Title: Navigating the Intersection of Healthcare, Data, and Sustainability: Allie Gaines ‘14 [00:00:06,280] CHRISTA DOWNEY: Welcome to the Engineering Career Conversations. I'm Christa Downey, Director of the Engineering Career Center at Cornell University. [00:00:14,240] TRACI NATHANS-KELLY: And I'm Traci Nathans-Kelly, Director of the Engineering Communications Program. We are excited to bring you this forum where we will host lively conversations that we hope will inspire you. We had the chance to catch up with Allie Gaines, a Cornellian who completed her undergraduate degree in 2014 from ISST. With her many interests, she works on issues of food, food production, data analysis, epidemiology, the health of the planet, sustainability, and more. Since leaving Cornell, she's gone on to do incredible work across several disciplines. And on the day we spoke, she was getting ready to defend her Ph.D. in a couple weeks. She's working full time right now in consulting. Listen in, as we can learn so much from Allie. Thank you for being here. [00:01:09,760] CHRISTA DOWNEY: Hi, Allie. It's good to have you here today. [00:01:12,959] ALLIE GAINES: Hi, Christa. I'm excited to be here. [00:01:15,420] CHRISTA DOWNEY: I'm excited to share your story. And I'm hoping you can start by telling us a bit about your path. How did you get here? Maybe some of your degrees along the way, as well as your current work and your most recent work before that, because I know you're in a new position. [00:01:30,879] ALLIE GAINES: I graduated Cornell in 2014 and I was in the information science systems and technology major. Right after school, I started at Athena Health, which is an electronic medical record company in Boston. I'd always had an interest in health care, but I hadn't really explored it. So I was really excited to do that in my first job. On that team, I worked on data interoperability. I had a pretty technical role. After a few years, I realized that even though I could understand the technical side and was prepared for all of that from all of my studies at Cornell, I really liked working on the healthcare clinical solution side. I was put on a project that had to do with cancer registries and making sure we sent all of our medical record data to government cancer registries. And I just thought, I was seeing how we were tracking and we get those statistics that you see on the news. And I was like, this is something I feel like you can really do a lot with the information and really use data, healthcare data, to make a big difference. If we see what's the prevalence of diseases, what can we do about that? What is common about the people who are being diagnosed with these things? I did then spend a year doing consulting where I was getting a bit more of the supplied experience. And then after that, I went on to do my Master's in Global Health and Epidemiology. And I was at the University of Oxford, was an awesome experience to get, to go overseas. I always like to say you get to dress as Harry Potter when you take your exams, which is the wildest thing. But it was really fun to go over there. Yeah, I did my Master's in Epidemiology and I actually got to focus more in healthcare and learning about how people's habits, I guess both their daily habits, what their community is like, and also their nutrition affects diseases. And this all led to, we looked a lot at different cancers and different disease patterns. That was where I got to learn more about this one specific path. And then from there, I actually then never thought I would do this, but I got the opportunity to do my Ph.D., and this was also in epidemiology. And again, now I focused even more on nutrition and epidemiology. Which is very appropriate with a lot of the conversation that's happening today in the world. It also focused on climate change and how nutrition and the food that we're eating, not only affects our public health outcomes but also affects our planet. That was my last four years. Up until October, I was doing this work which was creating a method to calculate the greenhouse gas emissions to do with packaged foods. Which was really something that was, I think, really, really interesting and really applicable. We've all seen, I mean, we all know how much we go and grab a packaged snack and they're everywhere. They're everywhere from hospitals to schools and just to wherever you're hanging out at the mall. And that has a big impact on both our health and the planet. That was a really cool experience. And I got so far in the Ph.D. that we got to create a potential label for foods and we pitched that to the Australian government. So this is something we don't see a lot in the US and has been something that's really cool for me that I've gotten to explore since I did a lot of my work outside of the US. Where we have, or where some countries have a little less, let's just say red tape in getting this kind of stuff done. There's potential that we could use that food label so that not only can industry and different companies see how their products compare, but also consumers can hopefully see what are better choices. Not only for their health, but for the environment. That's all my educational background. And then in the last month I've gone back to full time work. I am working at a company called Exponential Data as a Product Manager in Healthcare and Business Strategy. And this is a really cool company that sort of brings together a lot of my background. It's specializing in machine learning and AI technology solutions to provide industry leading products and data products in the healthcare industry. Or at least that's where I'll be working. So we'll be looking