Community Supported Agriculture: A Conceptual Model of Health Implications

Abstract

Community supported agriculture (CSA) is an alternative food marketing and distribution model in which consumers pay a membership fee before the season in return for a weekly share of a farm’s harvest. Since the first two were initiated in the 1980s, the number of farms operating as CSAs in the US has grown to more than 6,000. This paper offers a conceptual model of the health implications and challenges of CSA for individuals, families, communities, and local food systems. CSAs benefit individual health by improving diet; contribute to family health by advancing food skills and encouraging family meals; foster the development of healthy relationships between growers and eaters in communities; and promote sustainability in local food systems by conserving natural resources, improving economic viability of small–scale agriculture, minimizing the need for food processing and long–distance distribution, and improving access to high quality food. Challenges for CSA members include more time to prepare whole foods compared to processed foods, inconvenience compared to one–stop shopping at a supermarket, and prohibitive pricing for limited–resource families. Fully utilizing CSA as a health promotion strategy will require the support of health professionals, policy makers, and private sector industries such as health insurance.

Keywords: Health Implications; Community Supported; Agriculture.

Introduction And Background

What is CSA?

Community supported agriculture (CSA) is an alternative food marketing and distribution model in which consumers pay a membership fee in advance of the season in return for a weekly share of a farm’s harvest [1,2]. While CSAs typically provide fresh produce, some also include eggs and flowers. Others distribute bread, grains and legumes, meat and poultry, and more recently fish [1–4]. CSAs that distribute fresh produce are the most common, and will be the focus of this paper. CSAs often provide members with weekly newsletters containing recipes, and sometimes cookbooks as well [1]. Educational tours and opportunities for social gatherings where food is shared are a common feature of CSAs [1,5]. In some cases, CSAs offer members a place to return food waste for composting [1].

Purpose of this Paper

This paper offers a conceptual model of the health implications of CSA for individual members, families, communities, and local food systems. This work adds to the current body of CSA literature by providing a systems view of health implications. Previous studies mostly focus on one aspect of CSA such as members, growers, CSA structure, economics, environmental issues, or the evolving philosophy of CSA. The proposed model of health implications is meant to provide a broader view of the benefits and challenges associated with CSA, and intends to illustrate why this alternative food network deserves consideration and support from the range of local food system stakeholders including consumers and potential members, the agricultural community, health professionals,community development specialists, planners, federal and local policy makers, and private enterprise. By generalizing and simplifying, conceptual models provide a vehicle for understanding the interconnections among parts of a system, in ways that more specific analyses cannot [6–8].

History and Philosophy of CSA

While early CSA projects were initiated in Japan and Chile in the 1970s, CSAs in the US were mainly inspired by the biodynamic farming tradition that evolved in Europe after World War II [9]. Austrian Rudolf Steiner developed this spiritual–ethical–ecological approach to agriculture, food production and nutrition, subsequentlybrought to the US from Switzerland by Jan Vander Tuin [9–10]. The first two CSAs in the United States were started in Massachusetts and New Hampshire in the mid–1980s, and they are still in operation today [1,9]. CSAs embody Steiner’s vision of a diversified, balanced farm ecosystem that generates health and fertility from within, seeking to satisfy a triple bottom line—ecological, social, and economic sustainability [10].

The enduring philosophy of CSA includes creating mutually beneficial relations among producers and consumers, and developing n economy where food consumed locally is produced locally [9]. CSA remains a way to reestablish a sense of connection to the land, particularly for urban dwellers. It also fosters a sense of community around food, contributes to farmland protection, and provides farmers growing on a small–scale and marketing directly, a way to earn returns that exceed wholesale prices [1].

More broadly, the initiation of CSA asserts local control over a food system that is increasingly consolidated and distanced from consumers [1–2, 11]. CSA represents an effort to internalize the societal costs of agricultural production by minimizing the degradation of natural resources, improving animal welfare, and helping to create fair wages and improved working conditions for farm labor [12].

