NUSC 3230 Final Exam

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Budget authorization establishes programs:

- Sets a ceiling on spending - Does not provide money

NSLP and Breakfast Program

- The NSLP is the nation's second largest nutrition assistance program - Both programs provide financial assistance to schools so that every student can receive a nutritious meal - 1946, NSLP signed into law - Operates in public and nonprofit private schools, residential childcare institutions - Free lunch (130% or less of poverty) - Reduced cost lunch (185% or less of poverty): pushing for families to receive free lunch

Current legislation and emerging issues have the potential to affect:

- The delivery of food and nutrition programs - The way in which community nutritionists work

5 step federal budget process

1) The President submits a budget request to Congress 2) Lawmakers release their own budget plans and set overall spending levels with a budget resolution 3) House and Senate subcommittees set funding for each program through appropriations bills 4) House and Senate members come together to resolve differences in their appropriations bills 5) The budget returns to the President for his signature before it becomes law

4 purposes of evaluation

?

How an idea becomes a law (part 1)

A concerned citizen, group, or organization brings an issue to the attention of a legislative representative at the local, state, or national level The bill is written and submitted to the clerk where it is numbered and printed The bill must be sponsored by at least one legislative member (House or Senate, or both) The bill is referred to committee and subcommittee The greatest challenge is getting out with a favorable vote

Floor vote

A vote by all of the House or all of the Senate. Requires a majority vote to pass.

Steps of the U.S. Rulemaking Process?

Authorizing legislation, regulatory drafting, interagency review, public comment, agency revisions, interagency review, final publication, legislative/judicial review

Typical opportunities for input in the legislative process?

Bill introduction/sponsorship, subcommittees, committees

Causes of food insecurity in the U.S.

Causes of hunger and food insecurity are many and interrelated - Unemployment - Poverty - Low wages - High housing and health care costs

conference committee

Committee appointed by the presiding officers of each chamber to adjust differences on a particular bill passed by each in different form.

Poverty thresholds

Dollar amounts below which a family would be viewed as living in poverty - Used for calculating all official poverty population statistics

EFNEP focuses on:

Good nutrition and physical activity: - Healthy low-cost foods - Enhancing cooking skills - Food security - Healthy lifestyle changes help to achieve and maintain healthy body weights - Practical long term, lifestyle focus - Address issues low-income population face in the obesogenic environment

Poverty in the U.S.

Having too little money to meet minimum needs for food, clothing, and shelter - In 2013, 14.5% of people (over 45.3 million people) lived in poverty - 20% of children under the age of 18 lived in poverty

How an idea becomes a law (part 3)

If the bill passes, it goes to the other body of legislature or Congress for the same actions Finished versions of the bill will probably differ between bodies, so a conference committee meets to resolve differences The modified bill that is agreed upon is sent to the President (governor) for action

Second Harvest

LARGEST US national food recovery program, charitable agency that distributes food that would otherwise go to waste

Nutrition focus of EFNEP

Major focus: increasing fruit/vegetable intake - Affects risk for diabetes, CVD, several forms of cancer, Htn, stroke, obesity - Lower intake has been found for underserved populations - Taste, lack of preparation skills, cost and lack of availability mentioned as reasons - EFNEP model focuses on all of these issues: complementary to WIC

How an idea becomes a law (part 2)

Markup sessions by subcommittee and committee revise the original bill The committee votes on whether to send the bill forward with a favorable vote or table it Approved bills go before the full membership for debate, amendment, and vote

The federal fiscal year begins on...

October 1

Willing workers

People willing to do something such as writing letters or making calls.

National School Breakfast Program

Pilot program established in 1966 (result of Child Nutrition Act) - Permanent program in 1975 - Not as widespread as NSLP - Operates in same manner as NSLP

Lobbying

Provide technical information to policy makers to help pass legislation

WIC Farmers' Market Nutrition Program

Provides checks/vouchers to WIC participants to purchase locally grown fresh fruits and vegetables at their local farmers' market every year between June 1st & October 31st - Unfortunately not enough for all eligible participants

The Emergency Food Assistance Program (TEFAP)

Provides quarterly distributions of commodity foods by local, public or private nonprofit agencies, food banks, soup kitchens, homeless shelters - Farms to food banks to families in need!

Low income programs?

