My awakening to the connection between agriculture, social justice, and health came during a semester abroad in South Africa. There, during a stint in a public hospital in a small city surrounded by rural territories, I watched as HIV-positive mothers waited for hours each month—some having traveled two days in packed vans—to receive a free box of nutrient-dense foods from the government. Those mothers were, without exception, Black and poor. Few of them had access to land as their families did before apartheid, and thus their ability to provide good food for themselves and their families had been systematically stripped from them. Today, with the AIDS epidemic spreading like wildfire across the country, the poor’s labor force—and thus earned income—has fallen sharply, making it difficult to afford food at market. As malnutrition and acute hunger have become more common among poor populations in South Africa, HIV and tuberculosis spread faster and faster, as both diseases are easily passed to those with compromised immune systems from inadequate nutrition.

What does South Africa’s social and medical plight have anything do with with healthcare in America? We’re a first world country, after all. Indeed, and although our labor force may not be dwindling from HIV/AIDS and tuberculosis as South Africa’s is, we have our own epidemics to deal with, foremost among them obesity and all the diseases it brings with it such as Type II diabetes and severe heart problems. America’s children are strung out on high fructose corn syrup—concealed in nearly every food in our supermarkets—and thus cannot concentrate in school or develop properly, making it difficult for them to succeed academically and, subsequently, in the job market. According to study after study (or firsthand experience from spending an hour in any public emergency room), the groups most affected by diet-related health problems are the poor and non-white.

Eva Salber, one of the pioneers of the community health movement once wrote, “diseases resulting from societal inequities can’t be cured by medical care alone—no matter its excellence.” One of the most blaring inequities in our society today lies beyond lack of access to medical treatment in the inaccessibility of the means by which to prevent ill-health in the first place: good food.

The effects of our broken food system affect all of us, even the small percentage of Americans who choose—and can afford—to eat a healthy, safe diet. Treating chronic diseases is a major drain on our healthcare system an tax dollars, as is true in South Africa, and even equitable and accessible medical care for all will not provide a silver bullet fix to our population’s deteriorating health. If we are ever to enact lasting change on our health as a population, we all need healthy food to be accessible and affordable. Not the kind of healthy food that announces itself as such with a flashy label on a vacuum-packed wrapper, but the kind that comes from an ecologically and economically sound agricultural system, one that produces vegetables, fruits, grains, and animal products, not simply commodities to be processed into food products. We — individually and collectively — need real food to attain health.

America has watched, somewhat wide-eyed and dumbfounded, as a modern “back to the land” movement has emerged. Wealthy white college students, the ones have traditionally vied for summer internships in law, medicine, and finance — are increasingly swapping suits for dirty jeans and a spot on a farm crew for the summer. The number of farmers markets has exploded. And even among the most under-served communities in the country, the number of community gardens, community supported agriculture (CSA) operations, and community kitchens are growing faster than summer zucchini. But we can’t allow the movement towards systematic change in our food system to stop there. Without policy in place to support a new generation of farmers who have economic incentives to grow food for consumption rather than producing commodity crops (i.e. soy beans, corn, and wheat) for the corporate processing industry, and until we can make procuring farmland in rural areas and green space in densely populated communities less cost prohibitive, we will never be able to produce the amount of healthy food we need to support a healthy population.

We can argue until we’re blue in the face about the merits of publicly- versus privately-funded healthcare. We can ration medical services or not. The quality versus quantity debate as it relates to medical care can rage on for years. And we can calculate the potential cost of every permutation we come up with. But unless we begin to address root causes of ill health in this country — hunger, poverty, social injustice, and an agricultural system that feeds corporate greed rather than the citizens of this country — the costly burden on our health and thus our medical system will never diminish. President Obama and members of Congress, take a hint from the First Lady and her wildly popular garden and invite the farmers to the table. Our nation’s health depends on it.

Recently, a cadre of notable professors, chefs and policy leaders have spoken up about the dangerous links between our food and diseases like obesity, from Bill Clinton to Dr. Barry Popkin. Even Tom Vilsack has remarked that he would like to steer food policy under the umbrella of health care reform and just last week Michelle Obama spoke of reducing processed foods in our diets. But where is the voice of America’s #1 doctor, the Surgeon General?

