Assuring the implementation of effective public health strategies for nutrition
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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


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


Leading Nutrition Concerns

Obesity

Sustainability

Food Security


Effective Strategies to Address these Concerns require:

  • Transdisciplinary research base

  • Population-heath focus

  • Grounding in fundamental social and economic determinants of health

  • Intersectoral engagement


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


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


Ecological Framework for Influences on What People Eat


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


  • 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


Assuring Functions of Public Health

Aday, LA. Reinventing Public Health. 2005


Assuring Functions of Public Health

Aday, LA. Reinventing Public Health. 2005


Serving All Functions

Aday, LA. Reinventing Public Health. 2005


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.


An Intersectoral Approach to Public Health

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


Key Components of the Food Sector

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


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


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


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


  • 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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