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EP141 Food Systems and Maternal Health with Dr. Brennan Rhodes-Bratton
Aman Chopra: Folks, welcome back to another episode of the "I am GPH" podcast. As you have seen in our previous episodes or if you're new to the podcast, public health is so diverse. You can bring areas that apply from things that wouldn't be public health into one area, collectively, that makes it public health. Everything is public health, you can choose your own path, and our guest is someone that is representative of the multifaceted nature of public health, Brennan Rhodes-Bratton. Brennan is an avid researcher who's currently in the line of health inequities, with a focus on the intersection of gentrification, food systems, and maternal child health. Brennan completed her DrPH at Columbia University in Sociomedical Sciences, and is currently a post-doctorate fellow at the Center for Anti-Racism and Social Justice here at NYU GPH, who we have interviewed a lot of people from that department on the podcast, as well. We can't wait to hear all about your journey, and what you do, and what's going on with you right now. Brennan, welcome to the podcast.
Brennan Rhodes-Bratton: Thank you so much, I'm happy to be here.
Aman Chopra: So, you know, I'd love to start off with your introduction to public health. When I was reading about you, and when we connected, there was a lot of multifaceted nature to what you do. There's different areas. To me, while all of these seem to fit in together, it also seems that they've come from different areas, so how have your interests formulated to where you are right now?
Brennan Rhodes-Bratton: That's a great question. So I think a lot of us in public health, well, I shouldn't say us, I should stick to myself here, you know, it's my journey, and I started off wanting to be pre-med, and I wanted to really work with individuals as a physician, 'cause I really wanna affect change, and I saw it best by doing it with one-on-one, but over time, I realized that that wasn't gonna be my path, and that I wanted to do something that was impactful with greater numbers while also still having those moments where you can work with an individual, and hear their lived experience, and kinda shine that light on it, and so I found my way into public health, and I got my Master's, and then I went back again and got some more work, but in between, I worked at the Center for Children's Environmental Health at Columbia, and every single step of the way, it built to these questions around how our neighborhoods and the different structures within our society impact the individual-level choices that we're making, and how those individual-level choices also impact the structures that be, and that, you know, back and forth interplay really kind of began to be my focus and the nexus for my work.
Aman Chopra: You mentioned structure. So structure feels like, when I hear it, the bigger picture, right? So you found your pockets when it comes to structure, like this pocket applies, that pocket. How did you find your direction into the pockets that you're in right now? I know you were doing what you were doing in Columbia and how did it... It's expanded into two to three different areas, and now you're at the Center for Anti-Racism. It feels very interesting to me how these have come up.
Brennan Rhodes-Bratton: Well, see, for me, they all intersect, like there's these... It's like where the disconnected, like, seamlessly connect, and so one of my most beloved mentors, Mindy Fullilove, I was in her office one day, and we were having a conversation, and I wasn't sure what to do my dissertation on. So many things were happening in the world at the time, and I've always been interested in cardiometabolic health, and wasn't really sure how to get at it. And another interest of mine was food, like a fun fact, I was raised on fast food, and so for me, I've always been intrigued by home-cooked meals, and what does that mean, and what does that represent, and so a part of it also is, grocery shopping has been a different experience, I think, for me. We would get all the, we would go, like, once a month and get all the prepackaged goods in, like, and that's what we would have, right, so like Lunchables, SpaghettiOs, Chef Boyardee, Gushers, these are all things that were very prominent in my childhood, and when I was talking with my mentor about, like, what I should do, she said, "Well, what's upsetting you right now?" And I took a moment, and I thought about it, and I explained to her, on my walk back to school, I would cross at the intersection of Lenox Avenue, which is in Central Harlem and 125th Street, and that's, like, a very famous corridor that runs from east to west across Harlem, and at that time, there was a vacant lot, and it was said that a grocery store was gonna be moving in, Whole Foods, and then across the street, juxtaposed of this new development, was gonna be, not was gonna be, was the boarded-up Lenox Lounge, which is an iconic institution within the Black community, and so many amazing leaders and just fabulous entertainers have graced the doors of that space, and so you had divestment in an iconic space, and across the street, redevelopment or revitalization, or whatever word you'd like to put in there, for a new space that is a grocery store, which was huge, and fantastic, and great, but it was also a space that represented change by the type of grocery store that it was, and so I explained to her that this feeling of kind of frustration but also hope was what was kind of having that tension or kind of, I guess, pissing me off, for lack of a better word, and that's kinda what she said to focus in on, that's the thing to research, and so that's what I did. I tried to look at how, when you have structure, as in gentrification, occurring in a neighborhood, how is that changing our relationship with food as the food environment then changes around you, and so that's how I kinda came to it as thinking about the structure and the individual. And then also, with moms and their kids, because often, we see that mothers are the ones making the decisions around food in the home, and so if the mother is the one going out and going grocery shopping in these new spaces, as it's changing, then how is their relationship with food, and also their children's relationship, gonna change or not change in the context of what's occurring through these different social processes. And so that's kind of what was born out of that conversation and out of being in that space over time.
