Nutrition Education Opportunities and Challenges for Healthy Aging Shirley A Gerrior PhD, RD, LD

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Nutrition Education Opportunities and Challenges
for Healthy Aging Shirley A Gerrior PhD, RD, LD

• SNE Awakening to Aging An Introduction to our
  Future
• San Francisco, California
• July16, 2006

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Presentation Objectives

• Describe U.S Dept. of Health Human Services
  (HHS) and U.S. Dept. of Agriculture (USDA) food
  and nutrition programs and nutrition education
  efforts at the federal, state and local levels
• Discuss USDA, Cooperative State Research
  Education and Extension Services role in these
  efforts
• Present related policy and program challenges and
  recommended actions

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All Levels of Government must Invest in Healthy
Aging

• Federal agencies
• set health policy, identify strategies, conduct
  research, and promote best practices
• direct program funding to state and local levels
• State agencies
• work with state and local health departments and
  community-based organizations
• Local agencies
• deliver health-related and supportive services in
  the community

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Federal Departments are the Drivers to Healthy
Aging

• HHS
• US Administration on Aging (AoA)
• National Institutes on Health NIA, NHLBI, NIDDK
• Food Drug Administration (FDA)
• CMS, State Medicaid, Medicare, MNT
• Centers for Disease Control and Prevention (CDC)
• Agency for Healthcare Research Quality (AHRQ)
• Office of Asst Secretary for Planning
  Evaluation (ASPE)

• USDA
• Food and Nutrition Service (FNS)
• Center for Nutrition Policy and Promotion (CNPP)
• Agricultural Research Service (ARS)
• Economic Research Service (ERS)
• Cooperative State Research and Education and
  Extension Service (CSREES)

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HHS Agencies and Programs

• US Administration on Aging (AoA)
• Charged with developing a system to help older
  adults stay at home and in their communities with
  dignity.
• Works through national aging network to provide
  service to 9M older Americans annually
• Provides nutrition services, including congregate
  home-delivered meals, through grants to states
  American Indian Tribes
• Supports You Can! Steps to Healthier Aging as
  part of HealthierUS
• Opportunity for nutrition education intervention
  for healthy eating, physical activity and
  lifestyle changes

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• Older Americans Act Nutrition Program
• Largest federal nutrition assistance program for
  older adults
• Promotes health, decreases malnutrition, prevents
  physical/mental deterioration, reduces social
  isolation
• Targets those at greatest social economic need
  with particular attention to low income
  minorities individuals in rural communities.
• Provides meals, congregate home-delivered, plus
  nutrition screening, education, counseling
• Links to other supportive in-home
  community-based services.

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• Older Americans Act Nutrition Program
• Title III Grants to states for nutrition
  services, including meals
• Multiple funding sources
• Congregate Meals 41 federal 40 state/local
  19 participant contributions
• Home-Delivered Meals 31 federal 52
  state/local 17 participant contributions
• Note OAA (federal) funding includes C1, C2, NSIP
• Title VI Grants for Native Americans

US Admin on Aging, 2004 data www.aoa.gov
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• Older Americans Act Nutrition Program
• Nutrition Services Incentive Program (NSIP)
• 1 of the 3 Older Americans Act funding sources
  for meals to States and Tribes
• NSIP 11 of total expenditures for AoA
  nutrition programs
• 2003 transferred from USDA-FNS to HHS-AoA with
  the Consolidated Appropriation Resolutions, (PL
  108-7).

