Five Fellows Collaborate to Tackle the Public Health Implications of Industrial Food Animal Production

These five CLF-Lerner Fellows were doctoral students at the Bloomberg School over three decades, and each has remained engaged with the Center for a Livable Future. Moreover, the distance in years hasn’t hindered powerful collaboration on one of the Center’s highest priorities, addressing the harms associated with industrial food animal production and exploring solutions for it.

Keeve Nachman and Lance Price are the elder Fellows, earning their doctorates, respectively, in Health Policy & Management and Environmental Health and Engineering (EHE) in 2006. Meghan Davis earned her doctorate in EHE in 2012, Joan Casey in EHE in 2014, and Gabriel Innes is one of the more recent Fellows to earn his doctorate, in EHE in 2020.

All five are well into their careers now, but they return to each other for mentoring, networking, and research collaboration. While they’re located across the country they’re united in their quest to generate evidence that can inform policy change and support a shift away from our food system’s reliance on the industrial food animal production model. 

In the last year, this fabulous five have published several papers on the relationship between food animal production practices and antimicrobial resistance, a topic that the Center has continued to help bring to the spotlight over the last 20 years. The first of these papers was published in 2021. All three papers use government data for bacteria isolated from packages of meat from the grocery store, referred to as “retail meat” in the papers. The team used information from the package labels to learn as much as possible about the production origins of each package of meat. They used that information in tandem with data on bacterial sampling and antibiotic resistance testing, allowing them to answer key food safety and policy-relevant questions, such as “Does meat with the labels ‘United States Department of Agriculture Certified Organic’ or ‘No antibiotics ever’ contain fewer antibiotic resistant bacteria than conventionally produced meat?” and “Does how far a package of meat travels between a meatpacking plant and your grocery store have implications for how likely the package is to contain multi-drug resistant bacteria?”

“Our complex animal agriculture industry is not a monolith in animal husbandry, processing, and product handling practices. These studies begin the journey to help consumers understand potential exposures when they’re at the meat counter,” says Innes, a health science policy analyst at FDA, Center for Drug Evaluation and Research. “Further, we hope that our work continues the conversation and collaboration with industry and policymakers to identify and quantify factors that could attribute to antimicrobial resistant bacteria development and dissemination among the general population.”

The poultry industry has made quite a few changes to how they raise chickens, likely in response to consumer demand, state and federal statutes, and the work of  advocacy organizations that have been informed by evidence generated by CLF’s research teams. Drugs that are important to human health are less likely to be misused by the US poultry industry, which means that there is hope for preserving their usefulness for fighting human infections. The swine and cattle industries are moving more slowly—it remains to be seen if they will follow suit. 

Both Davis and Innes are veterinarians, bringing special perspectives and insights with regard to animal health, welfare, and husbandry to the research done by the team. In fact, Davis was Innes’s faculty adviser and recently co-authored a guest essay in The New York Times about bird flu virus H5N1 and how we might protect the dairy work force from an outbreak.

“The large-scale nature of industrial food animal production, including large farms in the dairy industry, can mean that farms or farm families employ sometimes vulnerable workers who are migrants or immigrants to assist,” says Davis, who currently directs the Johns Hopkins P.O.E. Total Worker Health® Center in Mental Health. “These workers may have language barriers or fears of deportation—with an outbreak like the dairy strain of H5N1, an avian influenza virus, this means that both veterinarians and public health officials need good access to these workers to understand what is happening with the cows and to help protect these workers from the hazards they face.” 

In addition to collaborating on these three papers, they’ve also joined forces in various combinations to produce peer-reviewed research on antibiotic use policy in the United States, as well as agriculture stakeholder perceptions of antimicrobial resistance. (All research is listed at the end of this article.)

“Policies are our best tool to create system-level change to reduce health risks from livestock production,” says Joan Casey, who is an assistant professor of Environmental and Occupational Health Sciences at the University of Washington in Seattle. “Not all policies are created or implemented equally, so it’s important to study them to determine what works best. Plus, policies offer natural experiments to help us understand causal relationships between industrial food animal production and population health.”

Shawn McKenzie, the CLF’s director, says, “The collaboration on these important papers is a wonderful illustration of the lasting effect and enduring value of the CLF-Lerner Fellowship program. It’s heartening to see multiple generations of fellows with different specializations and institutional affiliations continuing to work together to advance public health and food systems change. It’s a great testament to the commitment each of our fellows has made addressing public health challenges and improving food systems.”

“Becoming a CLF-Lerner Fellow in 2004 was an enormous honor and afforded me an amazing opportunity to work on some of the world’s most pressing public health and food system issues,” Nachman says. “What I didn’t realize at the time was that the fellowship was just the start of a decades-long collaboration with other fellows focused on using public health science to fix the food system.” 

At a recent lecture at the Bloomberg School, Price cited research by these fellows and said, “We started collaborating together, and 17 years later, we’re still collaborating.”

The collaborations resulting from the fellowship are part of the legacy of the Center for a Livable Future, he contends. Speaking to the latest generation of CLF-Lerner Fellows, he predicted that there’s a high likelihood that bonds that they are forming now will last for the rest of their lives.

All five of the fellows—Casey, Davis, Innes, Nachman, and Price—collaborated on “Impact of a Statewide Livestock Antibiotic Use Policy on Resistance in Human Urine Isolates: A Synthetic Control Analysis,” published in Environmental Health Perspectives in 2023.

The fellows have collaborated in different combinations to produce even more peer-reviewed research relevant to antimicrobial resistance and industrial food animal production:

Casey and Nachman collaborated on “Limitations of Reporting Requirements under California’s Livestock Antimicrobial Restriction Law,” published in Environmental Health Perspectives in 2024.

The same team, Casey and Nachman, created a corresponding policy brief for the Stanford Woods Institute for the Environment, “Monitoring Antimicrobial Use in Livestock Production: Learning from California,” published in 2024.

Davis, Innes, and Nachman collaborated on “How animal agriculture stakeholders define, perceive, and are impacted by antimicrobial resistance: challenging the Wellcome Trust’s Reframing Resistance principles,” published in Agriculture and Human Values in 2021.

Casey, Davis, and Nachman collaborated on “A review of the effectiveness of current US policies on antimicrobial use in meat and poultry production,” published in Current Environmental Health Reports in 2022.

Casey, Davis, Nachman, and Price collaborated on “Impact of California’s Senate Bill 27 on Antimicrobial-Resistant Escherichia coli Urinary Tract Infection in Humans: Protocol for a Study of Methods and Baseline Data,” published in JMIR research protocols in 2023.