Recruiting Public Health Nutritionist: Sarina Hospital Report

This report, written by a student in the Master of Public Health program, advocates for the recruitment of a public health nutritionist at Sarina Hospital and Primary Health Care Centre. The report highlights the critical role of nutrition in preventing and managing various chronic diseases prevalent in the Australian population, including obesity, type 2 diabetes, cardiovascular disease, cancer, and osteoporosis. It emphasizes the limitations of non-nutritionist health professionals in providing adequate dietary guidance and the need for an expert to address nutrition-related health issues. The report provides detailed discussions on each disease, including the impact of nutrition, relevant health statistics, and the benefits of a public health nutritionist in providing patient-centered care, nutrition education, and effective dietary advice to improve health outcomes. The student argues that recruiting a PHN will reduce healthcare costs, improve patient well-being, and address the increasing morbidity and mortality rates associated with poor nutrition.

Running head: MASTERS IN PUBLIC HEALTH
MASTERS IN PUBLIC HEALTH
Name of the student:
Name of the University:
Author note:

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To,
The manager
Sarina hospital and primary health care centre
Sir,
I, (Client’s name) a non-nutritionist health professional of Sarina hospital and primary health
care centre, would like to inform you about the necessity of recruiting public health nutritionist
in our health care centre. According to the current health condition of the patient, their nutrition
status has become one of the main concern of the health professionals. The non-nutritionist
health professionals could manage the patients with nutrition related health issue, however, they
could not guide the patients with their diet as they lack adequate knowledge about food and
nutrition. Hence, an expert need to recruit who has adequate knowledge about food and nutrition
and a public health nutritionist would be the best choice for this post.
I have provided details about the importance of recruiting public health nutritionist in the
following position paper. If you kindly look into the matter and take some effective steps to
mitigate the issue I shall remain much obliged.
With thanks and regards,
(Client’s name)

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Introduction
Public health nutrition is associated with the promotion of health and well-being through
nutrition in order to prevent the nutrition related health issues in the population. In this regards
the public healthy nutritionist play an important role as they are the experts in both food and
nutrition (Combs & McClung, 2016). According to Ross et al., (2014) food and nutrition play a
significant role in the maintenance of health and well-being as it provides adequate energy which
is required to stay healthy. On the other hand it has been found that there are several chronic
health issues that are associated with nutrition status of individual, for example, diabetes,
cardiovascular risk, cancer, obesity and others. Effective diet with proper nutritional elements
could help to reduce the risk of such chronic disease, in turn; poor nutritional condition could
make the people more vulnerable to such chronic diseases (Ippolito, 2017). The health statistics
of Australia has shown that half of the population suffer from the chronic associated with food
and nutrition (aihw.gov.au, 2018). Due to such increasing health risk the health care cost and
expenditure has also increased. The above conditions have contributed to high morbidity and
mortality rate as well. Such condition has indicated that it is important to introduce interventions
that could help the population to maintain food and nutrition related requirements and reduce the
prevalence of chronic disease associated with food and nutrition (Raiten & Aimone, 2017).
Hence, it is important to focus on public health nutrition and increase the service of public health
nutritionist to control the nutrition related health complications. In this regards, this essay aims to
explore the effectiveness of nutrition on chronic disease and importance of the role of public
health nutritionist in health organization.

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Discussion
Nutrition related issues:
According to Mahan & Raymond, (2016) health issues cannot be developed by one food
component or nutrient alone. In addition, the genetic, behavioural, social and environmental
factors also associated with the nutrition related health issues. Due to the correlation between
such factors, it becomes difficult to evaluate the impact of nutrition on health and development
of various health issues (Ross et al., 2014). In addition, lack of health education is also
responsible for poor understanding about the contribution of food and nutrition in healthy life. A
balanced diet includes all the essential elements of nutrition in order to ensure effective growth,
repair and maintenance of tissue. Hence it is required to maintain the amount of carbohydrate,
protein, fat, vitamins and minerals appropriately in the diet in order to maintain positive health
status and well-being (Combs & McClung, 2016). However, due to low consumption of fruits
and vegetables along with behavioural factors such as smoking and alcohol intake has increased
the prevalence of nutrition related health issues (Ippolito, 2017). In this regards, Australian
population has been found to be one of the most vulnerable group to illness associated with poor
or lack of nutrition (aihw.gov.au, 2018). Hence, diet related non-communicable disease such as
obesity, type 2 diabetes, cardiovascular risk, iron deficiency, cancer and osteoporosis is highly
prevalent in this country (Castrejón-Pérez et al., 2018).
Nutrition in obesity:
Obesity is one of the major health concerns for the health department of Australia as two-
third of adults and one-third of the children are suffering from obesity in this population
(aihw.gov.au, 2018). According to Ivanescu et al., (2016) some of the contributing factors to