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Other HHS Agencies and Programs

• National Institute on Aging
• Sponsors research for evidence-based studies to
  promote health prevention among older adults
• Centers for Disease Control and Prevention
• Brings together public health agencies with AoA
  services
• Funds grants to states to increase collaboration
  between state agencies and health departments
• Builds capacity for program implementation
  locally
• Collects and monitors health of older Americans
• Agency for Healthcare Research and Quality
• Funds patient-centered care research and
  evidence-based services in health care settings

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USDA Agencies and Programs

• Food and Nutrition Service
• Administers Food Stamp Program to many eligible
  older adults
• Administers Senior Farmers Market Nutrition
  Program to provide low income seniors with
  coupons for fresh produce and offers nutrition
  education
• Sponsors Commodity Supplemental Food Program,
  making commodities available to States and Tribal
  Organizations
• Administers The Emergency Food Assistance
  Program to supplement diets 

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Food and Nutrition Service Food Stamp Program

• Provides benefits to improve diets by increasing
  food purchasing power
• Only one-third of eligible elderly participate
  due to application burden, lack of information
  and stigma concerns
• Elderly remain one of the largest underserved
  groups of potential food stamp participants.
• Average monthly benefit 50
• Value is commonly underestimated by eligible
  older adults
•  

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Other USDA Agencies and Programs

• Center for Nutrition Policy and Promotion
• Dietary Guidelines for Americans and MyPyramid
• Agricultural Research Service
• Human Nutrition Research Center on Aging at Tufts
  University

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Other USDA Agencies and Programs

• Economic Research Service
• Administers the Food Assistance and Nutrition
  Research Program which funds research that
  targets diet and nutritional outcomes and food
  program delivery
• Provides Federal, State, and local policymakers
  with information to help enhance the quality of
  life and well-being of rural older Americans

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Other USDA Agencies and Programs

• Cooperative State Research Education and
  Extension Service
• Unites the research, education, and Extension
  resources of USDA through public and private
  partnerships on agriculture, the environment,
  human health and well-being
• Encourages enhanced education efforts and
  outreach for public awareness and community
  involvement

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CSREES The Cooperative Extension System

• State Partners
• The Cooperative Extension System is a nationwide
  educational network. Each U.S. state and
  territory has a state Extension office at its
  land-grant university
• Local Partners
• These regional or county level offices provide
  useful, practical, and research-based information
  to consumers and others in rural areas and
  communities of all sizes

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CSREES Supports Healthy Aging

• Provides opportunities for public policy issues
  and education on aging
• Provides funding targeted to older adult
  interventions
• Offers training and assistance grants to states
  for prevention community-based programs
• Supports evidence-based research and programs
  through its partners to implement and monitor
  tested interventions
• Supports state and community agency partnerships
  to help coordinate and expand nutrition services
  for older adults
• Supports nutrition education of older adults and
  families across the nation

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Aging Research by CSREES Partners

• Food Security (Lee, 2005), Understanding
  targeting from the perspective of program
  providers in the elderly nutrition program
• Community-based services (Weddle Wellman,
  2001), Aging, Nutrition and Extension an
  Integrated Network for Rural America
• Nutrition Assessment (Zulkowski, 2000),
  Promoting Optimal Nutrition through Assessment of
  Rural Elderly in Montana

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Policy and Program Challenges

• HHS AoA Limited nutrition infrastructure
  limited funding for nutrition education research
  with older adults
• HHS NIA Needs to continue with research efforts
  and expand focus to promote the translation of
  its research into real-world programs
• USDA FNS Needs to expand outreach and service to
  enroll more and better serve food stamp eligible
  older adults
• USDA ERS CSREES Needs to partners with
  communities, including rural, and increase
  program support for research and outreach for
  older populations

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Recommended Actions for Nutrition Educators

• Document local program effectiveness timeliness
  to justify increased funding for more services
• Include educational programming that attracts
  more people increases marketability of these
  programs
• Make programs culturally ethnically relevant
• Lead the way in interpretation of government
  nutrition polices advocacy for nutrition
  programs their funding
• Integrate partner with public (state local),
  private, health agencies programs to promote
  healthy lifestyles for successful aging.

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• USDA/CSREES
• Families, 4-H and Nutrition Unit
• Waterfront Centre
• 800 9th Street SW
• Washington, D.C. 20024
• 4124
• http//www.csrees.usda.gov/
• sgerrior_at_csrees.usda.gov