SNAP-Ed, EFNEP, TEFAP, food distribution programs

The Policy Cycle

Stages through which policy passes, including, in order : agenda setting, policy formulation, policy adoption, policy implementation, and policy evaluation (sometimes policy termination)

Budget appropriation provides money for programs

The appropriation may cover a single year, several years, or an indefinite period of time

Political realities

- "Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it's the only thing that ever has" (Margaret Mead) - You can make a difference in your community by: Understanding the policymaking process, Taking time to express your opinion, Being persistent and patient

Political Action Committee (PAC)

- "Political arm" of interest group - Raises money to support candidates whose views are favorably aligned with the group's missions and goals

Formulation of alternatives

- A key consideration: Is the best proposed solution reasonable? - In the U.S., policy is formulated by the legislative, executive, and judicial branches of the government at the national, state, and local levels

Reducing food insecurity

- Affordable housing - Increasing SNAP benefits - Providing more job-training programs

Federal Budget Process (final stages)

- All revenue and appropriations bills passed by the House are forwarded to the Senate for consideration - Differences between the two houses are worked out in conference committee (Ultimately a reconciliation bill is passed) - Congress adopts its version of the budget in a budget resolution (If unable to pass a budget by the beginning of the fiscal year, Congress may adopt continuing resolutions)

Where can SNAP participants shop?

- Any store that accepts EBT (grocery store, convenience store, pharmacy, corner store) - Some farmers' markets

Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)

- Authorized in 1972 as an amendment to the Child Nutrition Act of 1966 - Goal: "to serve as an adjunct to good health care, during critical times of growth and development"

SNAP ineligible items

- Beer, wine, liquor, cigarettes or tobacco - Any nonfood items, such as: Soaps, paper products; household supplies, vitamins and medicines, food that will be eaten in the store, hot foods, pet foods

SNAP eligible items

- Breads and cereals - Fruits and vegetables - Meats, fish and poultry - Dairy products - Seeds and plants which produce food for the household to eat

Legitimizing policy

- Choice in implementation - Willingness of citizens that the government has the right to govern - Depends on a majority of the population accepting that the government has the right to govern

Food Distribution Programs

- Commodity Supplemental Food Program (CSFP) - Food distribution Program on Indian Reservations - Emergency Food Assistance Program - Nutrition Services Incentive Program - Food Distribution Disaster Assistance

Problem definition and agenda setting

- Convince other people that a public problem exists - Bring together a broad-based grassroots constituency - Gain and seek support from administrators and policymakers

Filling the gaps to strengthen the food resource safety net

- Despite all of the food assistance programs, emergency shelters and community food programs are straining to meet the rising request for food - Much of the increased demand is coming from the working poor and families with children - need comes from income, housing, lack of kitchen appliances (fridge, microwave, oven, etc.)

The Academy of Nutrition and Dietetics is currently addressing the following three priority areas:

- Disease prevention and treatment - Life-cycle nutrition - Quality health care

Origination of food assistance programs

- During the 1960s and 1970s that hunger was prevalent (poverty and hunger became national priorities) - Old programs were revised and new programs were developed to prevent malnutrition. - As a result of these efforts, hunger diminished in this country until the 1980s - Reagan administration reduced federal spending for antipoverty programs. - Today, hunger affects all segments of the population.

EFNEP continued...

- Federal extension program operated through land grant universities - Research-based approach to help low income families and youth eat healthier diets and be more physically active

Regarding nutrition, the strategies for solving problems typically include:

- Food and nutrition assistance programs - Dietary recommendations - Reimbursement mechanisms for nutrition services

Food insecurity vs. very low food insecurity?

- Food insecurity: limited or uncertain ability to acquire or consume an adequate quality or sufficient quantity of food in socially acceptable ways - Very low food insecurity: Per USDA (reports of multiple indications of disrupted eating patterns and food intake), Per textbook (due to lack of money or food (Table 10-3))

SNAP (Supplemental Nutrition Assistance Program)

- Goal = To improve diets of low-income households by increasing access to food and food purchasing ability - SNAP benefits enable recipients to buy approved food items in approved grocery stores - SNAP is an entitlement program (130% or less of poverty line + criteria)

Enactment

- Law is referred to appropriate agency responsible for issuing guidelines or regulations - Publication of proposed guidelines (mandatory comment period of 30-120 days for public response) - Agency reviews all comments before issuing final regulations - These are incorporated into the Code of Federal Regulations (CFR)

The legislative and regulatory process

- Laws are a unique tool of government used to influence the lives of citizens - Congress that sets policy and supplies the basic legislation that governs our lives

Laws and regulations

- Laws passed by Congress tend to be vague - Define the broad scope of the policy - Administrative bodies must interpret the law and provide detailed regulations - "Secondary legislation"

Long term health benefits of SNAP?

