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Chapter 1
Opportunities in Community Nutrition
Lecture Launcher
Did you know that food portion sizes and obesity rates have grown in parallel? In the 1960s, an average
fast-food meal of a hamburger, fries, and a 12-ounce cola provided 590 calories; today, many super-sized,
extra value fast-food meals deliver almost 3 times the number of calories (1500 calories or more). What
impact does this have for nutritionists and dietitians working in the community settings?
Chapter Outline
I.
Introduction
A. Community nutritionists face many challenges in practice.
1. The challenge of improving the nutritional status of different kinds of people.
2. The challenge of influencing lawmakers and other key citizens.
3. The challenge of studying the scientific literature.
4. The challenge of mastering new technologies.
5. Successful community nutritionists are flexible, innovative, and versatile.
II. 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.
A. Opportunities in Community Nutrition
 The focus of community nutrition includes people, policy, and programs.
1. People. People who benefit from community nutrition programs are found in a variety of
community settings.
2. Policy. 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.
3. Programs. Programs are instruments used by community nutritionists to seek behavior
changes that improve nutritional status and health.
B. Public Health and Community Interventions
a. Public health focuses on protecting and promoting people’s health through actions of society.
b. 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.
1. The Concept of Health
a. The proper definition of health focuses on the interaction of humans among themselves
and with their environment.
b. A constellation of factors influence health, including individual factors, lifestyle factors,
working conditions, social networks, community services, and national health policies.
IM for Community Nutrition in Action 4e, by Melanie Burns of Eastern Illinois University
2.
Health Promotion
a. Health promotion focuses on changing human behavior and lifestyles to move toward a
state of optimal health.
b. There are three types of prevention efforts and three levels of intervention.
1. Primary prevention aims to control risk factors and prevent disease.
2. Secondary prevention focuses on detecting disease early through screening and other
forms of risk appraisal.
3. Tertiary prevention aims to treat and rehabilitate people who have experienced an
illness or injury.
3. Health Objectives
a. The goal of the world community is to protect and promote the health of all people of the
world.
b. 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.
c. Nations differ in how they formulate health objectives for their peoples to achieve
behavior change.
1. 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.
2. The health objectives for the peoples of the United States are published in Healthy
People 2010: Understanding and Improving Health.
C. 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.
o Goal 1 is to increase quality and years of healthy life.
o Goal 2 is to eliminate health disparities.
 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.
o Coronary heart disease.
o Some types of cancer.
o Stroke.
o Diabetes mellitus
 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.
1.
Healthy People 2010: Progress Report
a. The average life expectancy at birth is 77 years, and death rates for heart disease, stroke,
and certain types of cancer have declined.
b. 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.
II. Community Nutrition Practice
 Community nutritionists have numerous job responsibilities although there are common themes
that emerge.
IM for Community Nutrition in Action 4e, by Melanie Burns of Eastern Illinois University
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o
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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.
A. Community versus Public Health Nutrition
 Community nutrition is not considered to be synonymous with public health nutrition as
defined in this textbook.
o Community nutrition is the broader of the two terms and includes any nutrition program
whose target is the community.
o Public health nutrition refers to those community-based programs conducted by a
government agency.
1.
2.
3.
4.
Educational Requirements
a. Minimum requirements include a bachelor’s degree in community nutrition, foods and
nutrition, or dietetics from an accredited college or university.
b. Most community positions require registration as a dietitian by the American Dietetic
Association.
Licensure of Nutrition Professionals
a. In some states the term nutritionist is not legally defined.
b. Licensure of nutrition professionals is designed to protect the public, control malpractice,
and ensure minimum standards of practice.
c. As of 2004, 44 states, the District of Columbia, and Puerto Rico had enacted some form of
licensure law.
d. There are many advantages of licensure:
1. Americans are accustomed to identifying licensed health professionals.
2. The initials L.D. assure consumers, health professionals, and insurance companies
that persons providing nutrition services meet the specified professional standards.
Practice Settings. Practice settings for community nutritionists are numerous and include
worksites, universities, health organizations, day care centers, fitness centers, food
companies, and hospital outpatient facilities.
Roles and Responsibilities
a. Roles and responsibilities for community nutritionists include educator, counselor,
advocate, coordinator, ideas generator, facilitator, and supervisor.
b. Community nutritionists are increasingly expected to manage projects, resources, and
people.
III. 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.
A. Entrepreneurs and Intrapreneurs
1. Entrepreneurs are change agents who share common personality traits.
a. They are achievers and set high goals for themselves.
b. They work hard, are good organizers, enjoy nurturing a project to completion, and accept
responsibility for their ventures.
IM for Community Nutrition in Action 4e, by Melanie Burns of Eastern Illinois University
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3.
c. They strive for excellence and are reward oriented.
d. These qualities also describe an intrapreneur whose job is located within an organization.
Business competencies expected of community nutritionists include:
a. Perform organizational and strategic planning.
b. Develop and implement a business or operating plan.
c. Supervise procurement of resources.
d. Manage the integration of financial, human, physical, and materials resources.
e. Supervise coordination of services.
f. Supervise marketing functions.
To change people’s eating habits community nutritionists must be entrepreneurs who use
new ways of reaching desired target groups.
IV. Social and Economic Trends for Community Nutrition
A. Leading Indicators of Change
 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.
1.
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.
2. 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.
3. Increasing Demands for Nutrition and Health Care Services
4. Increasing Ethnic Diversity
5. Challenges of the Twenty-First Century Lifestyle
a. The World Health Organization describes obesity as “an escalating epidemic” and one of
the greatest neglected public health problems of our time.
B. Watchwords for the Future
1. Change, innovation, creativity, community, and entrepreneurship are watchwords that
herald the beginnings of a new century.
2. Unprecedented global social change is occurring in which the world is growing smaller.
IM for Community Nutrition in Action 4e, by Melanie Burns of Eastern Illinois University