Chapter 1
Opportunities in Community
Nutrition
© 2006 Thomson-Wadsworth
Learning Objectives
• Describe the three arenas of
community nutrition practice.
• Explain how community nutrition
practice fits into the larger realm
of public health.
• Describe the three types of
prevention efforts.
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Learning Objectives
• List three major health objectives for
the nation and explain why each is
important.
• Outline the educational requirements,
practice settings, and roles and
responsibilities of community
nutritionists.
• Explain why entrepreneurship is
important to the practice of community
nutrition.
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Introduction
• Community nutritionists face many
challenges in practice.
– The challenge of improving the nutritional
status of different kinds of people.
– The challenge of influencing lawmakers and
other key citizens.
– The challenge of studying the scientific
literature.
– The challenge of mastering new
technologies.
– Successful community nutritionists are
flexible, innovative, and versatile.
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The Concept of Community
• A community is a grouping of people
who reside in a specific locality and who
interact and connect through a definite
social structure.
• Four components of a community
include: people, a location in space,
social interaction, and shared values.
• Communities can be defined on
different scales: global, national,
regional, and local.
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The Concept of Community
• Opportunities in Community Nutrition
– The focus of community nutrition includes
people, policy, and programs.
– People who benefit from community
nutrition programs are found in a variety of
community settings.
– A policy is a course of action chosen by
public authorities to address a given
problem and they are accomplished through
laws, regulations, and programs.
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The Concept of Community
• Opportunities in Community
Nutrition
– Programs are instruments used by
community nutritionists to seek
behavior changes that improve
nutritional status and health.
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The Concept of Community
• Public Health and Community
Interventions
– Public health focuses on protecting and
promoting people’s health through actions
of society.
– The scope of public health includes
infectious diseases, such as AIDS and
tuberculosis, and chronic diseases, such as
heart disease, stroke, and cancer, that kill 7
of every 10 Americans each year.
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Leading Causes of Death
United States, 1900
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Leading Causes of Death
United States, 2002
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The Concept of Community
• The Concept of Health
– The proper definition of health focuses on
the interaction of humans among
themselves and with their environment.
– A constellation of factors influence health,
including individual factors, lifestyle factors,
working conditions, social networks,
community services, and national health
policies.
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The Concept of Community
• Health Promotion
– Health promotion focuses on
changing human behavior and
lifestyles to move toward a state of
optimal health.
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The Concept of Community
• Health Promotion
– There are three types of prevention efforts
and three levels of intervention.
• Primary prevention aims to control risk factors
and prevent disease.
• Secondary prevention focuses on detecting
disease early through screening and other forms
of risk appraisal.
• Tertiary prevention aims to treat and
rehabilitate people who have experienced an
illness or injury.
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The Concept of Community
• Health Objectives
– The goal of the world community is to
protect and promote the health of all people
of the world.
– Challenges of translating this global goal
into action include understanding the many
physical, biological, social, and behavioral
factors that influence the health of
individuals and communities and the
challenge of changing human behavior.
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The Concept of Community
• Health Objectives
– Nations differ in how they formulate health
objectives for their peoples to achieve
behavior change.
• A document released by Health Canada presents
a new vision for promoting health and preventing
disease by advocating a balance between
individual and societal responsibilities for health.
• The health objectives for the peoples of the
United States are published in Healthy People
2010: Understanding and Improving Health.
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The Concept of Community
• Healthy People in Healthy
Communities
– This document includes two broad
goals and 467 specific, measurable
targets or objectives to be achieved
by the year 2010.
• Goal 1 is to increase quality and years of
healthy life.
• Goal 2 is to eliminate health disparities.
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The Concept of Community
• Healthy People in Healthy Communities
– Many nutrition-related activities are
essential to this initiative because four of
the leading causes of death in the United
States are related to dietary imbalance and
excess.
•
•
•
•
Coronary heart disease.
Some types of cancer.
Stroke.
Diabetes mellitus
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The Concept of Community
• Healthy People in Healthy Communities
– Each objective has a target for specific
improvements to be achieved by the year
2010.
– The surveillance and data tracking systems
of Healthy People 2010 will collect, analyze,
interpret, disseminate, and make use of
health data to understand the nation’s
health status and plan prevention
programs.
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The Concept of Community
• Healthy People 2010: Progress Report
– The average life expectancy at birth is 77
years, and death rates for heart disease,
stroke, and certain types of cancer have
declined.
– Health disparities remain evident among
Americans, with significant differences
between whites and minorities in mortality,
morbidity, health insurance coverage, and
the use of health services.
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Community Nutrition Practice
• Community nutritionists have numerous
job responsibilities although there are
common themes that emerge.
– Data gathering about the community itself or about
the people who use or implement community-based
programs or services.
– Issues involving policy, program management, and
how to use scarce resources.
– Determining whether nutrition programs and
services are reaching the right audience with the
right messages and having the desired effect.
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Community Nutrition Practice
• Community versus Public Health
Nutrition
– Community nutrition is not considered to be
synonymous with public health nutrition as
defined in this textbook.
• Community nutrition is the broader of the two
terms and includes any nutrition program whose
target is the community.
• Public health nutrition refers to those communitybased programs conducted by a government
agency.