- Less days off work - Economic stimulus through food purchases - Stimulates farm production/farm jobs - Health care savings

The Community Nutritionist in Action

- Make your opinion known - Become directly involved

2 types of spending

- Mandatory spending for entitlements - Discretionary spending

The Rising Tide of Food Assistance Need

- Millions of people rely on food banks, soup kitchens, and other agencies for emergency food - However, these programs cannot keep pace with the growing number of hungry people seeking assistance - To fill the gaps in the federal programs, citizens are working through community programs and churches to provide meals for the hungry - Second Harvest is the nation's largest supplier of surplus food and distributes food to food banks and other agencies

How SNAP benefits are calculated

- Net income x .30 = Expected expenditure on food ($543 net monthly income x 0.3 = $163) - Maximum monthly allotment - Expected expenditure on food = benefits ($642 (max SNAP for 4 people) - $163 = $479 for a full month)

Peer Education Model

- Peer educators from the community provide interactive lessons - Practical, hands-on format - Layperson (not a professional) - Adult learning theory, participatory

Who are the food insecure in the U.S.?

- Poor and working poor - Young and older adults - Ethnic minorities - Inner-city and rural dwellers - Certain southern and western states - Many farmers - Homeless

Considerations related to food insecurity

- Poverty is a root of food insecurity - Diets of households experiencing food insecurity are inadequate - Food insecurity can lead to physical, social, and mental health problems - Low-paying jobs result in incomes inadequate to meet fixed expenses - Current minimum wage $7.25/hour - Families rely on emergency food assistance facilities in emergencies and as a steady source of food - Individuals self-select to participate in food assistance programs - Private charity cannot solve the food insecurity problem

Pandemic EBT expansion

- Reduced the share of families in SNAP households where children experienced very low food security by 17% - Reduced food insufficiency among SNAP households by 28% - Had the largest effects in alleviating food hardship in states with relatively high rates of school closures due to COVID-19 - Reduced child very low food security by 22% - Reduced household food insufficiency by 39%.

What else does WIC offer?

- SNAP, Head Start (early childhood edu), medical and dental services, substance abuse programs, child care and more - Education on immunizations, preventing lead poisoning, tobacco and substance use impact on health and growth - Breastfeeding peer counselor program

Impact of child nutrition programs?

- School meal programs - Participation resulted in a positive effect on consumption of milk, fruits, vegetables, and some vitamins and minerals - Some evidence that school meals contributed too much fat in menu items - In 1995, a final rule directed schools to upgrade nutritional value of their meals

What does the nutrient claim "healthy" mean?

- The FDA is proposing to update the definition for the implied nutrient content claim "healthy" to be consistent with current nutrition science and Federal dietary guidance (DGA) - Food-group approach - Foods must have at least 1 food group represented - Limits: saturated fat, sodium, and added sugars

Federal Domestic Nutrition Assistance Programs Today

- The Food and Nutrition Service administers all of its programs in partnership with the states. - 96% of all federal expenditures for food assistance went to five programs in 2014: (1) Food Stamp Program (FSP) - Supplemental Nutrition Assistance Program (SNAP) (2) National School Lunch (NSLP) (3) Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) (4) School Breakfast Program (SBP) (5) Child and Adult Care Food Program (CACFP)

New directions in SNAP-Ed

- The Healthy, Hunger-Free Kids Act of 2010 (Public Law 111-296), section 241, established SNAP-Ed as a Nutrition Education and Obesity Prevention Grant Program - Activities must be evidence-based and delivered through individual and group-based strategies, comprehensive multi-level interventions, and/or community and public health approaches - SNAP-Ed efforts may also address environmental and policy-level interventions.

Mechanisms for legitimizing policies include:

- The legislative process - The regulatory process - The court system - Various procedures for direct democracy, such as referenda, which put sensitive issues directly before the people

Reasons for policy termination

- 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 the need - A political system or sub-government ceased to function - The policy was too costly

Policy adoption

- Tools and instruments are selected to achieve the policy goal - Policy adoption can occur on a local, state, or national level

The people who make policy:

-An organization's or committee's executives, administrators, committees -Elected officials -Employees of municipal, state or federal agencies -Members of Congress and state legislators -Street-level bureaucrats -Community nutritionists/RDs

WIC Food Packages

-milk/cheese -yogurt -soy products -juice -fruits/vegetables -cereals -whole grains -infant foods

Grassroots Pyramid

-power players -party people -willing workers -banner carriers----critics -fence sitters

2 Assumptions of WIC

1. Inadequate nutritional intakes and health behaviors of low-income women, infants and children make them vulnerable to adverse health outcomes 2. Nutrition intervention at critical periods of growth and development will prevent health problems and improve health status of participants

Federal Budget Process

2 Stages - The president proposes a budget (The budget is the president's financial plan for the federal government) - Congress reacts to the president's proposal

Define the correct order of steps in a nutritional needs assessment?

