[0:32] Shireen: In today’s episode, we welcome Dr. Caree Jackson Cotwright, a leading policy expert and researcher who specializes in the prevention of diet related conditions, food insecurity, and racial inequality. As she discusses the critical issues driving inadequate nutrition in underserved populations, we’ll explore how access to healthy food options plays a pivotal role in disease prevention and consider the policy changes necessary to combat food insecurity, and nutrition insecurity. Stay tuned.

[1:08] Shireen: Dr. Caree Cotwright leads a whole of department approach to advancing food and nutrition security. Dr. Cotwright is on leave as an associate professor of nutritional sciences in the University of Georgia’s College of Family and Consumer Sciences Department of Nutritional Sciences. She holds a PhD in foods and nutrition and community nutrition and MS in foods and nutrition both from University of Georgia and a bachelor’s degree in biology from Howard University and as a registered dietitian nutritionist. She lives in Athens, Georgia, with her loving husband and adorable three daughters. Welcome, Dr. Cotwright.

[1:46] Dr. Caree Cotwright: Thank you so much, Shireen. Happy to be here.

[1:48] Shireen: Such a pleasure having you on. Dr. Cotwright, one, I, just given your incredible accomplishments, tell us a little bit more about yourself. What really drew you to pursue a career in food and nutrition policy in particular?

[2:04] Dr. Cotwright: Well, that’s a great question. Thank you. I really grew up around a family who loved food. And my grandmother was a gardener, my mother was a gardener, and there wasn’t a time when my mother didn’t prepare these wonderful, delicious, and nutritious meals with plenty of fruits and vegetables. So at a very early age, I just had a love for food for nutrition and cooking and learning how to cook. So I actually started to learn to cook when I was about five, when my mom let me help with making cornbread. And so in terms of my career path, I really wanted to, I focused on pre med when I was in college. And then I really thought about focusing on prevention in particularly for black communities because as I grew up I saw major differences in neighborhood food environments and I thought about how that could affect health outcomes and so in doing so I actually did when I was At a master’s student intern at the Center for Science and the Public Interest in Nutrition Policy.

And that was my first understanding of nutrition policy. And later, after earning my PhD and going to the CDC as a fellow, learning more about policy and disseminating policy and policy system environmental approaches really helped me. a lot. And at that time I was promoting Let’s Move, the Let’s Move child care initiative specifically because I looked at early childhood obesity prevention. And so from there I became a professor at the University of Georgia and I knew I would do both intervention and policy. I’m an interventionist at heart. I love to create. innovative nutrition education programming, but policy is so important to that. And my research has focused on programs that we have here at USDA, like the Child and Adult Care Food Program that provides healthy meals for our children and adults in care. And the SNAP Ed Program, which we have at UGA, which helps to educate our participants about healthy eating habits.

[3:49] Shireen: Now, you have this role right now, Dr. Cotwright, the director of nutrition security and health equity, the food and nutrition service within USDA. That’s a very heavy title. Let’s start there. What are some of your primary responsibilities and more importantly, what are your goals in advancing food and nutrition security?

[4:09] Dr. Cotwright: Yes, it is a big title, and I’m just privileged and honored to be in this role. And so in this role, I lead a whole of department approach to advancing food and nutrition security. And let me start by defining nutrition security. The way that we define it at USDA is to everyone, everyone in our country has consistent and equitable access to healthy, safe, and affordable food that is optimal for their health and well being. And that’s a change. You know, people say, well, what’s the difference between that and food insecurity? Well, in food insecurity, we know that people are not certain where the next meal will come from. But when we look at nutrition security, we want to make sure not only will they know and have access to that healthy, safe and affordable food, but it will be optimal for their health and well being. And so we have pillar pages on our website that I encourage our listeners to look at across all eight of our mission areas. We have assets that work together to tackle food and nutrition insecurity, and that’s what our nutrition security initiative is about. So Secretary Tom Vilsack, about a year and a half ago, Set out on a mission to have this initiative around nutrition security, and I’m one of two points of contacts on the White House Conference on Hunger, Health, and Nutrition, which was a huge undertaking that we hadn’t had in 50 years that many of you know about, and that’s what we’re talking about. And so as we think about that, we want to continue to implement USDA actions, make sure that we’re playing a large role in making sure that we meet our national strategy and goals for the White House Conference, and then working with non government organizations to To have new and enhanced commitments. I’m also charged with leading secretary bill sets goal of making my plate a household name, which is our federal symbol for healthy eating. And I am a policy official for snap ed and a policy advisor for the dietary guidelines for Americans, which are now being reviewed by a committee and will be released in 2025.

