Public Health
Nutrition
Module 1:
Concept and Principles of Public Health
Module 1: Concept and Principles of Public Health
• Learning objectives: At the end of this modules, students will be
able to understand the:
• Basic Concepts and Scope of Public HN
• Theories of PHN
• PHN principles related to Dietary nutrients requirements, health
maintenance, and factors influencing nutritional requirements at
population level
• What is Public Health - Introduction
• Public health refers to those aspects of health that affect the population as a
whole, their study and the services that aim to deliver it.
• Public health nutrition is where these two concerns – population health and
nutrition – interact or overlap
• ‘The science and art of promoting and protecting health and well-being,
preventing ill health and prolonging life through the organized efforts of society’ or
• Public Health is the science of promoting health and preventing disease of
a population by systematic efforts of society, communities or individuals,
usually in the presence of limited financial resources.
• The Science and art of helping people change their lifestyle to move
toward a state of optimal health’’.
The three main public health roles are:
● The assessment and monitoring of the health of communities
and populations at risk to identify health problems and priorities.
● The formulation of public policies designed to solve identified
local and national health problems and priorities.
● To assure that all populations have access to appropriate and
cost-effective care, including health promotion and disease
prevention services.
• Current Role of Nutrition in Public Health
• Socio-demographic changes are affecting many parts of the globe
• Transition from traditional diets typical ‘westernised’ patterns
• In less economically developed countries, there is a rising burden of cardiovascular
disease, and some cancers breast, colorectal and prostate – related to nutritional
factors
• In more affluent nations, with increasing age the major non-communicable disease
group is predicted to be cancers, many of which are related to dietary patterns, body
fatness and physical activity levels
• Meanwhile malnutrition – stunting and wasting in children, short stature in adulthood, as
well as specific micronutrient deficiencies – remains prevalent. Even in richer countries,
where food security is less of a problem, rickets remain persistent in vulnerable groups,
and are possibly increasing
• Principles of Public Health Nutrition
• Effective public health nutrition requires three discrete functions
• the acquisition, synthesis and dissemination of knowledge relating
nutrition to health and disease;
• surveillance programmes to detect potential nutritional problems
across the life course among the population, and to monitor
• and to monitor change; evidence-informed policy development and
implementation.
• Principles of Public Health Nutrition
• The primary prevention of disease relies on the identification of the
causes of disease
• The identification of infectious causes has led to the
development of vaccination and antibiotics, and of means to
control their vectors, such as the mosquito for malaria.
• The identification of a deficiency of the essential nutrients
allowed for dietary approaches to their prevention, and policies
such as food fortification.
• In all health practice:
• epidemiological information
• clinical trial data or laboratory evidence,
• or less reliable forms
• Components of PHN
● Health protection through Nutrition - protection against
infectious / chronic such as metabolic diseases and
environmental threats
● Health promotion through Nutrition - target individual
behaviour or promote health by education, legislation
• Health-care services - provide, analyse and improve /
optimise health-care services
• Prevention Approaches for Optimal Health:
Personal prevention involves people at individual level; for instance,
educating and supporting a breastfeeding mother to promote the
health of her infant.
Community-based prevention target groups; for example, public
campaigns for low fat diets to decrease the incidence of obesity or
heart disease.
System-based prevention deals with changing policies and laws in
order to achieve the objectives of prevention practice; laws regarding
childhood immunization, food labels, food safety and sanitation.
Level of Prevention
Each part of prevention itself has three levels.
• Primary prevention is aimed at preventing disease by controlling
risk factors that are related to injury and disease.
• For example, low-fat cooking classes, help people change their
eating and cooking patterns to reduce their risk of
cardiovascular disease.
Level of Prevention
Each part of prevention itself has three levels.
• Secondary prevention focuses on detecting disease early through
screening and other forms of risk assessment.
• For example; public screening for hypertension at a health fair
identify people whose blood pressure is high, these individuals are
then referred to a physician or other health professional for follow-up
and treatment.
Level of Prevention
Each part of prevention itself has three levels.
• Tertiary prevention aims to treat and rehabilitate people who have
experienced an illness or injury.
• Education programs for people recently diagnosed with diabetes
help prevent further disability and health problems, such as
blindness and end-stage renal disease.
Levels of Prevention and Intervention Approaches
Levels of Prevention and Intervention Approaches
Reducing
Risk Through
Prevention
• Socioeconomic
models have been
used to develop
policies and dis- ease
prevention
strategies, such as
the Mackenbach
model, which can be
used as a basis for
developing policies
and intervention
strategies
CLASS ACTIVITY
Examples on The Relationship Between Eating Behaviors and Chronic Diseases
The Relationship Between Eating Behaviors and Chronic
Diseases
CLASS ACTIVITY
Role of Health Professionals in Uplifting PHN
• Role of health professionals in uplifting PNH
• Health professionals must be a member of an
interdisciplinary team in order to provide an effective nutrition
program. An interdisciplinary team is a collaboration among
personnel representing different disciplines of public health
workers (nurses, social workers, physicians, daycare
workers, dietitians, and dietetic technicians).
● Role of health professionals in uplifting PNH
● Various approaches are used to diagnose and ad- dress public or community issues,
including:
● Utilizing interventions that promote health and prevent communicable or chronic
diseases
● Channeling funds and energy to problems that affect the lives of the largest
numbers of people in a community
● Seeking out unserved or underserved populations (due to income, age, ethnicity,
heredity, or lifestyle) and those who are vulnerable to disease, hunger, or
malnutrition.
● Collaborating with the public, consumers, community leaders, legislators, policy
makers, administrators, and health and human service professionals to assess
and respond to community needs and consumer demands.
● Monitoring the public or community’s health in relation to public health objectives,
and continuously addressing current and future needs.
● Planning, organizing, managing, directing, coordinating, and evaluating the
nutrition component of health agency services.
Factors affecting nutritional requirements through lifecycle
• Low per capita income
• Low and unequal distribution of income
• Poor and highly unstable growth performance especially in agriculture
• Unemployment and underemployment
• Low and declining farm size
• Inequalities in land distribution
• Low land utilization
• Social discrimination
• Population growth
• Access to market
• Food taboos: certain restrictions in the food consumption due to cultural and social norms.
• Poverty
• Climate induced insecurity: climate change, deforestation, landslide, declining soil fertility
• Political instability
• Poor, marginalized, ethnic group & lower caste groups
• High maternal and infant mortalities
Social
Determin
ants of
Diet and
Health
Four levels: individual (white); micro (local; pale grey); meso (social; mid
grey); macro (national/international; dark grey)