even more at how we can use data that already exists in companies, in healthcare companies, so whether that's pharmaceutical companies or electronic medical records. And how we can improve upon the data they already have. And build knowledge networks and knowledge graphs to help create solutions for helping in promoting them for better lives and better cures for patients and whatever their outcomes are. [00:06:55,750] TRACI NATHANS-KELLY: That sounds really amazing. So in your current position, you're trying to untangle or weave a new web of some sort, right? Of all of these different kinds of inputs. So what does that mean for you day to day? What, what does it look like for you? [00:07:09,750] ALLIE GAINES: Yeah, so I mean, the exciting thing for me of getting to have this change from my Ph.D., as cool as an experience at the Ph.D. was, I worked on one thing really, really in the weeds for a long time, which I'm so proud of. But now in my day to day, we have multiple projects going on. So I listed a few of them, but I can go into a little more detail. But we have pharmaceutical companies, so we can see how different drugs are performing on different populations and compare drug information. And also one really cool thing that I think we're doing is looking at co-morbidities. And that's when you have two diseases at the same time. How commonly people are being prescribed two of the same drugs. So that we can get a better understanding of what kinds of issues are working together and how we can get ahead of that. And then also where I find things to be a bit more interesting is on the clinical patient data side. So you get to learn more about before the outcomes. So what are the demographics of these people? What is more of the patient journey and what's in common between these people? And, you know, that's where my original interests lie with respect to nutrition. I think that's a really key part of where we're at today with some of the public health issues we deal with. So day to day, it's looking at the data that we have from these companies, how their structures are, or seeing how efficient they're currently working. So that they can combine the types of data that they have. You know, one thing in the healthcare data world is there's a lot of siloing of data. So we get to see, you know, we have all these electronic medical records now and we have patient data, and then we have outcomes data. But being able to look at it together and link up different systems is still something that we're not doing that well across the board. So that's a lot of what we get to look at, seeing all these different pathways. And then we're trying to optimize how we can combine and improve the way we analyze the data that already exists. [00:09:28,480] TRACI NATHANS-KELLY: I'm just sitting here thinking about all of these elements and I'm glad there's people like you doing it. I'm not even sure my head can hold all the wonderful things that you're trying to accomplish here. So I really appreciate that explanation so much, so much. [00:09:45,054] CHRISTA DOWNEY: Yeah, I agree with Traci. I'm also thinking about you are an information science student here at Cornell and that's a major that opens people up to, you can work in any industry, right? And so you have this skill set that you can take and apply to any interest area which can be exciting. It can also be overwhelming sometimes if you know your skill set is applicable in so many different places, but you don't know where you want to focus. And somewhere along the way you got on this path with human health and nutrition. Is that something that's always been an area of strong interest for you? Is that something you developed along the way? Tell us more about that. [00:10:29,349] ALLIE GAINES: So it is something that's always been an interest of mine. It really comes from, you know, personal experience with food and just with health. I mean, I think, I mean, I'll just go back into the food industry. But the food that we eat now, you know, it doesn't really look like the food that our grandparents and people before us ate. And it really aligns with, I mean, the trajectories of, you know, obesity and also different types of cancer and heart disease, unfortunately. I'll just tell my story, it's a little embarrassing, but, you know, I was a kid that I was a bit on the chubbier side, and my parents were both working and we ate a lot of fast food, we ate out a lot. I thought Diet Coke was a normal part of my diet. And I think it's important to note that a lot of people don't connect what healthy food is. Because there's just so much out there. So yeah, for me it was always a personal interest. And as I got deeper into it and into just general public health, one thing that was really cool and what I really liked, and it's sort of been a pattern throughout my career, is I do have this interest in nutrition and specifically healthcare. But to your point, I mean, it can be...not everyone knows exactly what they want to do. And I think it's important to know that you don't have to know what you want to do. And if you have interests and you have the opportunity to explore them, I think that's amazing. With even where I am now, I mean, I was always interested in healthcare. So my first job I took in a healthcare position. Coming out of ISST, to your point, I had an offer in, I was also in a very lucky time where there are a lot of job offers. I know that changes throughout the years. But I was looking at this where I was Athena Health Electronic Medical Record Company. I was also looking at a job at Citibank and then also consulting firms, which obviously span or often span a number of