© 2006 Thomson-Wadsworth Chapter 1 Opportunities in Community Nutrition

© 2006 Thomson-Wadsworth

Chapter 1

Opportunities in Community Nutrition


Learning Objectives

• Describe the three arenas of community nutrition practice.

• Explain how community nutrition practice fits into the larger realm of public health.

• Describe the three types of prevention efforts.


Learning Objectives

• List three major health objectives for the nation and explain why each is important.

• Outline the educational requirements, practice settings, and roles and responsibilities of community nutritionists.

• Explain why entrepreneurship is important to the practice of community nutrition.


Introduction

• Community nutritionists face many challenges in practice.– The challenge of improving the nutritional

status of different kinds of people.– The challenge of influencing lawmakers and

other key citizens. – The challenge of studying the scientific

literature.– The challenge of mastering new technologies.– Successful community nutritionists are

flexible, innovative, and versatile.


The Concept of Community

• A community is a grouping of people who reside in a specific locality and who interact and connect through a definite social structure.

• Four components of a community include: people, a location in space, social interaction, and shared values.

• Communities can be defined on different scales: global, national, regional, and local.



• Opportunities in Community Nutrition– The focus of community nutrition includes

people, policy, and programs.– People who benefit from community

nutrition programs are found in a variety of community settings.

– A policy is a course of action chosen by public authorities to address a given problem and they are accomplished through laws, regulations, and programs.



• Opportunities in Community Nutrition– Programs are instruments used by

community nutritionists to seek behavior changes that improve nutritional status and health.



• Public Health and Community Interventions– Public health focuses on protecting and

promoting people’s health through actions of society.

– The scope of public health includes infectious diseases, such as AIDS and tuberculosis, and chronic diseases, such as heart disease, stroke, and cancer, that kill 7 of every 10 Americans each year.


Leading Causes of DeathUnited States, 1900


Leading Causes of DeathUnited States, 2002



• The Concept of Health– The proper definition of health focuses on

the interaction of humans among themselves and with their environment.

– A constellation of factors influence health, including individual factors, lifestyle factors, working conditions, social networks, community services, and national health policies.




• Health Promotion– Health promotion focuses on

changing human behavior and lifestyles to move toward a state of optimal health.



• Health Promotion– There are three types of prevention efforts

and three levels of intervention.• Primary prevention aims to control risk factors

and prevent disease.• Secondary prevention focuses on detecting

disease early through screening and other forms of risk appraisal.

• Tertiary prevention aims to treat and rehabilitate people who have experienced an illness or injury.





• Health Objectives– The goal of the world community is to

protect and promote the health of all people of the world.

– Challenges of translating this global goal into action include understanding the many physical, biological, social, and behavioral factors that influence the health of individuals and communities and the challenge of changing human behavior.



• Health Objectives– Nations differ in how they formulate health

objectives for their peoples to achieve behavior change.

• A document released by Health Canada presents a new vision for promoting health and preventing disease by advocating a balance between individual and societal responsibilities for health.

• The health objectives for the peoples of the United States are published in Healthy People 2010: Understanding and Improving Health.



• Healthy People in Healthy Communities– This document includes two broad

goals and 467 specific, measurable targets or objectives to be achieved by the year 2010.• Goal 1 is to increase quality and years of

healthy life.• Goal 2 is to eliminate health disparities.




• Healthy People in Healthy Communities– Many nutrition-related activities are

essential to this initiative because four of the leading causes of death in the United States are related to dietary imbalance and excess.

• Coronary heart disease.• Some types of cancer.• Stroke.• Diabetes mellitus



• Healthy People in Healthy Communities– Each objective has a target for specific

improvements to be achieved by the year 2010.

– The surveillance and data tracking systems of Healthy People 2010 will collect, analyze, interpret, disseminate, and make use of health data to understand the nation’s health status and plan prevention programs.




• Healthy People 2010: Progress Report– The average life expectancy at birth is 77

years, and death rates for heart disease, stroke, and certain types of cancer have declined.

– Health disparities remain evident among Americans, with significant differences between whites and minorities in mortality, morbidity, health insurance coverage, and the use of health services.




Community Nutrition Practice

• Community nutritionists have numerous job responsibilities although there are common themes that emerge.– Data gathering about the community itself or about

the people who use or implement community-based programs or services.

– Issues involving policy, program management, and how to use scarce resources.

– Determining whether nutrition programs and services are reaching the right audience with the right messages and having the desired effect.



• Community versus Public Health Nutrition– Community nutrition is not considered to be

synonymous with public health nutrition as defined in this textbook.

• Community nutrition is the broader of the two terms and includes any nutrition program whose target is the community.