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obesity include improper diet, lack of physical activity and substance abuse such as smoking and
drinking alcohol. It has been found that changes in lifestyle have impacted on the food habit and
health behaviour of individual in an effective manner. With the development of varieties of food
and beverages people has started to consume unhealthy food to an extent without caring about
their impact on health (Archer, Pavela & Lavie, 2015). In addition, consumption of fruits and
vegetables has been reduced. Further, high availability of sugar drinks and beverages has
contributed to the consequence of obesity as well. With increase in the intake of high energy
food decrease in physical activity has been noted and such imbalance in energy consumption and
expenditure has contributed to the high prevalence of obesity (Ivanescu et al., 2016). Archer,
Pavela & Lavie, (2015) has indicated that obesity is one of the major risk factor of other chronic
disease such as cardiovascular risk, type 2 diabetes and even cancer. The health statistics has
indicated that 63% adults are found to be overweighted in Australia and the proportion is
increasing over time (aihw.gov.au, 2018). In this regards the public health nutritionist could help
the population to reduce the risk of obesity by providing effective advice on food and nutrition. It
would help people to understand the impact of improper diet and high intake of sugar beverages
on their health, hence could encourage the people to modify their food habit and improve health
status (Hughes, Begley & Yeatman, 2016). Due to such significance it is important to recruit
public health nutritionist in every public health unit.
Nutrition in diabetes:
Another significant nutrition related health issue includes type 2 diabetes and obesity has
been identified as one of the major contributor in the consequence of type 2 diabetes. In
Australia 1.2 million people including children and adults have been identified with type 2
diabetes (aihw.gov.au, 2018). Due to lack of knowledge people fail to understand the appropriate

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amount of carbohydrate in their diet. On the other hand carbohydrate is the major source of
glucose. Hence, high intake of carbohydrate results in the increase in the amount of glucose in
human body which may lead to the development of type 2 diabetes (Ong & Ozanne, 2015).
Furthermore, in public health unit different nutritional therapy has been provided to the patients
that are unable to intake food orally or suffering from malnutrition and dehydration. For example
total parenteral nutrition is one of such therapy in which high amount of dextrose is provided to
the patient. Adequate amount of dextrose needs to be decided for particular patient in order to
avoid the risk of increase in blood glucose level (Dominguez, 2015). Hence it is important to
have adequate knowledge about food and nutrition in order to manage such things in health care
service and a public health nutritionist contains effective knowledge about these things (Hughes,
Begley & Yeatman, 2016). Therefore, it is required to recruit such specialists for safe and high
quality health service.
Nutrition in cardiovascular risk:
Heart disease and stroke is the major contributor to the poor health status of Australian
population. It has been found that about 3.5 million Australian suffer from cardiovascular disease
(aihw.gov.au, 2018). It is notable that cardiovascular disease is associated with blood vessels and
heart. However, unbalanced diet and inadequate physical activity are also considered as the risk
factor of the illness (Eckel et al., 2014). In addition, behavioural aspects such as smoking and
high alcohol consumption are also associated with cardiovascular risk (Stone et al., 2014). As per
Eckel et al., (2014) cardiovascular disease is considered as nutrition related disease as it is
associated with high cholesterol and fat. Hence minimize the consumption of saturated fat and
trans-fat could be effective in order to reduce the risk of cardiovascular disease in an effective
manner. Therefore, an experienced health professional is needed to take care of such nutritional

