Assuring the Implementation of Effective Public Health

Strategies for Nutrition

http://www.health.gov/phfunctions/public.htm

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

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

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

Obesity

Sustainability Food Security

Leading Nutrition Concerns

Effective Strategies to Address these Concerns require:

• Transdisciplinary research base

• Population-heath focus

• Grounding in fundamental social and economic determinants of health

• Intersectoral engagement

Ecological Framework for Influences on What People Eat

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

An Intersectoral Approach to Public Health

IOM. The Future of the Public’s Health, 2002

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.

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

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

Media• Ubiquitous advertising for

unhealthy foods has a powerful impact on nutritional health

http://www.rwjf.org/files/research/20081103herfoodmarketing.pdf

Media Actions

• Nutrition advocates can use “framing” and media advocacy.

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

www.wapartnersinaction.org

www.accesstohealthyfoods.org

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

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