Jean Inman - Nutrition Assessment of Populations and Community Needs

states determine the eligibility of needy families and the benefits and services those families will receive

• USDA
• provides foods to help meet nutritional needs of children and adults and strengthens agricultural market for products produced by American farmers
• food given to School Lunch, elderly feeding, supplemental food programs
• Commodity Supplemental Food Program
• The Emergency Food Assistance Program

• USDA
• administered by state health agencies
• monthly commodity canned or packaged foods
• low income women (pregnant, breat-feeding, postpartum), infants and children up to 6 years, some elderly; at nutritional risk

• USDA
• Quarterly distributions of commodity foods by local, public or private nonprofit agencies, food banks, soup kitchens, homeless shelters
• Supplements diets of low income households

• USDA
• Entitlement program to improve nutrition of children, especially from low income families; utilize surplus production of foods
• Cash grants and food donations; dollars reimburse schools on basis of numbers of meals served
• Implement the Dietary Guidelines into the Lunch and Breakfast Programs
• Lunch must provide on average over each school week: 1/3 of the recommended intake for protein, vitamins A and C, iron, calcium 
• Team Nutrition implements School Meals Initiatives for Healthy Children -- motiviates child to make healthy choices; helps schools meet Guidelines; provides recipes, training, support

• USDA
• Entitlement program, meals must meet Dietary Guidelines
• Breakfast must provide on average over each school week: 1/4 daily recommended levels for protein, calcium, iron, vitamin A & C

~1/2 recommended levels fro protein, calcium, iron, vitamin A & C

• USDA
• Provides healthy snacks
• Schools receice cash subsidies for each snack served
• Same eligibility bases as NSLP

• USDA
• Purpose is to encourage consumption of milk by children
• Objective is to provide subsidy for milk served to children in participating schools, residential child care centers, summer camps not participating in other federally subsidized meal programs, and free milk to needy

• USDA
• School Lunch
• Entitlement program, purpose is to initiate, maintain or expand food service programs to children when school is not in session
• Objective is to provided meals or snacks to children at participating institutions in poor areas
• Administered by FNS, state educational agencies, public or private nonprofit residential summer camps

• USDA
• Supports public and non-profit food service programs for family day care centers, neighborhood houses, homeless shelters, nonresidential adult daycare centers
• Reimburses operators for meal costs, provides commodity foods and nutrition education materials
• Meals must meet guidelines; must offer free or reduced-price to eligible
• Eligibility standards same as NSLP

• USDA
• introduce children to fresh fruits and vegetables; help develop eating habits that improve health, prevent obesity and subsequent chronic disease
• Free to children nationwide in selected schools

• USDA
• a. For pregnant, postpartum, breast-feeding women; infants and children up to 5
• b. Provides food for low income mothers at nutritional risk (abnormal weight gain, history of high risk, LBW, underweight, overweight anemia)
• c. Risk: weight, height, head circumference in infants, hemoglobin, hematocrit
• d. Provides food, nutrition education, referrals to other agencies
• e. health exam is REQUIRED 
• f. must meet income standards, be at nutritional risk, and in need of foods offered
• g. foods provided included: iron-fortified formula, cereal, milk, cheese, fruit juice
• h. NOT an entitlement program: cap on amount of federal dollars allocated
• i. Priorities: pregnant and breast-feeding women, infants up to 1 year
• j. WIC Farmers' Market Nutrition Program: coupons to purchase fresh, locally grown foods at farmers' markets

• USDA
• +education; NO food
• Provides grants to universities that assist in community development
• Trains nutrition aides to educate the public
• Improve food practices of low income homemakers with young children
• Works with small groups; teaches skills needed to obtain a healthy diet (how to budget, meal planning, shop, cook)

• DHHS
• Under Title V of the Social Security Act
• Fosters public health nutrition programs at the state and local levels
• Provides training, consultation, funding
• Women of child-bearing age, infants, children; state eligibility requirements

• DHHS
• Reduce infant mortality and improve health of low income women, infants, children, families

• Developed services to foster independent living; chas and commodities to state agencies
• OAA (Older Americans Act Nutrition Program)

• DHHS - Title III
• Formerly ENP (Elderly Nutrition Program)
• One hot meal each day, 5 days/week, provide 1/3 recommended intake
• Eligibility: all aged 60 and older plus spouse, regardless of income
• Congregate Meals
• Home delivered meals
• Counseling, nutrition education, referrals, social interaction

• Congregate meals: ambulatory; transportation essential for rural elderly
• Home delivered meals: Meals on Wheels - must be homebound

• USDA
• a. Largest food assistance program - entitlement
• b. Assist low income with monthly benefits; net income must be at or below certain % of poverty level; income limits vary by household size and are adjusted to the cost of living
• c. Designed to increase their purchasing power; not for non-food items
• d. Figures are adjusted to reflect cost of food in Thrifty Food Plan for June of preceding year - least costly of USDA four food plans
• e. Nutrition education program: provided to program participants

