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Assuring the Implementation of Effective Public Health
Strategies for Nutrition
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http://www.health.gov/phfunctions/public.htm
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Assuring Functions of Public HealthIOM 1994 Proposed by Aday
Enforce laws and regulations that protect health and ensure safety
Design model legislation to promote population health-centered programs within and across sectors
Link people to needed personal health services and assure the provision of health care when otherwise unavailable
Collaborate to develop and finance an integrated continuum of primary prevention, treatment, and long-term care programs and services in the community.
Aday, LA. Reinventing Public Health. 2005
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Assuring Functions of Public HealthIOM 1994 Proposed by Aday
Assure a competent public health and personal heath care workforce
Train pubic health, planning and development professionals in the population-based health approach
Evaluate effectiveness, accessibility, and quality of personal and population-based public health services
Evaluate public health and intersectoral initiatives in terms of their population health impact.
Aday, LA. Reinventing Public Health. 2005
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Serving All Functions
IOM 1994 Proposed by AdayResearch for new insights and innovative solutions to health problems
Design and conduct transdisciplinary research to address fundamental determinants of population health
Aday, LA. Reinventing Public Health. 2005
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Obesity
Sustainability Food Security
Leading Nutrition Concerns
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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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Ecological Framework for Influences on What People Eat
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It’s all about Collective Impact
Roadmaps to Health
http://www.countyhealthrankings.org/roadmaps
“Large-scale social change requires broad cross-sector coordination, yet the social sector remains focused on the isolated intervention of individual organizations.”
Conditions of collective success:1.Common agenda2.Shared measurement systems3.Mutually reinforcing activities4.Continuous communication5.Backbone support organizations
http://www.ssireview.org/articles/entry/collective_impact
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An Intersectoral Approach to Public Health
IOM. The Future of the Public’s Health, 2002
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Academia: 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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Healthy Communities Projects
• Healthy Communities don’t happen by accident. Communities are concerned about health effects of rising obesity rates and are taking action. Community leaders recognize that their residents can’t move more or eat healthier foods without changes in their community environment. Education and awareness alone won’t result in change. Safe sidewalks, trails, and bicycle lanes make it easier for people to move about and leave their car at home. Healthy food choice in school cafeterias and restaurants, well supported food banks, and neighborhood farmers markets offer options for healthier food. Making sustainable community changes involves long term partnerships among public health, private business, municipal government, community advocates, transportation planners, and schools.
http://www.doh.wa.gov/cfh/nutritionpa/our_communities/healthy_communities_projects/default.htm
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Health Care – Actions
• Implement coordinated comprehensive strategy
• Advocate for policies and organizational change to improve community environments
• Mobilize patient populations to engage in changing community environments.
• Strengthen partnerships• Establish model organizational practices
Prevention Institute
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Media• Ubiquitous advertising for
unhealthy foods has a powerful impact on nutritional health
http://www.rwjf.org/files/research/20081103herfoodmarketing.pdf
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Media Actions
• Nutrition advocates can use “framing” and media advocacy.
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Key Components of the Food SectorProduction Farming, gardening, aquaculture,
wild foods
Transformation Processing, packaging, labeling, marketing
Distribution Transportation, wholesaling, warehousing
Access Retail, food safety, food security
Consumption Purchasing, preparing, preserving, eating
Resource & Waste Mgmt.
Disposal, recycling
Muller, Tagtow, Roberts, MacDougall. J Hunger Envir Nutr. 2009
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www.wapartnersinaction.org
www.accesstohealthyfoods.org
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Emerging Model for an Intersectoral Approach to Public Health Nutrition
Assuring conditions for access to adequate and
appropriate food
Media
public health
Academia
Food System Sectors
Communities
Business
Institutions
NGOs
Health Care Agriculture
Education
Environment
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Today’s Work
• Build on your work on the nutrition problem you addressed in the systems discussion.
• For each point where public health might make a difference :– Choose an approach or intervention to improve the
system– Designate At least 5 sectors that could play a role– Outline the roles each sector could play to assure that
the intervention is well designed, effective and sustainable