- Author: Michael Hsu
Nutrition Policy Institute researcher developed techniques that help identify effective public health programs
When Suzanne Rauzon and May Wang were in the master's of public health program at the University of California, Berkeley during the mid-1980s, Wang knew that her classmate had unique brilliance to bring to their field.
“You know how you vote for the person in high school who's most likely to succeed? That was Suzanne,” said May Wang, a professor of community health sciences in the UCLA Fielding School of Public Health. “Suzanne was always ahead of every one of us; she was so visionary and forward-thinking and I think we were all – to be honest – a little bit in awe of her.”
Decades later, as Rauzon prepares to retire in January 2024 as director of community health at the Nutrition Policy Institute, she has fulfilled that exceptional promise. Her many contributions are helping communities identify the most effective programs to benefit public health.
Lorrene Ritchie, director of NPI (an institute under UC Agriculture and Natural Resources), said that Rauzon has played a pivotal role in translating research findings into community action and policy change. She added that Rauzon has brought an extraordinary combination of strategic vision for the overall direction of nutrition studies and tactical savvy to anticipate the needs of project funders and communities.
“Few people can bring both of those skills – efficiently complete the day-to-day tasks as well as be a big-picture thinker,” Ritchie said. “She has been so instrumental in contributing to NPI's impacts.”
A unique skill set to tackle complex challenges
Part of what makes Rauzon unique in her field is her extensive experience in the private sector. After attaining her master's degree, Rauzon developed a comprehensive employee worksite wellness initiative at a telecommunications company – a new set of programs that led the field in the 1990s.
“Suzanne was, is and has always been very visionary,” Wang said.
After years in the corporate space, however, Rauzon leaped at the chance to return to academia (and reunite with Wang) in 2001 at UC Berkeley's Center for Weight and Health, a precursor to NPI. Working with center co-director Patricia Crawford, Rauzon said the project to investigate the effects of sugar-sweetened beverages was a “perfect fit” for her.
Concerned with rising childhood obesity, the researchers studied the significant differences in health outcomes for students in high schools that limited access to beverages such as soft drinks, versus schools that did not.
“That field in general – looking to limit sugar-sweetened beverages – started with a focus in schools, and expanded into other environments (such as college campuses) over the years, and has continued to be a focus in public health,” Rauzon said, “all the way up to work now on limiting sugar-sweetened beverages access in other public institutions.”
Rauzon's change-management and communication skills also were crucial in studying the revolutionary School Lunch Initiative in the Berkeley Unified School District – a collaboration with chef Alice Waters' Chez Panisse Foundation and the Center for Ecoliteracy to engage young people in the growing and preparation of food. Brought in to evaluate the efficacy of the program, Wang and Rauzon found they had to alter their mindset and methods when working with partners who were responding to oft-changing circumstances.
Rauzon's cross-sector perspective, practical know-how and people skills in cultivating positive relationships with district staff and educators were instrumental in successfully completing studies with as much rigor as possible in real-world settings such as schools.
The researchers created new analytical tools to evaluate health interventions developed by communities themselves – as opposed to programs engineered by academics and applied to community members with the expectation that they would accept it.
“Most researchers, to be honest, are still striving to do that with communities,” Wang said. “It is an incredibly challenging task because communities will do what they want to do – and what they need to do – to respond to the needs of people.”
Wang, who now trains academics in community-based participatory research, said that the ground-up paradigm has been shaped by Rauzon's thinking. “A lot of the ideas I have today really came about from our work together on the School Lunch Initiative,” Wang said.
A legacy of new methods, mentoring early-career professionals
One of Rauzon's longest-running – and most complex – projects has been the evaluation of community health interventions across the country, including a variety of Kaiser Permanente initiatives to promote healthy eating and physical activity.
“What was interesting about that work was we really were trying to understand the combined effects of doing a lot of different things that are related – and to see the overall effect that can have on the community,” said Rauzon, noting that interventions ranged from nutrition classes to policy changes to park and bike-safety improvements.
Wang said some of their findings, particularly from one study in Los Angeles County, suggest that effective programs are early childhood interventions (including an emphasis on breastfeeding), home visitations by nurses and social workers to vulnerable households, and partnerships with retailers to make healthy food choices more accessible.
In the process, the researchers helped pioneer new research tools – including interdisciplinary “systems mapping” approaches in which computer scientists discern linkages among various programs and their effects, and the highly influential “community intervention dose index” concept that can be used to evaluate multiple intervention strategies within a community.
In addition to Rauzon's contributions in research and evaluation, Ritchie also highlighted her role in supervising and mentoring students and NPI staff and researchers during her 20-plus years with the UC – the role in which Rauzon takes the most pride.
“While I made a contribution to community health in effective interventions and how to measure them,” Rauzon said, “I would say personally the most rewarding part of the work I've done over the last couple of decades is seeing the growth and development and advancement of people who have worked for me and who have really taken off in their own careers – that to me has been immensely satisfying.”
As an emeritus researcher, Rauzon will continue to support NPI professionals and their research, and she added that she's excited to embark on a new partnership – with her husband, a geographer – to mitigate impacts of climate change on human and environmental health across the globe.
People interested in supporting Rauzon's legacy and the ongoing work in health and nutrition can donate to NPI's Student Fellowship, which provides students from underrepresented groups the opportunity to work on NPI research and be mentored by NPI researchers.
- Author: Mike Hsu
Nutrition Policy Institute researcher influenced obesity research, SNAP-Ed evaluation
Young people across California and the U.S. enjoy healthier, more nutritious food options at school, thanks to the contributions of Gail Woodward-Lopez, who retired on July 1 as the associate director of research at the Nutrition Policy Institute, a part of University of California Agriculture and Natural Resources.
