Medicine Needs Structural Solutions, Not Just Clinical Care

Many communities face an uneven food landscape: plenty of cheap junk food, but few places to buy fresh, healthy food. This pattern—often called “food apartheid”—doesn’t happen by accident; it grows from redlining, unfair rules, and corporate control. The impacts are steep: higher rates of type 2 diabetes, kidney failure, and learning problems in Black, Latino, and Indigenous communities, along with unsafe conditions for farmworkers. These harms have a long history, and government subsidies and convincing marketing keep ultraprocessed foods on top. However, we take practical steps to make change including investing in regenerative and community farms, protecting and fairly paying farmworkers, and enforcing civil-rights laws so public dollars support real food, healthy soil, and communities that thrive.

In this episode, Leah Penniman, Dr. Rupa Marya, Raj Patel, Karen Washington, and I discuss why food injustices exist and how we can create regenerative food systems to serve everyone.

Leah Penniman is a Black Kreyol educator, farmer/peyizan, author, and food justice activist from Soul Fire Farm in Grafton, NY. She co-founded Soul Fire Farm in 2010 with the mission to end racism in the food system and reclaim our ancestral connection to land. As co-Executive Director, Leah is part of a team that facilitates powerful food sovereignty programs - including farmer training for Black & Brown people, a subsidized farm food distribution program for communities living under food apartheid, and domestic and international organizing toward equity in the food system. Leah has been farming since 1996, holds an MA in Education and a BA in Environmental Science from Clark University, and is a Manye (Queen Mother) in Vodun. 

Dr. Rupa Marya is a physician, activist, mother, and composer. She is an Associate Professor of Medicine at the University of California, San Francisco where she practices and teaches Internal Medicine. Her research examines the health impacts of social systems, from agriculture to policing. She is a co-founder of the Do No Harm Coalition, a collective of health workers committed to addressing disease through structural change. At the invitation of Lakota health leaders, she is currently helping to set up the Mni Wiconi Health Clinic and Farm at Standing Rock in order to decolonize medicine and food. 

Raj Patel is a Research Professor at the University of Texas at Austin’s Lyndon B Johnson School of Public Affairs, a professor in the University’s department of nutrition, and a Research Associate at Rhodes University, South Africa. He is the author of Stuffed and Starved, the New York Times bestselling The Value of Nothing, co-author of A History of the World in Seven Cheap Things. A James Beard Leadership Award winner, he is the co-director of the award-winning documentary about climate change and the food system, The Ants & The Grasshopper. 

Karen is a farmer, activist, and food advocate. She is the Co-owner and Farmer at Rise & Root Farm in Chester, New York. In 2010, Karen Co-Founded Black Urban Growers (BUGS), an organization supporting growers in both urban and rural settings. In 2012, Ebony magazine voted her one of the 100 most influential African Americans in the country, and in 2014 Karen was the recipient of the James Beard Leadership Award. Karen serves on the boards of the New York Botanical Gardens, SoulFire Farm, the Mary Mitchell Center, Why Hunger, and Farm School NYC.

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Full-length episodes can be found here:
Why Food Is A Social Justice Issue

Food Justice: Why Our Bodies And Our Society Are Inflamed

A Way Out Of Food Racism And Poverty