industries. And I had that interest in health care, so I started there. But then I did go into consulting for a year, and I got to work on finance projects and other things, which I think is also important. And what I've learned is sometimes I need change just throughout time. And want to expand and learn different things. So again, obviously I do, I always hold nutrition at my heart of what I, what I'm most interested and passionate about. After doing my Ph.D., I was ready again with the focus in healthcare and that's what my company focuses on. But we do span other industries because all of those data issues that I mentioned, they're not really strictly for, or specific to the healthcare industry. You know, better communication and interoperability in all spaces really could probably do a lot of good. So I'm back in where I'll have this healthcare focus and I'm really lucky to be in a position where we're growing the company and I'm an integral part to that. So I'm going to hopefully pave a path to do, you know, more patient work and even actually some environmental work in combining the two. But we also have energy projects and finance projects. So it really is nice to get that breadth as well. So even for me where I do have this special interest, I just, I think it's worth also noting that it's nice to learn about other things as well. [00:14:13,709] TRACI NATHANS-KELLY: It's what keeps us going. Right. Oh, there's a new thing over there. Let me go look at. Right. That's what we do, whether we're humans or crows. Right? We all like the new shiny things to look at it, so we go look at them. So we ask of all the people that we interview, and I know you wanted to talk about STEM in particular, but tell us, I mean, you've kind of already explained some of this, but how your work as you see it today, contributes to a more equitable world, sustainable world. [00:14:44,430] ALLIE GAINES: I mean, I think in a lot of different ways, the different paths I've taken to get here have contributed different parts of that. Obviously, specifically with respect to public health and helping to mitigate the diseases that we see today. My epidemiology research has contributed to that. Hopefully more with the company I'm at now, Exponential. We're working on data solutions for those things. And I also feel like being a woman in STEM has been something that I also want to emphasize. You know, we're a small but mighty group. And I think it's important that even though we're still a small group, and it's been so many years of us wanting to continue to grow, that we should share our experiences and help nurture other women in STEM because we do belong here and we should be confident in that and sharing our unique perspectives and ways of thinking. I think I want to make sure I continue to foster that kind of environment too because I think it's really important. [00:15:50,270] TRACI NATHANS-KELLY: You spoke to us earlier before we started our talk about your Ph.D. Emphasizing a lot of that work with climate crisis and stuff. Tell us a little bit more about that. [00:16:00,849] ALLIE GAINES: Yeah, through all of my learning about nutrition and the public health impacts of that, I also dug into learning about the climate impacts of the food system. So some things that I really didn't know before even starting my Ph.D. in this is that the food system is second to the energy industry in contributing global greenhouse gas emissions that are human caused. And this attributes to about 30% of greenhouse gas emissions today. Again, that are human caused or anthropogenic greenhouse gas emissions. The food system is integral in making a change to climate change. And what I was so excited, not excited to learn, it's a horrible fact to know, but the one thing that's really cool to me and sort of aligns with what I was saying before, is there's co-benefits to learning more about the food system and making sure it's healthier and better for both people and the environment. And it's not an easy thing. None of these things are, otherwise I'm sure it would be done. But I think it's really important that we can that we start to make those changes and start to spread that knowledge of what is healthier for both people and the planet. That was the main concept at the crux of my Ph.D. And from there, like I mentioned, I worked on the packaged food and beverage supply. Which led to a whole other interesting thing for me. The first part of my Ph.D. was to look at all of the ingredients that are in the packaged food and beverage supply. Because I'm sure you might have seen on different news articles, but there is always talk about when you talk about climate change and diet, there's talk about meat. And that meat has the highest greenhouse gas emissions impact. And also there's a lot of land use change attributed with the growing of meat, the production of meat because of how much land we need for cattle grazing and creating the slaughterhouses and other places that are required in that supply chain. So, ingredients are, based on my research, are the main part of what is contributing to greenhouse gas emissions within packaged foods and beverages. Even, I mean, obviously a lot of people talk about packaging and they talk about the transport of foods which are important, but they're actually much less important than the ingredients themselves. While this is true of meat, we have to actually look at the emissions that are associated with all ingredients across the food supply. Meat is just one part of it and it is a very big part of it. But there's more that's important to consider. So anyway, so the first step was to look at all these ingredients. And what I