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Daily Archives: January 17, 2018

Why Public Health?

Most of you probably know that I’m currently pursuing a Master’s degree and doing all the coursework and hours to be eligible to sit for the RD exam. What you might not know is that my Master’s degree will be a Master’s of Public Health in Nutrition. Whenever people hear about this, I get lots of questions! My dad asks me about it at least once a month. 🙂 He’s always like, “Okay, so why public health? And does it help you get a certain type of job? And is this class for public health or nutrition?”

As part of the public health part of my degree, my classmates and I went to DC for a Nutrition Policy Seminar. It was a whirlwind, but I learned a lot and garnered a greater appreciation for policy work. As Grace and I drove home, she said that this trip really made her appreciate being in a public health program and I totally agreed. So I thought this was a great time to write this post!

So… why a public health program?

TBH I would have enrolled in UNC’s program if it was a Master’s in Science as well. UNC has the only coordinated dietetics program in the state, and I didn’t want to move. So, I kind of landed in public health by chance, but I was still excited about it! I’m sure even if you enroll in a program that isn’t in a school of public health, you could probably find some courses with a public health focus. Plus, I bet that some of the same concepts are brought up in other programs and weaved into curriculum.

So…what is public health. exactly?

From UNC’s website: “Our mission is to improve public health, promote individual well-being and eliminate health inequities across North Carolina and around the world.”

That can look like…

  • Laws that limit where you can smoke
  • Having sidewalks to walk on or bike lanes so you can ride safely
  • Research into new vaccines or treatment for diseases
  • Having clean water to drink
  • Promoting access to fruits and vegetables
  • Designing all kinds of programs to improve health
  • Promoting access to food in general! Whether that’s SNAP (formerly known as food stamps), WIC (where I spent most of my time last summer), etc.
  • Working hard to fight for equity and to reduce health disparities
  • Breastfeeding programs in hospitals
  • Asking a community what THEY want rather than prescribing a program that may not be a good fit
  • Laws that limit carbon emissions from manufacturers
  • Fighting for affordable access to health care (although we certainly have different ideas about how to get there!)
  • And so much more!

Basically if an issue relates to health in any way… it falls under the umbrella of public health.

So what does this have to do with becoming a dietitian?

Right. Dietitians just tell people what to eat, right!? (I hope you can hear my sarcasm.) In addition to courses like Medical Nutrition Therapy and all the biochemistry classes every student takes to become a dietitian, our program requires courses like epidemiology, biostatistics, health behavior, health policy and management, and environmental sciences. In addition, our first of three dietetic internship rotations was specifically focused on public health. Most of us spent the summer in health departments across the state, although a few of my classmates worked in other parts of public health.

We learn about amazing public health programs and new solutions to overcome some of the barriers that are in the way of pursuing health (and how that differs based on the population). Overall, I feel like taking these courses gives me a lot of context for thinking about nutrition and health. I can zoom out and see the big picture of where someone is coming from. As we know, nutrition is about so much more than just food. Your life experiences, job, salary, amount of leisure time, stress levels, the amount of discrimination you face and the amount of agency you have in your life… all of that impacts how we experience food and health.

Although I do not plan on working directly in a public health program or on policy, I think that this background will serve me well wherever I end up. It also makes me take a hard look at what I think I want to do eventually-private practice-and how I can also serve people who typically have less access to those services, as well as ways I can be involved in public health in my community.

I think sometimes public health gets a bad rap from the HAES/Intuitive Eating crowd (which I’m 100% a part of and can understand). Many public heath programs and research focus so much on weight loss and seem to pathologize certain body sizes. I totally get that and sometimes I grapple with being a public health student who promotes body acceptance and self-compassion. It is frustrating when a conversation or lecture equates health and weight, when it is about so much more than just one number. However, I do have to give a hand clap to my school, because we actually have learned about things like weight stigma and even had exposure to the concepts of Intuitive Eating and Health at Every Size.

from the Gillings Instagram

My instructors are very respectful and are great at putting things into context and treating our patients (made up ones lol) as a whole person. A person with a life, who is so much more than their BMI. I am immensely thankful for the exposure and the attention these important issues get at my school. Plus, I feel like we have a pretty well-rounded education on all different aspects of public health, from childbirth to older adult care, so I don’t feel like we are bogged down in weight talk all the time!

from the garden at the Health Department I interned at last summer!

So even though sometimes I grapple with being a huge proponent of intuitive eating and HAES while being a public health student, I’m actually don’t think those things are at odds. Health at Every Size is really about giving everyone the opportunity to pursue health as they wish. Intuitive Eating is a framework for nourishing your body in a way that feels good and is sustainable.

For me, it boils down to this: I believe in and support the right of every single person to pursue health to the degree they choose. I believe everyone should have access to nourishing foods. I think it is wrong to discriminate on any basis, including weight. I do wish we could change some of the focus in public health in general and move away from things like calorie labeling on menus and weight loss programs and shuttle that energy into more positive (and sustainable) ways to talk about food and bodies. As a whole, I think the tide is shifting and I’m excited about that. After all, there’s plenty of evidence to support this more positive approach! So that is encouraging. I’m really excited to see where public health goes during my career and I can’t wait to roll up my sleeves and get started.