The implications of trade liberalization for diet and health: a case study from Central America

Abstract

Background: Central America has undergone extensive trade liberalization over the past two decades, and has recently signed a Free Trade Agreement with the United States. The region is also experiencing a dual burden of malnutrition with the growth of dietary patterns associated with the global 'nutrition transition'. This study describes the relationship between trade liberalization policies and food imports and availability, and draws implications for diet and health, using Central America as a case study region.

Methods: Changes in tariff and non-tariff barriers for each country were documented, and compared with time-series graphs of import, production and availability data to show the outcome of changes in trade policy in relation to food imports and food availability.

Results: Changes in trade policy in Central America have directly affected food imports and availability via three avenues. First, the lowering of trade barriers has promoted availability by facilitating higher imports of a wide range of foods. Second, trade liberalization has affected food availability through promoting domestic meat production. Third, reductions in barriers to investment appear to be critical in expansion of processed food markets. This suggests that changes in trade policies have facilitated rising availability and consumption of meat, dairy products, processed foods and temperate (imported fruits) in Central America.

Conclusion: This study indicates that the policies of trade liberalization in Central American countries over the past two decades, particularly in relation to the United States, have implications for health in the region. Specifically, they have been a factor in facilitating the "nutrition transition", which is associated with rising rates of obesity and chronic diseases such as cardiovascular disease and cancer. Given the significant cost of chronic disease for the health care system, individuals and the wider community, it is critical that preventive health measures address such upstream determinants of poor nutrition.

Figure 1

Total food imports into the Central American countries, 1990–2005. Note: "Food" includes animal meat (bovine, swine, sheep, poultry); fish; animal products (e.g. dairy products, eggs); vegetables; fruit; cereal grains; flours; raw nuts & seeds; fats & oils (some appear to be for industrial use, but are not split out for this spreadsheet); processed meats; sugar; cocoa beans & derivatives; cereal foods (processed); preserved foods (esp. vegetables); food preparations; non-alcoholic beverages. It excludes: live animals; inedible animal products (e.g. hair); plants, cut flowers etc; coffee, tea, spices; seeds definitely for planting etc; gums & saps; vegetable material (inedible); vegetable waxes & residues; alcohol & alcoholic drinks. Source [15].

Figure 2

Production, imports and consumption of rice in Central America, 1990–2005. Source [15].

Figure 3

Meat imports from the United States into Central America, 1989–2006. Source [16].

Figure 4

Imports of chicken meat from the US into Guatemala, 1990–2005. Source [16].

Figure 5

Production, imports, and availability for consumption of chicken meat into Central America, 1990–2005*. Source [15]. *The graph includes all chicken imports into the region, but the change since 1997 reflects imports from the United States.

Figure 6

Production, imports, consumption of corn (yellow and white) in Central America, 1990–2005. Source [15].

Figure 7

Imports of apples and grapes into Central America, 1990–2005*. Source [15]. * This graph shows imports into Central America from all countries, but imports are overwhelming dominated by the United States and Chile.

Figure 8

Imports of french fries (frozen) into the Central American countries from the United States. Source [16].

Figure 9

Pastry, biscuit and confectionary imports into Central America, 1990–2004. Source [14].

Figure 10

Snack imports from the United States into Central America, 1989–2006. Source [14].