Aman Chopra: That is actually such... I picture myself there right now and seeing how that... I've had a few people on the show that are in the world of nutrition, and their life is nutrition. When I say the word nutrition in public health, what comes up for you?
Brennan Rhodes-Bratton: That's a great question. For me, in my head, I see that quintessential plate of a well-balanced meal, and, like, a family around a table, and individuals trying to, like, enjoy a meal. I don't necessarily think about the macronutrients, I don't think about, like, how processed the food is, or the level of vitamins, or any of that kind of stuff, but I do also think about who has access, who is available, who is able to get the different types of foods that they want to bring to their table, and how that might change based off of social and economic determinants, and so that's, for me, nutrition kinda holds that whole space.
Aman Chopra: Let's take a step back. Social and economic determinants, how would you describe that? What does that mean?
Brennan Rhodes-Bratton: Okay, so for me, that's really looking at, like, what does somebody have the resources for, whether it is within themselves, or within their family, or within their community, and how that can either provide or hinder the types of food choices that individuals can make, and so when I'm thinking about nutrition, I also think about, like, nutrition security, in the sense that, not just food security, right, but making sure that somebody can have a well-balanced meal, you know, is, I think, what I really focus on.
Aman Chopra: Wow. Where is your journey in nutrition taking you right now, so what are you focusing on, what's going on in your journey, what's next right now?
Brennan Rhodes-Bratton: So there's... It's exciting, I guess. There's, like, a few different spaces that it's going. In one space, during previous research, from working with mothers and talking about, like, how the relationship with food may or may not have changed in the context of gentrification, I learned something happened to a lot of moms in the study that I had worked with, Two things actually. One of the themes that came out was this internalized stigma around cultural heritage foods. So I would ask individuals, you know, like, "What's your favorite food?" and we would have a lovely conversation about this, and then I would ask, "So, hey, so how healthy do you think this food is on a scale from one to five?" and I was really shocked how many individuals mentioned their favorite foods that were heritage foods, as being very unhealthy Like, people would say things, like, you know, "Well, you know, but we eat disgustingly," and things of this nature, and it was really upsetting to me to hear somebody talk about foods that seemingly were pretty healthy, a well-balanced plate, as being so, you know, unhealthy, and so I started asking myself, like, what is happening for that individual to get to that kind of connection with their food in that way? How do they get to a point where they internalize it to be so negative? And so I started on a journey to try to understand a concept of, like, food stigma in this space. We know that there's stigma around food insecurity, we know there's stigma around weight and other aspects, like we even see stigmas within, unfortunately, like, eating disorders and things of that nature, but we don't see in the literature too much about this notion of stigma around what we're eating if it's related to our ethnicity, or culture, or race, and so that's something that I want to explore more.
Aman Chopra: What were some examples of people judging their cultural heritage food – them speaking of their own food as something that's unhealthy? How did that... What's incorrect, perhaps, about their mindset, and how can we, where did the research take you to change that, and what unlocked for that?
Brennan Rhodes-Bratton: I wouldn't say anything about their mindset is wrong. I think what ends up happening is is we live in a space where we're told, like, a healthy meal looks like this, and you're told this often through media, or even with your doctors, or even us, within public health, and what we're saying is to eat, and if we are not giving messages that are culturally relevant, and are, you know, more understanding of the different aspects of cuisine can be healthy, then that message could then be internalized as, you know, having a mindset of something being unhealthy when it's just rice, beans, and chicken.
Aman Chopra: Ah.
Brennan Rhodes-Bratton: You know, so I, or I had an individual once tell me how much they really wanted to pursue eating asparagus, but didn't really acknowledge the other different heritage greens that she was eating as well.
