MIDTERM
USDA Foods provide approximately _______ of the food offered in each school lunch
15%
The National School Lunch Program serves over
32 million children each day
Randomized Control Study
An experiment in which individuals are randomly allocated to receive or not receive an experimental preventative, therapeutic or diagnostic procedure and then followed to determine the effect of the intervention.
Aims to protect the health of all Americans especially those who are least able to help themselves
DHHS (Department of health & Human services)
This department houses the CDC. NIH and FDA
DHHS (Department of health & Human services)
Ultimately the goal of the food assistance program is toImprove the nutritional statusFood security and health by providing free food to the masses
False
What does it mean for an objective to be specific?
It is Concrete, detailed and well defined
USDA Foods program supports Federal nutrition assistance programs, including
National School Lunch Program (NSLP)
WIC
No: Women, infants and children provides healthcare and nutrition of low income pregnant women, breastfeeding women, and children under the age of 5
The NHANES study look sat what parameters?
Nutritional, clinical, biochemical
Define what a community needs assessment is
The process of evaluating the health and nutrition status of a community, determining what the community's health and nutrition needs are, and identifying places where those needs are not being met.It involves systematically collecting, analyzing, and making available information about the health and nutrition status of the community or some subgroup of it.
Define epidemiology
The study of where and when diseases occur and how they are transmitted in populations-
Explain the paradoxical relationship between food security and obesity in the U.S
They are known together as the "hidden crisis". Those with insufficient resources to purchase adequate food can still be overweight. 1. The need to maximize caloric intake: families need to make decisions to stretch their food money and max their calories to make sure that their family aren't hungry. Lower income families have to purchase cheaper foods that have more calories because they can't afford the healthier food options. 2. The trade-off between food quantity and quality: The quality of the food is going to be affected before the quantity of the food. Households reduce their food spending by changing the quality of food consumed before reducing the quantity of food eaten. They may get enough food to not be hungry, but they are not getting enough nutrition from their food. 3. Overeating when food is available: Chronic ups and downs in food availability can cause people to overeat when food is available. It is an adaptive response for people to overeat when food is not always available. When money (SNAP benefits) is not available for food purchasing during a certain part of the month the family may overeat when the food is available. Low-income mothers may sacrifice their food intake to make sure their child doesn't go hungry.
Social Security
Yes: a social insurance program consisting of retirement, disability and survivor benefits
SNAP was formally referred to by this name
food stamps
Policies are:
guides for the scope of permissible activity to address a problem
What does the "M" in the SMART acronym stand for ?
measurable
The Healthy People 2030 goals are an outgrowth of a report by
the Surgeon General (HHS)
Describe the 7 steps to a community needs assessment
1. Set the parameters of the assessment: limits of the assessment: It sets the direction for the assessment. It defines the community. Determine the purpose of the needs assessment. Set goals and objectives for the needs assessment. Begin collecting data about the community, environment, and background factors. Then decide on the population to target and collect data. 2. Develop a data collection plan: The type of data depends on the purpose, goal, objective of the assessment. The assessment's overall purpose is to paint a picture of the many factors that are affecting food selection. In this section there are three categories: 1) Community data ~ demographics, economic factors, and health indicators. 2) Community environment and backgrounds factors ~ social and cultural norms, food availabilities, policies 3) Target population data ~ food preferences and attitudes, health beliefs and knowledge. 3. Collect data: about the community, about the community environment and background factors, about individuals who represent the target population 4. Analyze and interpret data 5. Share the findings of the assessment 6. Set priorities 7. Choose a plan of action
What is the income threshold percentage above the poverty guideline to be eligible for WIC
185%
You work for the CDC and just received the latest data caused by heart disease: 647,457 deaths during the past year. The average population over the past year was 328 million. What is the cause specific death rate for heart disease?
197 deaths per 100,000 population
interventional study
A study where the assignment of subjects is controlled by the investigator.
cohort study
A type of epidemiologic study where a group of exposed individuals (individuals who have been exposed to the potential risk factor) and a group of non-exposed individuals are followed over time to determine the incidence of disease
Case-control study
A type of epidemiologic study where a group of individuals with the diseases, referred to as cases, are compared to individuals without the disease, referred to as controls
What does the "A" in the SMART acronym stand for ?
Attainable
example of a vital statistic
Birth rate, maternal mortality rate, infant mortality rate ( not colon cancer)
What is the similarity between WIC and snap
Both are regulated by the USDA
Recall the three types of data that can be collected in a needs assessment and provide an example of each.
Community Data: Community health, community organizational power and structures, demographic data and trends, existing community services and programs, and social data and trends. Community environment and background conditions: food systems and food availability, geography and climate, health systems, housing, national policy, recreation, social and cultural conditions, community values, transportation systems, and water supply. Target Population Data: nutritional status, food preferences and attitudes, health beliefs and knowledge, lifestyle factors, sociocultural factors, and priorities and motivation.
