Quantifying the hidden costs of the Swiss food system for health and the environment

Introduction: Food systems impose large hidden costs on society that market prices ignore. Under True Cost Accounting (TCA), environmental and health externalities make up the majority of the hidden costs of food, with diet-related health effects alone accounting for roughly 70% of the hidden costs generated by agrifood systems. The objective of TRUE-COST-CH is to make the hidden costs of the Swiss food system explicit, so they can inform prevention and food policy, a question of both national and planetary health. Methodology: Environmental externalities are calculated by aggregating, modelling and monetizing environmental and land-use indicators such as greenhouse-gas emissions, land use, biodiversity loss, water use and others. In parallel, published diet–risk relationships from insufficient dietary fibre, excess salt, excess meat and others are combined with Swiss consumption patterns to obtain the Swiss burden of disease in DALYs, which can then be monetized. Through the population attributable fraction, DALYs can then be attributed to single food groups. Results and Discussions: The Swiss data model and use case confirm the international figures: health externalities constitute the largest share of hidden costs. This distribution can inform policy accordingly. Unlike environmental externalities, these costs arise not at the production stage but after consumption, making it harder to pinpoint who should bear them. Conclusions: Pricing the hidden health costs of the Swiss food system shows that diet-driven health externalities dominate, yet, unlike environmental costs, they surface downstream of consumption, complicating responsibility and cost-bearing. Expressed in monetary terms, they give clinicians, economists and policymakers a shared basis to target the highest-impact levers more easily, a concrete contribution to planetary and global health.