President Obama’s plans to reform the healthcare system in U.S. have taken over the headlines in the past several weeks. Doctors, economists, insurance executives, public health experts—all of them are being afforded the chance add their two cents on how to fix our broken healthcare system. The voices that are strikingly absent, though, are those of the agricultural community. What, you may ask, does agriculture have to do with overhauling the healthcare system? My answer– everything.

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.