Consider multi level framework of action to support nutrition during the Covid 19 Pandemic by Naja & Hamadeh Which of the following was not part of the community level framework?
Eating patterns & physical inactivity
WIC
Eligibility: Pregnant, breastfeeding, and postpartum women, infants up to one year of age, and children up to five years of age are eligible if they are individually determined by a qualified health professional to be in need of the special supplemental foods provided by the program because they are nutritionally at risk (having a medical-based or dietary-based condition), and if they meet an income standard (gross income at or below 185% of the poverty guidelines).
Are the following programs entitlements: SNAP, WIC, Medicare, Social Security, Agriculture subsidies?
Entitlement programs means anyone who meets eligibility standards are entitled to receive benefits Non-entitlement programs means the program can only serve as many people as its annual appropriation from Congress permits
A job that pays minimum wage lifts a family above the federal poverty threshold
False
Define epidemiology-
From the Greek word meaning "upon the people"; the study of epidemics; the basic science of public health; "the study of the distribution and determinants of health-related states in specified populations, and the application of this study to control health problems
What is Healthy People 2030?
Healthy People 2030 sets data-driven national objectives to improve health and well-being over the next decade. Healthy People 2030 includes 355 core — or measurable — objectives as well as developmental and research objectives.
what is the difference between mandatory and discretionary spendingha
Mandatory spending: required by law for entitlements (programs that require the payment of benefits to any person who meets the eligibility requirements established by law) · Discretionary Spending: budget choices that can be made in areas of defense, energy assistance, nutrition assistance, education after mandatory allocations have been made
Recall what Medicare and Medicaid, including can receive services under each program.
Medicare : a federally run entitlement program through which people 65 years of age or older and people in certain other eligible categories receive health insurance. Medicare part A- hospital insurance; inpatient care -deductible and coinsurance fees apply- Long term care- 1 days covered annually Medicare part B- optional medical insurance; outpatient care -supplementary medical insurance benefits for eligible medical expenses Prescription drug coverage and skilled nursing/long term institutional care-Medigap policy may be purchased if pt has A & B coverage - Medicare part C Medicaid: a federally aided state-administered entitlement program that provides medical benefits for certain low-income persons in need of health and medical care. joint state and federal program for low-income persons, the aged, blind, and disabled, dependent children of one parent families. Income must be below the 133% of poverty line- covers inpatient and outpatient hospital services, physician, laboratory and x-ray, skilled nursing home, home health services. Some states include other benefits such as Rx & dental. , but there is significant variability among states.
Explain what NHANES is and recall what this acronym stands for.
National Health And Nutrition Examination Survey. Series of health related programs conducted by the CDC and NCHS monitoring nutritional health Through a combination I have interviews physical examinations and lab tests
You conduct a cohort study among older adults in California and find that the older adults who live alone had a relative risk of 2.0 for exercise weight loss compared with older adults who do not live alone. Which is the correct interpretation of the relative risk ?
Older adults who live alone have a higher risk of excessive weight loss than than those who do not live alone.
Discussion of policy options , or possible solutions to public problems is something that often begins in grass roots level and is called
Policy formulation
NSLP= National School Lunch Program
Purpose(s): Assist states in providing nutritious free or reduced-price lunches to eligible children. Schools receive cash subsidies and USDA commodities for each meal served. (Meals must meet federal requirements. Eligibility= Public or nonprofit private schools of high school grade or under and public or nonprofit private residential childcare institutions may participate. Eligibility standards for children: All students attending schools where the program is provided may participate. Children from households with incomes at or below 130% of poverty guidelines are eligible for free meals. Children from households with incomes between 130 and 185% of the poverty guidelines are eligible for reduced-price meals. Children from households with incomes over 185% of the poverty guidelines pay full price, a price set by the school.
SNAP= Supplemental Nutrition Assistance Program
Purpose(s): Improve the diets of low-income households by increasing access to food/ food-purchasing ability. It provides direct payments in the form of electronic benefits transfer (EBT)redeemable at most retail food stores. Household eligibility and allotments are based on household size, income, assets, housing costs, work requirements, and other factors.
Head Start and Early Head Start Programs
Purpose(s): Increase the school readiness of young children in low-income households. Also, to promote healthy prenatal outcomes, enhance the development of infants and toddlers, and foster healthy family functioning. Provides= Comprehensive, focused child development programs (including home-based programs) serve children from birth to age five, pregnant women, and their families. Health, education, nutrition, and social services are provided and are responsive and appropriate to each child's and family's heritage and experience services encompass all aspects of a child's development and learning. Eligibility: participants reside in households with incomes below the official poverty guidelines.
