20. Informed Activated Patient Productive Interactions Prepared Proactive Practice Team Functional and Clinical Outcomes Delivery System Design Decision Support Clinical Information Systems Self- Management Support Health System Resources & Policies Community Health Care Organization Chronic Care Model
“ From 1983 to 1999, life expectancy declined significantly in 11 counties for men ( by 1.3 years) and in 180 counties for women (by 1.3 years); another 48 (men) and 783 (women) counties had non significant life expectancy decline. Life expectancy decline in both sexes was caused by increased mortality from lung cancer, chronic obstructive pulmonary disease (COPD), diabetes, and a range of other noncommunicable diseases, which were no longer compensated for by the decline in cardiovascular mortality. Conclusion: “Female mortality increased in a large number of counties, primarily because of chronic diseases related to smoking, overweight and obesity, and high blood pressure.” p. 0557 Ezzati Plos Med (2008)
Adapted using a CPI increase of 57% over that time period, from Putnam J, Allshouse J, Kantor LS. U.S. per capita food supply trends: More calories, refined carbohydrates and fats. FoodReview 2002; 25(3): 2-15.
These questions are usually not asked. Story p. 222
Source: Tagtow, A & Harmon, A: Healthy Land, Healthy Food, Healthy Eaters: Dietitians Cultivating Sustainable Food Systems. 2009
Source: Healthy Land, Healthy People: Building a better understanding of sustainable food systems for Food and Nutrition Professionals: A Primer. March 2007 American Dietetic Association
Hunger and obesity are often flip sides to the same malnutrition coin: Joel Berg, NY City Coalition Against Hunger. Quoted NY Times March 2009 by Sam Dolnick. Less than one in ten americans meet guidance for fruit and vegetable intake. The average 300 kcal increase in daily intake for americans from 1985 to 2000 was made up of refined grains (46%), added fats for 24% and added sugars for 23%.
Food stamps and nutrition = 48.4% Commodity and Foreign = 33.2%
The Airlie Conference built on a landmark 2007 Wingspread Conference on Childhood Obesity, Healthy Eating and Agriculture Policy (the “ Wingspread Conference”), the first conference to discuss the impact of federal agricultural and food policies on public health, nutrition, and obesity and opportunities for agricultural policies to contribute to healthier eating (http://www.healthyeatin gresearch.org/content/view/90/145/). From the Wingspread Conference emerged two broad principles: (1) the nation’s food system ought to simultaneously serve the American population’s physical health and well-being, the environmental health of the planet, and the economic health of the food and agricultural sector. Public policies should support, rather than hinder, a health-based food system; and (2) agricultural policies must be realigned with national recommendations for healthy eating and good health, specifically the USDA/DHHS Dietary Guidelines for Americans, and support public health goals of preventing obesity and chronic diseases.
Higher quality diets are more costly for the low income women studied. Policy interventions are required to allow low income families tin the US to improve the quality of their diets given their food budget constraints. Conclusions: The finding that higher quality diets were more costly for these low-income women has implications for the food assistance and education programs of the US Department of Agriculture. Policy interventions may be required to allow low-income families in the United States to improve the quality of their diets given their food budget constraints.
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