Public Health Nutrition

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Public Health Nutrition

• January 4 2007

Nutrition 531
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What is Health?
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Health

• A state of complete physical, mental, and social
  well-being, not merely the absence of disease.
• WHO

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Prerequisites for Health - WHO

• Freedom from the fear of war
• Equal opportunity for all peoples
• Satisfaction of basic needs
• food
• clean water and sanitation
• decent housing
• education
• Right to find meaningful work and perform a
  useful role in society

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Determinants of Health
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What is Public Health?
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Public Health...
Public healthis the combination of sciences,
skills and beliefs that is directed to the
maintenance and improvement of the health of all
people through collective or social actions...
Public health activities change with changing
technology and social values, but the goals
remain the same to reduce the amount of
disease, premature death, and disease-produced
discomfort and disability in the population.
Source Last M. A Dictionary of Epidemiology.
Oxford 1988.
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Mission of Public Health

• to fulfill societys interest in assuring
  conditions in which people can be healthy.

IOM. Future of Public Health.
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Core Functions of Public Health
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Assessment

• Assess the problems and needs of the population
• Monitor the health of populations and related
  systems of care.

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Policy Development

• Develop policies, programs and activities that
  address the highest priority problems and needs

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Assurance

• Assure the implementation of effective strategies
  by providing or monitoring activities and
  services.

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The Future of the Publics Health in the 21st
Century, IOM, November, 2002

• Areas of action and change
• Adopting a focus on population health that
  includes multiple determinants of health
• Strengthening the public health infrastructure
• Building partnerships
• Developing systems of accountability
• Emphasizing evidence
• Improving communication

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Population Health

• Considers a broad set of options for improving
  and sustaining health
• Highlights role of social and economic forces in
  combination with biological and environmental
  factors
• Results in benefits to all

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Population Health
Improving Everyones Quality of Life Group
Health Foundation, 2001
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What About Nutrition?
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Mission of Public Health Nutrition

• To assure conditions in which people have access
  to adequate and appropriate food.
• To assure conditions in which people can achieve
  optimal nutritional health.

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Unhealthy diet and lack of physical activity
account for at least 300,000 deaths each year and
increase a persons risk for many chronic
diseases.
CDC. Actual Causes of Death
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Leading Causes of Death, 1900
Centers for Disease Control and Prevention,
National Center for Health Statistics. National
Vital Statistics System and unpublished data.
1997.
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Leading Causes of Death, 1997
Centers for Disease Control and Prevention,
National Center for Health Statistics. National
Vital Statistics System and unpublished data.
1997.
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Source Centers for Disease Control and
Prevention. Health-related quality of life
prevalence data. National Center for Chronic
Disease Prevention and Health Promotion, 2003.
Accessed March 21 at lthttp//apps.nccd.cdc.gov/HRQ
OL/gt.
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What defines a public health approach?

• Multiple focal points levels (individual,
  population-based, organizational, and societal)
• Includes both policies and programs
• Addresses factors close at hand as well as
  remote influences

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The Socio-Ecological Model
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Ecological Approaches to Public Health Nutrition
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Societal policies and processes influencing the
population prevalence of obesity
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How are the functions of Public Health performed?
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10 Essential Public Health Services Public
Health Functions Steering Committee - State and
Local

• Monitor Health Status to identify community
  health problems
• Diagnose and investigate health problems
• Inform, educate, and empower people about health
  issues
• Mobilize community partnerships to identify and
  solve health problems
• Develop policies and plans that support
  individual and community health efforts
• Enforce laws and regulations that protect health
  and ensure safety

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• Link people to needed personal health services
  and assure the provision of health care when
  otherwise unavailable
• Assure a competent public health and personal
  heath care workforce
• Evaluate effectiveness, accessibility, and
  quality of personal and population-based public
  health services
• Research for new insights and innovative
  solutions to health problems

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Public Health Practice Compared to Clinical
Nutrition Practice
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Public Health Nutritionists Guidelines for
Comprehensive Programs to Promote Healthy Eating
and Physical Activity (CDC, ASTDPHN)

• Leadership create vision, convene partners
• Planning/Management structure, planning,
  communication, funding
• Coordination integration of nutrition efforts
  across programs at the national, state, and local
  level consistent messages

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Goals for 531
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Students will demonstrate the ability to gather
targeted information about existing community/
population-based nutrition programs and
resources examine current policies and systems
of assuring population nutritional health apply
the science of nutrition to policy development.
Public Health Nutrition Policies Programs
ADA Competencies
-Public policy development -Legislative advocacy
-Food, nutrition, and food safety
laws/regulations and policies -Application of
management principles to public health nutrition
programs and services -Nutrition programs in the
community
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Students will demonstrate the ability to conduct
the full process of program planning and
evaluation including assessment setting
priorities, goals, and objectives program
implementation and monitoring and evaluation.
Public Health Nutrition Program Development
ADA Competencies
-Cultural competency for nutrition program
development -Issues of access to food and food
security -Application of management principles
to public health nutrition programs and services
-Application of social marketing principles to
health and nutrition programs
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Brief History of Public Health Nutrition
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Achievements in Public Health, 1900-1999 Safer
and Healthier Foods (MMWR )

• During the early 20th century, contaminated
  food, milk, and water caused many foodborne
  infections, including typhoid fever,
  tuberculosis, botulism, and scarlet fever.
• Once the sources and characteristics of
  foodborne diseases were identified--long before
  vaccines or antibiotics--they could be controlled
  by handwashing, sanitation, refrigeration,
  pasteurization, and pesticide application.
  Healthier animal care, feeding, and processing
  also improved food supply safety.

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• The discovery of essential nutrients and their
  roles in disease prevention has been instrumental
  in almost eliminating nutritional deficiency
  diseases such as goiter, rickets, and pellagra in
  the United States.

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• During 1922-1927, with the implementation of a
  statewide prevention program, the goiter rate in
  Michigan fell from 38.6 to 9.0 .
• In 1921, rickets was considered the most common
  nutritional disease of children, affecting
  approximately 75 of infants in New York City.

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