Growth of CSA

The participation of both farmers and consumers in alternative food networks has grown tremendously. Ten years after the first CSAs began operating in Massachusetts, there were an estimated 450 CSAs operating in the United States [13]. In the next decade, the number nearly quadrupled to 1,700 [14], and in the decade since, the number of CSAs has nearly quadrupled again. “Local Harvest”, an on–line CSA locator, currently lists more than 6,000 operations in the US, with several in each state [15]. The popularity of CSAs mirrors the growth in farmers’ markets, which have increased in number from 1,755 in 1994 to 8,144 in 2013 [16]. Expansion of farmers’ markets and CSAs are strong indicators of public interest in locally grown, organic, and healthful food [17].

When they began, CSAs were a major source of organic produce, and concern about the use of pesticides in food production motivated participation [11,18]. The vast majority (94%) of CSAs use organic methods [19–20]. Since the 1980s, the National Organic Program and Organic Certification have ensured access to organically produced food in mainstream supermarkets, amidst growing awareness and subsequent demand. The organic food production industryhas become large scale, monocultural, and even corporate–owned [11,21]. CSA, however, still offers a true alternative to consolidated industrial–scale food production and distribution systems by creating connections among eaters, and between eaters and producers. It also sustains economically viable small–scale production within the context of a local food system [11,22].

CSA has the potential to provide food security for disadvantaged groups through improving access to locally grown foods [1,23]. Strategies for reaching low–income audiences include creating affordable CSA memberships, providing opportunities to pay membership fees with food assistance, and developing connections with emergency food providers [1,23]. Still CSA primarily attracts well–educated and higher income participants [24–26].

CSA Structure and Operation

Prepayment for a produce share is a common trait of CSAs, but they differ in how they are initiated and structured, and in how food distribution is handled. Currently, there are three common ways CSAs are initiated and structured. Shareholder CSAs are formed by a core group of members who make administrative decisions, and collectively hire a farmer. Subscription CSAs, in contrast, are initiated by the farmer who maintains ownership of the operation, makes decisions, and hires other staff as needed [1,11,27]. Shareholders are more likely to provide labor on the farm in addition to payment, where subscription owners typically only pay a membership fee [1]. In most CSAs members may have the opportunity to participate in harvesting labor–intensive crops [1]. CSAs that operate as non–profit organizations represent the third type of structure, where decisions are made by a board of directors in collaboration with paid or volunteer staff [1]. Of these three types, the subscription farm has become predominant [1,27,25,28].

Other differences include when food is available seasonally, where and how food is distributed, and how much choice members have in selecting produce. Some CSAs operate year–round while others are limited to specific seasons of the year. Some deliver produce boxes to residences or a mutually convenient location, while others require members to travel to the farm to pick up produce. Others still are operating in conjunction with a particular workplace, university, or church [2,29–31]. Some CSAs allow members to choose the components of their weekly share under a weight limit, or simply to choose which individual produce items will go in the share, while others pre–package the complete share in a bag or box. Some CSAs distribute shares in conjunction with a regular community farmers’ market. Others offer differently–sized weekly shares to accommodate small and large families [2,31].

Multi–farm or collaborative CSAs are becoming more common, with a single operation representing a cooperative of farms [32– 33]. This arrangement enables individual producers to specialize in growing particular crops or raising animals, while still enjoying a guaranteed market, increased financial security, and the opportunity to build community with other growers. Centralized marketing and distribution for multiple farms reduces labor for any one grower. Formembers, the multi–farm CSA may offer greater variety in foodstuffs, decrease risk, and perhaps offer more convenience or lower prices [32–33].

CSA Membership, Motivation, and Satisfaction

CSA members are characterized as a homogenous and privileged group that is predominantly Caucasian, female, college educated, and politically liberal, with higher than average household incomes [25– 26]. Also important in this characterization is that members tend to be socially and politically aware, and have strong environmental values [25–26, 34]. A significant motivation for joining is the desire to purchase fresh, high–quality produce that is grown organically, improve eating habits, and improve health overall [25,35–36]. Members also want to support local or small–scale farmers, meet likeminded people, and to learn about food issues [25].

