Nutrition in Public Health

502 Pages·2017·6.075 MB·English

by  Sari Edelstein (editor)

F O U R T H E D I T I O N
NUTRITION
IN PUBLIC HEALTH
Edited by
Sari Edelstein, PhD, RDN
Professor, Retired
Department of Nutrition
School of Health Sciences
Simmons College
Boston, Massachusetts
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Library of Congress Cataloging-in-Publication Data
Names: Edelstein, Sari, editor.
Title: Nutrition in public health / [edited by] Sari Edelstein.
Other titles: Nutrition in public health (Edelstein)
Description: Fourth edition. | Burlington, MA : Jones & Bartlett Learning,
[2018] | Includes bibliographical references and index.
Identifiers: LCCN 2016048923 | ISBN 9781284104691 (pbk. : alk. paper)
Subjects: | MESH: Nutritional Physiological Phenomena | Needs Assessment |
Nutrition Policy | Public Health Practice | Risk Factors | United States
Classification: LCC RA601 | NLM QU 145 | DDC 362.17/6–dc23 LC record available at https://lccn.loc.gov/2016048923
6048
Printed in the United States of America
21 20 19 18 17 10 9 8 7 6 5 4 3 2 1
© Bocos Benedict/ShutterStock, Inc.© Bocos Benedict/ShutterStock, Inc. DDeeddiiccaattiioonn
To Late Mildred Kaufman
To all our wonderful students,
who will make a positive change worldwide for generations to come.
Contents © Bocos Benedict/ShutterStock, Inc.
Preface viii Guidelines for Causality 44
Acknowledgments xi General Considerations in Nutritional Epidemiologic Studies 47
The Role of Nutritional Epidemiology in Public Health 48
Contributors xii
Conclusion 48
Case Study Contibutors xiii
Issues for Discussion 49
Reviewers xiv
Practical Activities 49
Online Resources 49
Part I Applying Nutrition in
Part II Shaping the Policies
Public Health 1
that Affect the Public’s
Health 53
1 Applying Nutrition Science to the Public’s Health 3
Carol E. O’Neil, PhD, MPH, RD, LDN
3 Creating Public Policy and Advocating for
Theresa A. Nicklas, DrPH
Nutrition Policies 55
Introduction 4
Jody L. Vogelzang, PhD, RDN, FAND, CHES
Public Health Nutrition and Public Health Nutritionists 5
Introduction 56
Peer-Reviewed Literature and Evidence-Based Practice 5
Characteristics of Public Policy 56
Nutrition Monitoring 10
U.S. Public Health Policy 57
Epidemiologic Studies 16
Policy Formulation 59
Metabolic Diet Studies 19
Policy Creation at the Federal Level 61
Clinical Trials 20
Policy Development at All Levels of Government: Federal, State,
Animal Studies 20 and Local 62
Healthy People 2020 20 Advocating and Influencing Health and Nutrition Policies 67
Nutrient Requirements 21 Importance of Building an Infrastructure of Support 70
Center for Nutrition Policy and Promotion 23 Advocacy Activities and Skills for Individuals 70
Dietary Guidelines for Americans 23 The Future of Public Health 71
MyPlate, MyWins 24 Conclusion 71
Healthy Eating Index 26 Issues for Discussion 71
The Food Label 27 Practical Activities 71
Conclusion 29 Online Resources 72
Issues for Discussion 30
4 Role of the Federal Agencies in Public Health
Online Resources 30
Nutrition 74
Sari Edelstein, PhD, RDN
2 Nutritional Epidemiology: An Introduction 38
Lisa S. Brown, PhD, RD, LDN Introduction 75
Elisabeth Offenberger, MS, RD Overview of Food, Nutrition, and Consumer Services 75
Introduction 39 Overview of the Food Safety and Inspection Service 77
Overview of Epidemiology 39 Overview of Research, Education, and Economics 77
Overview of Nutritional Epidemiology 39 History of Nutrition Education at the USDA 83
Types of Study Designs Used in Nutritional Epidemiology 41 Food and Drug Administration 87
Contents v
Centers for Disease Control and Prevention 87 8 Intervening to Change the Public’s Eating
Environmental Protection Agency 88 Behavior 150
Brandy-Joe Milliron, PhD
Conclusion 89
Margaret-Claire Chenault, MS
Issues for Discussion 90
Dana Dychtwald, MS
Practical Activities 90
Introduction 151
Online Resources 91
The Obesity Epidemic 151
Part III Assessing and Intervening Current Eating Trends 153
in the Community’s Changing Eating Behavior 156
Nutrition Needs 93 Conclusion 174
Issues for Discussion 174
5 Community Needs Assessment 95
Practical Activities 174
Elizabeth Metallinos-Katsaras, PhD, RDN
Katherine Deren, MS Online Resources 175
Introduction 96 Part IV Promoting the Public’s
Community Needs Assessment: Definition and Overview 96 Nutritional Health 183
Steps to Conduct a Community Needs Assessment 97
