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									   Introduction to
Public Health Nutrition
     January 2011
        Nutrition 531
What is Health?
A state of complete physical, mental, and
  social well-being, not merely the
  absence of disease.
What is Public Health?
 Mission of Public Health

“…to fulfill society’s interest in assuring
conditions in which people can be
                 IOM. Future of Public Health.
Population Health

        Improving Everyone’s Quality of Life: Group Health
        Foundation, 2001
        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
Public Health Practice Compared to
Clinical Nutrition Practice
              Public Health   Clinical Nutrition
              Practice        Practice

 Focus        Prevention      Disease treatment

 Target       Populations     Individuals

 Setting      States &        Clinics &
              Communities     Hospitals
 Strategies   Multiple,       Counseling and
              Reinforcing     education
Core Functions of Public Health
• Assess the problems and needs of the
• Monitor the health of populations
• Assess and monitor the determinants of
  population health
       Policy Development
• Develop policies, programs and
  activities that address health outcomes
  and the determinants of those outcomes
• Assure the implementation of effective
  strategies by providing or monitoring
  policies, activities, and services.
What About Nutrition?
  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.
Leading Causes of Death, 1900

   Centers for Disease Control and Prevention, National Center
   for Health Statistics. National Vital Statistics System and
   unpublished data. 1997.
Leading Causes of Death, 1997

      Centers for Disease Control and Prevention, National Center for
      Health Statistics. National Vital Statistics System and
      unpublished data. 1997.
10 Essential Public Health Services: Public
Health Functions Steering Committee - State
and Local
• Monitor Health Status to identify community health
• Diagnose and investigate health problems
• Inform, educate, and empower people about health
• 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
• 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
Brief History of Public Health
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.”
• “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
• “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.”
1917    USDA issues dietary recommendations (5 food
1924    Iodine added to salt
1920s   Maternal and Infancy act – state health
        departments employ nutritionists
1930s   Federal gov’t. establishes food relief, nutrition
        education, school feeding, food consumption
1940s   25% of draftees had present/past malnutrition;
        National Nutrition Conference for Defense: first
        RDA, War Order Number One: enrich wheat
        flour with vitamins and iron
1949    Framingham
1968   Hunger USA

1969   White House Conference on Food, Nutrition,
       and Health
70s    “McGovern committee”, Preschool survey, 10
       State Nutrition Survey, Food Stamp legislation,
       Child Nutrition Act – WIC, EFNEP,NET,
       nutrition labeling
1979   Surgeon General’s Report: Healthy People

1980   First Dietary Guidelines for Americans

1988   Surgeon General’s Report on Nutrition and
1990   National Nutrition Monitoring and Related
       Research Act
1997   First DRIs
Last Decade: Strong Emphasis on
 Policy & Environmental Change
         Healthy People 2020
•   Healthy People provides science-based, 10-year
    national objectives for improving the health of all
•   Overarching Goals
    1. Attain high-quality, longer lives free of preventable
       disease, disability, injury, and premature death.
    2. Achieve health equity, eliminate disparities, and
       improve the health of all groups.
    3. Create social and physical environments that promote
       good health for all.
    4. Promote quality of life, healthy development, and
       healthy behaviors across all life stages.

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