community nutrition hnu 365 dr. laurie wadsworth
TRANSCRIPT
Text Book
Community Nutrition: An entrepreneurial approach, 5th Edition. Boyle & Holben, 2010
Web site with chapter summaries, quizzes and Power Point slides
Chapters with case studies, summary points, glossary, programs in action
Entrepreneurship in Health Promotion
Opportunities expected to expand in future
Skills used with marketing, management, & other business skillsDesign, implementation,
evaluation of programs
Eddy, & Stellefson, 2009, Health Promot Pract, 10 (3), 333-341
Rules of Engagement
Responsibility for own learning & contribution
Openness – open to new ideas & opinions
Participation – at own comfort level
Experimentation – experiment with thinking & sharing
Sensitivity – listen for intent
Course Evaluation
Assignment Value
Lab Assignment #1 5 %
Lab Assignment # 2 5%
Mid-term Exam 20%
Final Project Report 10%
Project Tool 15%
Community Project Fair 10%
Final Exam 35%
Public Health Educators’ Participation in Teams
Participated in average of 4 teams3 of these were inter-
organizational40% respondents participated
in 5 or more
Curricula should reflect collaborative work
Lovelace, et al., 2009, Health Promot Pract 10 (3), 428-435
“Apart from hermits, people live and work in groups . . So if you have it in mind to influence the way in which life goes on, you will not do it solely by trying to influence people-as-individuals, you will have also to think of people-in-groups.”
J. Yukdin & JC McKenzie
Changing Food Habits
Weeks 1 & 2
Introduction and course overview
The ‘who’, ‘what’ and ’how’ of community nutrition
Weeks 3 & 4Public Health, Health
Promotion, and Population Health
Review for Lecture
Stepping it up: Moving the Focus from Health Care in Canada to a Healthier CanadaHealth Council of Canada
http://www.healthcouncilcanada.ca
Social Science Key to Restoring Health
“The puzzles of better health promotion and disease prevention may be approached more rapidly and effectively through intensified social science research, rather than by awaiting the expected evolution of gene-based explanations and interventions based on future genetic discoveries.”
• Floyd Bloom, President Am. Assoc. for the Advancement of Science (2003)
“a group of people who share a common culture, identify themselves as a group, and usually live within a defined geographical area” (WHO, 1985)
“a body of people living near one or another and in social relationship; a body of people with a faith, profession or way of life in common; common ownership; a sharing” (Webster’s Encyclopedic Dictionary, 1988)
Community is…
“a group of inhabitants living in a somewhat localized area under the same general regulation and having common norms, values and organization” (Green and Ottoson, 1994)
“a group of people residing in specific geographical area who have common values, cultural patterns and social problems, together with an awareness of belonging to a group that causes them to interact more intensely with one another than they would with outsiders in a similar context” (Agudelo, 1983 in Jewkes, 1996)
Community is…
“is whatever one wishes it to be; but it is always (1) more than one person, (2) sharing, (3) commonalities” (Community Building Resources, Roberts, 1997)
“when a group has the power to decide what is a problem, the power to decide how to solve the problem, and the power to become an active part of implementing the solution (McKnight and de Toqueville in Roberts, 1997)
Community is…
The absence of disease or illness
A state of complete physical, mental and social well-being and not merely the absence of disease and infirmity (WHO, 1974)
The ability to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment; a resource for everyday life, not the objective of living; a positive concept emphasizing social and personal resources, as well as physical capacities.” (WHO, 1986).
Health is…
Emerged as an important component of health and social programs in the early 1940s.” (WHO, 1986).
Aims to prevent problems related both to food insufficiencies and excesses, and to promote well-being through a secure and safe food supply and healthful eating habits
Community Nutrition…
Community Nutrition
Focus includes people, policies & programs
Policy action chosen by decision
makers to address specific problem
Through laws, regulations, programs
ProgramsInstruments used to seek
behaviour changes that improve nutritional well being
Public Health Agency
Organizations involved in community nutrition…
(Obert, 1986 in Davis, 1989)
Social Services
Day Care,
SchoolsAgricultu
ral Extension
Food Industry
Health Care
Providers
Fitness Centres
Work Site
Self-help Groups
Voluntary Agencies
Food Aid Programs
Key Actions for Successful Nutrition Programming
Service Delivery-Assess needs, tailor services
-Sustainability
Program monitoring& Evaluation-Collect data
-Conduct evaluations
Program Design-goals, population
-planning
Indicators of Change
Social & economic trends↑ ethnic diversity↑ Women in global workforce↑ older adults
Future Trends
Change, innovation, creativity, entrepreneurship
Global social change smaller world
Internet links people around the world
↑ connectedness of human beings challenges for community
nutritionists
Nutrition Trends:Baby-Boom Generation
82% report being very knowledgeable about food and nutrition
75% report good to excellent eating habits & health status
Average 2 snacks per day82% use vitamin & other
supplementsTracking Nutrition Trends 2008, Canadian Council of Food and Nutrition
Nutrition Trends:Baby-Boom Generation
Meal most often eaten away from home Lunch (12%); breakfast (9%);
dinner (7%)71% get dietary info from
dietitiansLabels (71%); Internet (52%);
print materials (47%); health professionals (43%)
Nutritional content leads food choiceWhole grains (86%); protein
(80%); calories (79%); total fat (78%)
Tracking Nutrition Trends 2008, Canadian Council of Food and Nutrition
Life Expectancy
“Some Canadians live their lives in excellent health with one of the highest life expectancies in the world . . . Others spend their life in poor health, with a life expectance similar to some third world countries. We cannot correct this inequity through the health care delivery system itself, regardless of the expenditure we devote to it.”
