Food Equity Ideas Lab Awardee

Globally Integrated Food Systems, Land Use Change and the Double Burden of Malnutrition Among Small Holder Farmers in the Dominican Republic

Photo Credit: Carlos Columna.

Photo Credit: Carlos Columna

In middle-income countries, food systems are being reshaped by a variety of factors including rising household incomes, urbanization, multi-scalar supply chains (regional, national, transnational), women’s labor force participation, state food programs, and changing international trade rules. Our project looks at this process from the perspective of smallholder farmers in the Caribbean, as both producers and consumers of food. 

As producers, smallholder farmers face unprecedented challenges to position themselves within domestic and international supply chains in the wake of increasing trade integration and declining state support. These rural transformations in production are linked to a broader nutritional transition as diets shift from grains to animal products, and from fresh produce to processed foods. As a result, middle income countries, including those in the Caribbean, face a “double burden” of malnutrition: undernourishment, on the one hand, and overweight and obesity, on the other. 

Our project examines the double burden of malnutrition among small farmers in a middle income Caribbean country to ask how farmer participation in different supply chains shapes household health outcomes. As most studies focus on international comparisons, the geographical distribution of under- and over-nourishment within countries and its relationship to trade integration is poorly understood. The study develops an intra-national comparison of two rural regions in the Dominican Republic (DR). The DR is a large agricultural producer undergoing significant trade liberalization, with moderate but rising rates of overweight and obesity. The study will ask how small farmer participation in different supply chains shapes household nutritional health outcomes.

We will develop an intra-national regional comparison of the northeast and southwest of the DR. These robust agricultural areas are integrated differently into national and export markets and are undergoing ecological and market stresses that are changing crop patterns. Social scientists, an applied economist, a public health expert, and a spatial scientist will collaborate in order to integrate existing large household survey and health data, remote sensing imagery and analysis, primary survey data, and semi-structured interviews. These methods will be applied to each region in order 1) to merge remote-sensing land use data with household surveys to explore the resulting nutritional and health outcomes; and 2) to complement and cross-validate the findings with regional in-depth data collected from field surveys and interviews. The project will advance new strategies for monitoring and measuring agricultural production, trade and nutritional transitions in rural settings in middle income countries. It will contribute to our understanding of the ways that agricultural production, trade integration and changes in diet interact. The project will innovate new data generation methods, train scientists in the United States, build greater research capacity among research collaborators in the Caribbean, and produce policy-relevant findings for decision-makers in the Dominican and US governments.

Our Team

Marion Werner

Project Lead, Double Burden of Malnutrition; Associate Professor


111 Wilkeson Quad

Phone: 716-645-0475


Ying (Jessica) Cao

Former Assistant Professor

Division of Health Services Policy and Practice, Epidemiology and Environmental Health

Sarah Robert

Associate Professor

Department of Learning and Instruction

514 Baldy Hall

Phone: 716-645-4046


Lucia Leone

Assistant Professor

Community Health and Health Behavior

333 Kimball Tower

Phone: 716-829-6953


Le Wang



110 Wilkeson Quad

Phone: 716-645-0474


Jaume Franquesa

Assistant Professor


372 MFAC

Phone: 716-645-0404


Xinghe Liu

Master's Student


Jessica Gilbert

PhD Student