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factors associated with cardiovascular risk (Stone et al., 2014). The public health nutritionist
plays the key role in managing nutrition and food related factors in the health care unit. They
could help the people by educating about the negative impact of improper diet and behavioural
factors such as smoking and alcohol intake on their cardiovascular system. Such contribution of
public health nutritionist could increase awareness regarding proper diet and food habit. In
addition, such effort could help to manage the issue of high blood pressure, another contributing
factor of cardiovascular disease (Savastano et al., 2017).
Nutrition in cancer:
The list of cancer associated with nutrition factors include cancer of kidney, liver, breast,
oesophagus, colorectal, stomach and endometrium (Ekelund et al., 2015). On the other hand
Zamora-Ros et al., (2016) has indicated that maintenance of weight is a vital factor for the
patents with cancer. Thus, proper diet can be considered as the crucial factor in case of cancer. In
Australia, 484 cases of cancer have been identified per 100,000 persons (aihw.gov.au, 2018).
There are a few studies that have considered diet as effective factor to reduce the risk of cancer.
However, the result of the study conducted by Zamora-Ros et al., (2016) has indicated that diet
of people with and without cancer differs regarding particular dietary components. It has been
found that there are some dietary components which could reduce the risk of cancer. For
example, the fruits and vegetables containing anti-oxidants are effective for the patient with
cancer (Ekelund et al., 2015). A specialist such as public healthy nutritionist has adequate
knowledge about the foods that are effective for reducing the risk of cancer in an effective
manner. Hence, it is important to discuss with a public health nutritionist in order to prepare an
effective diet chart for a patient with cancer. Such nursing approach would help to provide

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patient centred care as well while understanding the health and nutritional needs of a particular
patient (Hughes, Begley & Yeatman, 2016).
Nutrition in osteoporosis:
Osteoporosis is considered as a health condition in which the reduction in bone density
occurs due to lack of calcium, magnesium and vitamin D. vitamins and minerals are essential
components of a proper diet. The bone tissue renewed rapidly in order to replace the old bones
with the newer one and replace the damaged bone as well. In this way the human body maintains
the bone density and integrity. However, it has been found that at the age of 35 years, the bones
becomes weaker and it break downs at a faster rate than it builds and excessive reduction in bone
density due to such condition results in osteoporosis (Yun et al., 2015). Hence, it is important to
include adequate amount of food components containing calcium, magnesium and vitamin D in
order to reduce the risk of osteoporosis. In this regards, public health nutritionist could help to
provide effective advice for preparing diet chart with food components that could fulfil the
requirement of calcium, magnesium and vitamin D in an effective manner (Qiu et al., 2017). The
health statistics of Australia has reported that approximately 2.2 million Australian are suffering
from osteoporosis including 27% women and 11% men aged 60 years or more (aihw.gov.au,
2018). In order to reduce the prevalence of osteoporosis it is required to communicate with
public health nutritionist to provide guidance to the patient with osteoporosis and aged people
regarding their diet to manage their illness or reduce the risk as well (Savastano et al., 2017).
Nutrition in iron deficiency anaemia:
Iron deficiency anaemia develops as the consequence of reduction in haemoglobin level
due to lack of iron. It is considered as the most common types of anaemia and pregnant women

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are most vulnerable to the illness (Lopez et al., 2017). In Australia 16% male and 20% females
have been found to suffer from iron deficiency anaemia (aihw.gov.au, 2018). Due to lack of iron,
the body fails to produce adequate amount of oxygen carrying red blood cells which lead to the
consequence of iron deficiency anaemia. As the illness is highly prevalent among pregnant
women it is considered as a great threat for the development of foetus and new born as well.
There are some restrictions to several foods for the patients with iron deficiency anaemia such as
citrus fruits as such fruits make it difficult to absorb iron (Camaschella, 2015). Hence, it is
important to inform the patients with patients regarding food components that could help to
maintain the iron balance and about the food components that are restricted. Such information
could be communicated by a public health nutritionist as they contain adequate knowledge about
food and nutrition (Hughes, Begley & Yeatman, 2016). Hence, it is required to recruit public
health nutritionist in health care unit in order to reduce the risk of iron deficiency anaemia and
provide adequate guidance to the pregnant women regarding their diet and give birth to a healthy
child.
Morbidity and mortality associated with nutrition related health issues:
Morbidity is considered as the state of remaining unhealthy within a specific population.
Poor nutritious condition is associated with high morbidity and mortality as well. Substantial
morbidity related to a chronic disease impact on the physical, psychological and socioeconomic
well-being of individual. In addition the morbid situation of patient affects the care taker and
family members as well (Stoll et al., 2015). The nutrition related chronic diseases have been
found to contribute in the high death rate of Australian population. It has been found that approx.
1.1 million hospitalization and 295 deaths occur due to cardiovascular disease in Australia per
year (aihw.gov.au, 2018). On the other hand rate of deaths due to diabetes is also high, 16.4