[5:59] Shireen: Lovely. And, you know, a minute ago, you mentioned sort of this distinction between nutrition security and food security. Can you double click into that a little bit? Why this focus on nutrition security? And you mentioned it steps even beyond food security. It’s not only about access, but it’s about the quality of the nutrients is what you mentioned. So can you help us understand nutrition security a little better and how do some of the efforts around nutrition security differ or are similar to that of food security?

[6:28] Dr. Cotwright: Right, and so as we think about nutrition security, so our suite of 16, over 16 nutrition assistance programs at USDA are really our most powerful and far reaching tools to, that the federal government has to ensure that people have access to healthy, safe and affordable food. So as we think about that, I still want to go back to within that definition that through our nutrition security efforts, we’re building on and complementing our longstanding efforts to address food insecurity. And so as we are working on that and just making sure that, you know, repeating again, that this means that everyone has consistent and equitable access to healthy, safe and affordable food that is optimal for their health and wellbeing. We’ve changed it based on two core reasons. First, We recognize that structural inequities make it hard for many people to eat healthy and be physically active. So it’s not just the person, it’s not just the individual. There are so many things that are going into that, and we have to take note of those structural inequities. The second thing is to emphasize an equity lens every step of the way when we think about our efforts. And so with our nutrition security initiative, USDA is really holding ourselves accountable. And so we’ve established our first USDA equity commission, and we also have our health equity goals embedded in our outcomes for our strategic planning. And so as you think about that, really taking key or honing in on those structural inequities and making sure that the efforts that we have to decrease food insecurity are also promoting optimal health and well being are those major differences and what makes such a difference with our initiative right now.

[8:05] Shireen: That’s helpful. Can you briefly talk to us about this relationship between structural inequities, food access, and then poor nutrition?

[8:14] Dr. Cotwright: Certainly. We know with the COVID 19 pandemic, it brought forth the vital need for access to healthy food. We saw the need, we saw how much it increased, and we know that COVID 19 was associated with diet related diseases and disparities. So one study even estimated that two thirds of COVID 19 hospitalizations in the U. S. were related to obesity, hypertension, diabetes, and heart failure. And so when you think about that, I know that Many of your listeners and you might even on your own sharing have personal stories of seeing how disparities are born out in communities or in your family. But disparities in food and insecurity and diet related diseases are a long standing problem. And they’re associated with decades of structural limitations in food retail outlets that sell healthier foods. And so, in particular, in the neighborhood where I grew up I saw different disparities and I grew up in a nice neighborhood where all my neighbors were really fun and we were just rooted in taking care of one another. And if we couldn’t get the products that we needed at the store, there was a man that drove around with his fresh fruit veggie truck and we would always have. Holders, we were nutrition security even before we knew it was that term. And so, but when I would go from my neighborhood to another neighborhood that was more fluent in Atlanta, I would see these differences. And so when you think about what are some of those longstanding historical or structural inequities, they’re an education. They’re in employment, they’re in housing. And so when you think about that and they’re in access, right? We talk about access to healthy, safe and affordable food.  And so health disparities can start very early black and indigenous children are more likely to be overweight or obese. And we recognize that structural racism is not. simply the result of individual preferences. And so we know that structural racism, it can be described and measured and dismantled, right? And so we have to think about those ways on how we can really transform policies. programs and practices into having meaningful and equitable access to healthy, safe and affordable food. And so as we think about that, we are continually to carefully examine our existing and our potential policies to make sure that we prioritize equity and address the social determinants of health. because those are part of those structural inequities. And while we’re bringing attention to the social determinants of health, we’re also looking at nutrition across all life stages and all demographics because poor nutrition is the leading cause of death in the United States. And it’s caused more than 600,000 deaths per year. So we know that poor nutrition and diet related diseases have far reaching impacts. Above health, even our academic achievement and financial stress, and we want to change that. And so all of those things are part of why we recognize those structural inequities.

