Federal Overview for Public Health Nutrition

Dept. of Homeland Security

Some Major Public Health Nutrition Players:

• USDA• Food, Nutrition and Consumer Services

• Center for Nutrition Policy and Promotion

• Cooperative State Research, Education and Extension Service (CSREES)

• Department of Health and Human Services• CDC

• HRSA

• NIH

• Administration on Aging

• Office of Disease Prevention and Health Promotion

USDA Mission: Enhance the quality of life for the American people by supporting production of agriculture: • ensuring a safe, affordable, nutritious, and accessible food supply • caring for agricultural, forest, and range lands • supporting sound development of rural communities • providing economic opportunities for farm and rural residents • expanding global markets for agricultural and forest products and services • and working to reduce hunger in America and throughout the world.

USDA Vision: A healthy and productive Nation in harmony with the land.

Older Mission and Vision….

Current Mission & Vision

• Mission: We provide leadership on food, agriculture, natural resources, and related issues based on sound public policy, the best available science, and efficient management.

• Vision: We want to be recognized as a dynamic organization that is able to efficiently provide the integrated program delivery needed to lead a rapidly evolving food and agriculture system

Mike JohannsTom Vilsack

Agriculture Secretary Tom Vilsack Operates a Jackhammer Breaking Ground for the People's Garden Project Agriculture Secretary Tom Vilsack Operates a Jackhammer Breaking Ground for the People's Garden Project

Food and Nutrition Service (FNS)

• Works to increase food security and reduce hunger by providing children and low-income people with access to food, a healthy diet, and nutrition education in a manner that supports U.S. agriculture and inspires public confidence in the Nation's domestic nutrition assistance programs.

• FNS nutrition assistance programs represent about half of USDA's budget.

FNS Programs

• Supplemental Nutrition Assistance Program (Food Stamp Program)

• Child Nutrition Programs• Special Supplemental Nutrition Program for

Women, Infants, and Children (WIC)• Child and Adult Care Food Program • Food Distribution Programs• Disaster Assistance

Child Nutrition Programs

• School Meals– National School Lunch Program– School Breakfast Program– Special Milk Program– Team Nutrition

• Summer Food Service Program

Center for Nutrition Policy and Promotion (CNPP)

• “The USDA Center for Nutrition Policy and Promotion (CNPP) works to improve the health and well-being of Americans by developing and promoting dietary guidance that links scientific research to the nutrition needs of consumers.”

Center for Nutrition Policy and Promotion (CNPP)

• Partner with HHS for Dietary Guidelines• Healthy Eating Index• Nutrient Content of the Food Supply• My Pyramid• Thrifty Food Plan• Publications:

– Nutrition Insights

– Family Economics and Nutrition Review

Thrifty Food Plan

• Last revised 2006• Establishes menus and market basket costs

for a minimal cost healthful diet• Based on 2005 Dietary Guidelines for

Americans, 2005 My Pyramid. • Used as the basis for food stamp allocation

decisions, and to determine the federal poverty level

Federal Poverty Guidelines

• Poverty thresholds were originally derived in 1963-1964, using:– U.S. Department of Agriculture food budgets designed

for families under economic stress– Data about what portion of their income families spent

on food• The current thresholds were originally developed

as the cost of a minimum diet times three • If total family income is less than the threshold

appropriate for that family, the family is in poverty

The 2009 Poverty Guidelines for the 48 Contiguous Statesand the District of Columbia

Persons in family Poverty guideline

1 $10,830

2 14,570

3 18,310

4 22,050

5 25,790

6 29,530

7 33,270

8 37,010

For families with more than 8 persons, add $3,740 for each additional person

Food Research Action Committee (FRAC) on the Thrifty Food Plan

• “USDA research shows that only 12 percent of low income households who spend at the Thrifty Food Plan level get their recommended dietary allowances for 11 key nutrients.”

http://www.frac.org/html/federal_food_programs/programs/fsp_faq.html

FRAC on the Thrifty Food Plan, cont.

• The Thrifty Food Plan contains a number of assumptions which may not be accurate for many food stamp recipients. For example, purchasing foods for a nutritious diet requires adequate food preparation facilities, extensive time for food preparation, an in-depth knowledge about nutrition and inexpensive transportation to warehouse-type grocery stores or supermarkets.

