Community and Public Health Nutrition

This article discusses the importance of community and public health nutrition and the need for a community nutritionist position. It explores the demographic profile and health issues in Cairns and the Hinterland, as well as the determinants and interventions for improving nutrition and health outcomes. The article emphasizes the role of community nutritionists in implementing nutritional interventions and collaborating with healthcare organizations and local governments.

Running head: COMMUNITY AND PUBLIC HEALTH NUTRITION
COMMUNITY AND PUBLIC HEALTH NUTRITION
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1COMMUNITY AND PUBLIC HEALTH NUTRITION
Background
An individual’s as well as a nutritional status is a resultant of not merely alleviation of personal
disease conditions via optimized dietary intake but is also heavily dependent upon an individual’s
socioeconomic position, his or her soundness in terms of social and emotional wellbeing along with factors
associated with cultures, healthcare accessibility and affordability, equitable resource distribution and
prevalence of diseases and vulnerable populations (Lu et al., 2017). Hence, to address these issues, a
community nutrition position is required, comprising of community nutritionist armed to implement dietary
and nutritional interventions at the community level, playing a key role in public health policy formulation
and evaluation of healthcare practices across community organizations such as community care homes,
schools or universities (Maher, Lowe& Hughes, 2015).
The absence of a community nutritionist position in Cairns and the Hinterland is alarming considering
the aforementioned public health issues and determinants proliferating in the area.
Cairns and the Hinterland
According to the data presented in the report by the Cairns and the Hinterland Hospital Health
Services (CHHS), the demographic profile of the Cairns and the Hinterland is characterized by a high
prevalence of ageing, where an estimated 20% of the population were aged 60 years and above in the year
2015. Further data is indicative of the high rates of socioeconomic disadvantage in the area where an
estimated 60% of the population have been calculated to belong to the bottom disadvantage quintiles.
Further, this area reports the largest concentration of Aboriginal and Torres Strait Island communities (14%)
as compared to the overall area of Queensland (4) (Queensland Government, 2019). Considering the
predicted rise in these population trends in the following years, there is a growing possibility of emergence of
age associated chronic diseases, especially at the neurological, musculoskeletal and metabolic levels
coupled with emergence of infectious disease transmissions based on the high socioeconomic disadvantage
and possible associations with decreased healthcare accessibility (de Andrade et al., 2015). Hence, a
comprehensive public health approach is necessary which would take into consideration the role of such
chronic physiological and socioeconomic conditions in determining a person’s health. Further, the high
cultural diversity necessitates implementation of culturally competent healthcare interventions to ensure long
term treatment adherence (Colles, Belton&Brimblecombe, 2016). Hence, this necessitates the opening of a
community nutritionist position which would comprise of implementation of healthcare intervention across
the community level based on these unique cultural and socioeconomic needs (Holden et al., 2015).

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Diet related Issues
As per the CHHHS report, the prevalence of chronic diseases across the Cairns and the Hinterland has
been estimated to be similar to rates estimated across Australia and Queensland, that is 25 to 30%.
Additionally, the area is prone to a range of health and diet associated risk factors such as: consumption of
alcohol (5.7%), engagement in smoking (23.1%) and obesity (31.9%) (Queensland Government, 2019).
Considering that dietary modification is a key intervention underlying obesity and that nutritional practices
have been evidenced to be effective treatment procedures underlying multidisciplinary management of
substance abuse behaviors, such alarming diseases numbers necessitate the need to implement nutrition
therapy at large scale, community based levels, which can only be possibly by a team of community
nutritionists (Gyawali et al., 2015).
Determinants
Taking insights from a systems approach, the determining factors influencing the current health status
and disease conditions of the population at the Cairns and the Hinterland can be assessed across
environmental, ecological, economical, technical and legislative aspects. Upon evaluation of the
environmental, ecological and economical aspects, they key factors of income, affordability of food
commodities and culture can be predicted to determine the health of the population significantly (Carey, G.,
&Crammond, 2015). This can be evidenced by the high indigenous population and prevalent socioeconomic
disadvantages, since ethnic and cultural practices as well as financial resources play a key role in food
purchasing, buying and healthcare practices. While technical determinants in the form of a wide range of
healthcare services, as reported by the CHHS, may be beneficial, the lack of healthcare legislations like a
community nutritionist and prevalence of healthcare services in remote areas may be deemed as facilitators
of negative health outcomes in the area (Knai et al., 2018).
Need for a Community Nutrition Position
Overview
Hence, taking insights from the above data reflective of the health of the population, the need of the
hour is to implement a novel community nutrition framework, comprising of a team of community
nutritionists. The role of the community health nutritionist lies in the ability to implement nutritional and
dietary interventions across public health organizations with the usage of public health policy frameworks to
ensure community wide positive health outcomes (Malik, Kanwal& Hussain, 2017). A community
nutritionist also plays a key role in improving health literacy by conducting educational programs to enhance
nutritional and food selection awareness across the community (Ramalho et al., 2019).Further, community

3COMMUNITY AND PUBLIC HEALTH NUTRITION
nutritionists improve community nutritional health collaborating with local governments and healthcare
organizations in the development of nutrition policies, implementation of community programs or nutritional
campaign, provision of a multidisciplinary form of care for disease treatment and administration of advocacy
for empowering disadvantaged groups towards personal achievement of optimum health and nutrition status
(Rokusek et al., 2017).
Priority Populations
As reported in the CHHHS report, the vulnerable populations, susceptible to poor health outcomes
and disease burdens, include, the elderly population, aged 60 years and above, communities with a low
socioeconomic status and Aboriginal and Torres Strait Islander communities (Queensland Government,
2019).Hence, the delegated community nutritionist must seek to implement nutritional interventions at the
community level aimed at these groups, keeping health determinants in mind.
Interventions
1. One of the key interventions which community nutritionists can implement is the administration of a
community based educational campaign consisting of practical cooking classes teaching low
socioeconomic groups on cost effective ingredient selection and menu planning, along with
dissemination of educational resources like brochures, recipe books or diet charts with written
information on financially feasible dietary practices (McPake et al., 2015).
2. Community nutritionists can also form a door-to-door intervention where by collaborating with public
health workers, elderly citizens can get regular health assessments, age appropriate diet plans and
cooking assistance directly at their homes (Hamirudin, Charlton& Walton, 2016).
3. Community nutritionists can work collaboratively with healthcare organizations to design culturally
appropriate diets for Indigenous patients admitted across these networks (Ashman et al., 2017).
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