found was that there were over 30,000 unique ingredients listed on packaged foods and beverages. A lot of these being additives and other types of, you know, hydrogenated and isolates and processed ingredients. So that became a really key component of my Ph.D., which was looking at what is making up the food supply today. And then from there, we went on and looked at how much processing contributes to emissions as well. And then obviously considered packaging and transport as well, but the ingredients were really the key part. So after looking at all of the ingredients in the food supply, we then built on that. So we looked at each ingredient, weighted each ingredient in each product, and were able to do a product specific assessment of greenhouse gas emissions based on ingredients. And like I said, incorporated other factors as well. And what I really loved about my Ph.D. was that not only did I get to do all of this research, incorporate my experience and my knowledge of big data sets and data modeling and analytics, but I also got to have a business and a policy side to it as well. Where I was working on developing a label with a team that we could then use to inform consumers, and industry and policymakers. Which was really a unique experience to get to have that impact out of my Ph.D. Then of course, it's going to be exciting to continue to build off of this as I restart my career at the start up where we're going to be building on top of these types of solutions, data driven solutions. So I'm excited to round that out and continue on. [00:20:49,909] CHRISTA DOWNEY: Excellent, you're working on this big mission with health and in the environment. Who are the key collaborators toward this broader vision? [00:20:59,840] ALLIE GAINES: I mean, I think there's academics, there's industry, and there's policy. Actually, this is an opportune time to talk about it right now. There's a COP 28 that's happening, you know, that's the coming together of the parties that need to be involved. I was really lucky to be working with the George Institute for Global Health throughout my Ph.D. They're based in Australia, but they're a global health research institute that focuses in all different aspects of global health. And they partner with a number of different academic institutes, but operate as an NGO and are able to really dig into the global issues happening and have a really big food policy center. So they have representatives at COP 28 this year that I got to work closely with who are working in the first ever like food summit that COP 28 is having. So it's their first time having food as a headlining topic. So yeah, so that's a really big, academics are a really big part of this in bringing the data to life. But then of course, and what we're doing at COP 28 is bringing that into the light of different governments around the world. Because creating policy and making changes where it's from the top down is I really think where we're going to have a big difference. I, of course love the grassroots efforts as well. I think it's important that we get as much information as we can to people. But I do think the change we need at the speed we need, it will be coming from the top down. Industry will be the hardest part of that because it obviously affects their margins and the products they're producing. And it has the biggest like, financial effect on them. You know, I think some companies are starting to get there and as we offer insights with different solutions, I think that will be the start of the future. One example I talked briefly about like the meat industry, I don't think abolishing the meat industry or telling people they can't ever eat meat is the answer. But I think changing the way that meat is produced today and how prevalent it is, it's in a lot of different products and how easily accessible it is probably isn't the way of the future. I think eating meat in moderation without the industry having so much waste, optimizing their techniques of what they're doing, and which probably means having fewer cattle but also less waste, then I think we could make a big difference in that way. So anyway, those I think are the three big players. It's just figuring out how we can best get everyone to work together, which is the hard part. [00:24:00,270] TRACI NATHANS-KELLY: The engineering is easy but the people are difficult, right? That's my going mantra all the time. One of the past engineers I worked with told me that he was at NASA. Um, you mentioned earlier LLMs, the large language models, and some intersections that your work has had even with AI. Can you walk us through what that looks like for you right now? Like what are your thoughts or predictions or best case uses for AI or LLMs? [00:24:31,269] ALLIE GAINES: Yeah, a lot of our projects are how do we take this company, you know, that has been running this way for 30 years, and get them into the 21st century of technology to be able to learn from the data that they already have? So I mean, I think your actual question is how do I think this will be used? I mean, I think that one, getting companies and getting data sets that we already have into these new networks and ways of being able to analyze the data or being able to restore the data is like one big thing. So when we've been looking at specifically with patient data, with everything being in structured sequels, how do we rearrange that so that we can look at, you know, time series of data and knowledge networks? So that it's not just linking A to B, but it can be linking all you know, in many different directions. There's just a huge amount of opportunity and a huge amount of need for people with this kind