9 Growing a Healthier Nation: Maternal, Infant, Child, and
Conclusion 111 Adolescent Nutrition with an Emphasis on Childhood
Issues for Discussion 112 Overweight 185
Shortie McKinney, PhD, RDN, LDN, FADA
Practical Activities 112
Online Resources 113 Introduction 186
Healthy People 2020 Objectives 186
6 Planning and Evaluating Nutrition Services for the
Maternal Health 186
Community 115
Preconceptional Period 188
Julie M. Moreschi, MS, RDN, LDN
Infancy 192
Introduction 116
Childhood and Adolescence 195
Project Models 117
Overweight in Children from a Public Health Perspective 209
Intervention Mapping 123
Environmental Influences on Children Who Are Overweight 211
Community Health Assessment and Group Evaluation (CHANGE) 124
Public Health Initiatives 212
Program Implementation 125
Opportunities for Public Health Nutritionists to Intervene and Prevent
Determining Team Membership 125
Overweight in Children 214
Health Program Evaluation 127
Conclusion 216
Conclusion 129
Issues for Discussion 217
Issues for Discussion 130
Online Resources 218
Practical Activities 130
10 Importance of Public Health Nutrition Programs in
Online Resources 130
Preventing Disease and Promoting Adult Health 225
7 Serving Those at Highest Nutritional Risk 133 Marianella Herrera-Cuenca, DSc, MD
Rachel Colchamiro, MPH, RD, LDN Introduction 226
Jan Kallio, MS, RD, LDN
Chronic Diseases: The Leading Causes of Death and Disability 226
Introduction 134
Prevention Strategies 227
Defining High-Risk Factors 134
Dietary Guidelines for Disease Prevention 230
Improving Services to At-Risk Families 144
Diet and Health: Nutrition Strategies Health Determinants and Risk
Conclusion 144 Factors 232
Issues for Discussion 147 Policies and Programs 244
Practical Activities 147 Conclusion 245
Online Resources 148 Issues for Discussion 245
vi Contents
Practical Activities 245 Food Security in the United States 300
Online Resources 246 Impact of Food Insecurity on the Public 304
Strategies to Assist the Public in Securing Adequate Food 305
11 Promoting Older Adult Nutrition 252
Andrea T.K. Roche, MS, RDN, LDN Conclusion 305
Issues for Discussion 306
Introduction 253
Practical Activities 306
Unique Features of Baby Boomers 254
Online Resources 306
State of Health of the Older Adult Population 255
Health Insurance and Screening 256
14 Safeguarding and Securing the Food Supply 310
Aging-in-Place 257
Rebecca Kahn, MA
Wellness Screening and Interventions 257
Introduction 311
Nutrition Support Services for Older Adults 258
Food Safety Defined 311
Other Public Health Nutrition Interventions 263
Protecting the Food Supply 312
The Future 264
Food Safety Laws 314
Conclusion 265
Hazards to Food Safety 318
Issues for Discussion 265
Food Safety in the 21st Century 329
Practical Activities 265
Food as a Target 330
Online Resources 266
Public Health Preparedness for Food Biosecurity 332
12 Providing Nutrition Services in Public Health Primary
Food Biosecurity Triad: Food Systems Security, Public Health Vanguard,
Care 269 and Consumer Engagement 337
Lauren Melnick, MS, RDN, LDN
From Awareness to Security 344
Introduction 270
Conclusion 345
Room for Nutrition in Primary Care 270
Issues for Discussion 346
Agency for Healthcare Research and Quality 272
Practical Activities 346
Barriers to Providing Nutrition Services in Primary Care and Strategies
Online Resources 347
for Increasing Services 274
Systemwide Change Strategies for Reducing the Cost of Medical
Part VI Managing Programs 361
Care 276
Chronic Disease Management and Self-Management 276
15 Grant Writing in Public Health Nutrition 363
Summary of Health Insurance Plans 278 Kathleen Cullinen, PhD, RDN
Representative Programs That Deliver Nutrition Services in Primary
Introduction 364
Care Settings 280
General Revenue 365
Health Resources and Services Administration, Bureau of Primary
Third-Party Reimbursement 367
Health Care 283
Public Health Department Accreditation 367
Conclusion 287
Developing Skills in Grant Writing 367
Issues for Discussion 287
Preparing Your Grant Application 368
Practical Activities 288
Data in Grant Writing for Program Planning and Evaluation 370
Online Resources 290
Analysis of Quantitative Data 375
Part V Protecting the Public’s
Data in Program Management and Evaluation 376
Nutritional Health 293
Nutrition Monitoring and Surveillance 377
Protection of Human Subjects 377
13 Food Security and Adequate Food Access for the
Public 295 Data Compilation 378
