Tag Archives: social justice

Public Health in Action – Predictably Irrational



Richard H. Thaler is a kind of a big deal, and if you don’t know, now you know.

Professor Thaler, who teaches at the University of Chicago Booth School of Business, was awarded the Nobel Memorial Prize in Economic Sciences last month for his contributions to the field, specifically in understanding human behaviors. His life’s work illustrated that humans act irrationally in consistent ways that can be predicted and modeled. The implications of his work transcend all sectors. In 2008, Thaler co-authored “Nudge” and encouraged governments to use their insights for public good. Enrollment in retirement savings accounts significantly increased with a slight change: enrollment was the default option, which forced people to “opt out” if they weren’t interested. Observing and prioritizing human behavior, such as what behavioral economists describe above as “inertia”, over standard economic theories of rational actors, has made all the difference and has created myriad pathways into practical application.

Take the Center for Advanced Hindsight (CAH) at Duke, founded by Ted rockstar Dan Ariely. It houses decades worth of social and behavioral science knowledge, researchers AND entrepreneurs all under the same roof. CAH’s current focus has been working with startups that address financial security or health behaviors.

Public health, like economics, was built on the assumption that people behave rationally at all times. Thaler and Ariely have challenged those assumptions time and time again. We, as public health professionals, need to lean into uncertainty, especially when in matters of health behaviors. The populations that are most at-risk and need public health folks the most don’t live in ideal conditions. They may or may not have stable income, housing, transportation or have access to their next meal. If we can’t assume that people will behave rationally in a “normal” situation, we can’t assume they would behave rationally in a “distressed” situation.

Those are exactly the questions that crossed Allison Sosna’s mind at various points in her life and she shares her experience with us, below.


Allison Sosna, aka Chef Alli, is the founder of the MicroGreens Project


Me: How did you end up doing the work that you’re currently doing?  Describe your journey to your current role as founder of MicroGreens.

Allison Sosna: I was in college and on the rowing team. Food, at that time, was synonymous for fuel that my body needed to perform. Sure, I ate healthily – lots of veggies, carbs, and protein (mostly chicken and eggs) but I did not give it any further thought. In my junior year, I lived in Italy. It was there that I was enlightened by the power of food on a community and would therein change the course of my life. I lived in a small neighborhood outside of Rome where residents all knew one another. They knew the barista and asked him how school was going. They wanted to know if the butcher’s cold had gone away. Everyone cared about one another and food was clearly the denominator of affection. In Rome, I realized that I wanted to do something with food and people. I did not come back wanting to be a chef, but, I saw that as a way for me to create food and community. So, I volunteered as a prep cook down the street when I got back to DC. I loved it. I loved the physical exertion that went into working on the line during dinner service. I loved wearing a uniform and feeling part of a community; a diverse community of women, men, people of different races, and different backgrounds with different stories. The sociologist in me was in love.

Shortly after, I went to culinary school, had a jaunt in fine dining, and then got a full time job at Dean and Deluca. While I learned a lot there, I realized I wanted to do more with my community; I didn’t want to feed rich people anymore. I had veered off course from the initial eureka moment. Leaving that job, I landed a job at a non-profit called DC Central Kitchen overseeing Fresh Start Catering, the social enterprise of the non-profit. When I started, we were providing the food services for a private school for at-risk boys, but it was generic and too similar to the lackluster school food that America is known for. Seeing such, I brought in healthier options, started making food like meatballs in-house, a salad bar, and marketed our vegetables to be more “fun” by using them as anecdotes. For example, I would say that foods like roasted carrots was a veggie that basketball players ate to perform better on the court (It’s true!). We had a lot of success there and that led us to win a food service bid for 8 DC Public Schools. We served thousands of meals a day to low-income kids who didn’t have easy access to fruits and vegetables (in 2010). Kids, of course, were coming to school with chips and soda, but I wanted to do something about it. I thought about the parents or guardians that were at home with the kids. How did they eat? Was it influencing their kids’ eating behaviors? How could I shift behavior? What I drew from all these questions was the question of their budget. How does a low-income family eat healthily? If I was a parent on SNAP, how did I use my money? Did I know how to cook? Did I know what to buy? The majority did not. As a result, I started MicroGreens and the Allison Sosna Group (ASG). ASG is my consulting “firm” for menu development, food service consulting, and private chef services. I had left my job to start MicroGreens, but also needed an income! I continue to consult today.

MicroGreens teaches kids to cook on a budget of $3.50 per meal, per family of four. The program has graduated over 150 kids across the country, with the help of community leaders that want to make their neighborhoods healthier. MicroGreens can be implemented anywhere, for any income level, for any length of time, and with any age group.