Define nutritional problem, set parameters of assessment, collect data, analyze data, share findings, set priorities

SNAP eligibility is based on:

Income, household size, assets (eliminated in 36 states), housing costs, work requirements and other factors

Highest rates of food insecurity during recession?

Non-Hispanic Black and Hispanic households

WIC Activities

Provides supplemental foods for the following: - Pregnant women & postpartum women (6 months after give birth if not breastfeeding, 1 year if "mostly" or "fully" breastfeeding - Infants - Children up to age 5 years old (Nutrition education, monitoring and certification required to receive benefits)

Fence sitters

Respondents who present themselves as neutral when in truth they have an opinion.

Healthy, Hunger-Free Kids Act of 2010

Resulted in first major changes in school meals in past 15 years - More fruit/vegetables; weekly requirement for vegetable variety - Less meat/meat alternative depending on child age - All grains as whole grains by July 1, 2014 - Milk can only be 1% or less fat - Sodium levels of <740 mg for Grades 9-12 reached by July 1, 2022

How does EFNEP work?

Series of ~6 classes - Promotes learning through doing, taking several important issues into consideration - Language, Access to healthy foods, Culture, Literacy level

How an idea becomes a law (part 4)

Sign into law by the president Veto and return to legislature (Congress) - requires a two-thirds vote by each house to override No action while in session - automatically becomes law

Poverty guidelines

Simplified version of poverty thresholds (used for administrative purposes)

Marketing fruits/vegetables

Team FNV - uses celebrities to target younger audiences

EFNEP

The Expanded Food and Nutrition Education Program (EFNEP) is designed to assist limited resource audiences in acquiring the: - knowledge, skills, attitudes, and changed behavior necessary for nutritious diets and to contribute to their personal development - the improvement of the total family diet and nutritional well-being

USDA Nutrition Assistance Programs

The USDA Food and Nutrition Service implements 15 programs to provide low-income citizens with food or the means to purchase foods. - Programs are administered by Food and Nutrition Service (FNS) of USDA - DHHS administers Head Start and food programs for elderly - Department of Homeland Security administers "disaster feeding"

WIC target nutrients

The WIC food package was designed to supply foods rich in five target nutrients known to be lacking in the diets of the WIC target population: - Vitamin A - Vitamin C - Calcium - Iron - Protein

SNAP-Ed

The goal of SNAP-Ed is to improve the likelihood that persons eligible for SNAP will make healthy choices within a limited budget and choose active lifestyles consistent with the current Dietary Guidelines for Americans and MyPlate

Policy Evaluation

The process of determining whether a course of action is achieving its intended goals

Power players

These community nutritionists are "in the know." They understand the political system in their communities, know the key players, and use the system to help improve the community's health.

Banner carriers

These people feel strongly about an issue, but they prefer to talk about it rather than roll up their sleeves for action. Get them involved in the planning stages, where their opinions can be valuable.

Party people

These people have a strong party allegiance. They know elected officials and party leaders in the community.

This principle of nutrition education focuses on the degree of fit between the program and its objectives: a. Consonance b. Relevance c. Facilitation d. Feedback

a. Consonance (review in marketing nutrition slides from 3/29/23)* - consonance is related to objectives - relevance is population/target audience specific

Food security

access by all people at all times to enough food for an active, healthy life

Building coalitions (networks and other alliances)

joining with smaller groups to influence the political system

Food insecurity

limited or uncertain ability to acquire or consume an adequate quality or sufficient quantity of food in socially acceptable ways

Critics

not happy with the status quo, but aren't willing to help achieve change

3 components of policymaking

problem, policy, policymaking

Pandemic EBT

provides food supports to help families with children who were receiving free and reduced-price school meals pay for food

5 Components of food security

quantity, quality, suitability (culturally acceptable, storage/prep), psychological (anxiety, deprivation), social (methods of acquiring socially acceptable; food stamps, etc.)

Peer learning

shared identity traits, can relate to each other/share similar experiences

policy implementation

the stage of policymaking between the establishment of a policy and the consequences of the policy for the people whom it affects. It involves translating the goals and objectives of a policy into an operating, ongoing program.

4 steps to taking political action

writing effective letters, effective phone calls, good use of email, work with the media


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