Jump to content

The case for mass public education campaigns

JVBT JVBT, ASN (New) New Nurse

Specializes in clinic nurse.

                       Step One: The case for mass public education campaigns

“We are seeing this pandemic because it's been fueled by a slower pandemic of chronic illness that makes people at high risk, and we have not had the emphasis on disease prevention in our society that we all need and deserve.” -Dr Howard Koh on Yahoo Finance, July 5, 2020

As we now know, embedded structural inequities like redlining, underfunding of public schools, public sector/frontline employment, inability to afford healthy food, food swamps and the built environment, have contributed to disproportionate Covid-19 rates of infection, complications, and death among much of the country’s minority populations. But it’s important also to realize that, regardless of race or ethnicity, much of the destruction that SARS CoV-2 leaves behind clearly reveals the effects of diets high in processed food. As addictive as nicotine and heroin, processed food is a huge driver of hypertension, obesity, and diabetes – comorbidities one, two and three in Covid-19.

I am a clinic nurse, and I say this as someone who has dedicated hundreds of hours to education: It is not your fault or my fault or our fault that we have the current burden of chronic disease that we do, and it’s not our fault that processed food caused it, but though we as healthcare workers are nominally part of the solution, at times it seems like we are asked to be the entire solution.

A system whereby you ask doctors and nurses to one by one by one educate thousands of food-addicted, undernourished people could not be more inefficiently designed.

It is beyond time to seek ways to launch massive public education campaigns, definitively linking diets high in ultra-processed food directly to poor health outcomes.

Diet has been the kindling that has allowed this pandemic to blaze through. If all public health agencies and companies do is fall back on the assumption that stress and poverty lead to a poor diet, and leave it to a few doctors and nurses to talk to a handful of residents, the ramifications of a poor diet are not addressed at a mass level, and we have no hope of slowing the rate of severe chronic disease. I believe that people, even people under stress, presented with information vital to their health in a way that grabs their attention can (and have been shown to) adjust, to both make and demand better food choices.

Such a campaign is not meant to be unsympathetic to those forced to sustain themselves on unhealthy food, but rather a tool in the larger struggle for health equality.

And it is only step one in better health equity – making the case. While it does not preclude weaving in other strategies, illustrating the link between processed food consumption and chronic disease is fundamental to firmly situating health as a key driver and indicator of equality.

A Hit With The Ladies, BSN, RN

Specializes in Psych.

So how is "knowledge" about diet going to translate in our day-to-day lives? Americans' work-lives are stressful, and the last thing people need is stress over preparing and procuring delicious yet healthful meals. When you have a single-parent household or both parents needing to work, that becomes even harder. Food is stress relief and a mental break from life's hardships. Now, I'm not condoning McDonald's drive-thru every day - it's a sad state of affairs to live on an unhealthy diet, for sure - but I definitely do empathize with the legions of Americans who cannot eat healthy on a regular basis. Trying to "teach" people who already know is a bit patronizing and won't be received well.

It may be better use of resources to lobby Chipotle and Subway to offer drive-thru everywhere to spread healthy food options as a rival to McD's and Whataburger.

JVBT, ASN

Specializes in clinic nurse.

1 hour ago, A Hit With The Ladies said:

So how is "knowledge" about diet going to translate in our day-to-day lives? Americans' work-lives are stressful, and the last thing people need is stress over preparing and procuring delicious yet healthful meals. When you have a single-parent household or both parents needing to work, that becomes even harder. Food is stress relief and a mental break from life's hardships. Now, I'm not condoning McDonald's drive-thru every day - it's a sad state of affairs to live on an unhealthy diet, for sure - but I definitely do empathize with the legions of Americans who cannot eat healthy on a regular basis. Trying to "teach" people who already know is a bit patronizing and won't be received well.

It may be better use of resources to lobby Chipotle and Subway to offer drive-thru everywhere to spread healthy food options as a rival to McD's and Whataburger.

