Introduction to Public Health Nutrition

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Introduction to Public Health Nutrition

• January 2009

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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What is Public Health?
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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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Population Health
Improving Everyones Quality of Life Group
Health Foundation, 2001
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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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Public Health Practice Compared to Clinical
Nutrition Practice
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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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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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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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Ecological Approaches to Public Health Nutrition
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The Socio-Ecological Model
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Societal policies and processes influencing the
population prevalence of obesity
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Part of the Social Network from the Framingham
Heart Study with Information about Body-Mass
Index According to Year
Christakis N and Fowler J. N Engl J Med
2007357370-379
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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 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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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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