Woodward-Lopez officially joined UC ANR in 2015, when she and other researchers at the Atkins Center for Weight and Health at UC Berkeley merged with NPI. But her association with UC ANR goes back much further, as her work at CWH was always directed by UC Cooperative Extension academics – including the research that paved the way for California's “junk food ban” in schools.
Two bills, signed in 2005, set nutrition standards in California for “competitive foods”– the items sold in vending machines and from food service a la carte (as opposed to federally subsidized school meals). That legislation – which inspired similar policy changes across the country – was informed by the work of Woodward-Lopez and her colleagues, who had looked at the financial impact of establishing those standards.
“Our study was so pivotal that I literally had people calling me from the floor of the Senate or the Assembly when they were debating that legislation,” recalled Woodward-Lopez.
Changing perceptions of population weight gain
Originally intending to pursue a career in neurobiology, Woodward-Lopez found that lab work didn't suit her temperament. Seeking to work more directly on social issues, she embarked on a public health path, with an emphasis on nutritional aspects that incorporated her interest in biological sciences.
Woodward-Lopez's early work focused on a challenge that was just beginning to catch the attention of researchers: the rapid rise in the Body Mass Index (BMI) among the U.S. population. In tracing the causes of this epidemic, she and her colleagues shifted academic and public attention toward the host of environmental factors that contribute to weight gain – instead of focusing exclusively on an individual's choice to eat healthy and be physically active.
“Two decades ago, Gail led groundbreaking work to identify the determinants of obesity when child obesity was emerging as a public health concern,” said Nutrition Policy Institute Director Lorrene Ritchie. “While we and other researchers across the nation were working on generating more evidence to inform action, she had the vision that we could use a variety of existing data – from trends to trials – to point to the main causes.”
Many of the researchers' conclusions, which were published in the 2006 book “Obesity: Dietary and Developmental Influences,” stand to this day.
Helping to set the identity and agenda of the Center for Weight and Health when it was founded in 2000, Woodward-Lopez moved policy and practice beyond educational approaches and public awareness campaigns. As she noted: “No one thinks sugar-sweetened beverages are good for you.”
“Education alone is not going to work if people do not have access to the healthy foods and opportunities for physical activity, if they're not safe in their neighborhoods, or if they can't afford the healthy options,” she explained.
Given her seminal role in the field, Kaiser Permanente sought out Woodward-Lopez as a “thought partner” on the organization's community-based obesity prevention programs and school health work.
“Gail brought deep rigor and expertise, of course, but also a super-practical, community-focused perspective to our work,” said Loel Solomon, professor of health systems science at the Kaiser Permanente Bernard J. Tyson School of Medicine. “Her integrity and values around health equity were evident in everything we did together, and our communities are so much the better for it.”
Elevating and enhancing CalFresh Healthy Living
At the Nutrition Policy Institute, the focus of Woodward-Lopez's work has been refining the evaluation and delivery of SNAP-Ed, the educational component of the Supplemental Nutrition Assistance Program (commonly referred to as “food stamps”). Known in California as CalFresh Healthy Living, SNAP-Ed represents the largest single source of ongoing funding for nutrition and physical activity promotion in the state – outside of the WIC program which serves women, infants and young children.
“CalFresh Healthy Living can really impact millions of people,” Woodward-Lopez said. “For county health departments, this is one of their main sources of funding and provides the backbone for everything else they do in nutrition and physical activity.”
But given the variety of interventions implemented by health departments in response to local needs, determining the efficacy of those efforts is a daunting task. Woodward-Lopez and her NPI colleagues have been instrumental in devising creative approaches that help pinpoint the most effective public health measures.
For example, NPI researchers found that combining school policy changes with increased opportunities for physical activity during the school day was the best strategy to encourage student fitness. They discovered that reductions in nutrition programs during the COVID-19 pandemic disproportionately affected communities of color. And they also continue to emphasize that interventions need to be tailored to the specific cultural and political conditions within a community.
“I think in all of the work we do, we try to come up with those practical applications – what does this mean for communities? How can we do this differently? How are our findings actionable?” Woodward-Lopez said.
Her contributions toward the evaluation of California Department of Public Health SNAP-Ed have impressed and inspired Lauren Whetstone, chief of CDPH's Research, Evaluation and Strategic Alignment Section, Nutrition Education and Obesity Prevention Branch.
“Gail and her team have elevated the quality of our evaluation work and the evaluation support that we provide to local health department grantees,” said Whetstone, who has worked with Woodward-Lopez for nearly a decade. “Gail contributed substantially to statewide SNAP-Ed evaluation as well, again working collaboratively to ensure high quality evaluation. Our work is all the stronger due to Gail's dedication to excellent SNAP-Ed evaluation.”
To the benefit of the field and community health, Woodward-Lopez said she plans to remain engaged in her life's work.
“I'd really like to get more involved in policy through advocacy and through doing things like writing letters to the editor or social media commentary,” she said. “I already have some ideas for some editorials I want to write.”
And while she looks forward to spending more time with loved ones, traveling, and pursuing her interests in art and music, Woodward-Lopez will remain a guiding voice for advancing public health.
“Gail's leadership in public health nutrition – even after she retires – is a testament to her dedication,” Ritchie said. “She not only has contributed to sustainable changes in California and nationally, she has been a mentor to me and so many others in the field who will strive to continue her legacy.”
People interested in supporting Woodward-Lopez's legacy and the ongoing work in health and nutrition can donate to NPI's Student Fellowship, which provides students from underrepresented groups the opportunity to work on NPI research and be mentored by NPI researchers.