My point is, that nutrition education is in fact happening right now, regardless of what you or I think. And I maintain that, for those conducting the education, it is like pushing a too-heavy boulder up a hill. Without an overlay of support that mass public education can provide, we will never push it all the way up that hill. In other words, we will never get the outcomes we want.

Let me take a different tack - we don't tell people: "Aw, I know your life is stressful, it's OK that you smoke." Again, I along with thousands of others, do this education. I meet with stressed out people, often with few resources. It is not meant to castigate or patronize anyone. If that's what is taken away from my OP, then I have done a very bad job at communicating!

A Hit With The Ladies, BSN, RN

Specializes in Psych.

What I'm saying is that public education campaigns come off as trite and patronizing when they don't meaningfully change the reality of the world around us. People will, in the interest of politeness, nod their heads to what you say and then throw your pamphlets in the trash on the way out the door. I have nothing against education campaigns, but I am telling you that people are going to mentally retort, "Well, you should see the reality of my life and how impractical your ideas are to implement in my life!" Things are not going to change unless you can offer people alternatives that are easy to access and stress-relieving, rather than stress-inducing. Come up with "healthy food trucks" and lobby for healthy drive-thrus. You have to meet people where they're at.

States have a pretty long history of taking funds from public health budgets for other purposes...you know, like for paramilitary police equipment.

JVBT, ASN

Specializes in clinic nurse.

On 7/7/2020 at 5:52 PM, toomuchbaloney said:

States have a pretty long history of taking funds from public health budgets for other purposes...you know, like for paramilitary police equipment.

It's true that that we like to starve our public health agencies, I don’t think there’s any doubt about that. Nevertheless, it would be great if more people could weigh in on what I'm discussing - I don't think it's wholly dependent on any one state's public health agency. Maybe I’m way off base here, but I don’t think I am. I think what's staring us in the face is this  link between junk processed food and dire health outcomes. And I feel like there’s a lot of sidelined energy, energy that’s just sitting at home looking at Youtube videos when a lot of us could be doing a whole lot more. There’s just a lot of energy that’s not being put to use right now and I find that incredibly frustrating. And in this specific instance what I’m talking about is junk food. What I’m talking about is making a direct link from junk food to poor health outcomes. To metabolic conditions. To kidney disease. To stroke. To amputations. To chronic infections. To acute Covid infection, ICU admittance, intubation, and death. To me the connection is crystal clear, and if ever there was a time to compassionately mobilize and get out a clear message, it would seem to be now.

NRSKarenRN, BSN, RN

Specializes in Vents, Telemetry, Home Care, Home infusion.

There have been a lot of mass public nutrition education campaigns, especially when Michelle Obama was the First Lady and spearheaded efforts to reduce childhood obesity.  Many TV nutrition ads targeted  Southeast PA/NJ/DE area where I live near 2 of nations poorest cities: Camden, NJ and Chester, PA.  Additionally, programs developed with low literacy in mind.

Lets Move! https://letsmove.obamawhitehouse.archives.gov/

My Plate  --now has an app to download

image.thumb.png.c186cbcd2c317692067a80dc97a0dd14.png

USDA's food icon, MyPlate, serves as a quick visual reminder to all consumers to make healthy food choices when you choose your next meal, built off of the Dietary Guidelines for Americans. MyPlate can help prioritize food choices by reminding us to make half of our plate fruits and vegetables and shows us the other important food groups for a well-balanced meal: whole grains, lean proteins, and low fat dairy.

https://choosemyplate-prod.azureedge.net/sites/default/files/printablematerials/2013-WhatsMyPlateAllAboutInfographic.pdf

USDA Communitiy Nutrition Education

https://nifa.usda.gov/sites/default/files/resource/Community Nutrition Education Overview Brochure.pdf

Expanded Food and Nutrition Education Program (EFNEP)