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Community Nutrition Practice
• Educational Requirements
– Minimum requirements include a
bachelor’s degree in community
nutrition, foods and nutrition, or
dietetics from an accredited college or
university.
– Most community positions require
registration as a dietitian by the
American Dietetic Association.
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Community Nutrition Practice
• Licensure of Nutrition Professionals
– In some states the term nutritionist is not
legally defined.
– Licensure of nutrition professionals is
designed to protect the public, control
malpractice, and ensure minimum
standards of practice.
– As of 2004, 44 states, the District of
Columbia, and Puerto Rico had enacted
some form of licensure law.
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Community Nutrition Practice
• Licensure of Nutrition Professionals
– There are many advantages of licensure:
• Americans are accustomed to identifying licensed
health professionals.
• The initials L.D. assure consumers, health
professionals, and insurance companies that
persons providing nutrition services meet the
specified professional standards.
• Practice settings for community nutritionists are
numerous and include worksites, universities,
health organizations, day care centers, fitness
centers, food companies, and hospital outpatient
facilities.
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Community Nutrition Practice
• Roles and Responsibilities
– Roles and responsibilities for
community nutritionists include
educator, counselor, advocate,
coordinator, ideas generator,
facilitator, and supervisor.
– Community nutritionists are
increasingly expected to manage
projects, resources, and people.
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Entrepreneurship in
Community Nutrition
• Entrepreneurship is the creation
of something of value through the
creation of organization.
• Organization refers to the
orchestration of the materials,
people, and capital required to
deliver a product or service.
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Entrepreneurship in
Community Nutrition
• Entrepreneurs and Intrapreneurs
– Entrepreneurs are change agents who share
common personality traits.
• They are achievers and set high goals for
themselves.
• They work hard, are good organizers, enjoy
nurturing a project to completion, and accept
responsibility for their ventures.
• They strive for excellence and are reward
oriented.
• These qualities also describe an intrapreneur
whose job is located within an organization.
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Entrepreneurship in
Community Nutrition
• Business competencies expected of
community nutritionists include:
– Perform organizational and strategic
planning.
– Develop and implement a business or
operating plan.
– Supervise procurement of resources.
– Manage the integration of financial, human,
physical, and materials resources.
– Supervise coordination of services.
– Supervise marketing functions.
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Entrepreneurship in
Community Nutrition
• To change people’s eating habits
community nutritionists must be
entrepreneurs who use new ways
of reaching desired target groups.
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Emerging Issues in
Community Nutrition
• Should your state government restore
benefits to all legal immigrants residing
in the state?
• If you were employed as a school food
service director, what would you
recommend to your school
administrators and state legislators in
order to foster a school nutrition
environment that would support
healthful eating?
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Emerging Issues in
Community Nutrition
• If you were responding to a proposed
rule in the Federal Register, would you
favor giving the FDA more power in this
area?
• Given the current state of research,
should the nutrition education materials
used for clients in your organization’s
heart disease risk-reduction program be
changed to reflect plasma homocysteine
levels as a CHD risk factor?
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By the Year 2020 . . .
• Another 50 to 80 million people will
probably have been added to the U.S.
population.
• The population and labor force will
continue to diversify, as immigration
continues to account for a sizable part
of the population growth.
• The growing diversity of food choices is
likely to echo the increasing diversity of
the population.
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By the Year 2020 . . .
• Between 1980 and 2020:
– Hispanic population will have grown
from 6.5% to 18% of the population
– Blacks from 11.6% to 12.9%
– Asian or Pacific Islanders from 1.5 to
5%
– whites will have declined from 79.9%
to 62.5%
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By the Year 2020 . . .
• The world’s population will have grown
by about 2.2 billion people.
• The number of people over 65 years of
age will have grown from 35 million in
2000 to 54 million.
• People aged 65–74 will have increased
from 6 to 10% of the population.
• Those aged 75 and older will have
increased from 6 to 7%.
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By the Year 2020 . . .
• Total national spending on longterm health care will have risen to
$207 billion—up from $115 billion
in 1997.
• Spending on home care will
account for about one-third of
spending on long-term care.
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Social and Economic Trends
for Community Nutrition
• A worldwide increase in the
educational level of the workforce
is anticipated.
• The aging of the population,
coupled with a more ethnically
diverse society, will challenge
community nutritionists to develop
new products and services.
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Social and Economic Trends
for Community Nutrition
• An Aging Population
– The aging population will likely place many
demands on health care services, home
care services, and food assistance programs
– as will the millions of people who lack
health insurance.
• Generational Diversity
– Age diversity in the workplace now includes
five distinct groups with differences in
workplace values, lifestyle and social
values, motivation, communication styles,
and technical competence.
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Social and Economic Trends
for Community Nutrition
• Increasing Demands for Nutrition and
Health Care Services
• Increasing Ethnic Diversity
• Challenges of the Twenty-First Century
Lifestyle
– The World Health Organization describes
obesity as “an escalating epidemic” and one
of the greatest neglected public health
problems of our time.
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Social and Economic Trends
for Community Nutrition
• Watchwords for the Future
– Change, innovation, creativity,
community, and entrepreneurship are
watchwords that herald the
beginnings of a new century.
– Unprecedented global social change is
occurring in which the world is
growing smaller.
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