Public Health and Community Nutrition
Public Health and Community Nutrition tests population-level assessment, program eligibility, and prevention. Expect food insecurity, federal programs, and evaluation design.
Core rules
- Prevention levels: primary (prevent disease), secondary (early detection), tertiary (limit disability).
- Food insecurity is limited or uncertain access to adequate food; hunger is a physiological sensation. USDA measures food insecurity with the 18-item Household Food Security Survey Module; the Hunger Vital Sign is a two-item screen.
- SNAP: income generally at or below 130% of the federal poverty level. WIC: pregnant, postpartum, and breastfeeding women, infants, and children under 5, with income at or below 185% FPL or other eligibility.
- Other programs: NSLP and School Breakfast Program, CACFP, TEFAP, CSFP, EFNEP, SNAP-Ed.
- Community assessment uses primary data (surveys, focus groups) and secondary data (BRFSS, NHANES, census). Healthy People 2030 sets national objectives.
- Coalitions and policy, systems, and environmental changes reach more people than individual education alone.
Worked example
A county reports 22% food insecurity and a high rate of diet-related disease. A secondary-data review plus a food pantry survey confirm that transportation is a barrier. The coalition chooses SNAP outreach, a produce prescription program at a clinic, and a mobile pantry. Evaluation tracks pantry reach, redemption of produce prescriptions, and HbA1c at the clinic.
Traps
Using "hunger" and "food insecurity" interchangeably; misstating WIC's 185% FPL threshold; relying on education alone when the barrier is access; and evaluating only satisfaction rather than outcomes.