Nutrition insecurity is a significant national health concern, especially among low-income populations that disproportionately experience poor health. Often associated with food insecurity, nutrition insecurity is characterized by poor nutrition, limited physical activity, and unsafe food practices. The Expanded Food and Nutrition Education Program (EFNEP) is the nation’s first nutrition education program for low-income populations and remains at the forefront of nutrition education efforts to reduce nutrition insecurity of low-income families and youth today.  https://nifa.usda.gov/program/expanded-food-and-nutrition-education-program-efnep

SNAP Education resources, includes Spanish language material

https://snaped.fns.usda.gov/snap-ED-works/nutrition-education

 

Smart Choices: A Community Nutrition Education Program

Smart Choices: Eating and Exercising for Good Health (Adult Fact Sheet  https://snaped.fns.usda.gov/library/materials/smart-choices-community-nutrition-education-program

image.png.69a2fee71007e9e4a91cd85783ef0773.png

 

PA's Program: Be Healthy  includes cooking basics, healthy food substitutions, healthy eating tips for kids, healthy beverage choices.Hoe to shop and read food labels, healthy eating on a budget, need to MOVE-places to be active -outdoors and indoors, benefit physical activity..

https://www.behealthypa.org/

 

JVBT, ASN

Specializes in clinic nurse.

It has been said about more than one thing, but I think Dolly Parton's quote - you have no idea how much it costs to look this cheap - is in this case very apt. We are paying dearly for our cheap nutritionless food.

@NRSK

Thanks. I'm not looking for links, though no doubt they are helpful to others, as I have logged countless hours of nutrition / diabetes / hypertension education in my job. Some of the links are out of date, and very unfortunately Ms Obama is out of the picture now, though I agree it was great when she was here, and I loved the garden on the White House grounds. We use the plate method which emphasizes a half plate of vegetables, not a quarter, and de-emphasizes processed carbohydrates, if not advocating their absolute elimination. My point is that it is - well, I've posted several times here, no need to repeat!

Thanks for taking the time to log your input.

emtb2rn, BSN, RN, EMT-B

Specializes in Emergency.

I didn’t see any mention of food deserts. All the education in the world won’t help if you don’t have access to healthy food options. There are so many urban & rural communities that simply don’t have well stocked supermarkets or farmers markets available.  Fast food becomes the default nutrition source. 
 

I did a quick search for .gov links on food deserts. The most recent one I found was from 2015. So I guess it’s not a priority anymore...

JVBT, ASN

Specializes in clinic nurse.

1 hour ago, emtb2rn said:

didn’t see any mention of food deserts.

Hi there - did you see my original posting? I said, "As we now know, embedded structural inequities like redlining, underfunding of public schools, public sector/frontline employment, inability to afford healthy food, food swamps and the built environment, have contributed to disproportionate Covid-19 rates of infection, complications, and death among much of the country’s minority populations." I didn't use the word deserts, but swamps. Same deal. 🙂

There are now some very dynamic (but currently) stressed nonprofits working this issue, but with 1. the pandemic and 2. the administration, it is extremely difficult to handle on their own. There's no question that this needs to come from the government, preferably the federal government. But again, the point is it's not just either take on food deserts (or swamps) or do PSAs linking processed food to chronic disease. It's both! But the case is not now nor has seriously ever been made against processed food in a highly publicized way, like it has been against tobacco (see one of my other comments above).

NRSKarenRN, BSN, RN

Specializes in Vents, Telemetry, Home Care, Home infusion.

Chester PA, a city of 56,000 people is one of the food desert locations. In 2013, Philabundance a non-profit food bank that serves the Philadelphia and Delaware Valley region of PA helped establish a non-profit supermarket Fair and Square -first time city had a supermarket in 12 years.  It lasted until 2018, sold to for profit Cousins supermarket--location now closed.

Even Walmart is located 1 mile outside the city

https://nextcity.org/daily/entry/nations-first-non-profit-supermarket-opens-in-chester-pa

 

hppygr8ful, ASN, RN, EMT-I

Specializes in Psych, Addictions, Elder Care, L&D.