• Public health nutrition refers to those community-based programs conducted by a government agency.




• Educational Requirements– Minimum requirements include a

bachelor’s degree in community nutrition, foods and nutrition, or dietetics from an accredited college or university.

– Most community positions require registration as a dietitian by the American Dietetic Association.



• Licensure of Nutrition Professionals– In some states the term nutritionist is not

legally defined.– Licensure of nutrition professionals is

designed to protect the public, control malpractice, and ensure minimum standards of practice.

– As of 2004, 44 states, the District of Columbia, and Puerto Rico had enacted some form of licensure law.



• Licensure of Nutrition Professionals– There are many advantages of licensure:

• Americans are accustomed to identifying licensed health professionals.

• The initials L.D. assure consumers, health professionals, and insurance companies that persons providing nutrition services meet the specified professional standards.

• Practice settings for community nutritionists are numerous and include worksites, universities, health organizations, day care centers, fitness centers, food companies, and hospital outpatient facilities.



• Roles and Responsibilities – Roles and responsibilities for

community nutritionists include educator, counselor, advocate, coordinator, ideas generator, facilitator, and supervisor.

– Community nutritionists are increasingly expected to manage projects, resources, and people.




Entrepreneurship in Community Nutrition

• Entrepreneurship is the creation of something of value through the creation of organization.

• Organization refers to the orchestration of the materials, people, and capital required to deliver a product or service.



• Entrepreneurs and Intrapreneurs– Entrepreneurs are change agents who share

common personality traits.• They are achievers and set high goals for

themselves.• They work hard, are good organizers, enjoy

nurturing a project to completion, and accept responsibility for their ventures.

• They strive for excellence and are reward oriented.

• These qualities also describe an intrapreneur whose job is located within an organization.



• Business competencies expected of community nutritionists include:– Perform organizational and strategic

planning.– Develop and implement a business or

operating plan.– Supervise procurement of resources.– Manage the integration of financial, human,

physical, and materials resources.– Supervise coordination of services.– Supervise marketing functions.



• To change people’s eating habits community nutritionists must be entrepreneurs who use new ways of reaching desired target groups.


Emerging Issues in Community Nutrition

• Should your state government restore benefits to all legal immigrants residing in the state?

• If you were employed as a school food service director, what would you recommend to your school administrators and state legislators in order to foster a school nutrition environment that would support healthful eating?


Emerging Issues in Community Nutrition

• If you were responding to a proposed rule in the Federal Register, would you favor giving the FDA more power in this area?

• Given the current state of research, should the nutrition education materials used for clients in your organization’s heart disease risk-reduction program be changed to reflect plasma homocysteine levels as a CHD risk factor?


By the Year 2020 . . .

• Another 50 to 80 million people will probably have been added to the U.S. population.

• The population and labor force will continue to diversify, as immigration continues to account for a sizable part of the population growth.

• The growing diversity of food choices is likely to echo the increasing diversity of the population.



• Between 1980 and 2020: – Hispanic population will have grown

from 6.5% to 18% of the population– Blacks from 11.6% to 12.9%– Asian or Pacific Islanders from 1.5 to

5 %– whites will have declined from 79.9%

to 62.5%



• The world’s population will have grown by about 2.2 billion people.

• The number of people over 65 years of age will have grown from 35 million in 2000 to 54 million.

• People aged 65–74 will have increased from 6 to 10% of the population.

• Those aged 75 and older will have increased from 6 to 7%.



• Total national spending on long-term health care will have risen to $207 billion—up from $115 billion in 1997.

• Spending on home care will account for about one-third of spending on long-term care.


Social and Economic Trends for Community Nutrition

• A worldwide increase in the educational level of the workforce is anticipated.

• The aging of the population, coupled with a more ethnically diverse society, will challenge community nutritionists to develop new products and services.



• An Aging Population– The aging population will likely place many

demands on health care services, home care services, and food assistance programs – as will the millions of people who lack health insurance.

• Generational Diversity– Age diversity in the workplace now includes

five distinct groups with differences in workplace values, lifestyle and social values, motivation, communication styles, and technical competence.




• Increasing Demands for Nutrition and Health Care Services

• Increasing Ethnic Diversity• Challenges of the Twenty-First Century

Lifestyle– The World Health Organization describes

obesity as “an escalating epidemic” and one of the greatest neglected public health problems of our time.



• Watchwords for the Future– Change, innovation, creativity,

community, and entrepreneurship are watchwords that herald the beginnings of a new century.

– Unprecedented global social change is occurring in which the world is growing smaller.

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© 2006 Thomson-Wadsworth Chapter 1 Opportunities in Community Nutrition