Community Nutrition Final
Poverty Line Income in 2015?
$24,250 for a family of four
Calculating poverty level
(Yearly income/ Poverty guideline bases on number of family members) *100 = %
The nutritional requirements of school breakfast
- 1 cup fruit and/or veg daily - Grains: at least 1 oz/day for all grades; must be whole-grain rich - Milk: 1 cup, must be fat free or low fat (1%)
Eligible Food Items with SNAP
- Breads and cereals - fruits and vegetables - meats, fish and poultry - dairy products. - Seeds and plants which produce food for the household to eat - In some areas, restaurants can be authorized to accept SNAP benefits from qualified homeless, older adults, or disabled people in exchange for low-cost meals.
The purpose of the Fresh Fruit and Vegetable Program and its operating agency
- Efforts to combat childhood obesity by helping children learn more healthful eating habits. - Ohio Department of Education (ODE)
The eligibility of the Elderly Nutrition Program - congregate meals
- Individuals 60 yr and older, regardless of income, are eligible to participate in the ENP - The spouse of any age - Disabled persons < 60 yr who either live in housing facilities where ENP congregate meals are served, or who accompany seniors to meal sites - Nutrition service volunteers
What type of milk can be provided through the special milk program?
- Only pasteurized fluid types of fat free or low‐fat (1%) milk that meet State and local standards. - All milk should contain vitamins A and D at levels specified by the FDA - 2000 IU of Vitamin A per quart (500 IU per cup) - 400 IU of Vitamin D per quart (100 IU per cup)
Social Marketing
- Programs that seek to increase the acceptability of a social idea or practice among a target group - A method for changing consumer behavior
Elderly Nutrition Program
- Promotes health & well-being; decreases malnutrition; prevents physical/mental deterioration; reduces social isolation and hunger & food insecurity - Provides meals, congregate & home-delivered, and nutrition screening, education, & counseling
Lobbying
- Provide technical information to policy makers to help pass legislation - is often the method of choice when trying to influence the political system as individuals will talk to public officials and legislators to persuade them to consider the information provided - Form of advocating
What is the Special Milk Program? Who is eligible?
- Provides Milk to students - any child from a family that meets income guidelines for free meals is eligible
The Purpose of the Affordable Care Act
- Reform both private and public health insurance systems - Expand coverage to 25 million people by 2023 - Lower costs and increase benefits to consumers - Incentivize quality and innovation in the healthcare system - Provide funding for public health and prevention
In policy setting "Policy adoption " entails...
- Tools and instruments are selected to achieve the policy goal (ex: regulations, funding, tax breaks, government-sponsored programs) - can occur on a local, state, or national level
SNAP Eligibility
- U.S. citizens - Household must meet eligibility requirements: Resources, Income, Deductions, Employment Requirements, Special Rules for Elderly or Disabled, Immigrant Eligibility - 130% or less of Federal poverty line (Gross income) Benefits - EBT cards, monthly allotment, average monthly benefit ~$133.41
Consequences of world hunger...
- Under-nourishment (not enough calorie intake to meet minimum physiological needs for an active life): ~ 795 million undernourished people worldwide, mainly in developing countries - Malnutrition (inadequate intake of protein, energy and micronutrients), measured through body weight or height by age.
Poverty Guidelines
- Used to determine financial eligibility for certain federal programs - Issued each year in the Federal Register by the Department of Health and Human Services (HHS).
Focus area of USDA
- administers its programming through the Food and Nutrition Service (FNS) programs - Leads the federal anti-hunger effort with the Food Stamp, School Lunch, School Breakfast, and the WIC programs. - Responsible for the safety of meat, poultry, and egg products - Conducts research in human nutrition and new crop technologies - Ensures open markets for U.S. agricultural products - Provides food aid to people in need overseas
In policy setting "Policy evaluation " entails...
- determines whether a program is achieving its stated goals and reaching its intended audience.
At risk for hunger worldwide...
- developing countries - those living in rural areas mainly in the villages of Asia and Africa - around half of the world's hungry people are from smallholder farming communities - Children and Women
Negative outcomes of food insecurity in adults
- diabetic patients have poor glycemic control and increase risk of hypoglycemia events (esp. related to ER visits) - Prevalence of depression - low medication adherence is significantly higher in food insecure individuals
In policy setting "problem definition and agenda setting" entails...