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deaths per 100,000 people (abs.gov.au, 2018). In addition, osteoporosis has contributed to
increased rate of fracture in this population. For example, 42% women and 275 male are
associated with the risk of fracture due to osteoporosis in Australia and in each decade, the
prevalence is increasing by 40% (aihw.gov.au, 2018). Such morbidity and mortality rate due to
nutrition related chronic disease has indicated the need for public health nutritionist in the health
care unit who could help to create awareness regarding nutrition and nutrition related health
issues, so that people could focus on healthy diet in order to remain healthy and improve their
health status (Stoll et al., 2015).
Health care expenditure due to nutrition related health issues:
Increasing health issues is associated with high health care cost and expenditure. Due to
high prevalence of chronic disease, the demand for health service has also increased in last 10
years (Trogdon et al., 2015). As reported by the Australian Institute for health and welfare, the
health care expenditure for chronic disease has increased by 135 in 2015-2016 (aihw.gov.au,
2018). Health care cost for cardiovascular disease has estimated as $ 7.74 billion (aihw.gov.au,
2018). On the other hand health cost for diabetes has been estimated as 4 1.52 billion, cancer has
contributed to total health care cost of $ 4.95 billion (aihw.gov.au, 2018). It has been found that
due to such high expenditure for chronic diseases the Australian government is facing difficulties
in allocating fund for other specific disease or injury group (aihw.gov.au, 2018). Hence, it is
important to focus on the prevention measure for reducing the risk of such chronic disease in an
effective manner. In addition the treatment process needs to focus on multidimensional factors in
order to introduce adequate nursing strategies for the recovery or effective management of such
chronic diseases (Trogdon et al., 2015). In this regards focusing on the nutritional aspect would
be a great strategy as it has been found that most of the chronic diseases are associated with poor

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dietary intake (Combs & McClung, 2016). Hence, the recruitment of public health nurse would
be beneficial in order to provide advice for improving food habit to reduce and manage chronic
disease.
Vulnerable group:
Unequal access to health service is one of the major factors that contribute to the
disparity in the health status of indigenous and non-indigenous people in Australia. Hence, the
Australian aboriginals have found to be more vulnerable to chronic disease associated with poor
nutritious status (Raman et al., 2017). Due various social disadvantages the aboriginal
populations are unable to access adequate health resources. On the other hand, they lack
education that is required to understand the impact of nutrition and behavioural factors on health
and well-being. Due to such limitation to education and health resources the aboriginal
population is found to suffer from various chronic non-communicable diseases (Wain et al.,
2016). Raman et al., (2017) has indicated that rate of obesity is 62% higher in indigenous
population and risk of cardiovascular disease is 37% high in this population as compare to non-
indigenous population. In addition, the homeless people are also vulnerable to nutrition related
chronic disease. Further the young generation are more addicted to unhealthy and high energy
food along with sugar beverages and drinks. Hence, the risk of nutrition related chronic diseases
are high in adults. Therefore, the adult or young generation can be considered as one of the
vulnerable groups to nutrition related chronic disease (Amugsi et al., 2017).
Importance of public health nutritionist:

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The above discussion has indicated that food and nutrition play an instrumental role in
the maintenance of health and well-being and reduce the risk of nutrition related health issues. In
this regards, the public health nutritionist plays crucial role. The specialist could explain about
the importance of nutrition to the people that are at risk of nutrition related health issues
(Hughes, Begley & Yeatman, 2016). Savastano et al., (2017) has described that proper diet with
adequate physical activity is essential for remaining healthy. The nutrition experts could guide
the people with effective diet chart and physical activities that are essential for achieving good
nutrition status and healthy life. The experts could educate the people and share knowledge about
food and nutrition so that they could adapt healthy eating habit to remain healthy and disease free
(Vidgen, 2016). According to Brunner & Welch, (2017) PHN play an important role in
developing nutrition related policies in health organization that are required to meet the nutrition
requirements of the patients in the organization. In addition the PHN could guide the health care
staffs to remain healthy and provide adequate care to the patients (Hughes, Begley & Yeatman,
2016). Further, Savastano et al., (2017) have reported that scientific research on nutrition is
important to remain up-to-date and PHN play vital role in such research. Hence, it is required to
recruit PHN in the health care unit to improve the health service and reduce the risk of chronic
disease through the improvement of nutrition status of the population.
Conclusion
In conclusion, it can be said that, it is important to focus on food and nutrition in order to
remain healthy and reduce the risk of chronic disease as poor nutrition is associated with the
development of various chronic disease. Highly prevalent chronic disease has been found to be
associated with poor nutrition. Due to such increase in the prevalence of chronic disease the
health care cost has increased to an extent. Such chronic diseases have been found to be