• DHHS
• Medicare
• Medicaid

• DHHS
• Health insurance program fro people over 65; of any age with end-stage renal disease; employers and employees pay
• Part A - hospital insurance
• Part B - optional insurance for supplementary benefits (outside hospital insurance)

• DHHS
• Federal law administered by states
• Payment for medical care for all eligible needy - all ages, blind, disabled, dependent children

• Under Social Security Act, partnership between federal and state governments
• Expands health coverage to uninsured children whose families earn too much income to qualify for Medicaid but too little to afford private coverage

• DHHS
• Helps low income children; ages 3-5
• Introduces new foods, teaches good food habits
• Child's participation in food activities is important

• USDA
• Amendment to School Lunch Act
• Provides nutritional education training to teachers and school foodservice personnel

• USDA
• Grants to states to provide low income seniors with coupons to be exchanged for eligible foods at farmers' markets, roadside stands, community supported agriculture programs (CSA)
• Fresh, nutritious, unprepared fruits, vegetables, herbs and honey
• May be limited to specific and locally grown foods
• Nutrition education and information is provided (how to select, store, prepare)

• Receive both federal and private funds
• American Red Cross
• National Research Council - Food and Nutrition Board (developed RDAs)

• Voluntary health agencies - private, non-profit organizations, chartered and licensed by a government agency, funded by contributions from citizens or organizations - American Heart Assiciation (AHA)
• Professional organizations - Academy of Nutrition and Dietetics
• Foundations, business, industry

• FAO - Food and Agricultural Organization: raising world wide levels of nutrition by increasing efficiency of production and distribution of foods
• WHO - World Health Organization: developed RDAs for developing countries

Survey categorizing a populations' general health status (used in worksites, government agencies as a health education or screening tool)

population by age, ethnic groups, sex, birth rates, deaths

census data, housing statistics

# of NEW cases of a disease over a period of time

TOTAL number of people with a disease during a period of time

• Development of sustainable, community-based strategies to ensure that all have access to culturally acceptable, nutritionally adequate food at all times
• Strategies that strengthen local food systems
•    1) farmers' markets - increased access to fresh produce
•    2) food recovery and gleaning programs - collect excess wholesome foods that would otherwise be thrown away (from farms, packing houses, caterers, cafeterias, restaurants) for delivery to hungry people
•    3) PPFPs - Prepared and Perishable Food Programs - nonprofit programs that link sources of unused, cooked and fresh foods with social service agencies that serve the hungry

• Promote nutrition and improve nutrional care for the elderly to identify nutritional problems early
• DETERMINE checklist - identifies factors placing people at nutritional risk -- increases awareness of factors that influence nutritional health; disease, tooth loss, economic hardship, reduced social contact, multiple medication, involuntary weight loss/gain, needs assistance in self-care, elder years above age 80
• LEVEL I screen: identifies those who need more comprehensie assessments
• LEVEL II screen: provides more specific diagnostic info on nutritional status (we're most involved with level II)

• Includes all data collection and analysis activities of the federal government related to measuring the health and nutritional status, food consumption, attitudes about diet and health
• Jointly run by DHHS and USDA

• HHS
• Low income, high risk children, birth - 17 years, emphasis on birth-5 years
• Height, weight, birth-weight, hematocrit, hemoglobin, cholesterol, breast-feeding
• Monitors growth and nutritional status, infant-feeding practices

• HHS
• Low income, high risk pregnant women
• Maternal weight gain, anemia, pregnancy behavioral risk-factors (smoking, alcohol), birth-weight, counts # of women who breast-feed
• Identify and reduce pregnancy-related health risk

• Ongoing (repeated) survey to obtain info on health of American people
• Evaluates clinical, chemical (hemoglobin, hematocrit, cholesterol), anthropocentric, nutritional data (24 hour recall, food frequency list)
• _____ III - oversampling of adults ≥65 with NO upper age limit

• Dietary intake component of NHANES (also known as National Food and Nutrition Survey NFNS)
• 2 days of 24 hour dietary recall data with times of eating occasions and sources of foods eaten way from home
• USDA conducts over-sampling of adults ≥60, African American, Hispanics

• USDA
• To obtain info on food intake of individuals and total households from entire US
• Evaluate 7 nutrients - protein, calcium, iron, thiamin, riboflavin, vitamins A & C
• Diets rated good if intakes equaled or surpassed RDA; rated poor if less that 2/3 of RDA for 1 or more nutrients

• HHS
• Adults 18 years and older residing in households with telephones
• Telephone interviews collect info on height, weight, smoking, alcohol use, food frequency for fat, fruits and veg, preventable health problems, diabetes

• HHS
• Grades 9-12
• Smoking, alcohol use, weight control, exercise, eating habits

• FDA, HHS
• Telephone survey of randomly selected adults
• Tracks self-perception of relative nutrient intake levels, use of food labels, knowledge of fats and cholesterol, prevalence of supplement use