- gaining public recognition - Bring together a broad-based grassroots constituency that supports addressing the problem - Gain and seek support from administrators and policy makers
Physiological changes in older adults
- increase in total body fat mass & decrease in fat-free mass (muscle & bone) - Taste bud atrophy & impaired olfactory senses = decreased appetite - Dry mouth, tooth loss, gum diseases can cause trouble chewing - decreased visual & hearing acuity which leads to difficulty reading labels & recipes - Difficulty hearing in noisy environments - Can be less mobile due to disabling conditions; arthritis; stroke; fractures; osteoporosis; fear of falling
In policy setting "Policy termination" may occur if ...
- public need was met - Loss of political support - Policy was too costly - Private agencies relieved the need
In policy setting "Formulation of alternatives " entails...
-Interest groups, coalitions, networks of experts, and "grassroots" individuals interested in the problem can be asked to help with designing alternatives to be presented to policy makers
Negative outcomes of food insecurity in children
-Lower math and reading skills -lower scores on standardized tests - poorer grades - lower educational attainment - greater behavioral problems t - Poverty related stress is associated with symptoms of depression, anxiety, hostility, and aggression
explain the constructs of the Campinha-Bacote Model of cultural competency
1) Awareness: appreciate cultural influences, understand own culture 2)Knowledge: Understand history, values, belief systems, food practices, health customs, attitudes toward seeking help from health care providers, and behaviors of the members of another ethnic group. 3) Skill: Provide culturally sensitive assessments and intervention and feel comfortable with working with people from different cultures. 4) Encounters: Seek and engage in face-to-face cross-cultural interactions. 5) Desire: Have a true inner feeling of wanting to engage in the process of becoming culturally competent.
Steps in developing a Marketing Plan in Health Promotion
1. Determine the needs and wants of target population 2. Specify benefits of the product or service 3. Conduct a situational analysis 4. Develop a marketing strategy 5. Develop a budget and timetable
5 steps to practicing legislative advocacy
1. Getting involved 2. Understanding the issues 3. Planning an advocacy practice 4. Advocating 5. Presenting information
% of households with low food security in the US?
14%
Team Nutrition
An initiative of the USDA Food & Nutrition Service to support the Child Nutrition Programs through 1) training and technical assistance for food service 2)nutrition education for children and their caregivers 3)school and community support for healthy eating and physical activity.
Very low food security
At times during the year, eating patterns of one or more household members were disrupted and food intake reduced because the household lacked money and other resources for food. Lack quantity.
cultural destructiveness
Attitudes, practices, and policies that are destructive to other cultures
Cultural Blindness
Belief that a culture makes no difference
What are the causes of world hunger and the prevalent nutrient deficiencies in the world based on the WHO
Causes... Natural disasters (tropical storms and long periods of drought), War, Poverty trap, Lack of key agricultural infrastructure Prevalent nutrient deficiencies... Micro-nutrients - Iron, vitamin A, iodine, zinc Protein-energy malnutrition - kwashiorkor and marasmus
Who is the largest category of WIC participants
Children
Free lunch eligibility
Children from families with incomes ≤130 % of the poverty level
4 types of behavior change
Cognitive change Action change Behavior change Value change
Congregate meals vs. Home-delivered meals
Congregate meals: Meals are offered to older adults in groups at social & community centers such as senior centers, churches, and schools (provide older adults with social interaction and the chance to get involved in the community) Home-delivered meals (Meals on Wheels): Delivered to homebound older adults who are unable to travel to a congregate meal site. Volunteers who deliver meals spend time with homebound seniors & provide social interaction that the seniors might not otherwise get.
Policy
Course of action chosen by public authorities to address a given problem
Name the six stages of the cultural competence continuum model
Cultural destructiveness Cultural incapacity Cultural blindness Cultural precompetence Cultural competence Cultural proficiency
Name the two primary federal-level departments that deal with nutrition-related issues and their missions
Department of Health and Human Services (DHHS) and the U.S. Department of Agriculture (USDA)
Situational Analysis
Detailed assessment of the environment, including an evaluation of the consumer, the competition, and other factors that may affect the program or business.