Time Scarcity & Policy

• Thrifty Food Plan (1999) takes 16.1 hours a week to prepare.– Mean weekly time for food preparation by

employed women in 1999 was 6.4 hours

• Time scarcity exacerbated by lack of:– Reliable, convenient transportation– Affordable quality childcare– Job flexibility Reference: Jabs

Cooperative State Research Education and Extension Service

(CSRES)

Cooperative State Research Education and Extension Service :

Families, 4-H, and Nutrition

• Research, Education and Extension– Youth development– Expanded food and nutrition program (EFNEP) – Children, youth and families at risk– CSREES partners with state land grant

institutions and local counties

Department of Health and Human Services

Department of Health & Human Services Organizational Chart

ORGANIZATIONAL CHART

                                                                                                                                                                                                                                                                                                                                                                

 

Integral toPublic HealthNutrition

Mike Leavitt

National Institutes of HealthMany institutes include nutrition-related research

portfolios:• National Heart Lung and Blood Institute (NHLBI)

• National Institute on Aging (NIA)

• National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK)

• National Institute of Child Health and Human Development (NICHD)

• National Institute of Environmental Health Sciences (NIEHS)

• John E. Fogarty International Center (FIC)

• National Center for Complimentary and Alternative Medicine (NCCAM)

• National Cancer Institute

Cross-Cutting Nutrition Initiatives at NIH with Public Health Components• Division of Nutrition Research Coordination:

– “coordinate Nutritional Sciences-related research and research training across the National Institutes of Health (NIH) and among Federal Agencies by providing mechanisms to communicate research, research training, policy, and education initiatives.”

• The NIH Obesity Research Task Force: – “the NIH supports a broad spectrum of obesity-related

research, including molecular, genetic, behavioral, environmental, clinical, and epidemiologic studies.”

Health Resources and Services Administration (HRSA)

• Diverse Agency– Direct Services

– Supporting health care infrastructure

• Community and Migrant Health Services• Health Centers

• Expanding

• Maternal and Child Health• Block Grants to States

• Discretionary Grants

DIRECT

HEALTH CARE

SERVICES

(GAP FILLING)

Examples:

Basic Health Services and Health Services for CSHCN

ENABLING SERVICES

Examples:

Transportation, Translation, Outreach, Respite Care,Health Education, Family Support Services, Purchase ofHealth Insurance, Case Management, Coordination with

Medicaid, WIC and Education

POPULATION--BASED SERVICES

Examples:

Newborn Screening, Lead Screening, Immunization, Sudden Infant DeathCounseling, Oral Health, Injury Prevention, Nutrition and Outreach/Public Education

INFRASTRUCTURE BUILDING SERVICES

Examples:

Needs Assessment, Evaluation, Planning, Policy Development, Coordination, Quality Assurance, Standards Development, Monitoring, Training, Applied Research,

Systems of Care and Information Systems

CORE PUBLIC HEALTH SERVICES DELIVERED BY MCH AGENCIES

MCH

EPSDT

CHC SCHIP

Maternal

Child

Health

Bureau

Centers for Disease Control and Prevention (CDC): Mission

• Collaborating to create the expertise, information, and tools that people and communities need to protect their health – through health promotion, prevention of disease, injury and disability, and preparedness for new health threats.

National Center on Birth Defects and Developmental Disabilities (NCBDDD)

National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP)

National Center for Environmental Health (NCEH)

National Center for Health Marketing (NCHM)

National Center for Health Statistics (NCHS)

National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP)

National Center for Immunization and Respiratory Diseases (NCIRD)

National Center for Injury Prevention and Control (NCIPC)

National Center for Preparedness, Detection and Control of Infectious Diseases (NCPDCID)

National Center for Public Health Informatics (NCPHI)

National Center for Zoonotic, Vector-Borne and Enteric Diseases (NCZVED)

National Institute for Occupational Safety and Health (NIOSH)

CDC Centers

National Center for Chronic Disease Prevention and Health Promotion

• Vision: All people living healthy lives free from the devastation of chronic diseases.

National Center for Chronic Disease Prevention and Health Promotion

• Mission: To lead efforts that promote health and well-being through prevention and control of chronic diseases

National Center for Chronic Disease Prevention and Health Promotion

NPAO: Supporting State Programs

• Increase physical activity. • Increase the consumption of fruits and

vegetables. • Decrease the consumption of sugar sweetened

beverages. • Increase breastfeeding initiation, duration and

exclusivity. • Reduce the consumption of high energy dense

foods. • Decrease television viewing.

DHHS: Office of Disease Prevention and Health

Promotion,

• Works to strengthen the disease prevention and health promotion priorities of the Department within the collaborative framework of the HHS agencies.

• Collaborated with USDA on Dietary Guidelines

Administration on Aging (AoA)

• Elderly Nutrition Program

Grants to support nutrition services to older people throughout the country. The Elderly Nutrition Program, authorized under Title III, Grants for State and Community Programs on Aging, and Title VI, Grants for Native Americans, under the Older Americans Act, is intended to improve the dietary intakes of participants and to offer participants opportunities to form new friendships and to create informal support networks.

Administration on Aging (AoA): Nutrition Services to Older Adults

• Congregate & Home Delivered Meals

• Nutrition screening

• Nutrition education

• Counseling

• Supportive Health Services