In part two of this conversation, we continue our discussion with Hannah Shultz, shifting from rising food prices to the deeper policy and ethical questions shaping food access in the United States. This episode explores the debate around SNAP restrictions, including whether limiting certain food purchases actually improves health outcomes or instead reinforces stigma and inequity. We also examine how narratives around “healthy choices” often overlook broader structural factors, and what it means to approach food policy with dignity, autonomy, and real-world context in mind.

The views and opinions expressed in this podcast are solely those of the student hosts, guests, and contributors, and do not necessarily reflect the views or opinions of the University of Iowa or the College of Public Health.

Lauren Lavin:

Hello everybody and welcome back to Plugged Into Public Health. This week we’re continuing our conversation in part two of this two-part series led by one of our fellow student hosts, Raj. In this episode, we dive deeper into the policy and ethical questions shaping food access, including SNAP restrictions, dignity in food choice, and where there may actually be signs of progress in this system.

I’m Lauren Lavin, and if it’s your first time with us, welcome. We’re a student run podcast that explores major issues in public health and why they matter to everyone, both in and outside the field. Plugged Into Public Health is produced and edited by the students of the University of Iowa College of Public Health, and the views and opinions expressed in this podcast are solely those of the student hosts, guests, and contributors, and do not necessarily reflect the views of the University of Iowa or the College of Public Health. So let’s get plugged into public health.

Raj Daliboyina:

But I found it very interesting that you said they’re going to tag something like, okay, try to stop people from using SNAP for soda and candy. Is it like trying to make people give healthier choices or is it like they think that people don’t deserve to have soda or candy if they’re on SNAP? Do you think there’s a much more …

Hannah Shultz:

I think you should ask lawmakers to pass these for their opinion on that. The official rhetoric around it is typically that people should not be purchasing unhealthy foods, so it’s a way to encourage healthier choices. Their research on that does not say that works, for several reasons. One, a big one is that people who use SNAP often use their own money as well to buy food. They’re not buying all of their food using SNAP dollars, so they can still buy those foods. They’re just going to be using money that is not part of the SNAP program. Another reason that I get really frustrated with ideas like this is that we actually see across income spectrums that there’s not a huge difference in how people eat. Nobody in the United States has a healthy diet. I think it’s less than 10% of Americans eat in accordance with what is considered a healthy dietary pattern.

So this idea that we’re going to tell some people that they can’t buy certain foods and it’s just because of the money that they’re using to buy it, I find very paternalistic, and frankly, immoral. When we look at things like … There’s so much rhetoric around the bad food choices that we think low income people make. Eating too much fast food, buying too much soda, doing all of these things. When we look at the data, in many cases, upper income people do that more. So we know that most Americans eat fast food multiple times a week. Higher income people eat fast food more than lower income people, but this is the opposite of how we conceptualize this and what our collective rhetoric is about how people eat. So I often think about who is this narrative benefiting? How are we using these narratives to either promote someone’s dignity or take it away?

And on the case of SNAP restrictions, I really worry that it’s just a way to point fingers at other people for making the same choices and decisions that so many of us make. Years ago, I heard someone use a phrase that has really stuck with me, which is the thing that made … And I really apologize, I don’t remember who said this, but I asked what frustrated this person the most. And they said, “Any policy that blames poor people for being poor.” And I think about that all the time. So restricting low income people’s ability to make decisions that they want is just a way to punish them for being low income. And we know so many people who are low income are that way because of structural issues and systemic issues and not because of decisions that they’ve made.

Raj Daliboyina:

Yeah. It’s just that it sounds really condescending when a policy is worded in that way. It might not be the intention of the policy, but for someone who’s receiving it on the other side might find it really condescending to be restricted on not being able to buy candy just because they need some more help because they’re structurally poor. Yeah.

Hannah Shultz:

Yeah. I work at Feeding America, as we mentioned, and I work on a team that’s specifically looking at health and nutrition. So how can we support people, support food banks and sourcing healthier food? And how can we support people who use food banks and food pantries and having healthier food options? And one thing that we talk about a lot is that it’s still important for our pantries to have cake. Yes, we want more fresh produce. We want more healthier options. We have some food pantries that 40 to 50% of what they have is fresh produce, which is amazing. I haven’t been to a grocery store that has 40 to 50% of their product as fresh produce. So that’s just mind-blowing that someone might go to get their food at a place where there’s that much fresh produce.