• A Healthy, Productive Canada: A determinant of health approach, Senate of Canada, 2009
Evidence-based Public Health Approaches
Essential to changing public health outcomes
Requires skills to review evidence & to choose most workable strategy for problem defined
Baker, et al., 2009, Health Promot Pract, 10, 342-348
Evidence-based Public Health Approaches
Skills neededCommunity assessmentQuantifying issueDevelop problem statementDetermine what is known from
literaturePrioritizing program & policy
issuesDevelop & implement action
planEvaluate program or policy
Baker, et al., 2009, Health Promot Pract, 10, 342-348
Strengthening Public Health Nutrition Practice in Canada
Public health nutrition requires the leadership of dietitians with expertise in nutrition, food systems & related public health sciences.
Public health nutrition practice encompasses the assessment, promotion, protection & enhancement of health & the prevention of nutrition related disease.
Using population health & health promotion approaches, strategies focus on the interactions among the determinants of heath, food security, & nutritional & overall health.
Pan Canadian Task Force on Public Health Nutrition Practice, 2009
Strengthening Public Health Nutrition Practice in Canada
All dietetic students and/or interns are exposed to public health philosophies and/or environment in their preparatory education and/or practical training based on the updated dietetic competencies.
Dietetic competencies are updates to provide a foundation for desired public health practicePan Canadian Task Force on Public Health Nutrition Practice, 2009
Core Competencies for Public Health
Visitwww.corecompetencies.ca
Learn about development of competencies in Canada
Find links to projects, tools and resources to support public health practice
Build your portfolio by listing competencies you have used
Test your knowledge of core competencies
Canada Health Act (1984)
Five Principles for continued federal fundingPublic AdministrationComprehensivenessUniversalityPortabilityAccessibility
Future of Health Care in Canada
Canadians favour systemPublicly fundedComprehensive
Pessimistic about sustainability
Increasing privatization
Calls for substantial reformsConsensus remains elusive
Health Care Costs in Canada (1994)
0%
5%
10%
15%
20%
25%
30%
35%
40%
Hospital
MDs
Rx Drugs
Public Hlth
Home Care
Health Care Costs in Canada (2004)
$130 B on health/year= over $10,000 per household
Only ~2.1% goes to public healthFor every $100 spent on health
care in Canada, $2.10 goes into public health
For every 100 people working on the health outcome problems, only 2 work on the public health prevention side
Wellbeing
Institute of Wellbeing adopted this working definition:“The presence of the highest
possible quality of life in its full breadth of expression, focused on but not necessarily exclusive to: good living standards, robust health, a sustainable environment, vital communities, an educated populace, balanced time use, high levels of civic participation, and access to and participation in dynamic arts, culture & recreation.”
Institute of Wellbeing, 2009
Canadian Index of Wellbeing
CIW – www.ciw.caa new method for measuring
Canadian quality of lifeGoes beyond economic indicators
(i.e., GDP)Measures 8 interconnected areas
of wellbeingStandard of living -- Education Health -- Way we
use our timeVitality of communities state of arts, culture, recreation,
environment
Bringing it together
“If we want Canadians to be the healthiest people in the world . . . We have to cure ‘hardening of the categories’ which has over the years drastically compartmentalized many of the policy and programmatic tools that must be brought together to move us along the health outcome continuum.”
• Roy Romanow, Keynote remarks at inaugural meeting of the Health Council of Canada, 2004
Pan-Canadian Health Living Strategy
FPT ministers of health endorsed strategy in 2005
In 2010 endorsed 2 new initiativesCreating a healthier Canada:
Making prevention a priorityCurbing Childhood Obesity: A
federal, provincial, & territorial framework for action to promote healthy weights
Health Objectives
To protect & promote health of all people
Challenge is to translate goal into actionMany physical, social, biological,
behavioral health determinantsChanging human behaviour
Nations differ in formulation of health objectives & strategies for behaviour change
Community Nutrition:Key Documents
Nutrition for Health: an agenda for action
The Nova Scotia agenda for action
Eating Well with Canada’s Food Guide
Healthy Eating Nova Scotia 2005 http://
www.gov.ns.ca/ohp/repPub/HealthyEatingNovaScotia2005.pdf
Total Diet Approach
Evidence supports behaviour-oriented food & nutrition programs That help learners adopt total diet
approach• Sustainable
• Fits individual preferences
Some concern expressedMay be perceived as permitting
unlimited inclusion of low-nt dense products
• ADA Position paper – Total Diet approach to communicating food and nutrition information, 2007