of expertise. At Exponential, my current company, we have lots of people who are going to help me do that. And I was just talking to somebody and I was like, I'm going to need to learn from you about keeping up to date with what the capabilities are today because it really isn't my expertise. But what I can say is I also just think that's important. We need different minds. A lot of the people that have, you know, AI minds in how we can get the data into that format might need more help on the business side and how we can then apply it to what we need to do. So it's working together to be able to use the technologies that are available and what we need and the business impact side and business strategy side to be able to get to where we need to go. [00:26:27,109] TRACI NATHANS-KELLY: So we're going to make a jump now. We just asked you to like swim around in the super present moment, right? But we're going to ask you to try to think back now to when you're a sophomore. So that's the year that you decide what your major is going to be, right? And so that's why we ask about sophomore year. What did you think you wanted to do back then? Can you remember? [00:26:50,059] ALLIE GAINES: So sort of before the nutrition thing really got to be my interest, I was really interested in bio mechanics. So I started my college career being like I'm going to do mechanical engineering, do like sub-focus in bio mechanics. And I also thought you needed to know, and I already sort of, that's a little theme here that I don't think you need to know, and that you can keep changing. And I think it's important to do that if that's what you're drawn to. And not be afraid to change what you're doing, even though it is difficult to do that. Yeah, so I thought I was going to do that. I did start out in mechanics in mechanical engineering. Got through to thermodynamics, was like starting to build a lamp. And I was like, You know what, I don't think this is my direction, I'm pretty sure, I don't know if it is anymore. But that was like, the big MechE project was like building a light. Isst in computer science was sort of new even when I was going through it. I think I was drawn to that. Isst had the big web development aspect to it. Also staying on theme again, it had a had a little more flexibility in the things I could try out in that major as opposed to in the mechanical engineering major, which for me was something I needed. I had the ability with information science to go abroad. And actually one thing that I thought was sort of cool, I don't know why I do everything the hard way, but I was the first to go on my study abroad program to Budapest. So I had to apply and get it approved instead of just going to a pre approved place. But it was awesome. I highly recommend going to Budapest or somewhere abroad if you can. Anyway, that's how I landed with ISST and I think, I mean, it was a really amazing experience for me. I think it's important for people who are sophomores to know that it's okay to try things out and to change things up and just figure out what's right for you and don't be afraid to do it is it definitely can be hard to make a change whether that's in your major or later on in your career. But it's super rewarding to get that experience and to come out of it, you know, improving yourself, improving your knowledge, improving your network. [00:29:20,299] CHRISTA DOWNEY: So along those lines, what class are classes had the greatest impact in preparing you for your career? [00:29:26,839] ALLIE GAINES: I mean, a number of them. Like as you've seen, as you've heard, I've hopped around quite a bit. So I feel like at different times, different types of classes have really helped me in different ways. Or there's two that really stick in my mind. And I guess they were from later, I think from junior and senior year. First was my first web development class because you got to go and find your own client and build a website for them. That was essentially the class. My two peers and I, I also don't know if this is still around, but now it's just getting to Cornell history. We chose the chips on a stick guy who was on College Ave because a lot of people, yeah, he used to slice up at, it was like a late night food truck, get a potato all sliced up and curled, it was really good. But a lot of people were doing departments at within the engineering school and doing their websites, which is obviously a great thing to do. But for me, it was a really cool experience to get, to use my creativity, go out of the box, but also do something that was applied. And you had, you know, we were trying to help him got his first website going and use new tools that he'd never used before. And set up a billing system online and set up, you know, database structures of things that could help him potentially grow his business. So it was for me, getting to link together data and business, which was really exciting. I guess for me that all sort of linked with being outside of the box. But my other one was one of my final senior year classes was the computer game design class, where the final exam is getting teachers and their kids and colleagues to come in and play your game. And it essentially got rated based on whether it was fun to play. That was just really fun. You know, I think all of the other classes are so important. The ways you learn to problem solve in the school of engineering is second to none. I think it's taught me so much in figuring out data problems, but also figuring out problems just within any type of job. Whether it's talking to people and you know, if you work with somebody in one way, you have to and it doesn't work in the best way, figuring