Modern Hard Red Spring Wheat Cultivars Grown Organically and Conventionally in the Black Soil Zone of the Canadian Prairies.

Nelson, Alison G.; Quideau, Sylvie A.; Frick, Brenda; Hucl, Pierre J.; Thavarajah, Dil; Clapperton, M. Jill; Spaner, Dean M. 2011. “The Soil Microbial Community and Grain Micronutrient Concentration of Historical and Modern Hard Red Spring Wheat Cultivars Grown Organically and Conventionally in the Black Soil Zone of the Canadian Prairies” Sustainability 3, no. 3: 500-517. https://doi.org/10.3390/su3030500

NESTA: 2
Reduced-Tillage Increases Nutrient Concentrations in Stored Winter Squash: α-Carotene, Lutein, Phosphorus and Calcium

Zinati, Gladis, Lavanya Reddivari, and Dan Kemper. “Reduced-Tillage Increases Nutrient Concentrations in Stored Winter Squash.” REDUCED-TILLAGE INCREASES NUTRIENT CONCENTRATIONS IN STORED WINTER SQUASH. Rodale Institute, February 28, 2019. https://rodaleinstitute.org/science/articles/reduced-tillage-increases-nutrient-concentrations-in-stored-winter-squash/.

NESTA: 2
Palates Link Soil and Plants with Herbivores and Humans

Provenza F. D. (2018) Palates link soil and plants with herbivores and humans. Animal Production Science 58, 1432-1437. https://doi.org/10.1071/AN17760

NESTA: 1
Food Systems Approach to Cancer Prevention

Vanamala, Jairam. 2017. “Food systems approach to cancer prevention,” Critical Reviews in Food Science and Nutrition, 57:12, 2573-2588, DOI: 10.1080/10408398.2015.1028023

NESTA: 1
Are Glyphosate and Glyphosate-Based Herbicides Endocrine Disruptors That Alter Female Fertility?

Ingaramo, Paola, Ramiro Alarcón, Mónica Muñoz-de-Toro, and Enrique H. Luque. “Are Glyphosate and Glyphosate-Based Herbicides Endocrine Disruptors That Alter Female Fertility?” Molecular and Cellular Endocrinology. Elsevier, December 2020. https://www.sciencedirect.com/science/article/abs/pii/S0303720720302343.

NESTA: 1
Is Grassfed Meat and Dairy Better for Human and Environmental Health?

Provenza, Frederick D, Scott L Kronberg, and Pablo Gregorini. “Is Grassfed Meat and Dairy Better for Human and Environmental Health?” Frontiers in Nutrition. U.S. National Library of Medicine, March 2019. https://pubmed.ncbi.nlm.nih.gov/30941351/.

NESTA: 1
Impact of Grass/Forage Feeding versus Grain Finishing on Beef Nutrients and Sensory Quality: The U.S. Experience.

Elswyk, Mary E. Van, and Shalene H. McNeill. “Impact of Grass/Forage Feeding versus Grain Finishing on Beef Nutrients and Sensory Quality: The U.S. Experience.” Meat Science, January 2014. https://www.sciencedirect.com/science/article/pii/S0309174013004944.

NESTA: 1
A Review of Fatty Acid Profiles and Antioxidant Content in Grass-Fed and Grain-Fed Beef

Daley, C.A., Abbott, A., Doyle, P.S. et al. 2010. “A review of fatty acid profiles and antioxidant content in grass-fed and grain-fed beef.” Nutr J 9, 10. https://doi.org/10.1186/1475-2891-9-10

NESTA: 1
Unraveling the Food-Health Nexus

“Challenges and Opportunities.” Global Alliance for the Future of Food, March 3, 2021. https://futureoffood.org/our-work/the-challenges-and-opportunities/#.

NESTA: 1
Exposure to Pesticides and the Associated Human Health Effects

Kim, K. H., Kabir, E., & Jahan, S. A. (2017). Exposure to pesticides and the associated human health effects. The Science of the total environment, 575, 525–535. https://doi.org/10.1016/j.scitotenv.2016.09.009

NESTA: 1
Cultivating Healthy Growth and Nutrition through the Gut Microbiota

Subramanian, S., Blanton, L. V., Frese, S. A., Charbonneau, M., Mills, D. A., & Gordon, J. I. (2015). Cultivating healthy growth and nutrition through the gut microbiota. Cell, 161(1), 36–48. https://doi.org/10.1016/j.cell.2015.03.013

NESTA: 1
The Influence of Soils on Human Health. Nature Education Knowledge 

Brevik, E. C. & Burgess, L. C. (2014) The Influence of Soils on Human Health. Nature Education Knowledge 5(12):1

Each resource is assigned a rating of rigor according to the NESTA Standards of Evidence.

Define Metrics

Core Metrics

This starter set of core metrics — chosen from the IRIS catalog with the input of impact investors who work in this area — indicate performance toward objectives within this strategy. They can help with setting targets, tracking performance, and managing toward success.

Additional Metrics

While the above core metrics provide a starter set of measurements that can show outcomes of a portfolio targeted toward this goal, the additional metrics below — or others from the IRIS catalog — can provide more nuance and depth to understanding your impact.