But we also want to make sure that there is cake. Because if someone has a birthday, they deserve to have a birthday cake. We don’t promote anyone either at food pantries or anywhere else. It’s not healthy to eat cake every day. We all know that. But we’re telling people that they don’t deserve cake on their birthday or they don’t deserve cake to celebrate a promotion or they don’t deserve cake for any number of reasons. I just can’t get behind that. I think people deserve to make choices in what they eat and how they eat. And we can structure our grocery stores, our food systems, our pantries in ways that can help people make healthier decisions while still having the choice to have a cookie or eat ice cream or do any number of other things. I often, when I think about food restrictions to SNAP, I imagine myself going to the grocery store and someone telling me what I can or can’t buy, and it makes me want to scream.

I have been on SNAP. When I was in my 20s, I was underemployed and was on SNAP and it was really helpful for me. Before going on SNAP, I was buying my groceries on a credit card. So I was just adding to my personal debt, which was not a good way to be buying groceries. So having SNAP was really helpful. And guess what? I did buy unhealthy food on SNAP sometimes. Not usually. I usually bought really healthy, nutritious things, but sometimes I wanted a treat and I bought it and that is still the way that I shop now. I just cannot imagine going to a grocery store and someone telling me what I deserve to eat and what I don’t deserve to eat.

Raj Daliboyina:

Yeah. And I think it’s because being healthy is not denying yourself joy. I think that’s where it’s about being balanced in your diet. It’s always called balanced diet. It’s not about just eating broccoli every day and being sad about yourself. It is also about feeling nice once a week or once a month or whenever you want to be, you want to treat yourself eating a piece of cake, having a little bit of candy. So that’s just giving yourself joy and being joyful is really important as a human. And I think also it’s contradictory to the very fact that America is really big on choices, people choosing and making their own decisions without being told what to do or what not to do.

Hannah Shultz:

Well, and it’s an interesting commentary on who we think deserves to make choices and who we think doesn’t deserve to make choices.

Raj Daliboyina:

Yeah. But I know we have talked about a lot of several challenges, but would you say there are any examples where things are actually working well, whether there’s through policy changes, programs, or partnerships? I could say one, I recently researched that there was the whole milk being added to the meals for the children. Do you think something like that is a win?

Hannah Shultz:

It can be. Providing more choice, I’m often in favor of. My issue with whole milk being added is less about the milk being added, but more the way it was added. So that is a result of the new dietary guidelines for Americans. This is a process that is well laid out where there’s a dietary guidelines advisory committee that works for many months to put together a scientific report that is then handed over to the USDA to create the dietary guidelines. The dietary guidelines are supposed to be rooted in the scientific report and unfortunately the current dietary guidelines are not. So the whole milk being added comes out of those dietary guidelines, which is not rooted in the scientific report. So I am in favor of more choice generally. I also think when we’re making policy changes, we should do it based on evidence.

Raj Daliboyina:

But do you see any silver lining anywhere where policy is actually moving in the right direction or there is some kind of a partnership between policymakers and public health people who are trying to guide the policymakers?

Hannah Shultz:

I think there’s a lot of really exciting things happening on more local scales. I’m involved in an organization in Iowa City called Field to Family. We help connect local growers and producers to families, but also to institutional purchasers. So schools and other large purchasers like that. There are a lot of organizations like this around the state and around the country.

A few weeks ago, I was able to attend the Healing From the Ground Up Summit and I can’t remember if it was in Waterloo or City of Falls. I don’t know where the border is there, but somewhere up in that area and it was hosted by the Iowa Food Systems Coalition and the University of Northern Iowa. And it brought together people from across the state who are really committed to building better, stronger, healthier, more equitable food systems. And after being in that group for two days, I left really motivated and really excited to see some of the changes and commitments that are happening, not only in research centers or places that you might think of as being really leading into this progressive food system, but also in smaller communities.

I met a school nutrition director who has been doing her own research to look at buying ground beef through commodity programs that schools have access to or buying ground beef locally. And the ground beef locally might have a higher price tag, but they actually get more beef out of it because there’s less filler and less grease coming out of it. So on the whole, they actually save money by buying the ground beef that costs more. So there’s lots of really interesting studies like that. And I think as more and more, or I guess anecdotes like that, and there’s more and more of that happening. And as these people start talking with others, I think we’re going to see more really cool things happening. I think coming out of … One thing that is really exciting is during the pandemic, school meals were free for all students, which was incredible.

It lifted a lot of people out of childhood poverty, a lot of children out of childhood food insecurity. And then since the pandemic, many states have instituted that so that it’s continuing. A lot of states now just provide free meals for students. It’s not based on income. It’s any student who goes to that school can eat lunch and eat breakfast. That’s a huge win. There are a lot of states who saw that who experienced decreases in child food insecurity during the pandemic who have not continued that policy. And I think that’s a really interesting commentary on who we think deserves to eat and why when we have examples of policy that works, are we not continuing those? So I think looking at those states who are continuing to fund and find ways to do these programs that we know work makes me excited. And I think progress takes time.

