The Supplemental Nutrition Assistance Program, known as SNAP nationally, and commonly known as CalFresh in California, gives approximately 3.3 million college students access to essential food assistance. However, an estimated 57% of SNAP-eligible students do not enroll. The research team conducted individual and group interviews from February 2020 and December 2021 through Zoom to gain insight into the student SNAP application process from the perspective of CalFresh county agency workers. Through this qualitative approach, the research team aimed to better understand the student SNAP application process from the perspective of county agency workers. The study identified 5 central themes, in which county agency workers perceived the process as challenging for students, and burdensome for administration workers. The research study was recently published in the Journal of Nutrition Education and Behavior by Suzanna Martinez, Sonali Singh, and Erin Esaryk with the University of California San Francisco, San Francisco's Department of Epidemiology and Biostatistics and Nutrition Policy Institute researcher, Lorrene Ritchie.
In May 2020, running until the end of the 2021-2022 school year, the US Congress authorized the US Department of Agriculture to issue nationwide waivers that allowed all schools to provide universal free school meals to mitigate the impacts of school closures as well as the broader economic challenges faced by families during the COVID-19 emergency. This study aimed to examine parent perceptions about school free meals and whether these perceptions differed by race and ethnicity. In May 2022, 1100 California parents of K-12 students from varying racial and ethnic backgrounds, socioeconomic statuses, and State regions responded to a survey to share their perspectives about school meals during the school year 2021-22. Across all racial and ethnic groups, California parents reported that free school meals offered multiple benefits to families, saving them money, time, and stress, and expressed that the stigma associated with school meals was low. However, parents expressed that there was an area for improvement in the variety, taste, and healthfulness of school meals, where parents of Hispanic and Asian students reported less favorable perceptions of these qualities than parents of White students. This study suggests that there is strong support among parents for free school meals, but further efforts are needed to implement a variety of culturally appropriate school meals and make improvements in their taste and healthfulness. Results from the study were recently published in the Health Affairs Scholar journal. The study was conducted by Nutrition Policy Institute researchers Monica Zuercher, Christina Hecht, Kenneth Hecht, and Dania Orta-Aleman in collaboration with Juliana Cohen, Deborah Olarte, and Leah Chapman from Merrimack College, Punam Ohri-Vachaspati from Arizona State University, Michele Polacsek from the University of New England, Margaret Read from Share Our Strength, Anisha Patel from Stanford Pediatrics, and Marlene Schwartz from the University of Connecticut.
More Americans are now sick with diet-related conditions than are well. In the American Journal of Public Health's special issue on "Policies and Strategies to Increase Equitable Access to Family Nutrition," Lorrene Ritchie and Wendi Gosliner of the Nutrition Policy Institute advocate for bold action to improve the health and diets of all Americans. Their editorial entitled “Bold Action Needed for Equitable Access to Nutrition Assistance by All” along with the supporting research featured in the special issue emphasize that while federal nutrition assistance helps one in four Americans and over half of school-aged children, more needs to be done to address food and financial insecurity and improve the diet and health of Americans. Ritchie and Gosliner suggest that, “Currently the nutrition assistance programs conflate two separate issues, one involving people facing poverty with inadequate resources to secure adequate food and the other involving structural supports to the food system and societal norms that facilitate abundant access to and promotion of relatively cheap and unhealthy options, leading to poor diets being the status quo.” They recommend rethinking nutrition assistance's role in combating poverty, suggesting income and housing support, and separately, restructuring federal nutrition assistance programs to support healthy food consumption for all, like providing school meals for all K-12 students, and restructuring retail food environments to create new healthy norms. The special issue and editorial were published online on December 20, 2023.
- 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./h3>/h3>/h3>
- Author: Brianna Aguayo Villalon
- Editor: lauren au
A recent study found that higher infant diet quality scores observed in Hispanic Spanish-speaking participants account for certain racial and ethnic variations in later diet quality, suggesting that enhancing infant nutrition could mitigate early childhood diet disparities. Researchers focused on data from participants in the Special Supplemental Nutrition Assistance Program for Women, Infants and Children, known as WIC, to analyze nutritional practices based on racial and ethnic differences among young children. The researchers found that infant diet quality among Hispanic Spanish-speaking families accounted for 25% of later diet disparities based on racial and ethnic differences. The study was published in The Journal of Nutrition, including authors Lauren Au, Charles Arnold, and Sarina Lin from the University of California, Davis, Department of Nutrition, Lorrene Ritchie from the Nutrition Policy Institute, and Edward Frongillio from the University of South Carolina, Department of Health Promotion, Education, and Behavior.