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Assuring the Implementation of Effective Public Health Strategies for Nutrition. Objectives. Students will be able to: Describe the characteristics of public health approaches to assuring nutritional health Apply basic constructs of systems thinking to a public health nutrition concern.

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Assuring the Implementation of Effective Public Health Strategies for Nutrition

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Assuring the implementation of effective public health strategies for nutrition l.jpg

Assuring the Implementation of Effective Public Health Strategies for Nutrition


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Objectives

  • Students will be able to:

  • Describe the characteristics of public health approaches to assuring nutritional health

  • Apply basic constructs of systems thinking to a public health nutrition concern


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Leading Nutrition Concerns

Obesity

Sustainability

Food Security


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Effective Strategies to Address these Concerns require:

  • Transdisciplinary research base

  • Population-heath focus

  • Grounding in fundamental social and economic determinants of health

  • Intersectoral engagement


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Systems Thinking

  • the only way to fully understand why a complex problem occurs and persists is to understand the part in relation to the whole (O'Connor & McDermott, The Art of Systems Thinking: Essential Skills for Creativity and Problem-Solving)

  • Traditional scientific approach = isolating small parts of the system

  • Systems thinking = taking many interactions into account


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Systems thinking is needed for problems that are:

  • Complex problems that involve helping many actors see the "big picture" and not just their part of it

  • Recurring problems or those that have been made worse by past attempts to fix them

  • Issues where an action affects (or is affected by) the environment surrounding the issue, either the natural environment or the competitive environment

  • Problems whose solutions are not obvious

http://www.thinking.net/Systems_Thinking/Intro_to_ST/intro_to_st.html


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Ecological Framework for Influences on What People Eat


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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 healthproblems


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Assuring Functions of Public Health

Aday, LA. Reinventing Public Health. 2005


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Assuring Functions of Public Health

Aday, LA. Reinventing Public Health. 2005


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Serving All Functions

Aday, LA. Reinventing Public Health. 2005


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Responsibilities of Schools of Public Health

  • Educate educators, practitioners and researchers – prepare leaders

  • Transdisciplinary research

  • Contribute to policy

  • Work with other professional schools to assure quality public health content

  • Assure access to lifelong learning for practitioners

  • Actively engage in communities

Who Will Keep the Public Healthy? IOM 2002.


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An Intersectoral Approach to Public Health

IOM. The Future of the Public’s Health, 2002


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Key Components of the Food Sector

Muller, Tagtow, Roberts, MacDougall. J Hunger Envir Nutr. 2009/


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CONSUMPTION-ORIENTED FOOD SUPPLY CHAIN ANALYSIS

  • describe the steps in the chain from farm to fork;

  • describe the organizational, financial, technological, and policy characteristics of the processes and actors in each step of the chain

  • identify the organizational, financial, technological, and policy incentives and disincentives within the chain

  • analyze how incentives and disincentives affect the food environment: food availability, prices, and marketing;

  • identify how these incentives could be leveraged to better align the food supply chain with healthy diets

    Example: Coca-Cola supply chain.

Hawkes, J Hunger Envir Nutr. 2009


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Emerging Model for an Intersectoral Approach to Public Health Nutrition

Communities

Institutions

Media

NGOs

Assuring conditions for access to adequate and appropriate food

Govt.: public health, agriculture, education, environment

Business

Food System Sectors

Academia


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Determinants of Individual Food Choice

  • Proximal & Immediate

    • Taste

    • Cost

    • Convenience

    • Proximity

  • Overarching Influencers

    • Marketing

    • Cultural norms

    • For some specific individuals: health concerns and health literacy


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  • Pick a specific food-based behavior that needs to be improved in a specific population

  • How is this behavior linked to obesity, food security & sustainability?

  • Develop a graphic to describe the system that currently influences the specific behavior

  • Identify possible strategies to improve the behavior

  • Identify a role for at least 5 of these sectors:

    • Govt. public health (fed, state, local)

    • Govt. agriculture

    • Communities

    • Institutions (worksites, schools, faith institutions, etc)

    • Health care

    • Employers

    • Media

    • Academia

    • Food system actors


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