School Breakfast Program
Purpose: Assist states in providing nutritious breakfasts to children. Free and reduced-price meals must be offered to eligible children. Schools receive reimbursement for milk served to children eligible for free milk and cash subsidies for each half-pint of milk sold. Pasteurized fluid types of unflavored or flavored fat-free or low-fat (1%) milk that meet state and local standards may be served. All milk should contain vitamins A and D at levels specified by the FDA. Eligibility: Schools, childcare institutions, and eligible camps that do not participate in other federal meal service programs may participate; however, an institution may participate to provide milk to children in half-day prekindergarten and kindergarten programs where children do not have access to the school meal programs. Milk programs must be offered on a nonprofit basis. Any child from a family that meets income guidelines for NSLP free meals is eligible for free milk.
The components of food security are
Quantity quality sustainabilityPsychological social
What does the R stand for in the SMART acronym?
Relevant
Which food assistance program was established as an effort to strengthen the US military towards the end of WWII
SNAP
What does the "S" in the SMART acronym stand for?
Specific
The allowance for snap is based on
The USDA food thrifty program
Why is it important to conduct a needs assessment?
The importance of conducting a needs assessment is to provide a better understanding of how the community functions and how it addresses the public health and nutrition needs of its citizens. It identifies the areas where it performs well; local hospitals have good data on infant mortality and morbidity, and areas where it does not, although two food banks are available in the community some families go without food.
Recall the steps in the policy cycle and be able to draw this process.
The steps in policymaking process: a- Problem definition and agenda setting: Convince other people that a public problem exists, and to bring it to the attention of the public and policy makers. Once problem is defined and gains attention, it is place on the policy agenda b- Formulation of alternatives: possible solutions to the problem are devised (planned). c- Policy adoption: the tools or instruments for dealing with problems are chosen. Examples of the tools include regulations, cash grants, loans, tax breaks, price controls, etc.... d- Policy implementation: It is the process of putting a policy into action. After agreeing on the solution and tools, the policy is modified to fit the needs, resources, and wants of the implementing agencies. e- Policy evaluation: one the policy moves into the agenda-setting stage, the evaluation process begins. The purpose of the policy evaluation is to determine whether a program is achieving its stated goals and reaching its intended audience, what the program is accomplishing, and who is benefiting from it. f- Policy termination: a policy may be terminated for any of the following reasons: the public need was met, the nature of the problem changed, government no longer had a mandate in the area, the policy lost political support, private agencies relieved costs.
Ecological study
The unit of analysis in ecological studies is populations not individuals
Which of the following describes the role of the local government in food assistance benefits?
They do not typically administer the food assistance programs.
What does the "T" in the SMART acronym stand for?
Time-bound
Food security is one of the several conditions a population can be nourished and healthy
True
People who live with chronic hunger might have food available to them but lack of nutrients
True
Snap pass the USDA more money than all of the food programs combined
True
Aims to enhance the quality of life for All Americans working to ensure a safe, affordable nutritious and accessible food supply reducing food insecurity and supporting the production of agriculture
USDA (US Department of Agriculture)
This department houses the agencies that administer Supplemental Nutrition Assistance Program (SNAP) and National School Lunch Program (NSLP)
USDA (US Department of Agriculture)
Entitilement programs are part of mandatory protected spending that requires the payment of benefits to all eligible people. Which is not considered an entitlement?
WIC
Agricultural Subsidies
Yes: Government incentive for agricultural organizations and farms to stabilize food prices. Helps farms susceptible to pathogens , diseases and weather pay for commodities price changes.
SNAP
Yes: Supplemental Nutrition Assistance Program provides food-purchasing assistance for low/no-income individuals
Medicare
Yes: program for people +65 years to receive health insurance
Study
a scientific process of answering a question using data from a population Ex: Does smoking cause cancer
Which bill requests government funding?
appropriations bill
Define what a policy is.
course of action chosen by the public to address a given problem
Case Series:
describes the characteristics of a group of people who have the same disease or exposure. Understand the demographics, clinical presentation, prognosis and traits of people with a particular disease
What does NOT coexist with insecurityAnd obesity
food insecurity is associated with less food knowledge And nutritious diets. Therefore providing nutrition education Would be an adequate education Intervention for obesity amongst the food insecure
An example of secondary prevention program
implement a blood pressure screening program with referrals for those with pre-hypertensionor hypertension
Older Americans Nutrition Program
improve the dietary intakes and nutritional status of participating older adults and to offer them opportunities to form new frienships and create informal support networks
Who resolves differences in bills from the House and the Senate?
joint conference committee of the house and senate
Which is the food assistance program to older adults
older American Nutrition program (established 1965)
An example of Healthy People 2030 goal is
promote healthy behaviors across every stage of life
EFNEP: The Expanded Food and Nutrition Education Program
public & nonprofit private schools of highschool grade or under and public or non profit private residential childcare institutions may participate can enroll in this food assitance program
Cross Sectional Study
takes a selected population and measures health info at a given point in time giving a snapshot of their health. Ask participants questions with a survey. Also called prevalent studies. Has to be representative of the total population. Inexpensive. Help assess the health needs of a population.
Write a SMART objective using the formula learned in class.
y