I moved to New York City in 2013 and while I was still working on MicroGreens and taking chef jobs, I needed an income and a job I truly cared about. So, I applied to jobs in public health nutrition with a focus on project coordination. After a year and a half of coming close to many jobs (NYC is tough!), I went back to school for a Master in Public Health degree.

Over the last year I’ve been intrigued with hospital food and its obligation (or lack thereof) to ensure that everyone has access to healthy food – from its staff to patients and also to visitors. While I am not trained in therapeutic meal development, I am trained to assist in cafeteria food services. I’ve been fortunate, by way of hustling and networking, to be part of the NYC Department of Health and Mental Hygiene’s Healthy Hospitals and Colleges Initiatives. We are working with food distributors to get chefs and food service directors healthier products for their hospital or college. It’s an incredibly rewarding experience to be on the other side helping the chef. I would have loved this help when I was working.

Me: What inspires you on a daily basis, especially when things get hard?

AS: On a daily basis, knowing that I am a part of something larger gets me through tough times. I know inherently that I am making a difference by bringing in healthier options for people. Every time a consumer replaces an unhealthy product for a healthier option, I know that I helped facilitate that. And as we all know too well, establishing healthy behaviors takes time.

As a student with a part-time job, I’m constantly moving around, not being able to cook for myself nearly as much as I want to, paying copious amounts for transportation, and don’t have a social life. But, I know I will, and am looking forward to graduating next year, when I can stay put and focus on doing work for my community full-time.

Moreover, the people I work with are incredibly supportive and that support allows me to focus on doing well in school and do an even better job at work.

Me: Tell us more about MicroGreens. How did you get into the social impact space? Why is it important to reach underprivileged populations?

AS: We must think about sustainability when we design programs. That being said, MicroGreens was originally going to be funded by a fast casual restaurant I was going to open. It would serve as part of the capital going into the non-profit. I’ve always believed that business needs to be part of the equation when designing interventions such as MicroGreens. I got 70% funded for the project but then had to let it go. I came close though and I’m proud of that.

If we do not focus on creating upstream programs first, we are doing a disservice to our communities, whether they are privileged or not. It truly does come down to the old adage “Give a person a fish and feed them for a day. Teach a person to fish and you feed them for a lifetime.”

One of the most impactful experiences I had with MicroGreens was not related to cooking. A student who had taken the class before was walking by our teaching classroom and walked in to say hi. He walked over to one of the kids who was having trouble cutting carrots (cutting carrots is hard!) and said “If you ever need help, let me know. I’m MicroGreens alumni.” Not only had this student learned skills and put them into action, but the program had instilled pride and confidence to teach others. There was a kindred relationship forming, a mentorship. That made me so proud.

Me: What are the current needs in New York City as they relate to social determinants of health (i.e SES, poverty, access to care, transportation, safety, etc.)?

AS: 1 in 9 residents have diabetes in NYC. Communities have little access to healthy foods blocks from affluent neighborhoods with endless healthy food choices. Soda ads saturate low-income areas and schools are without outside playgrounds. All determinants of health are so greatly intertwined that it can be overwhelming, especially for public health officials trying to make a difference. We talk a lot about that at school. How do we design interventions that encompass all contextual factors? First, by working with community stakeholders.


Public Health in Action – Heather Freeman Believes We All Have Capes


Heather Freeman, MPH
Founder, Gutsy Girl Club

As I described on a previous post, the internet is one of the easiest ways to connect with someone else with similar interests and views.  Heather Freeman of the Gutsy Girl Club reached out to me after reading one of my blog interviews.  After checking out her website and understanding the concept of how she was impacting the world around her, I knew that it would be a great addition and offer a unique perspective – empowerment.  Empowerment is essential in sustaining new behaviors and programs long after funding resources have dried out.  Empowerment passes the torch to individuals and allows them to want it for themselves.  It shifts from motivation from extrinsic to intrinsic; it places ownership and accountability back into the individual’s hands.   Her concepts parallel the views Paulo Freire advocated for: an interactive form of education and social justice for everyone.

Now to my questions for Heather!

Me: How did it all start?  Where did you get the idea from?

Heather: The Gutsy Girl Club (GGC) was inspired by my own personal journey and struggle with self-confidence.  At a very young age I had a strong sense for who I was.  I loved to laugh, run, be outdoors, and simply enjoy the world and people around me.  But as I got older that high level of confidence started to crumble and I found myself having a difficult time finding my way.  My parents divorced when I was in 5th grade and my mother, whom I needed the most was caught up in her own swirl of mess, unable to help me navigate through the precarious teen years ahead.  On the inside, I felt my life spinning out of control.  However I didn’t dare show this vulnerability to the outside world.  Instead, I hid my insecurities behind the one thing I was well known for – my smile.  I made my way through the next critical season in my life not letting on of my inner truths & struggles to anyone.