[11:06] Shireen: That is so helpful to know. And also thank you for sharing the numbers there because we sort of hear about the impact that it has or the potential negative impact that it has. But to understand the Quantification of that problem is so important, which also leads me to the next question, which was, you know, a few minutes ago, uh, Dr. Cotwright, you mentioned the conference on hunger and nutrition. And this year, you know, we celebrated sort of the one year anniversary of that. Can you tell us of the work that has been done so far in the work that is a lot of work that is still ahead to be done? What are things we’ve been able to accomplish?

[11:39] Dr. Cotwright: Certainly. So as we think about the work that we’re doing, so many things are taking place. And so first, when we think about the work we’re doing at USDA, we do have a report out that we released on the, right after the White House conference. And it’s called the role of FNS, which is the food and nutrition service on nutrition security. And so when you think about that, I want everybody to know that that is available on the web. And then for the one year anniversary, we also released a fact sheet that looks at our progress today. So really excited about sharing that. So as you think about our approaches at USDA to advance food and nutrition security. We have the administration of 16 nutrition assistance programs. And again, these are the most powerful and far reaching tools available to the federal government to ensure that everyone has access to healthy, safe, and affordable food. Our programs reach one in four Americans, but we know we can do more to improve the health of Americans. And we need everybody’s help. We need to get the word out.  So at USDA, we are working on building awareness about structural racism and the ways that it can be described, measured, and dismantled. We are also exempt again, examining our existing and potential policies. And this is where this nutrition security piece comes in to look at, you know, not just. Thinking about do people have access to food, but looking at it, you know, within this equity lens and looking at it for the totality of all that we’re doing. And so as we continue to do that, we have also established our first USDA Equity Commission, and it’s really wonderful because we’re holding ourselves accountable. So we’re proud of the work that we’re doing, and we know we have a lot more work to do, but we’re really excited about this whole society approach.

[13:21] Shireen: Thank you for sharing that. Can you share any anecdotes or can you share any sort of firsthand impact that you have seen of some of these initiatives?

[13:29] Dr. Cotwright: Sure. One of the things that we’re doing is making sure that we are working better to integrate nutrition and health. And that’s one of our pillars. And so I’ll talk a little bit further as we talk about how our pillars are aligned and what we’re doing with nutrition security. But in summary, we really look at meaningful nutrition support across the lifespan. We look at that healthy access to healthy, safe and affordable food, collaborative action, and then prioritizing equity. So when you look at the collaborative action, I have two examples. One is that we’re working to bridge the gap between our nutrition assistance programs, our nutrition field and the healthcare sector. And what we found was that the healthcare sector was not. Totally aware of our programs. And so we partnered in many ways to be certain that we get the word out. And so we held our first National Nutrition Summit right after the White House conference, which helped to bring together health care leaders as well as leaders from the nutrition field and USDA. And we’re having seven regional summits hosted by ProMedica and the Root Cause Coalition so we can have similar conversations. Now, what comes out of that? For example, the American Academy of Pediatrics has committed to training all of their pediatrician over 69, 000 members on nutrition security. And I was able to participate at their national conference in DC. And they had a lived experience panel of moms who were SNAP participants and telling us what they had learned. And they want to do a web series to continue to train pediatricians. And now they have. created ways to train more residents about food insecurity screening and making sure that there’s a warm handoff to our programs. We always say that. So that’s one example. Another example is our my plate national strategic partnership, but we have more than 140 Partners from industry that are helping us to make MyPlate a household name and making certain that consumers know that MyPlate.gov has readily available resources that can guide them through healthy eating choices where we’ve got to get the word out. So those are just two examples. Thank you.