In my 57 years on this planet I have seen that we have plenty of mass education. Way before the internet there were govt mandated labels on processed food designed to inform people on healthier options. You can lead a horse to water, tell it how deliciously refreashing that water is, However you cannot make that horse drink, even if it is thirsty. Same goes with food and healthy choices. You can tell people where they are going wrong, show them how it could be so much better, even get them to vebally agree. When push comes to shove you can't force change on them. 

I don't often agree with A Hit with the ladies but in this case He makes a point. There was a time when I was homeless and living off of handouts though back door of fastfood restuarants at closing time. I knew it wasn't good for me but food is food. I am in a much better position now. 

Why would you change the MY plate to half vegetables and exclude fruit. May it's changed lately but the latest info from the FDA is five servings of fruits and vegatables a day. Fruit provides much needed soluable fiber as well as carbohydrates that you body knows how to process and utilize. 

I totally get what you are saying but may be barking up the wrong tree.

Hppy

JVBT, ASN

Specializes in clinic nurse.

On 8/6/2020 at 6:28 PM, hppygr8ful said:

Inm my 57 years on this planet I have seen that we have plenty of mass education. Way before the internet there were govt mandated label on processed food from fact food to better healthier option. But you can lead a horse to water, tell them how deliciously refreashing that water is, However you cannot make that horse drink, even if it is thirsty. Same goes with food and healthy choices. You can tell people where they are going wrong, show them how it should be so much better, even get them to vebally agree. When push comes to shove you can't force chang on them. 

I don't often agree with A Hit with the ladies but in this case He makes a point. There was atime when I was homeless and living off of handout though back door of fastfood restuarants at closing time. I knew it wasn't good for me but food is food. I am in a much better position now. 

Why would you change the MY plate to half vegetables and exclude fruit. May it's changed lately but the latest info from the FDA is five servings of fruits and vegatables a day. Fruit provides much needed soluable fiber as well as carbohydrates that you body knows how to process and utilize. 

I totally get what you are saying but may be barking up the wrong tree.

Hppy

I posted (barked) on this site (tree) because nurses are in a good position to push for change. The central point is that doing one by one education while potentially effective in individual cases will do nothing to stem the flood of patients with metabolic conditions. We need an overlaid message in the same vein as the smoking campaign of the 90s and early 2000s. As far as My Plate is concerned, a plate of half vegetables is a vast improvement over the foundation that fast-acting carbs held at the base of the pyramid. Sure, fruit is not a villain, most people know that. But emphasizing vegetables over fruit in a nation where the obesity and diabetes rate is extremely high is  on balance a good thing. People with diabetes can eat fruit in moderation of course. They can, alternatively, and realistically speaking eat all the vegetables they want.

Can we start by getting rid of Monsanto and their products in our food? Our food supplies has been hijacked by cancer and obesity causing agents. My grandparents and great grandparents ate whatever they wanted and were healthy. The older I get the more unhealthy generations are becoming. Yes, video games and pedophiles on every block, etc have contributed but I don't recall child obesity in record numbers when we were little. Children nowadays have just as many health issues as adults and it's not just the types of food eaten, it's what's in the food itself.

If round-up causes cancer, we know this and a multimillion-dollar case has been won against Monsanto, why do we eat the foods coated in round-up or other similar Monsanto products? And what the hell are they feeding our livestock? The food source is tainted from the root!

JVBT, ASN

Specializes in clinic nurse.

From Mexico:

Oaxaca Congress approves law prohibiting sale of junk food to minors

Thirty-one lawmakers voted in favor of the so-called ley antichatarra, or anti-junk food law, while just one voted against it.

Oaxaca becomes the first state in the country to prohibit the sale of items such as chips, candy, soda and other sugary drinks to children under 18.

The enactment of the law comes as health authorities blame Mexico’s high coronavirus death toll on the high prevalence of diet-related diseases such as diabetes and obesity. Deputy Health Ministry Hugo López-Gatell last month described soft drinks as “bottled poison.”

hppygr8ful, ASN, RN, EMT-I

Specializes in Psych, Addictions, Elder Care, L&D.