CSA Member turnover is common, with approximately 50% of CSA members not re–joining in the subsequent year [1,37]. Member satisfaction is correlated positively with their support of alternative agricultural practices, the number of times they visit the farm, the number of years one has been a member, and the likelihood that the produce share is meeting the needs of the family [37]. Share price can be a source of dissatisfaction, as can unfamiliarity with the produce supplied, or inconvenient quantities [5,38–40]. The time costs of membership appears to be one of the most important reasons members do not re–join [39–40]. As household income increases, thelikelihood of continuing membership declines, because individual members begin to place a higher economic value on their time [39–40].

Analysis And Interpretation

Conceptual Model of Health Implications

This paper offers a synthesis of health–related implications based on a review of the existing literature related to CSA and local food distribution. Current literature exists in a variety of disciplines including nutrition and health, geography, sociology and rural studies, agroecology and sustainable agriculture, agricultural economics, and community development. While this was not a systematic review, the author conducted a thorough search forliterature using Agricola and the Web of Knowledge database, a large and interdisciplinary combination of Medline, Biological Abstracts, Science Citation Index, and Social Science Citation Index. Emphasis was placed on literature from the current and previous ten years in addition to older but often cited seminal works. Key search phrases included Community Supported Agriculture, Local Food, Local FoodNetworks, and Alternative Food Networks.

Individual Health

One of the most obvious and predictable ways that membership in a CSA benefits health is the improvement of diet. Currently, very few Americans are following federal dietary guidance, particularly when it comes to consuming the recommended number of fruit and vegetable servings on a daily basis [41–42]. For individual CSA members, the amount and variety of fruits and vegetables consumed increases as a result of membership [43–48]. This positive outcome has also been observed when CSA or similar food distribution strategies are used as a health intervention in low–income urban areas, suggesting that CSA is a feasible approach to addressing health disparities resulting from low consumption of fruits and vegetables [49–50]. In studies comparing dietary intakes between CSA members and non–members, members consume more dark green and yellow fruits and vegetables; have higher intakes of fiber and vitamin A, as well as a slightly lower intake of saturated fat [51–52]. In general, fruits and vegetables provide many underconsumed nutrients such as folate, magnesium, potassium, dietary fiber, and vitamins A, C, and K [42].

Long term, improved fruit and vegetable intake has been shown to have positive health outcomes, including the reduction in chronic disease risk, and particularly cardiovascular disease. [42]. Speaking generally, vegetables and fruits contain high amounts of antioxidants and phytochemicals—substances that have been shown to protect against cancers and inflammatory diseases. Foods with modest to high levels of anticancer activity include vegetables that are often partof a CSA share such as carrots, parsnips, onions, broccoli, cauliflower, tomatoes, peppers, and cabbage [53–54]. Additionally, when simply prepared, fruits and vegetables are relatively low in calories and can contribute to healthy weight maintenance [42].

Furthermore, unlike produce bought in a supermarket that may have traveled more than 1000 miles and been stored for a significant period of time, produce received in a CSA box is very fresh, often harvested the same day the consumer receives it [55]. Although studies of declining nutritional value in stored produce are lacking, one analysis determined particular nutrient losses of 30 to 50% infruit and vegetables 5 to 10 days after harvest [56].

Related to the increased consumption of fruits and vegetables, is the opportunity for CSA members to modify their food choices and behaviors over time. The most important personal factors leading to food choices include health and nutrition, quality, convenience, managing relationships, and sensory perceptions [57–58]. Regular access to and consumption of high–quality and fresh–tasting produce has the potential to influence future food choices and behaviors.

The nutritional content of foods and perceived flavor is related to many factors including plant variety and genetics, state of freshness, ripeness, and time of harvest, soil quality, geographic location, climate, season of harvest, postharvest conditions, processing, packaging, and storage [59–60]. Eating foods that have grown nearby and soon after harvest should contribute to improved nutrition and flavor, as would consuming varieties that are selected for their nutrient content andflavor rather than shelf life or durability for long distance transport [56].