out another way to work. I think going through engineering teaches you that. That there's no one solution every problem. And it teaches you how to figure out multiple ways to get to the right solution. It's like showing your work and doing things in different ways. As long as you get to the end, it doesn't matter exactly how you got there. I think that's really what's helped me throughout my career and has been really amazing building blocks for me. [00:32:27,199] TRACI NATHANS-KELLY: With all these complicated intersections that you're working with right now. Where do you go to stay current? You mentioned you rely on the expertise of some of your colleagues. What are some other places that you look for? [00:32:40,179] ALLIE GAINES: For tech and AI I go to other people. I'm not the person. But you know, there's one person that I've really been loving to follow. It's again at the intersection of food, health and policy. So it's Marion Nestle. She has written a couple of books and she has a daily newsletter that's called Food Politics that I just absolutely love. It bridges a lot of things. Yeah. So it's just insightful with global topics, with local topics. It talks about academia. It talks about industry and farmers and also just public health outcomes. And the fun fact is that she's a Visiting Professor in Nutrition Science at Cornell too. So she's one of us. But yeah, I think she's just super interesting and super inspiring. One thing I really like about her is she isn't afraid to stand up in or against industry. So, you know, if they're making claims on, you know, the healthiness or different impacts of foods, she likes to call that out. And one other thing she's done recently, that has been something I've been really into at the moment, and I think everyone can relate and go watch it if they want. It's on Netflix. There's a docu series called Blue Zones. So it's about the five different areas around the world that has the most centurions. I think that's how you say people that live to be 100 or over 100. And it talks about the diets that they have in those areas. And she has a little cameo in there, which is cool. But just see how the broader documentary just talks about diet and health and longevity. So I think I'd definitely recommend that. [00:34:35,829] TRACI NATHANS-KELLY: We will absolutely add links to those in the show notes for everybody. [00:34:39,430] CHRISTA DOWNEY: So I think, you know, we sort of touched upon this, but just to circle back, if you weren't doing this right now, what might you be doing? And, you know, how does that compare to what you were thinking about as a child? [00:34:51,869] ALLIE GAINES: I think, I mean, I feel so lucky to be where I am in my career and to be working in health and helping people and the planet into getting to a better place. One thing I would love to be doing more of, and that I always wanted to do is in the educational side and helping kids learn more at a young age about, you know, eating healthier, living a healthy lifestyle. One of my original proposals for my Ph.D. was to do like a school lunch program as a part of it. Where you could teach kids really like where the food they're eating is coming from and how to connect with that. So yeah, so that's one thing I'd really still love to get into. And if I could do that, you know, alongside my current career, eventually get there as a part of my career, that would be what I'd really want to do. [00:35:54,869] TRACI NATHANS-KELLY: Well, working with kids is always fun, isn't it? So we usually like to conclude with a question about, with all your hard work, what is it that you like to do in order to re-energize yourself, refresh, regroup, whatever it may be. [00:36:10,009] ALLIE GAINES: I love everything outdoors. I started that funny because I think my answer is basically what very few people would find fun, as you can tell, with doing a Ph.D. and also being an engineer at Cornell, you know, I like a challenge. So what's fun for me is I've been running marathons lately. Not lately, but you know, I got into marathon running and there's, you know, six marathons around the world also traveling. It's something I love to do that are called the World Marathons. And I've done three of them so far. [00:36:46,869] TRACI NATHANS-KELLY: Wow! [00:36:48,929] ALLIE GAINES: Yeah, In London, New York, and Berlin. So I have three to go and that's what I do to sort of get time for myself and relax. And yeah, also I love to hike and do anything else outdoors. [00:37:04,450] TRACI NATHANS-KELLY: As a spouse to a runner, we totally get it. The runner's high is a real thing and it must be respected. [00:37:11,489] ALLIE GAINES: Well, we're thankful to our supporters and partners too, So thank you. [00:37:16,329] TRACI NATHANS-KELLY: I'm really great support staff. Well, thank you so much for your time today. Allie, you've just given us so much information and wonderful things to think about, flexibility and curiosity within whatever it is you've got sitting in front of you. So we really appreciate your time today. [00:37:35,710] ALLIE GAINES: Thank you so much, Traci and Christa. It was great talking with you. And thanks for asking about all of my stuff. I was so excited to share, and I really hope it helps anyone who listens and any sophomores with some inspiration that they might need. [00:37:53,830] CHRISTA DOWNEY: Thank you for listening. If you are enjoying these conversations, please follow, rate, and review on your favorite platform. Join us for the next episode where we will be celebrating excellence and innovation among engineers whose impact contributes to a healthier, more equitable, and more sustainable world.