Aman Chopra: Wow,
Brennan Rhodes-Bratton: Right. And I'm like, "Well, what's wrong with these greens? These sound great, and healthy, and lovely." So I think we, in public health, also need to be very mindful of the messages that we're giving around foods when, you know, not, we just need to be inclusive, I think, and that's one of the projects that I'm working on right now.
Aman Chopra: Is that at the center you're in, or that's a separate project that you're working on through the center, or something else?
Brennan Rhodes-Bratton: Yeah.
Aman Chopra: Wow.
Brennan Rhodes-Bratton: So I think the beauty of the work at the center is that Dr. Goodman has placed some really just brilliant minds in the same room, where you can kind of work off of one another, but also have very different ideas of how anti-racism can show up within social justice and public health, and so with that, like, my space is kind of within cardiometabolic health, and gentrification, and moms and kids, and stigma, and all these all these different things, but I think we all have a connection back to how can we see the world a better place when this invisible thing of racism is, you know, impacting our lives.
Aman Chopra: When I had them on the podcast as well, this was, I think, last year, or a few months ago, and it blew my mind to hear that racism has... I didn't even think racism is a public health crisis. It's so interesting being in this world, and speaking to all of you, that there's these areas that one doesn't think as a public health issue, but these are the biggest public health issues. When you hear of racism, gentrification comes up, if your areas come up, what are some other things that might surprise us about racism when it comes to public health?
Brennan Rhodes-Bratton: Hmm. I think that in our country racism is so ubiquitous that it becomes difficult to even see, and so our work is centered upon making it visible, and it's in so many different spaces, so it's... I wouldn't say we can pick and choose from a lot of different health conditions and factors that will increase the risk of unhealthy outcomes. So unfortunately, I think it... Just as much as we say public health is in everything and everywhere, I think, unfortunately, racism has its legacy in a lot of spaces where we also see health outcomes.
Aman Chopra: You were, you were... I'm fascinated by your journey from Columbia, to giving me all the stories, and how your research has transformed into where it's gone. Do you see it pivoting for yourself at this time, or do you see it evolving from these pillars, and now these pillars are forming a larger building in your research?
Brennan Rhodes-Bratton: Hmm. I think that food will always be a part of my work, I think that social theory will always be a part of my work, and inform it, and I think health can show up in a lot of different ways. One of the things that I have had an interest in recently is epigenetics, and thinking about how larger structural health, determinants of health, like, gentrification how could that show up in, you know, under the skin, in, like, a very intergenerational way, so that's something that I've been trying to think through and that's very, you know, in the beginning stages, so, but I do think that there is some, there's some answers there that could help us in trying to understand what is going on within our bodies as it relates back to this relationship within our environments, right? So one of the things that I'm very much interested in is this construct called habitus, and for me, it's looking at structure in the individual, and if we take that another step further, we could also take it to, maybe, our genes, right? So it's, like, keep on pushing the boundaries of how we interact with ourselves, with others, with our environment.
Aman Chopra: Tell me more about habitus.
Brennan Rhodes-Bratton: Tell you more about habitus? No one wants to know that much about habitus.
Aman Chopra: It has a significant influence, and I know you sent us a lot of information about habitus. It has a significant influence on your work. There must be someone, multiple people, frankly, listening to this podcast right now that have that multifaceted mindset but don't know how to channel it, and you are a representation of that. How has habitus influenced that for you?
Brennan Rhodes-Bratton: Oh, wow. Habitus is this, it's something that I think can open up a lot of windows to what we see in the world in a way that doesn't hold us to something big or macro, or something small and individual, it makes us think about our world as this kind of fluid and holistic thing that is in time and space, and it doesn't ignore that interplay that occurs, right, and because we have the social structure, we have the agency, and we have that interplay within habitus, right, it's formed within that back and forth relationship between our lived experience and also what we experience with our, like, with our culture, with the socialization, with our neighborhoods, and thinking about how all of these things are our building blocks to who we are and the decisions that we make, and then how those decisions that we make then create, again, that neighborhood, those policies, our socialization within our structure of our society, and so it's this back and forth that I think is really a beautiful concept to help us think through very complicated issues that require to think about something in a multifaceted approach instead of just, oh, you know, one avenue.
Aman Chopra: One dimensional.
Brennan Rhodes-Bratton: Mm-hmm, yeah.
Aman Chopra: Yeah.