The plasticity of the human palette ensures that regular consumption of recently harvested fruits and vegetables will help the individual develop a preference for the flavors of fresh produce and an appreciation for its quality [61]. What has been observed in CSA members is that once the consumption of fresh produce has become a habit, expectations related to flavor perception are raised. It becomes difficult to enjoy counter–seasonal produce that has been handled by multiple people in the supply chain, traveled long distances, or spent time sitting in a retail store [62].

Psychological factors are also an important individual health benefit of CSA membership. For some members, CSA participation enhances autonomy, competence, and relatedness [63]. According to Self–Determination Theory, fulfilling these unconscious psychological needs leads to internalizing motivation, and a higher likelihood of adopting a given behavior long–term [64]. Indeed, members who experience psychological benefit are more likely to continue their CSA membership, and the opposite is true when psychological benefits are not realized [63].

CSA membership is an opportunity for individuals to express their social values and engage in consciousness–raising. For members who join a CSA in part because of their commitment to the environment, the experience fosters resonance. Through CSA membership, individuals can take concrete actions to support their idealism. They can practice living in harmony with the local agricultural seasons [40].

Other than the membership fee, the primary challenge for individual CSA members is that of time costs and inconvenience [65]. Belonging to a CSA can require that an individual travel to the farm or distribution location to pick up the produce share. Some members also provide farm labor, which can be physically demanding, include encounters with stinging insects and prickly weeds, and expose one to inclement weather [40]. When a share is brought into the home kitchen, members must then spend time handling, washing, trimming, peeling, and storing or cooking food [26,39]. As previously stated, the additional time needed for the inconvenience and labor of CSA membership becomes relatively more expensive as household income increases [26,39,40]. For members unaccustomed to eating fresh produce, the large quantity of seasonal vegetables, some of which are unfamiliar, is overwhelming. Food is wasted, which creates negative feelings [65–66].

Family Health

Family members experience the same health benefits and opportunity cost described for individuals above, but family units as a whole also enjoy additional benefits. Households subscribing to CSAs report increased frequency of cooking at home, cooking together with family members, and family meals [26,31,39–40,46–47]. Children’s exposure to preparation of fresh produce in the family kitchen and the opportunity to learn cooking skills could have a long–term positive impact on health behaviors. Family meals have been shown to enhance the health and well–being of adolescents. For example, frequency of family meals is inversely associated with substance abuse, poor grades, depressive symptoms, and suicidal thoughts and attempts [67]. Family meals are associated with eating healthier foods and promoting family communication [68– 74]. Additionally, families have the opportunity to visit the farm, participate in tours, workshops, and farm festivals which encourage physical activity [1–2,5].

While research has not confirmed that food skills improve as a result of CSA membership, families certainly have the opportunity to develop increased competence with preparation of fresh produce and increased knowledge of local agriculture, produce varieties, and their culinary uses. In entering a CSA contract, members become acquainted with what the local agricultural landscape can provide throughout the growing season. The contents of the share changes on a weekly basis and sometimes depends on the weather [75].

CSA operators often provide a weekly newsletter with recipes to assist members in maximizing the utility of their share [1]. CSAs often provide members with educational farm tours and work days in addition to social events like seasonal festivals and children’s activities [1,5,75]. For families with children this is an opportunity to connect young people with the sources of their food and provide gardening experiences. Children who have grown their own vegetables are more willing to taste those foods [76].

CSA share prices range from $300–$600 or more depending on the number of weeks included in the season. This may seem expensive, but in studies comparing the weekly cost of a CSA share with the price of an equivalent amount of produce purchased at a retail store, a CSA share is a better economic value, even when compared with the price of conventionally grown food. In one study, the retail value of the CSA share was between 120–250% of its cost [66,77–79].

