To Lora Iannotti, MA, PhD, an expert on global maternal and child nutrition, the images of famine coming out of Gaza these days are heartbreaking and appalling. She knows more than most what the consequences of famine can be.
“I get very anxious when I see coverage of Gaza and starving babies,” Iannotti said. “The first 1,000 days of life are critical in nutrition, for survival, growth, and development. If you’re malnourished during that time, the consequences can be irreparable. A child may never recover the losses in brain development or reach their genetic potential for growth. In fact, the damage will be intergenerational.”
Growing up in the 1980s, Iannotti saw similar reports on the news about Ethiopia, which endured a terrible famine from 1983 to 1985. The harrowing images of starving people spurred in her a lifelong commitment to working on hunger and food insecurity. Now the Lauren and Lee Fixel Distinguished Professor of Public Health at the School of Public Health at Washington University in St. Louis, Iannotti focuses on dietary patterns, food production, access to nutritious food and sustainability around the world.
“To do global health well, you actually need to focus in on a few countries, not spread yourself too thin,” Iannotti said. “You have to build relationships, understand the culture and language. My first trip to Haiti was pivotal. I remember thinking, ‘This is going to be lifelong. I’m not going to stop going to Haiti.’ My lab has expanded into several countries, but Haiti is always there.”
Iannotti is the founder of the E3 Nutrition Lab at WashU Public Health. The lab aims to identify nutrition solutions that embrace principles embodied in the three E’s: equity, environment and evolution. She also is co-director of the School of Public Health’s Food and Agriculture Research Mission (FARM) and director of Planetary Health at WashU’s Center for the Environment.
She talks here about her work on global nutrition and the promise she sees in the new WashU School of Public Health.
Q: What are some of the challenges of working in the field of global nutrition?
“Working in this field requires you to look head-on at extreme poverty. For example, in Haiti, there’s a slum area in Cap-Haïtien called Madeline. People literally buy trash to put on the ground to keep the water out of their homes. You walk through trash to get to people’s homes. You can smell it; it’s not pleasant. But people live there.
“One day, we visited a woman’s home for an interview. She lived in a tent raised off the ground. She sold charcoal for a living, which is tragic because it contributes to deforestation, but it’s one of the only jobs available. She had moved from the countryside. For her, selling charcoal was a stepping stone to a better life.
“She asked us to take our shoes off before coming in. And I loved that. It gave her the dignity she deserved. Absolutely, we’re taking our shoes off before coming into your home! It was a poignant moment at the crossroads of extreme poverty and humanity.”
Q: You have leadership roles in both the Food and Agriculture Research Mission (FARM) and the Center for the Environment. Can you talk a bit about how nutrition research intersects with agriculture and the environment?
“I’ve been working on nutrition my entire career. Early on, I worked on agriculture and food security — how to produce good, healthy foods and ensure access. At WashU, we’ve focused more on the public health side of nutrition. FARM brings agriculture and food security back into the picture. We need both to address unhealthy food systems and drive transformative change. It’s unusual and distinctive to place agriculture within public health, and it’s going to be very cool to have the whole picture of food security here.
“As for the environment, we have no other option but to pay attention to what’s going on in the environment and with climate change. We cannot expect to provide nutritious food to all without considering the environmental impacts of producing, distributing, and consuming food. So, the short-term goal is to infuse our public health research with sustainability — do no harm to the environment as we move forward.”
Q: Why establish a school of public health now?
“At WashU, we’ve been thinking about this for a while — planning strategically. I was the associate dean for public health when we were a program in the Brown School, and I have been involved in the universitywide discussions about establishing a school. The realization is that this is absolutely necessary. In the current political climate, it’s even more impressive that WashU is committing to this. There’s momentum and now an infusion of resources, energy, and remarkable leadership.
“Public health is a very powerful science. It allows us to generate evidence that can have massive impacts. An example I like to give is Florence Nightingale. Many people think of her as a nurse, but she was also a leading figure in public health. She used data visualization to convince the Queen of England to invest heavily in preventing nosocomial — or hospital-acquired — infections by showing that in the Crimean War, more people were dying in hospitals than on the front. That’s transformational change from public health.”
Q: What are your expectations for the new School of Public Health?
“My hope is that we dream big and aim high. We should have big aspirations because it will matter — especially for vulnerable populations. I hope the new School of Public Health upholds principles including integrity, transparency, efficiency, compassion and, importantly, collective action. My view is that we should stay in our lane — stick to our expertise — but come together around the table with other disciplines. We should make an effort to learn other disciplinary lexicons, understand their paradigms, and integrate their metrics into our work. That yields promising novel solutions.
“Among the most exciting parts of the school are the Innovation Research Networks (IRNs). The IRNs are an effort to think creatively — not falling into traditional department structures such as epidemiology here, biostats there, global health over there — but integrating all of it. It goes back to interdisciplinary science. We’re forecasting public health problems on the horizon and marrying that with our expertise to make a big difference.”
Hayley Abshear is the School of Public Health’s digital content strategist and social media coordinator. She brings almost a decade of experience in writing, content strategy and social media marketing to the team.
Tamara Schneider, MPH, PhD, is the senior science writer and assistant director of communications for WashU School of Public Health. She holds a bachelor’s degree in molecular biophysics & biochemistry and in sociology from Yale University, a master’s in public health from the University of California, Berkeley, and a PhD in biomedical science from the University of California, San Diego.