Brennan Rhodes-Bratton: I think that construct allows us to do so.
Aman Chopra: Wow. Oh, man, okay. You've been a researcher for a long time.
Brennan Rhodes-Bratton: Mm-hmm.
Aman Chopra: We can say that. Like, you have been doing research for a very, very long time. What is it like being a researcher? Some folks might be listening, thinking, "What is this research thing? I mean, is it something I have to do for a paper?" What is life in research when it comes to public health, and what does research mean for you?
Brennan Rhodes-Bratton: I think research for me is, it's having a question and trying to find an answer, and you get to explore questions in ways that, with new methodologies, allow you to, you know, answer things that you might not have been able to previously. Or there's also the caveat of that you're answering questions that you, you know, have known for a long time that are of concern, and yet we have to provide evidence to do so. So I think, being in research for a long time, I think there was a part where we were always providing evidence of health disparities between groups within our country, where now we're pushing for more of an equitable lens and saying, you know, like, "Okay, we know that these differences exist. Why do these differences exist? Let's change them," right? Like, it's no longer okay just to research for the sake of there's a difference in X and y. Like, we just shouldn't do those things. So for me, research allows you to, you know, provide information to make change, right, and so that's why I got into this whole thing in the first place. I've always... I came into public health with a very advocacy lens, and it's been very rewarding to see that public health kind of re-embrace the aspect of advocacy through science and to really honor wanting to do this work in a way that's gonna provide information that can make equitable changes.
Aman Chopra: Wow, I love it. It's very similar to the work you're mentioning about, it's seeing the unseen, is what I heard in that, and it's very similar to the center that you're working at, as well, seeing the unseen, we're making the invisible visible, we're showcasing a research has a big role in doing that. Let's ask this final question that I ask to many guests in different ways. To you, what is the biggest public health crisis right now, something that, if you had a magic wand, that could disappear, what's the one public health crisis you would choose? Obviously there's many of them, but the one that's closest to your heart.
Brennan Rhodes-Bratton: That's a really tough question, right, because the public health trained individual wants to choose the thing that's gonna alleviate the most pain and harm for as many people as possible, but yet you say the thing that's closest to my heart. Even though I think that they may be similar, they might not always be the same, so now I'm trying to think off the top of my head what is the number one .
Aman Chopra: So perhaps let's rephrase that question because it's an unfair question, and every guest gets annoyed when I ask that question.
Brennan Rhodes-Bratton: Okay, okay .
Aman Chopra: So I'd say the public health… anything in public health, a crisis, an area that's closest to your heart right now where it's going. I mentioned a lot of things, right, so something where your mind starts immediately. You mentioned epigenetics, you mentioned nutrition, you mentioned gentrification, you mentioned racism. What's the one that is consuming most of your time right now and you see is gonna be the next few years.
Brennan Rhodes-Bratton: They're all connected,
Aman Chopra: They're all connected.
Brennan Rhodes-Bratton: Right, but one I haven't mentioned yet, but it really is, again, interconnected and intertwined in a lot of the things that we mentioned, is climate change,
Aman Chopra: Wow.
Brennan Rhodes-Bratton: Right? So, like, once we, again, thinking big, and thinking about structures and all of these aspects, right, our climate is impacting our food systems, and our food systems impact what's available for people to have on their tables, right, and so all of these different things can impact an equitable and just food system, that we all need to eat in order to survive, and that's gonna impact what we're capable of showing up and bringing to the world each day if we're nourished or not, right? So that's kind of the bigger picture.
Aman Chopra: Beautiful answer. I'd even say, I'd even say public health, there's no magic wand to public health. It's a big rope, and that's the one that we have to... It works together, everything is collaborative over here, and your answer kind of showed us that. Brennan, I can talk to you forever, but we're out of time and this was a true treat. Thanks for being on the episode.
Brennan Rhodes-Bratton: Yeah, thanks for having me. Sorry it took so long.
Aman Chopra: No, you're good.
Brennan Rhodes-Bratton: Thank you
Aman Chopra: Folks, one-dimensional screen but a multifaceted episode. We'll see you in the next one. Thanks for tuning in.
Aman Chopra hosts the I AM GPH podcast at NYU School of Global Public Health. With a keen interest in production, technology, and entertainment, he holds a master’s in Integrated Design and Media from NYU Tandon School of Engineering. Outside of podcasting, Aman is a public speaker and stand-up comedian in New York City.