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36 CHAPTER 04: PRIORITY OUTCOMES, INDICATORS AND MEASURESPublic HealthFor the purposes of this framework, “publichealth” is defined as “the combination ofsciences, skills and beliefs that is directed tothe maintenance and improvement of thehealth of all the people through collectiveor social actions. The programs, servicesand institutions involved emphasizethe prevention of disease and [the]promot [ion] [of] good health … of … thepopulation as a whole 13 .” This includes “…policy development and population healthsurveillance 14 .”Sustainable Food SystemA sustainable food system is one thatprovides healthy food to meet currentfood needs, while maintaining healthyecosystems that also can provide foodfor generations to come with minimalnegative impact to the environment. Asustainable food system also encourageslocal production and distributioninfrastructures and makes nutritious foodavailable, accessible and affordable to all.Further, it is humane and just, protectingfarmers and other workers, consumers andcommunities 15 .Health InequityDifferences in health that are not onlyunnecessary and avoidable, but in addition,are considered unfair and unjust 16 .Health EquityEquity in health implies that everyoneshould have a fair opportunity to attaintheir full health potential and thatno one should be disadvantaged fromachieving this potential, regardless fromsocial standing, ability, gender, economicfactors, race, culture or ethnicity. Healthequity is concerned with creating equalopportunities for health and with bringinghealth differences down to the lowestpossible level, often through distribution ofresources so that services and supports areavailable where they are most needed 16 .• Students’ attitudes toward, preferences for, and consumptionof, fruits and vegetables 45,47–58 .• Students’ consumption of less unhealthy foods 45,50,51• Students’ participation in physical activity in gardens 58,59A Public Health Lens for Farm to SchoolWith a public health lens, farm to school activities aim toprovide all preschool and school-age children and their familiesequitable access to healthy, local food and food educationthat empowers them to maintain and improve their health andwell-being. It is important to note that the two words — localand healthy — are not synonymous and are not meant to bein the context of farm to school. The entire spectrum of farmto school activities provides opportunities for local foods thatare healthy (such as fruits and vegetables, whole grains, leanproteins, etc.) to be introduced and incorporated into theschool food environment, along with experiential nutritionand agricultural education activities for children. Schools andearly childhood educators can use farm to school activities tobuild healthy cultural norms about food. This is crucial becausea healthy diet and good nutrition are major factors, along“It’s really important to bring the message that the kidsare learning at school back to the home so they canget it again,” Ashley Ponshok said. “If their parents feelstrongly about the same things their teachers are tellingthem, kids are more likely to develop those lifelongeating habits 60 .”—Ashley Ponshok is with Live 54218, a nonprofit that aims topromote healthier lifestyles in Brown County, Wisconsin, throughfarm to school activities.with physical activity, in preventing chronic diseases such astype 2 diabetes and high blood pressure 61–66 . With the recentupdates to the nutrition standards for school meals, basedin part on recommendations of the Institute of Medicine 67,68 ,schools are serving healthier meal options to children thanthey were before. The addition of local foods to the mix offersunique educational opportunities that support the provision ofhealthier food options. Sensory activities with locally sourcedfoods — such as taste tests before new foods are introducedin the cafeteria, engagement in the school garden, cookingEVALUATION FOR TRANSFORMATION