CSA shares spare the household food budget in other ways as well. A fully–utilized share can take the place of other more expensive and less nutritious foods. More meals cooked at home, means fewer relatively more expensive and less nutritious restaurant meals purchased [80–82]. The weekly CSA share requires a significant amount of space in the refrigerator, which may be part of the reason members report fewer food shopping trips as a result of CSA membership [45]. Fewer shopping trips equates to fewer opportunities to buy unneeded or non–nutritious items on impulse [83]. A study of supermarket circulars shows that supermarkets promote fruits and vegetables much less often than protein foods and grains. Significant space in newspaper advertisements is devoted to sweets and sugar–sweetened beverages [84].

Community Health

When CSA originated in Japan, it was referred to as “teikei” which means partnership or cooperation, and is often translated as “food with a farmer’s face” [2,85]. For communities, CSA represents a way to build relationships, and specifically, direct ties between eaters and the farmers and landscapes that sustain them with food [11,22].

While an eater’s desire for high quality produce may be the strongest motivation for joining a CSA, desires to develop a stronger sense of community and support local growers are also significant [86]. By paying ahead of the season, members are agreeing to share the risks of farming with the farmer. CSAs therefore, are more than a way for people to buy local food. The CSA arrangement allows us to reconsider the importance of relationships among food, economics, and community. In joining, members can participate in reestablishing a strong local agricultural economy, a moral economy, and an associative economy [2, 87–89]. Members and farmers are both sacrificing something to build a relationship they consider valuable [88, 90].

When compared to all US farmers, CSA farmers are younger and more likely to be women [20, 91]. Few have a background in agriculture, but most have a college degree and nearly all farm using organic methods [19, 79, 89, 91]. While for growers, a CSA is a means to marketing food locally, their motivation is not limited to a profitable return [17]. CSA farmers have a strong sense of obligation to their members, even exploiting themselves to ensure fulfillment [5, 87]. Surveys show that CSA farmers enjoy their work and their lifestyles, educating consumers, and being part of expanding the kind of agriculture they see as a true alternative to the industrial food system [87, 89]. Women CSA farmers describe their motivations within categories of lifestyle choice, feeding people, economic independence, commitment to sustainable food system, and as a way to educate people about food and farming [88].

Several social science researchers have questioned the ability of CSA to build community beyond the farmer–member relationship [18,35,45,92–93]. Indeed CSA has evolved from its initial “back to the land” ideals, and Subscription CSA farms are more common than farms supported by a core community of members who share the work, decision making, and planning of events [1,25,28].

The sheer growth of CSA numbers suggests that they are inclusive of a more mainstream audience than they were three decades ago. For members, CSAs have to compete with the convenience, variety, and quality provided by the dominant food system. Even idealists have busy harried lives and simply need to “pick up their vegetables” sometimes [28]. The success of CSA as an alternative food distribution model must in part be due to its dynamic nature, resilience, and ability to adapt [28,95–96]. The farmer–member relationship created by CSA allows the business to be particularly sensitive to customer needs. The tension between the social embeddedness of CSA and the instrumental approach of either growers or members, fuels its evolution while still keeping it intact [5,93]. CSA remains a source of organically–produced food that is connected to place. Even in its most pragmatic form CSA has the potential to contribute to food system change and the incremental development of “food citizenship,” which connects eating with political and social engagement [25,94,97].

Food System Health

The food system includes all entities and processes involved in creating the food supply in both sociocultural and biophysical contexts [6]. Food system sectors include production (farming and ranching, fisheries, gardening, wild foods); transformation (processing, packaging, labeling), distribution (wholesaling, storage, transportation), access (retailing, institutional foodservice, emergency food programs), and consumption (purchasing, preparation, and waste management). As shown in Figure 1, Human resources and natural resources serve as inputs and as the foundation of the food system, while technology, policy, economics, sociocultural trends, and education are sources of influence [98]. Sustainable food systems conserve and renew their natural resource base, advance social justice and promote animal welfare, build wealth in communities ratherthan concentrating it among corporate entities; and fulfill the needs of all eaters now and in the future [99].

Figure 1: Community Supported Agriculture (CSA): Health Implications for Individuals, Families, Communities, and Local Food Systems.