David H. Holben, PhD, RDN, LD, FAND Prior to Submitting Your Grant Proposal 379
Introduction 296 Conclusion 380
Measuring the Food Security Status of the Public 296 Issues for Discussion 380
Contents vii
Practical Activities 380 Synergizing with the Strategic Plan 428
Title of Proposed Project: Farm to Family 381 Partnering to Achieve Shared Goals 429
Online Resources 383 Relations with the Policy Board 429
Communications with the Media 429
16 Staffing, Managing, and Leading Public Health Nutrition
Conclusion 431
Personnel 385
Issues for Discussion 431
Esther Okeiyi, PhD, RDN, LDN
Practical Activities 431
Introduction 386
Online Resources 432
The Role of a Public Health Nutrition Director/Manager 386
Conclusion 402
19 Marketing Nutrition Programs and Services 433
Issues for Discussion 402
Debra A. Silverman, MS, RDN
Practical Activities 402
Introduction 434
Online Resources 403
Business Marketing Versus Social Marketing 434
Marketing Research 435
17 Leveraging Nutrition Education Through the Public Health
Primary Data 436
Team 405
Deepa Arora, PhD Market Segmentation 437
Introduction 406 The Social Marketing Mix 438
Modifying Nutrition-Related Behavior 406 Evaluation 443
Definition of Nutrition Education 406 Marketing Ethics 443
Impact of Nutrition Education 406 Conclusion 444
The Nutrition Education Team 409 Issues for Discussion 444
Education Programs 412 Practical Activities 445
National Initiatives to Promote Nutrition Education 413 Online Resources 445
Teamwork 414
20 Striving for Excellence and Envisioning the
Conclusion 416
Future 448
Issues for Discussion 416
Jennifer Hughes, MS
Practical Activities 416
Introduction 449
Online Resources 417
Importance of Professional Development 451
Future Challenges in Public Health Nutrition 453
Part VII Surviving in a Competitive Conclusion 454
World 419 Issues for Discussion 454
Practical Activities 454
18 Networking for Nutrition and Earning Administrative
Online Resources 455
Support 421
References 455
Sharon Gallagher, MEd, RD, LDN
Introduction 422
Appendix A Helpful Nutrition Web Sites 456
Networks, Alliances, Coalitions, and Consortiums 422
Appendix B State Health Department Web Sites 458
Collaborating with Others for Nutrition Networks 423
Appendix C Comprehensive Case Study 459
Developing a Community-Based Nutrition Network 425
Professional Networking 425 Appendix D List of Abbreviations 461
Earning Administrative Support 427 Glossary 462
The Administration’s Perspective 427 Index 469
Understanding the Agency Vision and Strategic Plan 428
Preface © Bocos Benedict/ShutterStock, Inc.
WHAT IS PUBLIC HEALTH 10. Research for new insights and innovative solutions
to health problems.
NUTRITION?
When these 10 elements are expanded to full
explanations, we create a compendium of information that
Public health nutrition is a complex, multifaceted set
mirrors the table of contents in this book. The organization
of programs dedicated to improving the health of the
of Nutrition in Public Health, Fourth Edition, embraces the
population through improved nutrition. In more detail,
Essential Public Health Service Functions.
public health nutrition primarily exists to:
• Improve the health of the whole population and
teach high-risk subgroups within the population
ORGANIZATION OF THIS TEXT
improved nutrition;
• Emphasize health promotion and disease prevention
The structure of Nutrition in Public Health has been
through improved nutrition; and
completely reorganized in an effort to better match the way
• Provide integrated community efforts for improved
courses are taught.
nutrition with leadership demonstrated by government
Part I, “Applying Nutrition in Public Health,” creates
offices.1
the necessary foundation for readers to understand public
To accomplish these three primary elements of public
health nutrition. These chapters include:
health nutrition, the U.S. Public Health Service has
delineated 10 Essential Public Health Service Functions.2 • An explanation that public health goals are built
Each of these 10 elements will assist the reader in on a foundation of sound research, wherein peer-
understanding the steps that must be taken by public health reviewed studies provide the groundwork.
professionals to bring about definitive qualitative and • A journey through studying populations utilizing
quantitative results. epidemiology, and how problems and solutions are
questioned and acted upon.