13 hours ago, JVBT said:

I posted (barked) on this site (tree) because nurses are in a good position to push for change. The central point is that doing one by one education while potentially effective in individual cases will do nothing to stem the flood of patients with metabolic conditions. We need an overlaid message in the same vein as the smoking campaign of the 90s and early 2000s. As far as My Plate is concerned, a plate of half vegetables is a vast improvement over the foundation that fast-acting carbs held at the base of the pyramid. Sure, fruit is not a villain, most people know that. But emphasizing vegetables over fruit in a nation where the obesity and diabetes rate is extremely high is  on balance a good thing. People with diabetes can eat fruit in moderation of course. They can, alternatively, and realistically speaking eat all the vegetables they want.

Well I didn't go there but I am an insulin dependant diabetic and I work closely with my endcrinologist on a strict program to keep my blood sugars well balanced. My food list includes all green leafy vegetables, unlimted fruits very low carbohydrates and meat that is lean. It's also 10%fat. Fat and the carbohydrate in fruit help to balance blood sugars and prevent spikes while processed carbs will cause blood sugar to spike. I don't eat bread at all and my carbs are mostly whole grains such a Farro, Barly, millet, Kamut, Teff and Frekeh. In doing my own research I have discovered that fruit does not in any way influence the developement of diabetes, nor does it cause the disease to worsen. The Mayo Clinic supports this: 

https://www.mayoclinic.org/diseases-conditions/diabetes/expert-answers/diabetes/faq-20057835

The American Diabetes Association aslo concurs:

https://www.diabetes.org/nutrition

While I am allowed to eat unlimited fruit with the exception of watermelon and mango. I am only allowed to eat non-starchy vegetables. I don't get to eat any member of the potato family except for sweet potatoes which I am slowly learning to love.  Oh and my endocrinologist allows me to eat refined sugar because artifical sugars and so very bad for the colon and brain health and he wants me to eat butter but no margarine. He gave me this whole speil on "Mirror Image isomers" and fake food and how these fake foods contribute to diabetes, heart disease and dementia. 

The very best thing I have done is start to grow most of the fruit and vegetables we (my family) eat. 

I am not disagreeing with  you on the need for mass education I just saying there's a lot of information out there. Here in California there are comercials every day on healthy eating and better food choices. So such mass education is being done, but again I say "You can lead a horse to water....."

Hppy

hppygr8ful, ASN, RN, EMT-I

Specializes in Psych, Addictions, Elder Care, L&D.

On 8/9/2020 at 4:26 PM, JVBT said:

From Mexico:

Oaxaca Congress approves law prohibiting sale of junk food to minors

Thirty-one lawmakers voted in favor of the so-called ley antichatarra, or anti-junk food law, while just one voted against it.

Oaxaca becomes the first state in the country to prohibit the sale of items such as chips, candy, soda and other sugary drinks to children under 18.

The enactment of the law comes as health authorities blame Mexico’s high coronavirus death toll on the high prevalence of diet-related diseases such as diabetes and obesity. Deputy Health Ministry Hugo López-Gatell last month described soft drinks as “bottled poison.”

legislating what people can buy/eat is not education it's facism. While I eat a very healthy diet there are occasions when a bucket of greasy, hot, salty chicken parts satisfies a craving and no law maker should be able to come between me and my KFC.

2 minutes ago, hppygr8ful said:

legislating what people can buy/eat is not education it's facism. While I eat a very healthy diet there are occasions when a bucket of greasy, hot, salty chicken parts satisfies a craving and no law maker should be able to come between me and my KFC.

I agree. Me and this brownie thing I have going. Somewhere in the future I picture myself in junk food group therapy saying "Hi, I'm NurseBlaq, and I'm addicted to brownies." 😂

Did VP Pence claim that the Biden/Harris administration would limit the amount of meat we could have? I hope not, that might really hurt God. 

×

By using the site you agree to our Privacy, Cookies, and Terms of Service Policies.

OK