Our food system has changed so much over time, and I think there are some really exciting things coming up, but in many cases it’s happening at a local level and not at the federal policy level.

Raj Daliboyina:

Where is Iowa when you describe on the schools, the states that continued the free meals and did not continue the free meals?

Hannah Shultz:

Iowa is not continuing free meals.

Raj Daliboyina:

Okay. Oh, good to know. I like that you said this progress takes time and good things are happening. So looking ahead, what changes or innovations in policy or practice are you most hopeful about, especially with regards to one level populations? Hope is a very big word these days.

Hannah Shultz:

Yeah, I’m thinking about that. I tend to be very cynical, so I’m trying to put on my optimistic hat. I think there are some cool things happening in smaller scale. I work in food as medicine a lot, so thinking about how we can use food to prevent and treat chronic disease. And there are a lot of things happening connected to food related to medical care that I didn’t even notice that I had participated in or seen, but until being more deeply embedded in this work work just flew by and I didn’t notice. So one example is there’s a two item screener for food insecurity called the Hunger Vital Sign. It has two very basic questions. I have since seen the studies and reports and data around this, noticed that every time I go to the doctor at the University of Iowa hospitals and clinics, that’s part of my intake is the hunger vital sign to item screener.

I’m sure that’s been there much longer than I have been doing this work, but I just hadn’t noticed it before. So I think there are a lot of things happening just in our general day to day structurally that are contributing to helping us understand who is impacted by food insecurity, who could benefit from some nutrition interventions, that for those of us who are food secure, who are fortunate enough to be food secure, it just goes right by us because it’s not going to impact us. So now every time I see that question on intake, I get excited. And I really want to know if I said, if I screened differently than I do, if I were food insecure and that came through on the screening, would my doctor have a conversation with me about that? You know how medical appointments are. They’re very short and very rushed, so I’ve never actually asked a provider that, but I’m really curious what the fallout of that is or what the followup of that is.

So I think that’s one area that’s exciting is trying to … I’m hoping things like that also help to reduce the stigma around it, that it just becomes a regular part of conversation. Are you able to provide food for your family? Do you ever worry about not being able to provide enough food for your family? And realizing it’s not a moral failing. It’s actually a societal failing that people are not able to buy food. I also want to go back to a comment you made about joy. I come to thinking about food and the world of food through joy in hospitality. I have a story from years ago where a chocolate cake with strawberries really just changed my day and made my day so much better. And thinking through what that situation was and that at a time when I was feeling sad and lost and just disconnected, how much that made me feel loved and welcomed and cared for.

And also understanding that there were strawberries on that cake because it was strawberry season. And I was in Peru, in a small town in Peru where we ate with the season. So when I asked for that cake later, it wasn’t possible to get strawberries on my cake because strawberry season was over. So it really helped me understand how we eat and why we eat. And another thing that’s making me really hopeful is I think there is more talk about the cultural importance of food. So we have to eat food to survive. We know that food is fuel, but food is not only fuel. Food is how we connect with people. Food is how we make meaning. Food is so important for so many different aspects of our life. And I think that recognition and that understanding is becoming more recognized and more talked about, and that makes me really happy.

One of my least favorite phrases is ethnic food. Every time I hear ethnic food, I want to scream, partly because I think many people use ethnic food to mean any food that a typical white American would not consider their normal food. So I think it’s just a way of othering food, when in reality, all food is ethnic food in some way, but there’s often been this idea that eating “ethnic food” is unhealthy. And we know that’s not true. We know many other countries and cultures outside of the United States have much healthier diets than we do. The standard American diet is sad. That’s the acronym, and I think it’s really telling. But thinking about indigenous food ways, or we see in many cases, a lot of immigrant populations are healthier than native born populations because their food ways are more nutritious and more life sustaining and healthy.

And I also think there’s finally some recognition of that, that there are ways to be healthy and eat healthy food regardless of your cultural background, which I think is a really big win, and I hope that continues.

Raj Daliboyina:

Yeah. I know if ethnic food, I know you feel like that, but I think ethnic food just means tasty food. That’s how I see it. So if someone is, “Oh, you make ethnic food.” I’m like, “Yeah, I’m tasty.” And I would say that even if you’re not considered healthy, we are definitely happier with our “ethnic food.” And I know food is really a joy. And as a guy who has claimed his mother’s spice box as a 15-year-old and got really judged for it, but it’s an art that stimulates almost most of your major senses. You look at it, you crave for it, you smell it, you taste it. The sounds of making food can be really enduring because you grow up in a household where someone is making food for you. So it’s nostalgic, sometimes melancholic. So yeah, food is more than just something that you consume to keep yourself alive.