1. Monitor health status to identify and solve
community health problems. Chapters 3 through 8 comprise Part II, “Shaping the
2. Identify and investigate the causes of health problems Policies That Affect the Public’s Health,” and Part III,
and health hazards in the community. “Assessing and Intervening in the Community’s Nutrition
3. Mobilize community partnerships and action to Needs.” These chapters illustrate the landscape of public
identify and solve health problems. health, including:
4. Develop policies and plans that support individual
• The role of the federal government in supporting
and community health.
public health nutrition.
5. Enforce laws and regulations that protect health and
• How researchers and others determine the need
ensure safety.
for public health nutrition in areas of the United
6. Link people to needed personal health services and
States.
assure the provision of health care when otherwise
• How researchers determine the needs of each
unavailable.
community and focus on its nutritional problems.
7. Inform, educate, and empower people about health
• An explanation of how nutritional services are
issues.
planned and evaluated for a community.
8. Evaluate effectiveness, accessibility, and quality of
• Changing the public’s eating behavior as a whole.
personal and population-based health services.
9. Assure a competent public health and personal In Part IV, “Promoting the Public’s Nutritional
healthcare workforce. Health,” Chapters 9 through 12, we strive to educate the
Preface ix
reader about federal programs that provide public health • Issues for Discussion encourage readers to discuss
nutrition for those at risk. These include: topics relevant to the chapter with their peers.
• Practical Activities suggest activities that allow
• Promoting maternal, infant, child, and adolescent
readers to apply what has been learned in the chapter,
nutrition.
either individually or as part of a group.
• Assessing and providing for adult nutrition.
• Online Resources direct readers to websites
• Caring for older adults and their nutritional
relevant to the chapter content.
problems.
• Explaining nutritional programs in public health. These pedagogical features assist in bringing the chapter
material to life as students will need to use critical thinking to
Part V, “Protecting the Public’s Nutritional Health,”
solve public health nutrition problems through application.
delineates 21st century issues in providing safe and secure
food supplies for the public. These include:
NEW TO THIS EDITION
• Providing food security and adequate food access for
the public.
• Safeguarding and securing the food supply. Nutrition in Public Health, Fourth Edition, has maintained the
cutting edge relevance of previous editions, while adding
Part VI, “Managing Programs,” and Part VII, “Surviving
several enhancements:
in a Competitive World,” address the administrative and
managerial portion of public health nutrition and programs. • Reorganized Table of Contents. The Table of
These include: Contents has been completely reorganized for this
edition in an effort to streamline the content and to
• Grant writing for funding of public health nutrition
better reflect the way many instructors teach public
programs.
health nutrition. This has involved rearranging,
• Staffing, managing, and leading public health
combining, and separating chapters as necessary. A
nutrition personnel.
Transition Guide comparing the Tables of Contents
• Leveraging nutrition education through a public
for the Third Edition and Fourth Edition is available
health team.
online.
• Networking for nutrition by earning administrative
• Thoroughly revised and in-depth content.
support.
Each chapter has been updated and enhanced to give
• Marketing nutrition programs and services.
the reader a vast supply of background information
• Striving for excellence and envisioning the future.
and a full understanding of public health nutrition.
In addition, new and expanded topics have been
added to the Fourth Edition to reflect current public
FEATURES OF THIS TEXT health issues. These include:
• Updated Dietary Guidelines for Americans,
MyPlate, Healthy People 2020, and other nutrition
An effort has been made to ensure that pedagogical features
indexes
are consistent from chapter to chapter. At the beginning of
• Updated federal nutrition policies and services
each chapter, the reader will find the following:
• Updated approaches to disease prevention and
• Learning Objectives present the chapter’s desired new disease statistics, including current U.S.
outcomes to readers. statistics and census information
• Key Terms help the reader quickly identify critical • Newly added grant writing procedures
new terms, with definitions included in the end-of- • New, comprehensive end-of-text Glossary
text Glossary. • Added Case Studies. Case Studies are now found
at the end of each chapter, reinforcing key concepts
At the end of each chapter, the reader will find the
by presenting real-life examples. Comprehensive
following:
Case Studies that utilize concepts found across the
• Case Studies provide a real-world dimension to span of the text are also found in Appendix C. An
chapter content, illustrating how public health Answer Key for all Case Study questions is available
nutrition issues and programs can affect real people. for qualified instructors.