[15:33] Shireen: Thank you for sharing that. You know when we talk about hunger, food insecurity, and diet related diseases, these are really complex issues just on their own, right? Forget the interaction that they have across the board. How do you see in your role really addressing these challenges and promoting nutrition security at both the policy and then at the programmatic level as well?

[15:55] Dr. Cotwright; Thank you for that question. And so there are a variety of ways that USCA can help to advance food and nutrition security and to leverage the momentum of the White House conference. So we just have this wonderful opportunity. There’s a wonderful time frame right now. And as we think about that, as I mentioned, those pillars. Our work is scaffolded by those pillars. So let me just go back and mention again, the first pillar being meaningful nutrition support from pregnancy to birth and beyond. And we did align things. So you think about nutrition security and that access to healthy, safe and affordable food. We did an historic reevaluation of the Thrifty Food Plan, which is the basis for SNAP benefits. So we wanted to align those SNAP benefits in line with the cost of eating healthy. So that was a major milestone. Second, we’re working to connect everyone in this country with healthy, safe, and affordable food sources like those through our various nutrition incentive programs that can benefit not only participants, but our local community. So one example is the Gus Shoemaker Nutrition Incentive Program that gives HODU’s prescriptions. Also, third, we are developing, translating, and enacting nutrition science through partnerships, including that National MyPlate Strategic Partnership that I just mentioned. And fourth, throughout all of our work, we’re prioritizing equity every step of the way. And so as we think about that, one example is establishing the Indigenous Food Sovereignty Initiative to make sure that our tribal communities have food sovereignty and have that access to healthy, safe, and affordable food, as I mentioned before.

[17:21] Shireen: Please share with us any notable opportunities or challenges you’re working through to achieve within the White House conference goals and share how our listeners here today can really help accelerate progress. What role can we play?

[17:35] Dr. Cotwright: I think as participants and as consumers, we can play a role by really thinking about how to get the word out. And so I want to remind our listeners, for example, that we have a new program coming out called Summer EBT, where many children will be able to have access to healthier food during the summertime. And so that’s just one example. And when we think about summer EBT. It is an opportunity to bridge that gap of summer hunger. And we know that’s a time when our kids may don’t have access to their healthy school meals. And while we’re working on healthy school meals for all with summer hunger and having summer EBT, this is an addition to, and not instead of. The, you know, your SNAP benefits. And so as we think about that, we can reduce hunger and malnutrition, and it’s a problem that we can solve together. So we really need help. We need help getting the word out. We need people to tell families, Hey, did you know that this program is coming out? We have new summer options that for people who are living in rural areas, where they don’t have to go to a congregate site, they can do grab and go meals or have meal delivery.

That’s going to be very exciting. And these efforts in totality really help us to bind that gap. Right. So getting the word out about that. Another place where we can get the word out is about our WIC program. We’re going through a wonderful period of WIC modernization where we are working to diversify the WIC workforce, working to improve and align the week food package with the latest nutrition science, and there are just so many wonderful things coming out of that. And for the first time in a decade, we’ve increased to over 400, 000 participants, which means that 6. 7 million women, infants, and children are benefiting from our programs. And we know it works. We know that it results in fewer premature births. And fewer infant deaths, and it also helps to lower healthcare costs. And so again, we need people in communities want to hear from people in communities. We need people out there advocating and letting people know these are your benefits. These are for you and for your families. And if we can get the word out, talk to your local leaders, your mayors, Congress members, and just let them know how our programs are making a difference in the lives of others. And so that we can make sure that we have all the funding that we need to do the great work that we’re doing. So those are just two core examples.