Hannah Shultz:

I also think it’s interesting we’re having this conversation during Holy Week, the week leading up to Easter for Christians. And just a week or two following the end of Ramadan, so many religions have really strong food components. So there’s also this religious and sacred understanding that food is more than just fuel. Thinking about almost every religion has some form of feasting and some sort of fasting. We don’t always call it fasting or feasting, but I grew up in a Christian family and a Christian community and communion is a way of breaking bread with one another and feasting together and giving up food during lent is a way of fasting and what is the spiritual practice of fasting. And many other religions have similar practices and food is joy. It invokes all of your senses. It’s also spiritual. It’s also, it is fuel, but it’s not only fuel.

And I think so often when we think about food policy, we’re only thinking about the nutrition components and what that means without realizing that by denying people the ability to choose to eat the food that makes sense for them and is meaningful for them, we’re also denying their humanity.

Raj Daliboyina:

I think it’s a very clinical way of looking at policy if you’re … And in a way, dehumanizing it a little bit. But on a good note, I think I should bring in the … When you mentioned the survey about food insecurity, the cancer center where I used to work during last semester, we had the survey and the outcome of the survey would be if any patients would pick that they are not able to provide for themselves, we would have a package, a food package for them that would be provided by the center.

Hannah Shultz:

That’s great. That makes me really happy.

Raj Daliboyina:

Yeah.

Hannah Shultz:

Saying someone who has cancer, who’s going through cancer treatment, that just adds another layer of challenge. Again, chemotherapy can make you feel really sick and make it hard to do other things. And if you don’t have a really strong support system around you, finding a way to feed yourself and get the nutrition and that fuel that you need to help heal your body is going to be more and more challenging.

Raj Daliboyina:

Yeah. I think that was just … You go cancer center. Yeah, shout out to that. So finally, I think what is one key message that you would like our listeners to take away from this conversation?

Hannah Shultz:

I’m going to give you two.

Raj Daliboyina:

Okay.

Hannah Shultz:

So I mostly grew up in Mount Vernon, Iowa, which is about half an hour away from Iowa City, a little less. There was a restaurant there called Lincoln Cafe, and their tagline was, “Food is important.” At the time, if you got a tattoo that said food is important, you could have free French fries for life. It closed, so I’m not really sure how that works now, but there’s a spinoff of that with new owners and a new concept. The Lincoln Wine Bar, they still use that tagline, Food is important. So food is important is one big message.

Several years ago, I was actually hosting a podcast and I was able to interview Shelley Buffalo who was at the Meskwaki Food Sovereignty Initiative. She was there at that time. I don’t believe she’s there still. And most of the way through our conversation about talking about indigenous food ways and why it’s really important to reclaim and recognize the food ways of your family and your ancestors, she said, “Food is everything.” And that has also stuck with me. I bet I think about that every day. So food is everything. Yeah, that’s it. Nothing to add.

Raj Daliboyina:

Yeah. Reminds me of a very nerdy thing that I need to bring in Harry Potter here. In that magical world, the only thing you can’t produce with your wand is actually food.

Hannah Shultz:

Really?

Raj Daliboyina:

Yes. You can’t just create food. You can only modify it. So even in a very children friendly magic world, food you can’t make it out of thin air. It takes a lot of effort, and that’s why it’s really important.

Hannah Shultz:

I am not a Harry Potter fan, so I did not know that, but I am now going to think about how to incorporate Harry Potter into future classes, so thank you.

Raj Daliboyina:

Oh, yeah. It’s going to be a lot of discussion around it because there’s a new thing coming out. That’s why I had to bring in, there’s a new TV version of it showing up.

Hannah Shultz:

Really?

Raj Daliboyina:

Yes.

Hannah Shultz:

Huh.

Raj Daliboyina:

Yeah. There’s so many things that are distracting us from the stuff. On that note, I would say that’s our episode for this week. A big thanks to you, Professor Hannah, for being with us today. It was really fun and a really enlightening conversation with you today. I hope you had a great time with us and I’m sure our listeners had an amazing time with us.

Hannah Shultz:

Thank you for inviting me.

Raj Daliboyina:

Great. That’s our episode. And this is Raj signing off. Hope everyone has a great day. Thank you.

This episode was hosted and written by Raj, and edited and produced by Lauren. You can learn more about University of Iowa College of Public Health on Facebook. Our podcasts are available on Spotify, Apple Podcasts, and SoundCloud. If you enjoyed this episode and would like to help support the podcast, please share it with your colleagues, friends, or anyone interested in public health. Have a suggestion for our team, you can reach us at cphgraduateambassadors@uiowa.edu. This episode was brought to you by University of Iowa College of Public Health. Until next week, stay healthy, stay curious, and take care. Thank you.