Community Nutrition

What is community nutrition? What is health?

CN and trends in healthcare

Risk reduction and disease prevention

Definitions

Nutrition =

Community = “unified body of individuals with common characteristics or interests who live in a particular area”

What is Community Nutrition?

Community Nutrition (CN) strives to improve the health and well-being of individuals and groups within the community

Three arenas:

Involves socioeconomic,

political, cultural, and psychological aspects of food…

CN vs. Public Health

CN draws on dietetics and public health» public vs private

Public Health = societal efforts to promote/restore people’s health» 1900s:

» now:

Ten Leading Causes of Death in the U.S. (1900)

Rank Cause of death

1

2

3

4

5

6

7

8

9

10

Pneumonia/influenza

Tuberculosis

Diarrhea and enteritis

Heart disease

Stroke

Liver disease

Accidents

Cancer

Diphtheria

Meningitis

Causes in which diet plays a part

Causes in which alcohol plays a part

Ten Leading Causes of Death in the U.S. (2000)

Rank Cause of death

1

2

3

4

5

6

7

8

9

10

Heart disease

Cancer

Stroke

Lung diseases

Accidents

Diabetes

Pneumonia/influenza

Alzheimer’s disease

Kidney disease

Septicemia

Causes in which diet plays a part

Causes in which alcohol plays a part

What is Health?

Absence of _____________

State of:

Components of a Healthful Lifestyle

Clinical Medical

Community nutrition interfaces with the realities of

the health care system

Trends in Nutrition/Healthcare

Reality

Prevention is more effective, but…prevention efforts are

_______________

Outcomes can also be hard to_______

Health Insurance

Fee-for-Service (private)» traditional individual or group

Managed care (private)» group, usually employer-based

Public (Medicare and Medicaid)» low SES» aged, blind, disabled» are entitlement programs

Uninsured» working poor, seasonal workers» uninsurable

U.S. Healthcare: Insurance Coverage

Insured:(number; %)

Uninsured:(White/Black)

2002

242.4 million; 84.8%

10.7% / 19.5%

2003 243.3 million; 84.4%

11.1% / 19.5%

Sources: Census Bureau, CDC (NCHS); August 2004

U.S. Healthcare: Insurance Coverage

Insured:(number; %)

Uninsured:(White/Black/Hispanic)

2002

242.4 million; 84.8%

10.7% / 19.5%

2006 ?? million; 85.2%

10.5% / 16%

2008 ?? million; 85.3% 10.4% / 16% / 31%

Sources: Census Bureau, CDC (NCHS); Accessed September 2009Heyman KM, Barnes PM, Schiller JS. Early release of selected estimates based on data from the 2008 National Health Interview Survey. National Center for Health Statistics. June 2009. Available from http://www.cdc.gov/nchs/nhis.htm

Trends in the Healthcare System

Increase in managed care: HMOs, PPOs Increased costs

(Trend in jobs: part-time)

Health Continuum

Risks and Disease Prevention

Risk =

Risk assessment =

Who is at Risk?

Individuals» referral» ill

Groups» risk factors

Population» known

problems

Depends on people and hazards considered

U.S. Health Disparities: 2008

2004 IMR

(per 1000 live births)

2005Life expectancy

(male/female in years)

2007

Poverty

(% of population)

White

5.7

75.7 / 80.8

10.5%

Black 13.6

69.5 / 76.5 24.5%

Hispanic 5.5 21.5%

Total 6.8 75.2/ 80.4 12.5%

Sources: Census Bureau, CDC (NCHS); Accessed September 2009; Health: United States, 2008; National Vital Statistics Reports, Vol. 55, No. 14, May 2, 2007; Income, Poverty, and Health Insurance Coverage in the United States: 2007

U.S. Health Disparities ~1998

IMR

(per 1000 live births)

Life expectancy(years)

Poverty

(% of population)

Whites

7.3

~75

11.6%

Blacks 17.6

~65 33.3%

Healthy People 2010

Mission = creating healthy people in healthy communities

2 Goals:» increase the quality of life and years of

healthy life» eliminate health disparities