Cultural competence
Differences are accepted and respected
Cultural Proficiency
Engages in activities that add to the knowledge base, conducts research, develops new approaches, publishes, encourages organizational cultural competence, and works in society to improve cultural relations
The nutritional requirements for school lunch
Fruit - No more than half of the weekly fruit offering may be in the form of 100% juice. Variety - Weekly variety requirement (5 subgroups): - Red/orange (carrots, tomatoes, sweet potatoes, etc.) - Dark green (spinach, broccoli, etc.) - Legumes/beans/peas (kidney beans, chickpeas, etc.) - Starchy (white potatoes, corn, green peas, etc.) - Other (cucumbers, onion, etc.) Meat/ Meat Alternate: - grades K-8 (at least 1 oz /day, 8-10 total per week) - 9-12 (at least 2 oz /day, 10-12 total per week) Grains - All grains must be whole-grain rich Milk - fat-free or low fat (1%)
Explain UNICEF's GOBI-FFF Programs
Growth monitoring Oral rehydration Breastfeeding Immunizations Female education Family spacing Food Supplements
Name the chronic health conditions that are the leading causes of death among older adults in the U.S
Heart disease Cancer Chronic lower respiratory diseases Stroke Alzheimer's Diabetes Influenza and pneumonia
What does Medicaid provide
Hospital services: inpatient & outpatient; lab & X-ray service, physician service, screening, diagnosis & treatment for children, home health care services Medical services: possibly dental care, health clinic services, eye care & glasses, prescribed medications, diagnostic, rehabilitative & preventive services including nutrition services
High Food securities
Households had no problems, or anxiety about, consistently accessing adequate food.
Marginal food security
Households had problems at times, or anxiety about, accessing adequate food, but the quality, variety, and quantity of their food intake were not substantially reduced.
low food security
Households reduced the quality, variety, and desirability of their diets, but the quantity of food intake and normal eating patterns were not substantially disrupted.
Legislative advocacy
Influencing public policy through the legislative process
Building Coalitions
Joining with smaller groups to influence the political system
Legislation
Law which has been enacted by a legislature or other governing body, or the process of making it
food insecurity
Limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire acceptable foods in socially acceptable ways
examples of "nutritional risk" in infants and children
Low-birth weight or preterm infants Inadequate growth Elevated blood lead levels Inborn errors of metabolism Inadequate dietary status by WIC standards
The eligibility of the Senior Farmers' Market Nutrition Program
Low-income seniors (generally defined as individuals who are 60 yr and older & household incomes < 185%)
What are the two major types of nutrition risks recognized for WIC eligibility:
Medically-based risks such as anemia, underweight, overweight, history of pregnancy complications, or poor pregnancy outcomes. Dietary risks, such as failure to meet the dietary guidelines or inappropriate nutrition practices. - Nutrition risk is determined by a health professional such as a physician, nutritionist, or nurse, and is based on Federal guidelines.
Medicare vs Medicaid Eligibility
Medicare: People aged 65yr or older; persons with certain disabilities and illnesses Medicaid: low-income persons
examples of USDA Food and Nutrition Programs for children
National School Lunch Program, School Breakfast Program, Fresh F&V Program, Special Milk Program?
Is WIC and entitlement program?
No
The purpose of Supplemental Nutrition Assistance Program (SNAP)
Nutrition assistance to low-income individuals
What does Medicare Provide? (Part A and B)
Part A: helps pay for inpatient hospital care, skilled nursing facility care, home health care, hospice care. Part B: physicians' services, outpatient hospital services, home visits, diagnostic X-ray, lab test, physical & occupational therapy, MNT for people with diabetes, kidney disease, and certain preventive services. Typical exclusions of Parts A & B: Most dental care and dentures, eye glasses, hearing aides and exams for fitting them, etc.
Cultural incapacity
Paternalistic attitude toward the "unfortunates" No capacity to help
WIC eligibility
Pregnant, breastfeeding or postpartum women, infants, & children up to age 5, at "nutritional risk", <185% of U.S. poverty line
Two major categories of the health insurance systems in the US
Private Health Insurance Public Health Insurance
The six steps of the policy making cycle
Problem definition and agenda setting Formulation of alternatives Policy Adoption Policy Implementation Policy Evaluation Policy Termination
The 4 P's of marketing strategies (marketing mix) and an example of each
Product (tailored nutrition education program to promote FVC) Place (internet) Price (i.e. tangible cost of the product) Promotion (i.e. sales promotion; coupons)
The purpose and benefits of the Emergency Food Assistance Program
Purpose/benefit: - Helps supplement the diets of low-income needy persons, including older adults, by providing them with emergency food and nutrition assistance at no cost (examples of foods include: canned & dried fruit, canned vegetables, fruit juice, dried egg mix, meat/poultry/fish, dried beans, pasts, PB, rice, soups)
Purpose and benefits of the Food Distribution Disaster Assistance Programs
Purpose/benefits: Following a storm, earthquake, flood or disaster emergency provide: food for shelters & other mass feeding sites, disaster SNAP benefits, food for distribution directly to households
In policy setting "Policy implementation " entails...