As the Obama administration began to take shape at the start of the year and whispers circulated over the naming of the next Surgeon General, I couldn’t help but wonder what this post is really about and how seemingly appropriate its station could be in the widespread communication of food sustainability and health to the mainstream.

According to the government website of the Surgeon General, the position is part of the Office of Public Health and Science within the U.S. Department of Health and Human Services and the office holder seeks to be “America’s chief health educator by providing Americans the best scientific information available on how to improve their health and reduce the risk of illness and injury.”

Unfortunately, our chief health advocate has been somewhat invisible or inaudible at least, some may argue, since the days of C. Everett Koop.

It is now time to revitalize this invaluable tax-supported post in our government and choose an intelligent agenda for the next Surgeon General. Although the sustainable-food movement has been gaining in leaps and bounds at the moment (e.g. White House organic garden), by tapping the top advocate for public health to join the squad, this base can be solidified to tackle issues from a government-backed, mainstream platform – at least on the health front. How better to contain the critics who profess that sustainable food advocates have a scattered and extreme agenda?

And there is no better time than now to have a Surgeon General dedicate resources to a healthier food supply. Some have now deemed obesity the #1 threat to American health (nearly 2 out of 3 Americans is either overweight or obese).

There are plenty of innovative and effective initiatives the next Surgeon General can roll out to inject techniques of sustainable food into an agenda combating diet-related lifestyle problems. Many of these ideas have been shuttled back and forth among food policy advocates, but by being heard through the office of America’s #1 doctor, awareness and change would be better guaranteed.

Firstly, a new campaign of health warnings pinpointing the perils of the average American diet should be considered, similar to the Surgeon General health warnings seen on alcoholic beverages, and most popularly, on packages of cigarettes. Although issuing warnings on items like cigarettes is a much easier task than enforcing rules on a vast array of retail foods, more attention should be given to finding effective ways to re-launch health warnings in a modified approach (e.g. levels of saturated fats in certain foods).

Secondly, the Surgeon General’s post could do a lot more to communicate the realities of food subsidies to the American mainstream by educating the public about how inexpensive, processed foods enter our food system and how important it is to promote healthy fruits and vegetables instead.

The Surgeon General could speak more powerfully on issues relating to fast-food outlets in urban areas and their proximity to schools, portion sizes and television advertising of processed foods to children. He or she could push for better front-of-package nutrition labeling (favored by almost 75% of American and developed for use in the U.K.), a redesigning of the Food Pyramid, and more research in the areas of local and sustainable food.

In general, the Surgeon General could be an invaluable teacher and poster child for the education of sustainable food to the masses by acting as the sole arbiter in the constant debate surrounding diet and health made more confusing by public misunderstandings over scientific findings, mixed messages from the media and a deluge of health claims pushed by corporate marketing initiatives.

Whatever the final agenda, the post of the Surgeon General needs to be rejuvenated and empowered with a new view of food policy in relation to public health. Although Admiral Galson (acting Surgeon General) has been seen very recently speaking about childhood obesity and their “Healthy Youth for A Healthy Future” initiative, these efforts are extremely weak and don’t go to the heart of the matter – changing our food system.

By choosing the next Surgeon General based on ideas relating to sustainability the Obama Administration and Congress can tackle a wide array of problems such as climate change, national security, and energy policy in addition to healthcare, as positive changes in the way Americans eat will have domino-like affects on many sectors and of society.

The time is now to harness attention and concern over the President’s next pick for the Office of Surgeon General and a remaking of its agenda based on the interconnected themes of sustainability, health literacy and disease prevention. Food policy advocates and the sustainable food community should make a push as well, for this post may be exactly what the movement needs in terms of mainstream awareness and government support. By capturing the momentum for change brought on by the Obama administration, a revitalized and progressive Surgeon General post can prove to be a wondrous agent for good food, good health and prosperity in our country.