[19:58] Shireen: That’s very helpful. And so it is all about driving that awareness, is what I’m hearing, just really driving that awareness to the work that you are doing at the USDA. Looking ahead, could you share any upcoming projects or initiatives that you’re particularly excited about? And what is this impact that these projects will have?

[20:15] Dr. Cotwright: Sure. As I look ahead, I am really, really excited about the fact that Secretary Vilsack has a core priority to tackle food and nutrition security. And so in fact, like you said, it’s a big title, my job in itself to have a director of nutrition security and health equity shows how important this topic and this initiative is to USDA. And I’m just excited about institutionalizing this approach and making sure that we embed nutrition security through everything we do because it really is essentially a great part of everything that we do. I mentioned earlier that he also made it a goal to make MyPlate a household name. And again, that’s our federal symbol for healthy eating. Many people still think we have the food pyramid, but now we have MyPlate and we are launching MyPlate listening tours across our country and talking to various audiences to see what their needs and their challenges are.

But we’re also celebrating the great work that has gone. on around my plate. So we’re very excited about partnering and launching that. I love, I’m a community engaged researcher. I love hearing from the community. I love partnering with the community and being out there so that we can make certain that everyone is aware of our programs. That’s very exciting to me. And then that we can foster collaboration so that we can do better together.

[21:32] Shireen: I absolutely love that. And it is again about just really bringing those resources together, helping amplify a lot of the work that you’re doing and really starting at the grassroots level, right?This is not only top down, but also a lot of bottoms up driving that kind of awareness. Speaking of my Can you tell our listeners or share with us some ways that we can help sort of promote MyPlate as well? And how can our listeners share with you ways that are working or, or need more work to make MyPlate symbol or messages really more culturally and contextually sensitive?

[22:03] Dr. Cotwright: All right. I would love for today’s listeners to share with me on our new MyPlate Instagram, which is our first Instagram page in the Food and Nutrition Service, ways that they are using MyPlate or seeing it in their everyday lives. You can follow that. Use our website, myplate. gov. And if you have any images of feedback, just please send it to me. My email address is simply my name. It’s usda. gov. I’m just happy to hear from you. I hear from people all the time and have you share. And again, as we think about it, we’ll be doing these listening tours for different audiences, but we are making certain that we hear. From others and from different types of audiences. So we can make sure that our messages are culturally, contextually and linguistically appropriate. And so we are definitely working on that and we have to work together, you know, in partnership to get the word out about all of these wonderful things. And we’re just so excited about doing the work.

[22:55] Shireen: Love it. With that, Dr. Cotwright, we are toward the end of the episode. Before I let you go, I know you just mentioned your email. Are there other ways that folks can connect with you and just stay on top of the work that you are doing and that your team is doing?

[23:06] Dr. Cotwright: Certainly. So you can also check out our nutrition security pillar pages. We have a video about our work. It’s very short. So if you want to share that with your organizations, you can put that out there to explain nutrition security and let people know about the efforts and the work that we’re doing. Of course, follow my plate on Instagram and then be looking for updates to our nutrition security webpage. We will keep those updated. We’re working very avidly to make sure that we’re getting the word out. And those are great ways to stay in touch.

[23:35] Shireen: Love that. Thank you so much, Dr. Cotwright for your time. And to our listeners, thank you for tuning in to another episode of the Yumlish podcast. And you know what time it is, head over to our social media, either our Facebook page or Instagram page, and comment to let us know this quick question, which is, how do you personally navigate the challenges of meal planning and food choices to effectively manage your health? Again, head over to our social media pages at Yumlish, either on Facebook or on Instagram. Find this podcast post and comment below to tell us again, how do you personally navigate the challenges of meal planning and making appropriate food choices to effectively manage your health? With that, thank you so much again, Dr. Cotwright.

[24:17] Dr. Cotwright: Thank you for having me.

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Bringing Nutrition to Fruition through the Creative Arts | Caree Cotwright | TEDxUGA