In the United States, and increasingly around the world, it’s easy for consumers to find high-calorie, nutrient-poor foods, including sugar-sweetened drinks, fast foods and highly processed snack foods — they’re abundant, easily accessible and perceived as more affordable than healthier foods.

The Farm Bill renewed every five years or so, plays a significant role in shaping this food environment by influencing what foods get produced, how they are produced, who has access to them and, in some cases, how foods are marketed.

The majority of dollars in the bill primarily support the production of agricultural commodities (corn, soybeans, wheat, rice and cotton) and food programs (the Supplemental Nutrition Assistance Program [SNAP], formerly called Food Stamps) for low-income Americans.

So even though the name of the bill suggests that farmers are the primary beneficiaries, the Farm Bill has a significant impact on American eaters and, to some degree eaters around the world. Yet, the idea that food and agricultural policy should consider public health is still a novel one, as is the unavoidable link between consumers having access to healthy food and farmers having the ability to make a living growing it.

A Farm Bill that maximizes the availability of healthy foods while making it economically viable for farmers to grow them requires strong collaboration between the public health and agriculture sectors. The public health community can take an important step toward collaboration by looking beyond Farm Bill nutrition programs to gain a better understanding of how farm-support programs in the Farm Bill affect what farmers grow and, ultimately, what’s available to eaters.

Commodity programs in the Farm Bill established a pervasive cycle of public support for a handful of crops that (along with relatively high commodity prices) incentivize a smaller number of ever-larger farms. There is no comparable support for fruits and vegetables. This lack of support, combined with more mechanized production practices, means it’s much easier for farmers to earn a living growing commodity crops for livestock feed and fuel additives than by growing fruits and vegetables. In turn, the overproduction of some commodity crops, such as corn and soybeans, incentivizes food manufacturers to use these cheap ingredients in the form of high fructose corn syrup and hydrogenated vegetable oils — ingredients now linked to increases in caloric intake due to their ubiquity in processed foods.

Credit and adequate crop insurance are vital for American farmers to meet the growing demand for healthier food. Farmers often can’t buy seed, plant or bring a crop to market without access to credit. Additionally, with the average age of American farmers at 57, credit is needed to enable beginning farmers to obtain land, seed and equipment. Lack of access to credit can also impact farmers’ ability to scale up production to meet demand for increasingly popular programs such as Farm to School.

Before granting credit, lenders want to know that farmers have adequate crop insurance to manage the inherent risk of crop failure due to increasingly unpredictable weather in the form of floods, drought and pests. Through the Farm Bill, the United States government provides billions of dollars in crop insurance subsidies to both insurers and farmers, but a 2007 USDA study found that 80 percent of total policy premiums (and federal subsidies) support just four commodities: corn, soybeans, wheat and cotton. Conversely, insurance for growers of fruits and vegetables, and diversified farms growing multiple crops plus livestock is inadequate — especially for smaller producers.

The Farm Bill also funds agricultural research, to determine future trends for what American farmers will produce and how they will produce it. Today’s agriculture reflects several decades of research focused primarily on large-scale, chemically intensive production of commodities, meat and poultry. Comparatively, support for fruits, vegetables and sustainable meat production without antibiotics has been miniscule.

Finally, in a summer of record-breaking drought, we cannot overlook the importance of Farm Bill conservation programs. These programs help farmers protect the environment by, for example, planting perennial crops that improve soil and require less water or creating buffers between fields and streams to protect water from pesticide runoff. We need to develop a food system that will be resilient in the face of global climate change. So far, the 2012 Farm Bill is shaping up to be more of the same: overwhelming support for a handful of commodity crops that primarily benefit agribusiness while nutrition, conservation, fruits and vegetables and socially disadvantaged farmer programs are slated for deep cuts.

Amid this scenario, there is little discussion on Capitol Hill about public health or the impact of proposed policies on American eaters. Stronger engagement from the public health and health care communities in concert with farmers is essential if we are to build food and agriculture policy accountable to everyone it impacts.