Putting the policy into action after needed changes are made *May involve a large number of people and organizations to carry out the process*
The DRIs that differ for older adults from adults
Reduced nutrient needs of... - Cr, Cl, Na, - Fe for female Increased need of... - Vit B6, B12,& D & Ca - relates to changes in gastric secretion, kidney function & endocrine system
health disparity causes in the US
Socioeconomic status (SES), Lack of health insurance, Culture Access to and utilization of quality health care services, Discrimination/racism/stereotyping, Environment
What does SWOT analysis stands for
Strengths Weaknesses Opportunities Threats
what are programs provided by FNS
Supplemental Nutrition Assistance Program (SNAP) Food Distribution Disaster Assistance The Emergency Food Assistance Program (TEFAP) WIC School meals Child and Ault Care Food Program (CACFP) Summer Food Service Program Farmers Markets Nutrition Program Nutrition education
ethnocentrism
The concept of considering the beliefs, values, customs, and viewpoints of one's own group superior to those of other groups
Policy Making
The process by which authorities decide which actions to take to address a problem or set of problems.
The Elderly Nutrition Program - home delivery meals
The program for individuals 60 yr or older who are homebound; The spouse of an older individual regardless of age; Persons < 60 yr with disabilities if they reside with the homebound older individual
Poverty
The state of having too little money to meet minimum needs for food, clothing, and shelter
The purpose of the Summer Food Service Program
To ensure that low-income children continue to receive nutritious meals when school is not in session
The goal of Team Nutrition and its focus areas
To improve children's lifelong eating and physical activity habits by using the principles of the Dietary Guidelines for Americans and MyPlate
The purpose of the Senior Farmers' Market Nutrition Program
To provide fresh, locally grown fruits, vegetables, & herbs from farmers' markets, roadside stands & community supported agriculture programs to low-income seniors.
Cultural precompetence
Weaknesses in serving culturally diverse populations are realized and there are some attempts to make accommodations
Is SNAP and entitlement program?
Yes
Acculturation
a process by which a cultural group adapts or learns cultural norms of another group.
Public Policy
a system of laws, regulatory measures, courses of action, and funding priorities concerning a given topic promulgated by a governmental entity or its representatives.
Focus areas of DHHS
administers the majority of public health & nutrition programs (Ex: Health and social science research, Disease prevention, including immunization services , Food and drug safety Medicare and Medicaid, Health information technology, Financial assistance and services for low-income families etc. )
SNAP-Ed
designed 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
definition of health disparity
diseases and other adverse health conditions that exist among a specific population
Reduced lunch eligibility
incomes between 130 % & 185 % of the poverty level (charged no more than 40 cents)
Cognitive change
is a change in knowledge and is the easiest to market.
Action change
is more difficult to achieve, as the individual must first understand the reason for change and then invest something of value to make the change.
Target Population of WIC
low-income pregnant, postpartum & breastfeeding women, and infants and children up to age 5 who are at nutrition risk
The requirements for the type of snacks that can be provided through After School Snack Program
must contain at least two different components of the following four options: a serving of fluid milk a serving of meat or meat alternate a serving of vegetable(s) or fruit(s) or full strength vegetable or fruit juice a serving of whole grain or enriched bread
WIC benefits
nutritious foods, nutrition education, referrals to health and social services
The mission of the Food and Nutrition Service (FNS)
provide children and low-income people access to food, a healthy diet, and nutrition education in a manner that supports American agriculture and inspires public confidence.
The benefits of the Senior Farmers' Market Nutrition Program
receive coupons that can be exchanged for food at farmers' markets
Dietary acculturation
refers to the process that occurs when immigrants adopt the dietary practices, eating patterns/food choices of the host country.
Groups who are at high risk for food insecurity in the United States
the poor working poor the young ethnic minorities inner-city and rural dwellers certain southern and western states the homeless