As difficult as this early experience was, I learned from it and slowly found my way back to myself.  With the help of a few key superheroes who showed up in just the right time, I began the journey to reconnect with my confidence.  After spending over 10 years working in health promotions I now help others reconnect with their true confidence through the GGC so they too can experience the joys of taking the lead in their health and wellness.

Me: What inspires you on a daily basis, especially when things get hard?

H: We are all superheroes, sometimes our capes just need a little mending.

The moment my first daughter Bailey was placed in my arms, I experienced a huge shift – an “Ah ha” moment so to speak.  Cradled in my arms, I looked down at her and realized I was in a very powerful position in terms of her survival.  This little girl was helpless and at the most simplest level of being; her life depended upon me.  Regardless of my own experiences as a child, my daughter depended on me to be her superhero.  From this moment forward, I was not only responsible for myself, but I was also responsible for nurturing my daughter’s health until she was ready to be her own superhero.  I also realized that survival wasn’t good enough.  I wanted her to thrive in this world.  I wanted her to have the most magical and extraordinary life.  I wholeheartedly believe every mother has this desire for her newborn child.  I truly believe that we all want a life for our children that is better than our own.  While holding my daughter in my arms, I realized that was my moment of truth.  There have been many moments where this truth has been challenged, but I continue to make the choice to do things differently.  There is not a day that goes by when things don’t get hard, when my work asks me to stretch and go beyond what I think I can give.  It is within these moments that I remember that little girl in my arms and that original moment of truth.  This is what inspires me to help the millions of other little girls out in the world who deserve the same opportunity for an extraordinary life.

Me: What do you think it will take for our society to view health more seriously?  As in, why is health lower in priority to careers and education and relationships?

H: Wow, what a great question. While we typically tend to get caught up in the complexity of the current situation of our society’s health, I believe the answer is quite simple and comes down to a simple choice.  When we choose to say to yes to health we make a mental shift, a shift which precedes a behavioral shift of doing more of the things that support health and wellness.  The choice is available to each of us many, many times each day.  If more people choose to say yes to health more often, then not only does the individual experience greater health in their own life, but it also impacts the people in their life in positive ways.  This creates a ripple effect which indirectly affect communities in which they live and ultimately the greater world.

Me: What are some important insights that the attendees get from your camps?  What are some that you and other staff members observe?

H: The Gutsy Girls Empowerment Camp is one of my favorite programs because evidence shows that by the age of 9 a girl’s self-esteem has peaked.  Which means that during the critical years of emotional development that lie ahead of her, she is at a disadvantage and is less likely to be able to make the smartest choices for her safety, health, and well-being.  The Gutsy Girls Empowerment Camp is all about increasing a girl’s self-esteem and confidence before this critical period hits by seeing her for all that she is and affirming her emerging talents and passions.  One of the biggest insights campers get is ‘hey, they get me here’ and “I am accepted because of who I am.” Girls of the Gutsy Girls Camp don’t have to act perfect, they don’t have to do art that looks like it should be hung in a museum and they don’t have to say the perfect things.  Girls at camp get to be kids, create wildly, and share themselves freely and honestly.  Moms love having a place their daughters can go to for this kind of support.  And through ongoing conversations with moms about the Gutsy Girls Empowerment Camp, I’ve learned that moms want to be a part of the action, too.  That’s why we are bringing the fun to both moms and their daughters through our GGC activities that are starting up this year.  These Club activities will give moms the chance to join in on the fun while at the same time strengthen the bond between her and her gutsy girl.

Me: What are the current needs in your city as they relate to social determinants of health (ie SES, poverty, access to care, transportation, safety, etc.)?  Social determinants of health are any factors that directly or indirectly affect health.  For example, being homeless could cause stress and malnutrition which could drastically affect one’s health.

H: While the GGC is growing to serve a national audience, our home base is in Tolland, CT.  Tolland is a community, which based on the Health Equity Index (a web-based assessment tool developed by the Connecticut Association of Directors of Health) rates average or above average on the social determinants of health (civic involvement, community engagement, economic security, education, employment and housing).  There are however groups of people within this community who for instance do not have equal access to healthcare and who experience transportation and housing issues.

The GGC is committed to building on the strengths of this community by empowering girls of all ages to take charge of their health.  A gutsy girl who believes in her power is able to confidently make healthy choices which not only serve her, but benefit the people around her and the community she lives in.